Food and drink choice; an increased risk of cavities?

Dr. Karen Benitez, founder & designer, board certified pediatric dentist at Chevy Chase Pediatric Dentistry will be writing a series of guest posts related to adolescent dentistry and questions she frequently receives from patients that may be of interest to you. If you have a topic you’d like to see her feature, leave it in the comments. 

The first post was one that many parents wonder about; whether it is necessary for your child to visit a pediatric dentist and how the experience will differ from just taking them to the dentist you see. The second post addresses the topic of why x-rays are important for your child to have. The third post explained why your child may be referred to an orthodontist at what may seem like a young age. The last post was all about cavities and how to proceed.

This blog subject is to address food choices and how they relate to an increased risk of cavities (not to mention overall body health). Let me first make a disclaimer that I am not a sugar-free, carbohydrate-free mommy of three. I too juggle rushing out the door and what will we all have for dinner as we dart in and out of after school engagements. Our weekends can be rather hectic and some food groups might be repeated more than I care to admit but we don’t make a habit of it.

In my daily dialogue with parents about what their kids are eating and drinking, I chime in that there is no perfect recipe to be cavity-free, but there are habits that we can fall into that can increase the risks. I feel that life is incredibly hectic for all of us and it seems exceptionally frustrating to go to the dentist and hear your little one has cavities. I see the frustration in parents’ eyes and the feeling of letting their kids down. I don’t keep a “cavity-free” club because kids themselves feel upset to hear they have a cavity. I am here as your liaison to help you better understand the process and an advisor on what changes to make. I ask for routine exams because if missed every 6 months, it’s super easy for cavities to get growing!

So why has the subject of food and drinks made it to this blog? Well, we are faced with a plethora of options, frankly. It’s not such a simple answer any more of what your kids will drink and it varies by age groups. Just to give a visual, walk into any grocery store, convenient store or gas station and you will be welcomed by an abundance of options of beverages and convenient snacks. This is what our market places now look like because we really are a society on-the-go. Drive (or walk) down any city street and you can’t go far without bumping into a Starbucks Frappuccino advertisement or a treat offering. Snacks now come in convenient pouches or bags because the consumers really are constantly in movement. So I bring to your attention, the hidden sugar intake in some of these—not to call out any brands, but to bring awareness to the subject.

Let’s begin to understand the steps of the development of cavities. The cavity process requires these parts: a bacteria source, a sugar source, a susceptible tooth, and time. We all carry a very specific bacteria involved in the cavity development: streptococcus mutans. This little bugger initiates the cavity process by being fed sugar from what we eat, creating an acid. Cavities are an active process of lower pH levels (more acidic saliva). It is the acidity level that allows for the tooth structure to become demineralized (eaten away), hence a susceptible tooth. This combination of bacteria-laden plaque, sitting proximal to our teeth, in a sugary, acidic salivary flow, is only awaiting time to actually cause the demineralized cavity.

We are all learning so much more about the breakdown of our carbohydrates into sugars. We know the more whole grain, the less the sugar. Every time we eat, the food choices we make affect the pH levels of our saliva. Our children in particular snack more often than we do and carry sippy cups in early years. The frequency of snacking easily lowers the salivary pH, maintaining a risky environment of sugary acidic attacks on these tiny pearly teeth.

This is a great subject matter itself: drinks! I find this to be the sneakiest of culprits to lowering the pH. I ask that parents be aware of the amount of sugar on labels for foods and drinks. It’s the easiest way for kids to ingest tons of sugar without our realizing it. Sports drinks, juices, any flavored milk—all these are to be checked for increases in sugar. The container in which they come in is far greater a serving size than the kids should take in, but they do. My favorite advice for parents is to drink WATER! If that’s not always cutting it, dilute the sports drink or juice and keep them to a limited intake. Milk naturally has sugar, no matter what milk you ingest. Keep it white—no additional flavors to sweeten it. The sweet taste that our kids are getting is altering their palate. No longer will low-sugar berries and foods appeal to them because they are acutely aware of how much less of “flavor” they offer compared to the sweet stuff. Conveniently packaged pouches of yogurt are also in my category of sweetened milk. Sure, they taste great and are easy to pack, but they also contain far more sugar than we should have them consume. Look for low-sugar options per serving size as consumers!

Every age group has its vice or lifestyle that might lend to higher sugar intake. I find that most parents are already acutely aware of the toddler-age advice of limited juice intake. Thankfully most of my parents are also in the habit of using sippy cups, no-drip rimmed cups or straw cups sooner with only water while on-the-go. This is exceptionally helpful in the young years of trying to maintain healthy hydration and dietary habits. I do find that as our kids get older and into sports, or the teenage coffee shop social, we increase risks of liquid sugar intake in very critical years. These are the years of braces and varying stages of the developing permanent teeth—or as I call them—your “forever-ever teeth”! I want parents to be aware of the drink options their kids are commonly exposed to, be it sports drinks, sodas, coffee drinks because of the frequency of acid attacks the sugar intake is causing.

Being acutely aware of the grams of sugar in the foods our kids (and ourselves) take in daily can actually be frightening! I think we all could benefit from minding this and reserving additional sugars in treats. Ice cream and cakes as treats adhere less to the nooks and crannies of teeth than candies. It’s the same example of Oreos and Cheetos I use below—anything that sticks to the teeth, allows more access of time to a susceptible tooth. Thankfully there are food products on the market aware of the excess sugars, offering low-sugar options. They provide tasty snacks with less sugar and more healthy fillers. It might take time to adjust to some of these snacks, but it’s worth it. I tend to stray from food packaging designed for kids. At least always compare the sugar to see if it’s a good decision.

It’s no surprise kids come into the office for a cleaning having eaten a snack. This is actually a great teaching moment for me as food remains in the grooves and in between walls of teeth. I engage parents to peer over my shoulder as I demonstrate how to brush and floss. It really takes good focus for some foods to be properly removed from these grooves and in-between walls. The perfect examples of the tenacity of some foods are Cheetos and Oreos! Seriously, they are incredibly difficult to remove even after bouts of brushing, flossing and rigorous swishing and spitting. Look at the images below to see how these foods stick into the grooves. Their bright and dark colors allow you to see them clearly, but other foods aren’t so easy to see. It provides a great visual on the behavior of food retention on the teeth that over time can cause cavities if not properly brushed and flossed. Say “cheese”!

Speaking of “cheese”, did you know that eating cheese helps to decrease cavity risks? Cheese is shown to elevate salivary pH making it more basic. That’s the opposite of what most food choices containing sugar do (they make your saliva more acidic). I love the idea of kids snacking on cheese and yes, there are conveniently packaged options out there. I could have been French with my love of cheese and I try to pass that along to my kiddos!

Another great idea that you will hear me say is WATER, WATER, WATER! Nothing hydrates the body better. I tell my little patients that water feeds their bodies. I ask them if they think we would feed our little gardens of flowers and vegetables juice or water to grow. They crinkle their noses and look at me like I’m absolutely nutty! I tell them that their bodies are also growing, and like their garden flowers and veggies, WATER is their best choice. Kids are so smart. “The solution to pollution is dilution”, that’s what my oral surgery attending would always say and I agree. Let’s dilute any sugar accumulation with water. I prefer they rinse and spit, otherwise it’s just all going down the drain to their bellies.

Thanks for tuning in again! Keep posted for the following subject: Oral Hygiene, Ah! I will discuss other tips I find exceptionally helpful, including early assessments! It’s clear that we all eat, but are we all setting up our kids with excellent brushing and flossing to lessen the cavity risks?

We at Chevy Chase Pediatric Dentistry welcome your child to come in and have a look. It would be our pleasure to have you!

You can also find us as Bethesda Magazine’s Face of Pediatric Dentistry, view our Top Docs video and read our stellar reviews on Yelp, GoogleandZocDoc.  Follow us on Facebook to learn more about what Chevy Chase Pediatric Dentistry is all about…Focusing on your kids.

-Dr. Karen Benitez, DDS

Location: 8401 Connecticut Ave #650 Chevy Chase, MD. 20815
Phone: 301-272-1246