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Eat an apple a day, but don't keep the dentist away

A child eats an apple during a Trunk-or-Treat event, which featured a healthy snack station as an alternative to candy, at Ramstein Air Base, Germany. (U.S. Air Force photo by Senior Airman Jimmie D. Pike) A child eats an apple during a Trunk-or-Treat event, which featured a healthy snack station as an alternative to candy, at Ramstein Air Base, Germany. (U.S. Air Force photo by Senior Airman Jimmie D. Pike)

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Deployment Health | Health Readiness | Nutrition | Preventive Health

FALLS CHURCH, Va. — From sodas and desserts to fruits and vegetables, sugar can be found in just about anything that’s consumed. While it’s part of almost any diet, sugar can impact more than weight and well-being. It can affect oral health, too.

Army Lt. Col. Paul Colthirst, deputy consultant for Dental Public Health and commander of the Fort Polk Dental Health Activity, said the oral cavity, which includes teeth, tissues, and gums, can tell the entire story of a patient’s overall health. Since everything passes through the mouth, proper nutrition is critical for good oral health, he said.

“Oral health is a big part of mission readiness, so it’s important for service members and their families to take care of their teeth, but it takes more than brushing,” said Colthirst. Tooth decay, a primarily diet-based disease, is one of the main causes for dental emergencies among deployed service members – and it’s preventable.

Colthirst said eating a poor diet filled with carbohydrates, sugars, and starches can lead to various dental health issues, including gum disease and tooth decay. Tooth decay is caused by the breakdown of the enamel – the tooth’s protective layer. When these foods are consumed, they produce sugars and plaque, a sticky film filled with oral bacteria. While consuming the sugars, these bacteria release acids that then break down the enamel, which leads to decay, he added. As the enamel weakens, cavities are formed.

According to the Centers for Disease Control and Prevention, tooth decay is the most common chronic disease for young people ages six to 19 and affects nine out of 10 adults older than the age 20 to some degree.

“People tend to believe that as long as they brush their teeth a couple of times a day that their dental health is assured, but there’s a lot more that goes into having good dental health and strong teeth that comes from nutrition,” said Army Maj. Susan Stankorb, a dietitian at Blanchfield Army Community Hospital at Fort Campbell, Kentucky.

Stankorb said tooth decay can be caused by sugar- and starch-filled substances, such as candy, juice, soda, and energy drinks. Snacking frequently and drinking beverages other than water in between meals causes the acidity in the mouth to increase and prolongs the amount of time the teeth are in breakdown mode, she added. 

“If you’re more of a grazer and you tend to eat fermentable carbs – crackers, anything sticky, chewy, sugary – that will sit in your mouth, you’re going to be more prone to having cavities or dental issues if this habit is consistent over time,” said Stankorb. The average acidity, or pH, of saliva is 7. On a scale of 0 to 14, this is considered neutral. Sticky or sugar-filled foods tend to bring the pH level down to about a 5.5 – the level where the cavity process begins.

While some nutritious foods containing natural sugars, including milk and fruit, should be included in the diet regularly, foods with added sugars should be limited. Reading labels helps keep track of the amount of sugar, carbohydrates, and starch in food and drinks. However, it’s important to also consider the serving size and number of servings per package. Stankorb recommends eating on a regular meal and snack schedule with at least three hours in between meals, and limiting non-nutritious snacks high in added sugars.

“If something acidic like soda or juice was consumed, we recommend not brushing immediately afterward because that can be very hard on the enamel,” said Stankorb, who recommends waiting at least 20 minutes to brush teeth; in the meantime, drink water to rinse the mouth. Staying hydrated with water produces saliva, which neutralizes pH in the mouth, prevents decay, and hardens teeth, she added. 

Foods that can help with dental health include nuts, raw vegetables, yogurt, and cheese. Hard cheese, such as cheddar, helps neutralize decay-causing acids that are produced by bacteria in the mouth. Army Maj. Akeele Johnson, a general dentist at the Fort Polk Dental Health Activity, recommends these steps to help maintain or improve dental health:

  • Drink sugary or acidic drinks quickly to limit exposure to teeth, and drink them through a straw to minimize contact with the teeth.
  • Replace sugary beverages with sugar-free drinks, water, or unsweetened coffee or herbal tea.
  • Limit juice to 6 ounces of calcium-fortified juice per day.

Teeth should be brushed twice a day in circular motions with fluoride toothpaste and the mouth should not be rinsed after brushing, said Johnson. By not rinsing or consuming anything for 20-30 minutes after brushing, fluoride is able to stay on the teeth for protection.

“Oral health is a showstopper,” said Johnson. “We want people to have good health, and we’re here to help.”

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