Health food mystery reveals tooth decay culprit.

Practicing dentistry for a patient base that is conscious of healthy food and lifestyle choices provides my staff and me with inspiration, motivation, and admiration. Thus, we were puzzled when many of our "purest health food only" patients were responding to their lifestyle changes with higher levels of dental tooth decay. How could this be? Their admirable choices for wellness involve research, commitment, and planning. Yet, for some patients the results for their teeth were perplexing. With a little research, the mystery was solved and their goals for a healthier lifestyle supported.

Why did Jim discover new dental decay during a dental examination when months prior he had replaced his cravings for soda with tea? Similarly to Jim, why did Paige have new decay on the side of a crown when she knew she had given up cookies and other refined carbohydrates? Both patients were certain the culprit could not be their dietary habits, having made such a conscious decision to eat and drink healthfully.

Certainly Jim and Paige's wise choices resulted in many advantages, including maintaining healthier blood sugar levels. Yet these patients were unknowingly exposing their teeth to an environment that was perhaps even more inviting for the growth of harmful bacteria.

Jim knew green tea was healthy for him and did not even consider it as the source of his cavities. Only after much questioning did he realize that he liked to sweeten his tea with honey. The honey- sweetened tea that he sipped bathed his teeth throughout the day. Paige knew nuts, raisins, and protein bars were healthier for her than cookies. She did not remember that snacking on and off throughout the day without brushing was allowing the chewy, sticky snacks to coat her teeth. Removing the sugars that teeth are exposed to is the key! Without departing from their wise choices, each patient learned how to also protect their dental wellness. To enjoy your healthier choices of "all natural sweeteners" and avoid suffering the consequences of "all natural decay, "we share these tips:

1. For dental health the "quantity and quality" of sugar is of less concern than the frequency during which sugar-sweetened foods are consumed during the day. In other words, it's better to "pig out" on a large quantity of sugar (although other health risks make this choice undesirable also!) than to expose your teeth to a small amount of sugar on a frequent schedule. For instance, snacking on dates, on and off, during the afternoon is creating a circumstance of far greater dental harm than eating your preferred sweet immediately after your meal. The child who delights in a box of raisins while running errands with Mom is far more likely to develop decay than the child who eats the box of raisins, with lunch.

2. Follow nutritionist's guidelines of two to three fruit servings a day. Did you know that two dates is a serving? A single serving is also considered to be two plums, two prunes, two tablespoons raisins or ten large cherries.

3. Individuals with high salivary flow (very wet mouths) will suffer less dental decay than those with a chronically dry mouth. There are many reasons why salivary flow can be reduced ranging from medications to insufficient water intake. If you have a low salivary flow, you may want to increase your brushing beyond twice a day and sip water throughout the day.

4. Many patients discover that the brushing patterns and habits they were taught as children are not longer the best method for their current dental needs. Ask your hygienist to review the best method for removing the acid- laden plaque that, particularly in adults, likes to accumulate along the gum lines at the softer juncture of the tooth's crown and root surface.

5. Clearing sugar from the mouth is key to reducing dental caries. Simply rinsing and drinking water after enjoying sweet hot tea or sweetened coffee significantly reduces the exposure of sugar to harmful bacteria. Be careful, however, of sweets that are sticky or compress easily (bread, chips) into the deep grooves and crevices of the teeth. Rinsing will not often dislodge these food products and they can bathe the teeth in sugar for hours after eating. Keep a toothbrush and floss at work and clean your teeth after consuming anything that contains sugars. You will reap great rewards of prevention!

6. Engage the services of a dentist and dental hygienist who share interests in the goals that you have for your overall health as well as dental health. Nutritional information as well as a preventive cleaning schedule should be designed specifically to address your interests and needs. Together, you can discover ways to enjoy your favorite foods while achieving your optimum wellness.

The health benefits of finding alternatives to refined white sugar are numerous. However, with the exception of xylitol, sugar alternatives do not provide a lower rate of dental decay. Similarly to white sugar, the molecules in natural sweeteners are quickly digested, breaking down rapidly and providing the perfect fuel for energizing and colonizing the nasty bugs that inevitably destroy tooth enamel. Among sweeteners that encourage the growth of acidic plaque are barley malt, beet sugar, brown sugar, cane sugar, date sugar, fructose, fruit juice, honey, malt syrup, raw sugar, sorbitol, turbinado sugar and a host of other "natural sugars." Unfortunately, the harmful decay-causing bacteria don't make concessions for health conscious consumers. The undesirable bacteria convert sugars into lactic acid making the acidic plaque powerful enough to de-mineralize the tooth enamel and the underlying dentin. This loss of tooth structure permits the invasion of bacteria that results in dental decay.

Roberta D. Cann, D.M.D.

Dr. Roberta Cann is a general dentist in Atlanta who respects her patient's healthcare choices. A graduate of the Medical College Georgia, Dr. Cann is a member of the International Academy of Oral Medicine and Toxicology and Georgia Dental Association. You are welcomed to submit your favorite low sugar recipes to her at [e-mail] for posting on her website.