How does one solve the problem of dental plaque by dietary methods? I
suffer from tooth decay although I floss and brush my teeth regularly.
My dentist suggests that a sugar free diet could help. Do you have any
other suggestions?
Age 63

Hello dougsut-ga,

I?m sorry to hear about your dental problems. Be sure to get regular
care and take appropriate preventative measures so you can avoid
exacerbating your existing condition. Bacteria found in dental plaque
can lead to periodontal disease which may put you at risk for other
systemic diseases.

My research shows that your dentist?s recommendation to cut down on
sugar is the most basic dietary step in maintaining good dental
health. I?ve collected a variety of articles to help you understand
how sugar relates to developing caries and periodontal disease. Most
of the recommendations are that you keep fermenting carbohydrates
(mostly sugars) from staying on your teeth in order to avoid
deterioration of tooth enamel and subsequent disease.

There have been some research projects to evaluate the impact of sugar
on dental health and the conclusions seem to be that lowering sugar
consumption may be statistically significant but that it is
insignificant compared to the importance of the preventative power of
taking fluoride and proper teeth cleaning.

The research I?ve collected is consistent and repetitious in giving
the same advice about dental health. The key points suggest limiting
sugar consumption, brushing regularly, eating a balanced diet and
getting fluoride treatments either through topical application or by
ingestion of fluoride tablets or fluoridated water.

A few of the articles I?ve found discuss possible modifications to
your diet and suggest specific foods, vitamins and supplements. I
didn?t find a high level of consistency in these recommendations.
Eating a balanced diet and keeping your teeth clean are the usual
requirements for achieving good dental health.

Since you?ve stated your age in your question I?ve also included a few
articles that discuss the effects of aging on dental health and
appropriate dental care.

Best wishes that with regular preventative care you avoid any serious
dental problems.

~ czh ~


======================
DIET AND DENTAL HEALTH
======================

http://www.nin.ca/public_html/Publications/NinReview/winter97.html
The Effect of Diet on Dental Health

The Dental Decay Process 

Dental caries is one of the most common infectious diseases. Its
etiology involves not only nutritional status, but also bacteria,
salivary flow, genetics, dietary and hygiene behaviours and overall
health.

Dental caries result when acid-producing bacteria, especially mutans
streptococci and lactobacilli species, dominate the bacterial coating
on the tooth surface called plaque.8 These bacteria mainly metabolize
dietary fermentable carbohydrates (e.g., glucose and fructose;
sucrose, maltose and lactose; cooked starch) into lactic acid, making
the plaque acidic. This causes demineralization of the tooth enamel
and the underlying dentin, leading eventually to loss of tooth
structure and further bacterial invasion.8

A recent review conducted in North America, Europe and Africa
concluded that it is the cariogenicity of the diet, not the extent of
bacterial infection, that determines the severity of dental decay.9

***** Be sure to read the whole article as it covers all the factors
that account for dental health. This article also includes a lengthy
bibliography that can help you continue your research on your own.

-------------------------------------------------


http://www.truestarhealth.com/Notes/3571004.html
Truestar Health Encyclopedia
Tooth Decay

***** This is an excellent article and discusses not only the effects
of sugar on dental health but also behavioral issues and dietary
supplements.

-------------------------------------------------


http://www.studentbmj.com/back_issues/1000/education/369.html
ABC of oral health: Dental damages, sequelae, and prevention

Disease 
Caries and inflammatory periodontal disease are the most prevalent
oral diseases, both as a result of the activity of dental bacterial
plaque. Plaque is a complex biofilm containing various microorganisms
that forms mainly on teeth and particularly between them, along the
gingival margin, and in fissures and pits, adhering by a variety of
mechanisms. If plaque is not regularly removed the flora evolves, and
plaque may calcify, forming calculus (tartar).

Fermentation of sucrose and other non.milk extrinsic sugars by plaque
bacteria to lactic and other acids causes tooth decalcification and,
with proteolysis, results in caries (decay). The main causal organism
is Streptococcus mutans. Caries has been declining for some years,
mainly because of the protective effect of fluoride, but it is more
prevalent in disadvantaged and deprived people, especially in
preschool children.

Four main ways to maintain oral health 

1) Diet 
 -- Reduce consumption and, especially, frequency of intake of food
and drink containing sugar
 -- Food and drink containing sugar should be consumed only as part of a meal 
 -- Snacks and drinks should be free of sugars 
 -- Avoid frequent consumption of acidic drinks 

-------------------------------------------------


http://www.nutritionaustralia.org/Nutrition_for_All_Ages/Dental%20Caries%20booklet.pdf
Diet and Dental Caries

***** This is a 10-page booklet. Page 5 covers the importance of diet
and page 9 gives advice for older persons.

-------------------------------------------------


http://www.brightfutures.org/oralhealth/pdf/Essntl_101to107.pdf
Control of Caries and Periodontal Disease
Dietary Habits and Oral Health ? Page 7

***** This is an excellent summary of how best to approach your eating
habits to achieve good dental health.

-------------------------------------------------


http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=0003183162&dopt=Abstract
The effect of previous diet on plaque pH response to different foods.

-------------------------------------------------


http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search&DB=pubmed
PubMed Search

***** Search for < diet effect on dental plaque > brought 147 results.
Browse through them to find articles that interest you.

-------------------------------------------------


http://www.thejcdp.com/issue003/jensen/jensen.pdf
Assessment of Selected Snack Foods on the Remineralization /
Demineralization of Enamel and dentin.

-------------------------------------------------


http://www.lindt.com/1222/1228/1254/1273.asp
The IOCCC (International Office of Cocoa, Chocolate and Sugar
Confectionery Industries)

http://www.lindt.com/public/canada/chocomania/dental.pdf
IOCCC -- Dental Caries

Page 5, Point 8
Additionally, recent epidemiological studies (UK, USA, Spain, New
Zealand) have shown that both in children and adults, the total of all
dietary factors examined (carbohydrate amount, type and frequency)
accounted for only a very small increase in caries incidence. Dietary
factors, although statistically significant were clinically
insignificant as they were overridden by the effects of fluoride and
oral hygiene programmes.

This contrasts markedly with older studies of the pre-fluoride era
where diet and particularly sugars intake was directly related to
caries experience in most countries and in most population groups.
Availability of fluoride, especially used topically in toothpastes,
has brought about a dramatic change in the aetiology of the disease.

***** This is an 8 page paper that provides a lot of information about
diet and dental health.

-------------------------------------------------


http://www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00060.htm
The Effects of Diet on Periodontal Disease

IN SUMMARY
Dietary texture has been shown to influence accumulation of dental
deposits in the dog, although such a link has not been established in
man. Nutritional deficiencies have been shown to affect periodontal
disease primarily by altering the host response to plaque, but no
nutrient will prevent disease development or progression.
Supplementation of nutrients has not been shown to affect disease,
although several, including folic acid and vitamin C, warrant further
investigation. The combination of a well balanced diet, regular dental
examinations and cleanings, and a good home dental hygiene program
will reduce the risk of developing periodontal disease in man and
animals.

-------------------------------------------------


http://www.hersheys.com/nutrition/dental.asp
Products: Diets and Dental Health

-------------------------------------------------


http://www.nationaldairycouncil.org/NationalDairyCouncil/Health/Digest/dcd73-5Page4.htm
Health Benefits of Cheese ? Dental Health

-------------------------------------------------


http://www.nationaldairycouncil.org/NationalDairyCouncil/Health/Digest/dcd71-1Page3.htm
A Protective Effect of Dairy Foods in Oral Health 



==============================
ORAL HEALTH AND GENERAL HEALTH
==============================

http://www.uq.edu.au/
The University of Queensland ? School of Dentistry

http://www.uq.edu.au/~dnlwalsh/mpe/lifestyle/index.htm
Interactions between Oral Health and General Health 

***** Explore the dozens of topics offered here that interest you.

http://www.uq.edu.au/~dnlwalsh/prev/15_strategies_ADA%20News%20Bulletin_prev.pdf
Fifteen strategies for dental caries prevention: towards target zero.

1) Reduce the pathogenic potential of dental plaque
2) Increase the resistance of tooth structure to caries attack
3) Augment salivary factors

***** This is a 4-page paper that provides an excellent plan of action
for maintaining dental health.

-------------------------------------------------


http://www.ncl.ac.uk/dental/oralbiol/oralenv/
University of Newcastle upon Tyne ? Department of Oral Biology

http://www.ncl.ac.uk/dental/oralbiol/oralenv/home.htm
The Oral Environment

***** This site provides a terrific collection of articles and
resources on maintaining oral health. There are articles about
behavior, nutrition, research and much more. Be sure to read the
tutorials to get an in-depth understanding of plaque formation.

-------------------------------------------------


http://uclasod.dent.ucla.edu/index.asp
UCLA School of Dentistry

http://www.dent.ucla.edu/ce/caries/
Dental Caries
A learning program on the nature and management of dental caries

Phase 3 - the present
For our present concept of the nature of caries go to Section A4and
for how the disease is treated today go to section A5.

***** This is an excellent article that will help you understand not
only your current concern about controlling plaque via diet but also
provides a good review of the history, current status and predictions
for the future of dental treatment and care.

-------------------------------------------------


http://www.ada.org/public/topics/oral_changes_faq.asp
Oral Changes With Age

http://www.ada.org/Search.asp
American Dental Association
Documents 1 to 25 of 62 matching the query "diet".

http://www.uspharmacist.com/oldformat.asp?url=newlook/files/Feat/peridontal.cfm&pub_id=8&article_id=434
Periodontal Diseases and Systemic Health

Periodontal diseases are infections caused by bacteria found in dental
plaque. Dental plaque is a complex mass comprising bacteria and their
metabolic byproducts, toxins, viruses, food debris, and dead cells.
Bacteria in dental plaque adhere to teeth above (supragingival) and
below (subgingival) the gumline and other oral surfaces. Some bacteria
can invade the soft tissues, eluding removal by instrumentation. Once
dental plaque organizes on the tooth surface near the gingiva, a
series of inflammatory and immunological responses to the plaque
occur. The net result is periodontal breakdown.

Because the prevalence and severity of periodontal diseases have
changed over the years, individuals are not considered to be equally
prone to periodontal diseases. Thus, some individuals are more ?at
risk?for developing periodontal diseases than others. Certain factors
put individuals at risk for developing periodontal diseases. On the
other hand, a more recent concern is that if a patient has periodontal
disease, he or she may be at risk for other medical conditions. This
article will review risk factors for developing periodontal diseases
as well as discuss the medical conditions that can develop if the
patient has pre-existing periodontal disease.



===============
SEARCH STRATEGY
===============

diet effect on dental plaque
diet effect on dental plaque elderly

Comprehensive and detailed which gives me a very clear direction to follow

I have a barrell full of suggestions that I would try if I was trying
to get rid of plaque.
(1) do not use commercial toothpaste...it is not the proper pH...20%
salt  80% baking soda?or 50-50 if you like it...put it in your hand
and wet your brush... the more salt the better it is for your
gums...Clean your gums by rinsing with ¼ teaspoon of vitamin C [it
must be the sodium ascorbate form, never ascorbic acid].  Mix it in 4
oz. of water and rinse with a hard flushing action pulling the water
between your teeth.

(2) use an electric spin brush

(3) after eating sugar or carbohydrates brush as soon as possible afterwards.

(4)  take 2000 mg. of vitamin C with each meal.

(5) one thorough brushing and flossing a day is better than 2 or 3 quick ones.

(6)  diet plays a part...juice is not part of a good diet as it is not
the whole fruit...oranges and grapefruit are not the way to get your
vitamin C...there are better ways.

Sorry I can't give you sources on this...if you like it, try it!!!

Browse through this guy's very extensive dental website:
http://www.doctorspiller.com/
He says a lot about the effects of sugar on tooth decay.  (Frequency
of eating sugar is more important than how much...  Sweets once a day
are better than sipping from a can of soda throughout the day because
you keep feeding the oral bacteria more sugar.)

I really like powerjug's comments.  They are great.  My grandfather
brushed with baking soda before people realized that sodium
bicarbonate was good for your teeth - he died never having a cavity or
gum disease.

Also, using other types of sweetener.  Please do not use sucralose
(Splenda) or aspartame (Nutrasweet), which are poison to your body.  A
natural plant-derived sweetener which is good for you is called:

Xylitol

It's the same stuff Trident chewing gum uses.  Its benefits are:

*actually kills plaque rather than feeding it
*safe for diabetics and hypoglycemics
*60% of the calories of sugar
*works the same in cooking as sugar except that it doesn't crystallize
- so you can't make hard candy.

Side effects:
*you should gradually begin using it rather than use a lot at once,
because it could have a laxative effect if you haven't built up a
tolerance over about 3 weeks.

I use it now, and although it's expensive, it's worth every penny. 
Even after drinking tea with xyitol added to it, my teeth don't feel
like they're being eaten away in the same way you feel after eating
sugar.  They feel clean.

You can buy some online here:

http://www.xlear.com

Although there may be other places too.

Hello dougsut-ga,

I'm glad the information found is useful. Thank you for the five stars
and generous tip.

~ czh ~

Here is a good picture showing the different stages of Periodontal Disease.
http://www.andymatlock.com/option,com_akogallery/Itemid,43/func,detail/id,21/