There are many things we like to put off till the next day, but for some strange reason, taking care of our teeth seems to be one of the most common. While weâre happy to spend hours looking after our hair, skin and even eyes, we barely devote two minutes a day to our teeth and ignore all the micronutrients that can help maintain them in tip-top condition âŠ
If you were asked to list the nutritional factors that prevent tooth loss, you might mention calcium and a low-sugar diet, but would you able to think of anything else?
Sadly, our ignorance soon comes back to haunt us: on average, we lose four teeth between the ages of 45 and 55 (1). And after that, everything speeds up: the figure rises to 10 teeth over the following decade, with 15%-30% of Western populations having lost all their teeth after their mid-sixties.
But by discovering the nutritional mechanisms that help prevent tooth loss, you could keep your teeth for an extra ten years or so, and even hold on to them into very old age. According to the WHO, dental infections resulting in tooth loss are among the chronic diseases that could be avoided through good nutrition (2).
We always under-estimate the importance of our teeth. Itâs only when we lose our first tooth that we realise just how crucial they are.
First of all, thereâs our smile, that tool of seduction we use to express pleasure, satisfaction and well-being. Looking at ourselves in the mirror, we immediately see the extent of the damage: âMy god, my smile is ruined âŠ it completely changes my face! I donât recognise myself âŠ â. This awful realisation is very often accompanied by a loss of self-confidence, and feelings of self-contempt and even shame. âWhat will people think? Theyâll say I donât take proper care of myself, that Iâve let myself goâ.
The negative psychological effects, which no medication can mitigate, will only get worse, especially as things arenât going to get any easier. If a tooth has fallen out prematurely, thereâs every chance that other teeth will soon follow. The way others look at you becomes hard to bear. When youâre missing certain teeth, the lips lose support, causing a gradual collapse of the lower part of the face. Facial expressions change completely (3).
Unfortunately, losing teeth doesnât just cause aesthetic problems. It also significantly increases the risk of several diseases. A trawl through the scientific literature reveals the following:
These health risks are in addition to the many constraints posed by wearing removable dentures or âfalse teethâ, the primary cause of bad breath in those over 50.
When you lose a tooth for the first time, itâs often when youâre doing something ordinary, like eating an apple or a piece of bread, for example. Itâs usually a molar or a premolar (canines are the teeth we keep the longest (8-10)). But whatâs the real reason for this tooth loss?
In fact, there are just four causes and they overlap:
âI tell thee, Sancho, a mouth without teeth is like a mill without a millstone, and a tooth is much more to be prized than a diamond;â, Cervantesâ Don Quixote
So what makes us get dental caries and periodontitis, the two main causes of tooth loss?
These two dental problems develop slowly. Throughout life, in fact.
Our mouths are host to billions of microorganisms from more than 1000 different species, most of which are beneficial for our health. Some float around in the oral milieu, some thrive on the tongue, while others stick to our teeth. Immediately after brushing, proteins in our saliva adhere to the tooth wall (this is the salivary biofilm) and attract harmless colonising bacteria. After a few minutes, theyâre joined by other bacteria, forming a complex habitat around which develops an increasingly strong barrier: dental plaque.
This plaque, which is constantly being added to by bacterial secretion products, poses no threat as long as the microorganisms developing in it are beneficial. Unfortunately, when we eat foods high in carbohydrates, particularly simple ones like sucrose, we encourage the growth of pathogenic bacteria within this plaque.
These bacteria are attracted by the plaqueâs sugary residues. They use it to produce vast carbohydrate chains, recruiting huge numbers of other similar bacteria. They then feed on these sugars and release lactic acid, a compound which is toxic to other bacteria and particularly harmful for the teeth.
Thereâs nothing as good as thorough brushing for getting rid of this unwelcome little community. It dislodges pathogenic bacteria from the teeth and removes the particles of sugary food that feed their growth. But itâs not enough. When we eat pasta for lunch (which is high in complex carbohydrates) or have a fizzy drink in the early afternoon (very high in sucrose), itâs likely that another eight hours will pass before our toothbrushes have the opportunity to remove the pathogenic bacteria that have accumulated.
So in the intervening period, they have plenty of time to break down the sugars and release acid. If the acidity in contact with the teeth falls below the critical pH of 5.5, tooth enamel starts to deteriorate. This happens frequently, particularly if you snack between meals. Bedtime brushing interrupts this deterioration but it will inevitably start again the next day! Itâs as if you have a team of workers digging a hole in your tooth who each morning tirelessly pick up where they left off the day before. This deterioration normally occurs in areas of the mouth that are difficult for the tongue and saliva to reach, such as the molars. The speed and intensity of this hole-digging depends on your diet and lifestyle. The higher your sugar intake, the bigger the team of diggers and the faster the hole will appear. If your mineral intake is less than optimal, the enamel will be less resistant and bacteria will find it easier to break through.
Then one day, after working for several months, years or even decades, the diggers reach the toothâs dentine. This is found beneath the enamel, the toothâs protective layer. From here on in, things move fast. Less mineralised than enamel, dentine is much less resistant to acidity: if the pH falls below 6.2, dentine will break down too. This means that from now on, you will not be able to tolerate the same intake of sugar as before. If a 60 year-old whose enamel has been âbreachedâ drinks a sugary drink, the consequences will be much greater than they would for someone in their 20s.
Thereafter, the hole in the tooth continues to get deeper, forming an actual tunnel, through which the pathogenic bacteria finally reach the toothâs pulp at which point the dental caries becomes particularly painful. But even thatâs not the end of it: if nothing is done, the bacteria can go on to attack the ligament, bone or gum, and even get into the bloodstream! And the tooth is hanging on by a thread âŠ
You might assume that brushing your teeth more often, say every hour, would be the right approach to preventing bacterial plaque from forming all the time. But in fact, itâs not: over the long term, excessive brushing damages the toothâs surface and actually encourages tooth decay. L'Union FranĂ§aise pour la SantĂ© Bucco-Dentaire (the French Union for Oral Health) thus recommends brushing twice a day, once in the morning and once at night, no more.
In fact, itâs best to tackle the problem with one of our natural weapons: saliva. We only realise how essential it is when the saliva glands are affected by disease or in the course of ageing. Saliva offers many benefits for combatting pathogenic bacteria:
If older people suffer more with dental caries, itâs also because saliva production decreases as we age. The same is true for smokers.
There are two ways of making the best use of this natural weapon:
Oral probiotics, an emerging field, offer the same advantage.
These beneficial bacteria, primarily from the strains Lactobacillus and Bifidobacterium, are able to check the growth of the pathogenic microorganisms responsible for tooth decay (12).
Though they come in a freeze-dried form, theyâre actually still âliveâ: once reintroduced into a soluble milieu like the mouth, they leave their dormant state and become active again. In order to colonise the environment and combat pathogenic bacteria, probiotics require nourishment from a specific food called fructooligosaccharides. Unlike simple sugars, these compounds act like soluble fibre in the body and as a result, are not converted by pathogenic bacteria. They are thus added to oral probiotic supplements to provide support to the âfriendlyâ bacteria, enabling them to compete with their âunfriendlyâ counterparts.
If you plan to try this ground-breaking new option, donât be fooled by appearances: rest assured that fructooligosaccharides are recognised as beneficial for health and have nothing to do with the sucrose responsible for dental caries. Even our taste buds can be taken in by them!
Saliva is a powerful weapon provided it has optimal composition. As this depends mainly on diet, itâs no surprise that deficiency in several micronutrients accelerates the process of tooth loss and disrupts the tooth remineralisation process (13).
Weâve known for decades that vitamin D maintains the structure of the skeleton, helps keep our bones and kidneys healthy, reduces the risk of cardiovascular disease, combats inflammation and stimulates the immune system (14). More recently though, weâve learned that it also significantly influences oral health. This is as a result of several actions:
A number of studies have thus shown that adequate vitamin D levels may help combat the development of periodontitis (affecting the tooth bone), one of the two causes of tooth loss. Vitamin D may prevent generation of the pro-inflammatory cytokines IL-1b and TNF-Î± both of which play a key role in the pathogenesis of periodontitis by causing bone resorption (destruction of bone tissue) and by impairing the healing process (15-16). A number of studies have also identified a link between a low intake of vitamin D (less than 800IU a day) and the presence of periodontal disease markers (17-19). Conversely, supplementation helps reduce loss of alveolar bone as well as TNF-Î± levels in the gums (20).br>
But thatâs not all - vitamin D is also effective when it comes to dental caries! Several studies have shown an association between low levels of circulating vitamin D and a higher risk of dental caries (21). Researchers have found, for example, that children with no tooth decay were two to three times more likely to have optimal vitamin D levels. Itâs a similar story when it comes to endogenous production of vitamin D from the sun: in the United States, the sunnier the region, the greater the vitamin D production and the lower the prevalence of dental caries (22).
A meta-analysis of 24 clinical trials recently confirmed these observations, demonstrating that vitamin D supplementation helped prevent dental caries (23). Other research has shown that almost all people who live at high or middle latitudes have inadequate vitamin D levels between the months of October and April.
Epidemiological studies suggest it may prevent both dental caries and periodontitis (28-30). And thereâs a clear explanation for this: the presence of calcium and phosphate in bacterial plaque and in saliva increases the remineralisation of enamel and reduces the adherence of bacteria associated with tooth decay (31-32).
Other factors highlighted by the scientific community:
In summary, if you want to hold on to your teeth for as long as possible, follow these eight recommendations:
Donât for a minute believe that losing your teeth is a normal part of ageing! In almost all cases, tooth loss is not directly linked to the ageing process but to the development of pathogenic bacteria.
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