Jeff Burgess, DDS, MSD; Chief Editor: Arlen D Meyers, MD, MBA
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.[1, 2, 3, 4, 5, 6] 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:[12, 13]
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.[14, 15, 16] 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.