This month, Saba Qureshi looks at 10 New Year’s resolutions that are damaging to patients’ teeth, and discusses how to make patients aware of them to reduce the risks.
The most common new year resolutions tend to centre around getting in shape, eating healthier and being more active.
While these are all good habits and should be encouraged, there are some healthy lifestyle choices that could seriously damage the dentition. Making patients aware of these and how to reduce the risks to teeth is a good way to start the year.
Apple cider vinegar
Apple cider vinegar (ACV) has been a popular home remedy for centuries. Due to celebrity endorsements, there has been renewed interest in its potential health benefits, particularly with respect to weight loss.
The problem is the main active components of ACV are acetic acid and polyphenolic compounds, with a pH of two to three. This means patients are at risk of enamel erosion, causing discolouration of teeth, sensitivity, and enamel fractures.
To minimise this, it should be diluted with water before drinking through a straw. It should also be drank all in one sitting and patients should rinse with plain water afterwards. However, you must remind patients to wait at least 30 minutes before brushing their teeth.
In addition, ingestion of large quantities and prolonged use should be discouraged.
Lemon water
Lemon water is easy to make and is known to aide digestion, strengthen immunity and detox our bodies.
The problem, again, is the acidity of the lemon juice and the way in which it is consumed. Many people will make a bottle of lemon water to sip throughout the day, subjecting their teeth to a prolonged acidic attack.
The result is enamel erosion along with sensitivity to hot and cold.
To reduce these adverse effects, suggest drinking lemon water all in one sitting with a straw, ensuring the water is not too hot. Water which is too hot will cause more rapid erosion. They should also follow up with a few sips of plain water.
Remember to remind patients not to brush immediately after consumption.
Fresh juice
Fruit juice is an easy way to get our required dose of daily vitamins and antioxidants, but they’re acidic with some containing the same amount or more sugar than Coca Cola (five teaspoons of sugar per 200ml glass). Therefore, excessive juice consumption can lead to enamel erosion and caries.
Recommending our patients stick to a single 150ml glass a day, with meals, through a straw, avoiding those with added sugar will help. Rinsing with water afterwards and waiting to brush are also important.
Best of all would be to swap juice for whole fruit which also has better nutritional value.
Smoothies
Smoothies seem like an easy way to increase your fruit intake but many are packed with sugar and acid. This can lead to caries, enamel erosion and staining from colourings.
Again, drinking through a straw in one sitting is advised, as well changing to vegetable smoothies to reduce the sugar content.
Lastly, suggest rinsing or sipping plain water to wash away the acidic and sugary residue.
Diet drinks
Diet drinks don’t contain any sugar, but the level of acidity is a big concern.
Such drinks actually have higher acid levels than regular fizzies, as they contain more acidic regulators which lead to enamel erosion and tooth sensitivity.
It’s best to discourage fizzy drinks but failing that, advise for them to be taken through a straw and not sipped over a prolonged period.
Sparkling water
Having enough water in your diet important and around six to eight glasses a day is recommended. But is sparkling water a safer alternative to still?
Sparkling water gets its fizz from carbon dioxide which oral bacteria converts into carbonic acid, giving the water a tangy, refreshing taste.
The good news is that sparkling water is minimally erosive. In addition because it contains no sugar, it’s still a healthier option when compared to sodas, especially if restricted to meal times using a straw.
Just ask patients to avoid the temptation to add a slice of lemon or lime.
High impact sports without a mouthguard
Physical activity is great for both body and mind, but dental protection is essential.
Research has shown that between 13% and 39% of all injuries to teeth are sports related and that one in four children in the UK will injure or lose a front tooth at some stage.
During high impact sports such as rugby, hockey, martial arts and lacrosse, teeth are particularly vulnerable. This puts patients at risk of tooth fractures and displacements, soft tissue injuries to the lips and cheeks, and avulsion.
A well-fitted mouthguard will reduce these risks significantly.
Energy drinks
Energy drinks are popular with athletes for enhanced performance, focusing the mind, or to overcome lethargy and tiredness. However, they are often full of sugar, acid and caffeine.
Frequent consumption of energy drinks can result in caries, enamel erosion and tooth sensitivity.
Swapping an energy drink for simple water would be ideal. But if the odd one is needed, then patients should avoid drinking small amounts over extended periods of time and be sure to rinse afterwards.
Dried fruit
In an attempt to be healthier, many of us turn to dried fruit to satisfy our sweet tooth. But in the process of drying, fruits attain seven times more sugar than their fresh form. In addition to this, they stick to the teeth and are difficult to remove, putting patients at risk of broken teeth, restorations, and caries.
In order to protect teeth from potential damage, portion size should be restricted to about two tablespoons of dried fruit and varieties that contain added sugar should be avoided.
Reminding patients to floss after eating will remove fragments lodged interdentally.
Frequent snacking/grazing
Eating little and often has become a popular way to avoid post-meal slumps and keep energy levels up throughout the day. But eating this way is not good for teeth.
As you know, whenever you eat oral bacteria convert sugars into acids which then attack the teeth.
During meals times, an increase in salivary production dilutes harmful acids and washes it away, along with food debris. However, it still takes a minimum of 30 minutes for saliva to neutralise all the acids within the mouth.
So, regular snacking means teeth aren’t getting a break from the acidic environment, which can lead to caries.
By limiting the number of snacks to two or three a day and saving sugary or acidic foods and drinks for mealtimes, you can help reduce patients reduce the risk of decay.
Catch up on previous Straight to the Point columns:
- NHS referral guidelines
- The periodontally compromised patient
- Optimum aftercare: tips for your patients
- Balancing patient demands and ethics
- The impact of thumb sucking on teeth.
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