Chew on this: 6 dental myths debunked

BOSTON (August 5, 2010) — Brushing, flossing, and twice-yearly dental check-ups are standard for oral health care, but there are more health benefits to taking care of your pearly whites than most of us know. In a review article, a faculty member at Tufts University School of Dental Medicine (TUSDM) debunks common dental myths and outlines how diet and nutrition affects oral health in children, teenagers, expectant mothers, adults and elders.

Expectant mothers may not know that what they eat affects the tooth development of the fetus. Poor nutrition during pregnancy may make the unborn child more likely to have tooth decay later in life. "Between the ages of 14 weeks to four months, deficiencies in calcium, vitamin D, vitamin A, protein and calories could result in oral defects," says Carole Palmer, EdD, RD, professor at TUSDM and head of the division of nutrition and oral health promotion in the department of public health and community service. Some data also suggest that lack of adequate vitamin B6 or B12 could be a risk factor for cleft lip and cleft palate formation.

In children, tooth decay is the most prevalent disease, about five times more common than childhood asthma. "If a child's mouth hurts due to tooth decay, he/she is less likely to be able to concentrate at school and is more likely to be eating foods that are easier to chew but that are less nutritious. Foods such as donuts and pastries are often lower in nutritional quality and higher in sugar content than more nutritious foods that require chewing, like fruits and vegetables," says Palmer. "Oral complications combined with poor diet can also contribute to cognitive and growth problems and can contribute to obesity."

It isn't the amount of sugar you eat; it is the amount of time that the sugar has contact with the teeth. "Foods such as slowly-dissolving candies and soda are in the mouth for longer periods of time. This increases the amount of time teeth are exposed to the acids formed by oral bacteria from the sugars," says Palmer.

Some research shows that teens obtain about 40 percent of their carbohydrate intake from soft drinks. This constant beverage use increases the risk of tooth decay. Sugar-free carbonated drinks and acidic beverages, such as lemonade, are often considered safer for teeth than sugared beverages but can also contribute to demineralization of tooth enamel if consumed regularly.

It is a common myth that losing baby teeth due to tooth decay is insignificant because baby teeth fall out anyway. Palmer notes that tooth decay in baby teeth can result in damage to the developing crowns of the permanent teeth developing below them. If baby teeth are lost prematurely, the permanent teeth may erupt malpositioned and require orthodontics later on.

Osteoporosis may also lead to tooth loss. Teeth are held in the jaw by the face bone, which can also be affected by osteoporosis. "So, the jaw can also suffer the consequences of a diet lacking essential nutrients such as calcium and vitamins D and K," says Palmer.

"The jawbone, gums, lips, and soft and hard palates are constantly replenishing themselves throughout life. A good diet is required to keep the mouth and supporting structures in optimal shape."

If dentures don't fit well, older adults are apt to eat foods that are easy to chew and low in nutritional quality, such as cakes or pastries. "First, denture wearers should make sure that dentures are fitted properly. In the meantime, if they are having difficulty chewing or have mouth discomfort, they can still eat nutritious foods by having cooked vegetables instead of raw, canned fruits instead of raw, and ground beef instead of steak. Also, they should drink plenty of fluids or chew sugar-free gum to prevent dry mouth," says Palmer.

In adults and elders, receding gums can result in root decay (decay along the roots of teeth). Commonly used drugs such as antidepressants, diuretics, antihistamines and sedatives increase the risk of tooth decay by reducing saliva production. "Lack of saliva means that the mouth is cleansed more slowly. This increases the risk of oral problems," says Palmer. "In this case, drinking water frequently can help cleanse the mouth."

Adults and elders are more likely to have chronic health conditions, like diabetes, which are risk factors for periodontal disease (which begins with an inflammation of the gums and can lead to tooth loss). "Type 2 diabetes patients have twice the risk of developing periodontal disease of people without diabetes. Furthermore, periodontal disease exacerbates diabetes mellitus, so meticulous oral hygiene can help improve diabetes control," says Palmer.

This article appears in the July/August issue of Nutrition Today.

Palmer CA, Burnett DJ, Dean B. July/August 2010. Nutrition Today. 45(4): 154-164. "It's More than Just Candy: Important Relationships between Nutrition and Oral Health." doi: 10.1097/NT.0b013e3181e98969

Founded in 1868, Tufts University School of Dental Medicine (TUSDM) is committed to leadership in education, patient care, research and community service. Students obtain an interdisciplinary education, integrated with medicine, with access to training in dental specialties. Clinics managed at TUSDM provide quality comprehensive care to more than 18,000 diverse individuals annually, including those requiring special needs. Nationally and internationally, the School promotes health and educational programs and researches new procedures, materials and technologies to improve oral health.

If you are a member of the media interested in learning more about this topic, or speaking with a faculty member at the Tufts University School of Dental Medicine or another Tufts health sciences researcher, please contact Siobhan Gallagher at 617-636-6586 or, for this study, Lindsay Peterson at 617-636-2789.