Nutrition & Dental Health
Many foods that contain sugars also provide nutrients that children need, such as milk. So, the American Academy of Pediatric Dentistry (1999) and the American Academy of Pediatrics (1999) stress that they not be eliminated, but selected and served wisely. Also, sugar means all forms of sugar: white sugar, brown sugar, maple syrup (and other syrups, such as corn syrup, cough syrup), honey, molasses, and all the sugars found naturally in foods such as fruit, fruit juices, and milk. Many sugars listed in packaged foods are listed in their chemical form and end in "ose". Sucrose, glucose, dextrose, fructose, and maltose are examples. Sucralose, or Splenda, which is an artificial sweetener, is the exception.
Some foods contain complex carbohydrates which are commonly known as "starches". When starches are eaten, the first stage of digestion occurs in the mouth, where some of the starch is broken down into sugar. When sugar is eaten, the bacteria in the mouth turn some of the sugar into acid. Each exposure of the tooth structure to these acid attacks demineralizes the enamel and eventually dissolves or decays the tooth.
Obviously, the more acid "attacks" the teeth are exposed to, the greater the risk for dental caries, or decay. So it is the frequency not the quantity of sugar that is harmful to the teeth. Foods eaten before bedtime or naptime is not recommended either, because saliva secretion rate is reduced, so the food is not cleared away and stays on the tooth. Also, most people are not as likely to brush after snacking, as they do after a meal. The consistency of foods is also important. Sticky foods stay on the teeth longer.
Here are some specific recommendations according to the American Academy of Pediatric Dentistry (1999) and the American Academy of Pediatrics (1999):
- Avoid sweets, including sweetened soft drinks and other sugary liquids. When sweets are eaten its preferable that they be included with a meal rather than eaten as a snack. At meals the combination of foods eaten helps to dilute the sugar concentration, and wash the sugars away. Also, children are more likely to brush their teeth after a meal than after a snack.
- For similar reasons, eat starches and fruits at mealtimes rather than as snacks.
- After snacking, if brushing is inconvenient or unavailable, rinse the mouth with water to clear food debris.
- Avoid snacking before bedtime or naptime since the potential for foods to adhere to the teeth surfaces for a longer period of time increases.
- Limit sticky, starchy foods (lollipops, soda pop, raisins, crackers, taffy) that cling to the teeth for relatively long periods of time and are not easily washed away.
- Limit bottle feedings and drinking from a "sippy" cup. Do not allow them to drink at will because the sugary liquids remain on the teeth causing frequent acid attacks on the enamel.
- Limit the frequency of snacks. Although children need snacks, every time they eat they are exposing their teeth to potential decay. Providing larger snacks with less frequency will reduce the total number of exposures.
- Fats and proteins may have a protective effect on enamel, making it more difficult for acids to attack the teeth by coating the teeth and increasing the buffering ability of saliva. Combining carbohydrates with fats and proteins may therefore inhibit caries or decay from occurring.
- Snacks like a slice of cheese or a glass of milk or celery sticks with peanut butter should be encouraged over sticky, long-lasting carbohydrates such as candy. In general complex carbohydrates found in fresh fruits and vegetables and whole grain products should be encouraged over simple carbohydrates found in candy, pastries, cookies, sweetened beverages (i.e. fruit drinks, soda) fruit roll-ups, dried fruit (raisons), or breakfast cereal.
RESOURCES
- Snack Smart for Healthy Teeth
- The Value of Good Nutrition and Oral Health
- Foods That May Cause Tooth Decay
- Breastfeeding and Infant Tooth Decay
- Snacking
- Food Guide Pyramid for Young Children and Menu Tracking Chart (pdf)
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