Dental Erosion - why 4 a day is better than 5 a day!!

The government has been promoting their 5 a day campaign to encourage us to have 5 a day of healthy portions of fruit/vegetables. This is a great idea for our general health particularly to help lower the incidence of heart disease and cancers, but one area of dental concern to us has been the widespread increase in consumption of fruit smoothies, to help gain some of these 5 a day portions. Our concern at Absolute is due to the erosive properties of fruit and particularly with certain fruits having a greater acidity than others, and greater capacity to cause reduction in the hardness of the tooth surface and also the reduction in the surface depth of teeth.

What erosion might feel like.

 

Some patients complain of an increase in sensitivity or pain.

 

What erosion might look like.

 

Teeth can take on a very smooth appearance particularly when loss of enamel occurs on palatal surfaces. The tooth can appear shorter in height and on some molar teeth, pits can appear on the biting surfaces of the cusps of the teeth.

 

Management

 

This includes an initial investigation into the cause of erosion and we often ask our patients at Absolute to complete a diet sheet which patients complete with all the drinks and snacks they have over a period of time e.g. a week and the times of day as well. This allows us to evaluate where acidic drinks/foods are being consumed.

 

The new threats to your teeth.............................................Smoothies and thickies!!!

 

Legally there is no legal definition of a fruit smoothie but it is well accepted in the soft drinks industry that fruit smoothies are made only from pure fruit blended with 100% pure fruit juice (not from concentrate) with no added ingredients e.g. sugar, dairy sweeteners or water. They were thought to have originated in Brazil as a by-product of juicing fruit and first appeared in the UK in 1994 and have steadily increased their share of the soft drinks market. Thickies however, are a variation of smoothies and they contain dairy products and are particularly good for general health as they are classed as probiotics and provide a very good aid to digestion. This is due to the lactobacillus acidophillus they contain. The dental concern with these is more likely linked to some of the other ingredients, e.g. honey which could have the potential for caries as opposed to erosion. The share of the market for smoothies is huge with an increase from 6 million litres in 2001 to 34 million litres in 2006 and this is projected to treble in the next 5 years. This is just the shop bought smoothies.......................................

 

One recent study into the erosive capacity of smoothies carried out comparing 5 smoothies, 1 thickie, water and orange juice revealed that apart from the water and the thickie, all of the drinks brought about reductions in the surface hardness of teeth but those which were classed as significant were cranberry, blueberry and cherry fruit smoothie. When they looked at the loss of the depth of the tooth surface, kiwi, apple and lime smoothie produced the greatest loss of the depth of the tooth.

 

The tooth surface can only withstand 4 acid attacks a day before damage occurs and it takes at least 45 minutes for the mouth to produce enough saliva to neutralise the acid in the mouth, and for patients whose saliva contains less bicarbonate of soda, or who's saliva flow is reduced, this may take much longer.

 

Whats being done to help?

 

Where children are concerned, the World Health Organisation have developed nutritional educational guidelines for schools and in some who have adopted these, a maximum of fruit juice is limited to 200ml at lunchtimes.

 

What can we do as individuals?

 

Ask the team at Absolute!!!!

 

• Avoid holding acidic foods and drinks in your mouth or sipping drinks over long periods.
• Check the foods and drinks you consume and perhaps try a diet sheet for a week and see if you can recognise where you could change your diet to limit the number of times you have acids.
• Brush your teeth gently but thoroughly with a soft or medium toothbrush and avoid rinsing after brushing.
• Use a good fluoride mouthwash after mealtimes.
• Wait until at least 45 minutes after consuming acid rich drinks or foods before brushing teeth.
• Use a specialised low abraision toothpaste.

 Maureen