Australians may be more health-conscious than ever, but tooth decay and gum disease are still major problems across different age groups. This is largely down to how much sugar we consume every day.
We all know that sugar is bad for teeth, but thanks to hidden sugars and confusing nutritional labels, many of us don't know how just much we or our children are really having.
If you want to lower your oral health risks, cutting down on sugar is a good start. Find out how much sugar is recommended, what to look for when you're shopping and what food and drinks to avoid.
The World Health Organization (WHO) recommends that free sugar should account for no more than 5% of an adult's total daily energy intake. Based on the recommended energy intake for adults, this means 24 grams or around 6 teaspoons of free sugar per day.
The idea of eating 6 teaspoons of sugar may be unappetising, but the fact is, the majority of Australians consume more than recommended in food and drink every day.
According to the Australian Health Survey 2011-12, Australians consumed an average of 60g (14 teaspoons) of free sugars daily.
Children and teenagers were the biggest sugar consumers. This is especially troubling, as children's teeth are smaller and thinner than adult teeth, making them more vulnerable to tooth decay.
Older age groups were less likely to exceed recommendations, but more than a third of over 50s still derived more than 10% of daily energy from free sugars.
Sugar alone doesn't harm your teeth, but when you eat or drink something containing sugar, so does bacteria inside in your mouth. This is what leads to tooth decay, gum disease and related oral health problems.
More than 90% of Australians experience tooth decay at some time in their lives. It's the most common chronic disease among children and a leading cause of tooth loss.
Tooth decay happens when bacteria feast on sugar in the mouth and release acids as a by-product. These acids dissolve tooth enamel, which can expose the softer, yellow-coloured dentine layer beneath or form cavities that expose the inner tooth to infection.
Symptoms of tooth decay can include:
Teeth that already have cavities may be treated with a white filling or larger restoration. If decay reaches the soft centre of the tooth, you may need a root canal treatment. Teeth that are severely decayed may have to be extracted to protect your other teeth.
The bacteria that damage teeth can also cause gum disease if plaque enters the gum.
Sugar doesn't only affect your teeth and gums. Oral health problems can increase your risk factor for other diseases, including heart disease and stroke. Too much sugar in your diet can also contribute to problems such as obesity and type 2 diabetes.
Sugary food and drinks are typically high in calories. While these can be useful for providing the energy you need as calories are burned, leftover calories remain in the body as fat, contributing to weight gain. Being overweight or obese increases the risk factor for a wide range of health issues.
Like tooth decay, sugar doesn't directly cause type 2 diabetes, but this condition is more likely to develop if excess sugar consumption causes you to gain weight or develop an oral health problem.
Not all sugar is bad for your teeth or your health. That's why nutritional recommendations distinguish between natural sugars and free sugars.
Checking nutritional labels in the supermarket can give you an idea of how much sugar is in your trolley, though with sugar being listed under more than 50 different names, this isn't always so simple.
The Australian Health Survey found that most free sugar in the average diet (81%) was consumed in discretionary food and drink – in other words, snacks and drinks that don't contribute many nutrients to the diet. Of these, more than half (52%) of sugar came from drinks, the remainder from confectionery, desserts and other processed food.
You may be surprised to learn that cakes and lollies aren't the worst overall offenders for tooth decay, but they still contribute to the total. In fact, with 32g or 8 teaspoons of sugar, a single blueberry muffin can put you over the WHO's daily limit.
A slice of cake is slightly less sugary at 5 teaspoons, sweet biscuits at 2 teaspoons, and a bar of chocolate at 1 teaspoon per block. Even cereal bars can be high in sugar at 1.5 teaspoons per bar.
Carbonated fizzy drinks are among the worst food and drinks for teeth, with a 600ml bottle of cola containing around 64g or 16 teaspoons of sugar (40g / 10tsp for a 375ml can).
Even low sugar options are still very acidic, which contributes to the erosion of tooth enamel and can make teeth even more prone to decay and injuries.
If soft drinks weren't bad enough, some sports drinks have as much as 67g or 16.8 teaspoons of sugar per 500ml serving – good for a burst of energy, less great for your teeth.
250ml cans of energy drinks contain around 27g or 6.8 teaspoons of sugar, above the average person's recommended daily limit.
Fruit juice and squash aren't a whole lot better for kids' teeth, as these can still be high in free sugars and acids. Just one glass of fruit juice can contain 25g or 6.5 teaspoons of sugar, comparable to a can of energy drink.
Whole fruit and fresh fruit juice are better for your teeth as they contain less free sugar, as well as being nutritious.
You don't have to give up all your favourite treats to be healthy, as long as you follow good oral hygiene and take other steps to protect your teeth. This includes:
Food and drink labels tell you roughly how much sugar is included in each serving. To stay within your daily limits, aim for 5g to 10g per 100g. One teaspoon is roughly equal to 4g of sugar.
It's not just what you eat and drink, but when. Sugary snacks and drinks do less damage to teeth when they're enjoyed at the same time as a meal, so your teeth have a chance to recover from acid attacks in-between.
The less time your teeth are in contact with sugar, the better. Avoid holding drinks in your mouth for longer than necessary and use straws to bypass the front of teeth.
Brushing twice a day helps to remove leftover sugar and reduce plaque on your teeth. You should also floss daily to clean the areas your toothbrush doesn't reach.
Chewing stimulates saliva, which helps to rinse the mouth and neutralise acids on the teeth. Just make sure the gum is sugar free!
Plain water is one of the best drinks for oral health and overall health, as it helps to rinse and hydrate the mouth. Tap water is better than most bottled water if your local water supply is fluoridated, as this helps to strengthen tooth enamel against plaque and decay.
Seeing a dentist and oral hygienist once or twice a year for a comprehensive check-up and clean improves your chances of spotting tooth decay and gum disease before they cause damage and preventing problems from developing in the first place.
If it's time for your check-up or you need to see a dentist, Face Value Dental has 5 convenient dental clinics in Brisbane CBD, Albert Street, Albany Creek, Helensvale and Toowong.
Australian Bureau of Statistics. Australian Health Survey: Consumption of added sugars, 2011-12 [Online] 2016 [Accessed January 2021] Available from: https://www.abs.gov.au/ausstats/abs@.nsf/lookup/4364.0.55.011main+features12011-12
Australian Dental Association. Rethink Sugary Drink [Online] 2012 [Accessed January 2021] Available from: www.rethinksugarydrink.org.au
Australian Dental Association. Sugar & Nutrition [Online] 2020 [Accessed January 2021] Available from: https://www.ada.org.au/Dental-Health-Week-2020/Oral-Health-for-Busy-Lives/You-are-what-you-eat-and-drink
Better Health Channel. Sugar: Are You Eating Too Much? [Online] 2016 [Accessed January 2021] Available from: https://www.betterhealth.vic.gov.au/-/media/bhc/files/infographics/bhcinfographicsugarv25.pdf