WKU News

By Julie Redfern, L.D., R.D.N.and Megan McCullough, Dietetic InternBrigham and Women's Hospital

Cavities, Gum Disease and Their Impact on Health

Plaque is the sticky, bacteria-filled substance that is always building on your teeth. After eating, bacteria in your mouth feed on particles of food and beverage that contain carbohydrates (sugars or starches). This makes the plaque more acidic. These acids dissolve minerals in your teeth's enamel - a process called demineralization - and can lead to cavities.

Saliva helps to neutralize acid in the mouth, promote enamel remineralization (the absorption of minerals to reverse the decay process) and clear away food that becomes trapped between teeth. The mineral fluoride also decreases tooth demineralization by preventing the growth of bacteria and promoting tooth mineralization.

Both cavities and gum (periodontal) disease cause inflammation in the mouth. Bacteria can get into your bloodstream, which may lead to other systemic or chronic diseases, such as cardiovascular disease, if left untreated. Similarly, poor oral hygiene can lead to sore gums and decaying teeth. This affects your ability to bite and chew properly, which impacts what you choose to eat.

Nutritious Tips to Promote Oral Health

The first part of digestion occurs in the mouth. So eat mindfully. Sit down at the table in a relaxed environment without distractions. Take small bites and allow saliva to moisten your mouth. This helps food to start breaking down. Put your fork down between bites and chew foods thoroughly. Eating slowly will help you appreciate tastes and textures and enjoy eating.

In addition to preventive oral health practices, follow these nutritious tips to promote oral heath:

Minimize carbohydrate snacks between meals. Remember there are no good foods or bad foods, just better choices. Be aware of your pattern of eating. Grazing throughout the day - munching on carbohydrate foods - can increase your risk of cavities and gum disease. Worst snack choices: Candy, cookies, cakes, crackers, bagels, granola bars, potato chips, pretzels, bananas, raisins or other dried fruits. These foods provide a source of carbohydrates for bacteria on teeth to produce acid. Better snack choices: Cheese, chicken or other meats, nuts or milk. These foods contain phosphorus and calcium, minerals that are needed to remineralize teeth.

Drink plenty of water. Limit soda and other drinks containing sugar between meals. Sipping soda, juice, sports drink or sweetened coffee or tea throughout the day provides a constant source of carbohydrates for bacteria. Wine, soda and iced tea also contain acids used as flavor additives that demineralize teeth. Water is the best beverage choice throughout the day. It can dilute acids in the mouth and help clear away bits of food. Brush teeth after eating and floss daily. Use a soft toothbrush and a pea-sized amount of fluoride toothpaste. Brushing and flossing will remove food that collects between the teeth, on the tongue and around the gums. Food particles stuck between teeth can rot, leave an unpleasant odor, cause bad breath and promote cavities. Chew sugarless gum. Sugarless gum can promote saliva. Avoid hard candies, breath mints and gum containing sugar. Take 1,000 International Units of Vitamin D3 daily. In addition to reducing the risk of many chronic diseases, vitamin D has been specifically shown to reduce gum disease and improve bone mass and strength by helping the body absorb calcium.

Oral Health Tips for Various Ages

In addition to the nutrition tips above, there are special considerations for the following age groups:

• Infants are also at risk for tooth decay even before teeth have erupted. Avoid allowing infants to sip on bottles all day or sleep with a bottle containing juice or milk. Infant's gums should be cleaned daily with a moist, soft toothbrush or washcloth. The American Academy of Pediatric Dentistry recommends that children visit the dentist for the first time when the first tooth comes in, usually between 6 months and 1 year of age. Meet with a registered dietitian to learn about introducing new foods and to promote healthy eating behaviors.
• Pregnancy can change eating habits and cravings. Frequent vomiting due to morning sickness can expose teeth to gastric acid causing erosion or demineralization of enamel. Also, due to hormonal changes, pregnant women are at greater risk for developing gum disease. Pregnant women and women planning a pregnancy should see the dentist for a routine dental check-up. A registered dietitian can make suggestions to cope with nausea and recommendations to promote healthy eating during pregnancy.
• Older age can lead to a decrease in the amount of saliva produced and also a decrease in taste and smell. Tooth loss requires some older adults to wear dentures. Consult a dentist to make sure dentures fit properly. If a softer diet is advised, consult a registered dietitian to help make eating enjoyable and ensure that calorie and protein needs are met.

Julie Redfern, R.D., L.D.N. is a registered dietitian in the Nutrition Consultation Service at Brigham and Women's Hospital. She specializes in nutrition counseling for the obstetrics and gynecology department. She is a graduate of the University of Vermont and completed her dietetic internship at the University of Cincinnati Medical Center.

Angela Illing is a dietetic intern at the Brigham and Women's Hospital.Megan McCullough graduated from Michigan State University and is a 2008 Dietetic Intern at Brigham and Women's Hospital.