The key aim when it comes to sugar and oral health is to reduce the amount and frequency of consuming food and drinks that contain free sugars.
What are free sugars?
It is probably easiest to think of free sugars as those that are added to food and drinks by the manufacturer, the chef/cook or yourself (the consumer), AS WELL as sugars that are naturally present in honey, syrups and fruit juices. It DOES NOT include sugars that are found naturally in whole FRESH fruit and vegetables and those naturally present in milk and milk products. Clear? Don’t worry! It can be a bit of a minefield trying to work out what is safe for teeth and what may contribute to tooth decay and cavities. If you’re unsure about what food and drinks are high in free sugars, check the labels. Check a product’s ingredient list and look for sugars among the first two or three ingredients including sugar, sucrose, maltose, brown sugar, corn syrup, cane sugar, honey and fruit juice concentrate. Learn more about food labels here.
Common food and drinks that are high in free sugars include:
• sugary soft drinks • sweets and chocolate confectionery • cakes and biscuits • buns, pastries, fruit pies • puddings • table sugar • sugary breakfast cereals • jams, preserves, honey • ice cream and sorbets • fruit juices and smoothies • milk-based beverages with added sugar • sugar-containing alcoholic drinks • dried fruits • syrups and sweet sauces
Honey, fruit smoothies, fresh fruit juice and fried fruit all contain decay causing sugars. Because dried fruit can stick to the teeth, it is better to eat this as part of a meal rather than a between-meal snack.
When it comes to fruit, fresh fruit is best. Fruit canned in juice is better than fruit in sugary syrup.
Unlike many foods that are high in free sugars, fruit is packed with lots of nutrients that help provide us with a balanced diet for good health. It is bursting with vitamins, minerals, antioxidants and many nutrients that our bodies need in order to boost immunity, fight diseases, keep us regular and build health skin, hair and nails.
Fruit contains natural sugars, a mix of sucrose, fructose and glucose. These sugars, unlike free sugars, are naturally occurring in fruit, rather than being added. Fructose is only harmful in excess amounts, and not when it comes from fruit. It would be incredibly difficult to eat excessive amounts of fructose by eating whole fruits.
Remember – fizzy drinks, soft drinks, juice drinks and squashes sweetened with sugar have no place in a child’s daily diet.
High-energy food supplements contain high levels of sucrose (free sugars). These may be prescribed for the elderly, those convalescing or recovering from illness. They may also be used as part of an elite athlete’s nutritional regime.
When food supplements are taken by anyone with natural teeth, it is important to seek advice on prevention. If you use dietary supplements, speak to your dental team or Growing Smiles Coach about what you can do to prevent tooth decay. Options may include using a high fluoride toothpaste and/or other products that help product teeth such as Tooth Mousse, MI Paste Plus or a fluoride mouth rinse.
If you take medication frequently or long term, ask that it is sugar free to reduce the risk of tooth decay.
The easiest and probably the safest way to prevent tooth decay is by eating at mealtimes only and avoiding sugary drinks and snacks. With regards to drinks between meals and before bedtime, it is recommended to stick to water, lower fat milk or sugar-free drinks, including plain tea/coffee (without sugar). Read more about the benefits of drinking water here.
So how do free sugars impact oral health?
Any food or drink that contains free sugars can be used by bacteria in the plaque biofilm (the sticky stuff that forms on the teeth) to form acids. These acids dissolve tooth surfaces which then leads to tooth decay.
Frequent sugar attacks on tooth surfaces can lead to tooth decay at ANY age. More people are living longer with their own teeth, making older people (who still have their own teeth), just as susceptible to tooth decay as younger people. Root surfaces that are exposed by receding gums (which is more common as we get older), are softer and will decay more rapidly than the enamel that covers the crown of the tooth. Find out more about tooth decay here.
Regularly eating food and drinks high in free sugars increase the risk of obesity and tooth decay. Reducing the amount and frequency of sugar intake will have health benefits including reducing weight gain and obesity, which in turn, will reduce the risk of heart disease, type 2 diabetes and some cancers. Find out more about how sugars affect our health here.
How much sugar is too much?
Reports by the World Health Organisation (WHO) and the Scientific Advisory Committee on Nutrition (SACN), highlight the need to reduce sugar intake to 5% of our energy intake. This equates to a maximum daily allowance of 7 teaspoons/cubes or 30g of sugar per day for an adult. For children ages 7-11 years this is 24g and children ages 4-6 19g.
For more information on cutting down on sugar click here.
Click here to view the UK dieticians association has a fact sheet on sugar which can be found here.
Eating too much sugar can make you gain weight and can also cause tooth decay.
The type of sugars most adults and children in the UK eat too much of are “free sugars”.
So, what’s the alternative?
SUGAR FREE? But who doesn’t enjoy a sweet treat? Surely there must be a way to have your cake and eat!
As you may be aware, there are a range of sugar substitutes available – some more popular than others. Here at Growing Smiles, our choice and recommendation for a sugar substitute is Xylitol.
Xylitol looks and tastes like sugar, but, doesn’t have the same impact on oral and general health. In fact, it has a range of benefits. It has fewer calories, doesn’t raise blood sugar levels and has anti-tooth decay properties. Xylitol has also been shown to have anti-inflammatory properties, which may have a positive impact on gum inflammation.
What is Xylitol?
Xylitol is a naturally occurring five-carbon sugar polyol. Polyols are carbohydrates, but they are not sugars. It occurs naturally in small amounts in fibrous fruits and vegetables, trees (birch and other hardwoods), corncobs, and even the human body.
How does it help reduce tooth decay?
Xylitol reduces the number of decay-causing bacteria (e.g Streptococcus mutans which are also referred to as S mutans) in the mouth, and stops these bacteria producing the acids which cause tooth decay. It has been shown to decrease the transmission of S. mutans from mothers to children and can be used to help control rampant decay in baby teeth.
As Xylitol creates an alkaline environment in the mouth, it may benefit those at risk of acid erosion. Find out more about acid erosion here.
Is there a down-side?
As with other sugar alcohols, it can cause some bloating and diarrhoea, but is generally well tolerated. Gradually increasing your use of Xylitol allows your body to adjust without side effects.
NB. Xylitol can be very toxic to dogs. Products containing xylitol should be stored in a safe place that pets cannot reach.
Xylitol can also be found in some toothpastes and mouthwashes. See our toothpastes here.
Learn more about tooth decay here.
Want to reduce sugar in your child’s diet?
We recommend taking a look at Dr Colette Reynolds website GrowingHeatlhyEaters.ie where you will find online courses to help including ‘How to reduce children’s sugar in positive ways’. Please keep in mind this focuses on reducing overall sugar in your child’s diet. For dental health, remember the frequency of eating/drinking sugary food/drink as well as the amount of sugar is a key component of reducing tooth decay. Along side good oral hygiene using a fluoride toothpaste. Learn more here.
How to Reduce Children's Sugar in Positive WaysDo you need some help trying to reduce the sugar in your child's diet? It is easier said than done! Sugar in the diet not only is a major risk for cavities/tooth decay but also for childhood weight gain and obesity.
Dr. Colette Reynolds (PhD) is a Childs Healthy Eating Coach and founder of Growinghealthyeaters.ie . Collette explains about her course on reducing sugar in your child's diet.