It’s something of a radical take on the science of tooth decay. While most dentists, dental organizations, and public policymakers have been shifting to a model that tooth decay is “multifactorial,” a small but increasing number of dentists is staking out the opposite position: tooth decay has only one cause: sugar. Other factors simply mediate the extent of tooth decay.
This is an important issue, and it needs to be addressed. In particular, more sugar control policies need to be put in place to help prevent tooth decay and reduce the need for reconstructive dentistry procedures like fillings.
A Mostly True Claim
The position these dentists are taking is mostly true. Tooth decay is caused when oral bacteria consume free sugars and excrete acids that attack the tooth enamel. Since everyone has oral bacteria, and this oral bacteria only becomes damaging when fed sugar, leading to an unhealthy imbalance in the population, leading to tooth decay and gum disease.
The evidence backs up that tooth decay really only became a chronic problem after the introduction of processed grains and sugars. As sugar consumption has increased in the US, so has tooth decay, with all our preventive dentistry just slowing the growth of the disease.
And there are other factors that can also help slow decay, such as oral hygiene habits, especially the use of a fluoride toothpaste. Genetic disposition to decay can change risk (though this is not as much a factor as for gum disease). Saliva flow is sometimes mentioned, but in studies, it seems to have little impact. Fluoridated water can help reduce cavity risk. Some lifestyle habits, such as frequent running or heavy training can contribute to the risk of tooth decay. The acids contained in foods and drinks can contribute to tooth erosion and decay.
Attention to these other factors should not be neglected, as they can make a significant difference in a person’s tooth decay risk.
A Strategically Important Position
Dentists who take the position that sugar is the cause of tooth decay can help, even if their claim isn’t strictly true. Because sugar consumption is the largest single factor in tooth decay risk, we need to work hard to implement policies that help control sugar consumption.
Because of recent focus on obesity, some of these policies are being implemented. Clearer marking of sugars contained in foods was adopted by the FDA earlier this year. Increased taxes on sugary beverages are being implemented in many areas around the country. Some areas have even considered warning labels for sugary drinks.
These policies need to be in place, and research has shown that they can be effective at reducing decay risk. But we also need to investigate the best policies for reducing sugar consumption that causes a greater risk of tooth decay, such as the consumption of hard candies. With these public policies in place, it may allow our preventive procedures to finally turn the corner against this health pandemic.
If you are looking for a Columbus, Ohio dentist that can help provide preventive care for your teeth and gums, please call (614) 848-5001 today for an appointment with Dr. Mike Firouzian.