Diet, Caries, and Dental Erosion

Many years of research have established that dietary factors are directly related to dental caries and erosion. Significant risk factors for these abnormalities include fat and sugar intake in both children and adults. In fact, not only does childhood sugar intake contribute to the development of caries, but the development of pediatric caries in children aged 5 years and younger is significantly associated with maternal weight and intake of sugar and fat by expectant mothers during pregnancy. Dietary habits and the risk of caries in children may also be confounded by maternal educational level.

Caries also occurs in adults, and its incidence appears to increase with age. In fact, incidence rates are similar to those observed in children. Numerous studies in Europe (Ireland, Netherlands, United Kingdom, France) and in the United states suggest that the dietary factors in children may be as important as they are in adults. In a recent study, severe tooth loss in older adults was found to be a key indicator of a compromised dietary quality.Evidence also shows that sport drinks may be increasing the incidence of dental erosion, which can precede caries in both child and adult athletes.

Specific dietary elements and related factors that have demonstrated significant potential for causing caries include the following:

• Number of fruit-based sugary soft drinks imbibed
• Frequency of fruit-based sugary drink intake
• Length of time taken to consume acidic drinks
• Eating processed starches as snacks (cooked starches: bread, crackers, cereal, chips/pretzels, pasta, fries)
• Eating fermentable carbohydrates
• Intake of long-lasting sources of sugars, such as hard candies, breath mints, and lollipops
• Clearance properties of the carbohydrate
• When the food is eaten
• The level of salivation or lack thereof
• The type of starch that is eaten
• The co-presence of buffers, such as calcium taken with fermentable carbohydrates

Foods and dietary habits that should be recommended because of their minimal risk of caries potential or their caries risk reduction include the following:

• Eating fruits such as apples, oranges, pears, and bananas
• Eating vegetables such as carrots, celery, tomatoes, lettuce, cucumber, nuts, and crisps
• Eating aged cheese or drinking milk
• Eating eggs and yogurt
• Imbibing xylitol-containing food products
• Eating of sugar-containing foods with meals rather than between meals
• Eating less sugar-containing food or carbohydrates
• Drinking versus sipping sugary drinks
• Rinsing with water after imbibing sugary snacks
• Eating fruit instead of drinking unsweetened fruit juices that have sugar and that are acidic
• Drinking sugar-free tea or coffee
• Avoiding the intake of sugar or sticky carbohydrates before retiring to bed

Numerous foods have alleged anticaries activity. These include foods with added xylitol or fluoride, green tea, apple, red grape seeds, red wine, nutmeg, ajowan caraway, coffee, barley coffee, chicory, mushroom, cranberry, glycyrrhiza root, ethanolic extract of Myrtus communis, garlic aqueous extract, cocoa extracts, and propolis.The extent to which these various anticaries foods or ingredients have been studied is limited, but some evidence does suggest an effect on the development of caries.

Antonenko et al evaluated the association between oral health and calcium (Ca) and vitamin D nutritional status. The results of this study showed evidence of an association between high cariogenic risk and great severity of oral disease in the studied group of young women and low Ca intake. The authors suggest that an adequate nutritional status of Ca and vitamin D could be an additional factor that may help preserve a good oral health

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