Tooth decay is the most common dental problem in Australia, affecting more than 90% of people in their lives, and the most common chronic disease affecting children. While teeth can decay for many reasons, the leading culprit is sugar added to food and drink.
Even if you've already tried to cut down on sugar in your diet, you and your family could still be consuming more than you realise, thanks to the presence of 'hidden' sugars – those that go under other names, but are just as bad for your teeth and gums.
This Dental Health Week (3 to 9 August 2020), the Australian Dental Association (ADA) and dentists across Australia are helping to raise awareness of these hidden dangers lurking in the grocery aisles to help people of all ages avoid tooth decay. Find out what you need to know or book a check-up with a Sydney CDB dentist.
Tooth decay (dental caries) can affect people of all ages, but children and teenagers are at the highest risk – both because their developing teeth are softer and thinner than adult teeth, making them more easily damaged, and because they consume the most sugar.
According to the most recent data from Australia's Oral Health Tracker:
What's more, many kids and adults have tooth decay that isn't treated:
Without treatment, tooth decay can spread to other teeth or lead to more serious problems, including gum disease and even losing teeth. Tooth decay is the leading cause of tooth loss for young people.
There are two main categories of sugar – natural sugars, such as those found in fruit, milk and natural yoghurt, and added (or 'free') sugars in processed food and drink. Natural sugars are healthy in moderation, but if they're released through juicing or blending they become free sugars, which are more damaging to teeth.
Having some sugar in your diet can provide energy, but most of us have more than necessary, which can cause problems. The World Health Organization (WHO) recommends a daily average of 24 grams or 6 teaspoons of free sugar in food and drink, which varies by age and gender.
The WHO also found that tooth decay is more likely to be present in people who consume more free sugar than recommended. The average Australian has 14 teaspoons of free sugar per day, which is well over the recommendation.
According to Australia's Oral Health Tracker, over 70% of children and teenagers have too much free sugar in their diet, which is largely thanks to their taste for soft drinks, fruit juices and sugary snacks. Adults are less likely to overindulge, but almost half (47.8%) still consume more free sugar than is recommended for health.
Sugar doesn't directly cause tooth decay. What happens is that when you eat or drink something containing sugar or other carbohydrates, bacteria on your teeth also consume it. This gives the bacteria the energy to multiply and spread, and they release acids as a waste product. These acids weaken and slowly dissolve the surface of teeth over time, which can eventually form cavities.
Most of this activity happens within 20 minutes of consuming sugar. Drinking water helps to rinse sugar off your teeth and your saliva can neutralise some of the acid, but by that time some of the damage may be done. Naturally, the more sugar you consume, the more there is to feed bacteria and the more acid gets released.
Each time you eat or drink something with sugar, the process starts again. That's why snacking between meals and frequent sips of sugary drinks can cause more damage than having drinks and snacks alongside meals.
Some more important things to know:
You might notice tooth decay in the early stages as white spots on teeth, close to the gum line. Improving your oral hygiene at home or visiting a dental clinic to have plaque removed and fluoride applied can usually stop or reverse tooth decay at this stage, before any permanent damage is done. If tooth enamel has started to dissolve, minerals in saliva and fluoride could help to repair it.
If tooth decay continues, spots on the teeth may darken and the enamel will continue to be weakened until cavities (holes) form in one or more teeth. This exposes the softer dentine layer under the enamel, which can cause toothache or sensitivity when you eat or drink something hot, cold or sweet.
More severe tooth decay may expose the interior of the tooth, infecting the soft tissues of the dental pulp or forming a dental abscess below the tooth. These can be extremely painful and need professional care as soon as possible. A badly decayed tooth may turn brown or black and you could risk losing the tooth without treatment.
Tooth decay is a preventable disease if you maintain good oral hygiene. Improving your oral hygiene habits could also help to reverse existing decay in its early stages, combined with treatments from your dentist.
To maintain good oral hygiene:
If you want to stay within your daily intake targets, you need to know what to look for on nutrition labels when you're shopping in the supermarket or online.
The ADA recommends choosing products with 10g sugar or less per 100g (the lower, the better). Checking sugar content per 100g is a more useful comparison than per serving, as serving sizes can vary between products.
More useful things to know:
If you're worried that you or your child might have tooth decay, you should make an appointment to see a dentist if:
Tooth decay can sometimes happen without any obvious symptoms. Having regular check-ups with a dentist makes it more likely that they'll spot tooth decay in its early stages before it causes permanent damage.
During your appointment, your dentist will examine your teeth and gums and recommend any treatments they think could help. Depending on how far tooth decay has advanced, these may include:
Your dentist will explain the pros and cons of treatment options and answer any questions you have so you can make informed decisions about your oral health.
If you want to talk to a dentist about your teeth or it's time for your check-up, get in touch to make an appointment at our George Street dental clinic at a time that's convenient for you.
Australian Health Policy Collaboration and Australian Dental Association. Australia's Oral Health Tracker [Online] 2018-20 [Accessed July 2020] Available from: ada.org.au/oralhealthtracker
Better Health Channel. Tooth decay [Online] 2018 [Accessed July 2020] Available from: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/Tooth-decay
Healthdirect. Tooth decay [Online] 2019 [Accessed July 2020] Available from: https://www.healthdirect.gov.au/tooth-decay
Moynihan, P. J., Kelly, S. A. M. 2013. "Effect on Caries of Restricting Sugars Intake: Systematic Review to Inform WHO Guidelines." Journal of Dental Research. URL: http://jdr.sagepub.com/content/93/1/8