If you ask most people what causes tooth decay, they will tell you “eating to many sweets” is to blame. In simple terms they are, of course, quite correct. If you walk around with a bag of sweets in your pocket, snacking all day long on them, you wouldn’t be too surprised if you ended up with a few cavities. But the problem is, whilst some children may do this, almost no adults do, yet I spend most of my working day treating adults with tooth decay. So where does their decay come from?
The answer to this question lies in the way sugar is contained with in food and how the body breaks it down in the mouth. Almost all foods contain sugar in either simple or complex form and, if it can be fermented, the bacteria in our mouths will make acid from it. All of the basic sugars – glucose, fructose and sucrose, and most of the complex starches can do this. It is the acid that is produced in this way that causes our tooth decay.
When I chat to my patients about their decay they will often say to me “but I don’t have any sugar”. Clearly this is not the case, as almost everything they eat will contain sugar. What I try to look at with this patients is the number of times a day that they eat or drink sugar containing substances, and what mix of sticky foods and complex carbohydrates they are consuming. Ideally I try to encourage my patients to keep below 6 intakes per day, of all food and drinks, to reduce the number of times that acid is hitting their teeth. We also look to avoid sticky foods in between meals (biscuits, crisps etc.) and replace these with less sticky, lower risk foods such as fresh fruit.
This advice is in keeping with the latest research, particularly that done by Prof. David Beighton at the KCL Dental Institute, London and Peter Lingstrom, associate Professor at Gotenberg University.
