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“What is the strongest substance in the body?” If this question comes up on trivia night, be prepared to impress your team when you confidently answer, “Tooth enamel!”

Tooth enamel? The reason for this surprising answer lies in the biology of our teeth. Minerals make up well over 90% of our enamel, a much higher percentage than is found anywhere else in the body, including our bones. But unlike bone tissue, which can heal and regenerate, tooth enamel cannot. Even though it is extremely strong, enamel can be damaged by a process called demineralization.

Demineralization

Demineralization is a result of acids at work in our mouths. Acids actually break down the minerals in our enamel, making the enamel softer. Over time, bacteria attack deeper into the tooth, eventually leading to decay. Acidic foods like sodas, citrus, pickles, and coffee are obvious culprits in providing an acidic environment, but there are other problem foods as well. We all have bacteria in our mouths, which can be helpful or harmful. The bacteria in plaque use the sugars and starches we eat to produce even more acids.

This process is something that takes place very quickly. In fact, even brushing too soon after eating something acidic can damage the demineralized surface of a tooth. Waiting at least 20 to 30 minutes to brush gives our bodies a chance to restore the enamel surface in a process called remineralization.

Remineralization

Our bodies are actually designed to help protect our enamel, and the most important part of this process is saliva production. Saliva cleanses our teeth and reduces levels of acidity. And our saliva constantly washes important minerals over our teeth. Calcium and phosphate ions rebuild and strengthen molecules where demineralization has taken place. This process is called remineralization.

We have other ways to help the remineralization process along. Fluoride toothpastes and fluoridated water speed up the movement of mineral building blocks back to the surface of the tooth. Fluoride also strengthens our teeth so that they resist acids and demineralization better than teeth without fluoride, making them less vulnerable to cavities.

New products are available for home and professional use that are designed to increase remineralization—talk to Dr. Werner at our Los Gatos, CA office if you would like the latest recommendations. In fact, talk to us about tooth-friendly menus, the best toothpastes, brushing techniques, and all the ways to keep your enamel its healthiest. You’ll be answering all those trivia questions with a strong, confident smile!

Scientists have discovered tooth decay in specimens that are more than 15,000 years old. The ancients once thought that cavities were caused by something called “tooth worms” … Eew! They didn’t exist, of course, but how else could humans explain the holes that cavities make in teeth?

The appearance of cavities on a widespread basis is often traced to the rise of farming. The new diet filled with grains and carbs made our mouths a haven for cavity-causing bacteria. As we added more sugar to our diets, our teeth got worse.

The “tooth worm” idea didn’t completely disappear until the 1700s when scientists finally began to understand the process of dental caries. Once that part of the puzzle was solved, they began focusing on filling existing cavities and preventing new ones.

Dental Fillings Come of Age

Many different materials, including beeswax, cork, aluminum, tin, and even asbestos, have been used to fill the holes caused by dental decay. Sometime in the mid-1800s, however, dentists began to use metal fillings such as gold, platinum, silver and lead amalgams.

The amalgam we use today is mixed from liquid mercury, silver, tin, copper, zinc, and other metals, but some patients still like the look of a gold filling. Newer options include composite-resin fillings, which are made from a tooth-colored mixture of plastic resin and finely ground glass-like or quartz particles that form a durable and discreet filling. Porcelain or ceramic fillings are natural in color, but more resistant to staining.

Dr. Werner can help decide which filling is best for you, based on cost as well as your dental and lifestyle needs. You may not have “tooth worms,” but if you have cavities, contact our Los Gatos, CA office so we can take the proper action to protect the health of your mouth.

Some languages have many different words for love. Some have many different words for snow. One language even has different words for a tasty layered sandwich. Is that a hoagie or a hero you’re having? A sub? Grinder? Po’boy?

“Sugar,” though, is a single word which has taken on many meanings, from casual endearment to monosaccharide molecule. Today, we’re examining scientific definitions, with a short and sweet look at the science of sugar.

Chemistry

First, let’s get basic—all the way down to the molecular level.

Carbohydrates, fats, and proteins are the three essential macronutrients which keep our bodies running. Sugars are molecules made of carbon, hydrogen, and oxygen atoms, and all carbohydrates are made of these sugar molecules, from single unit structures to very complicated chains.

Sugars called monosaccharides are the most basic of the carbohydrates. “Monosaccharide” comes from the Greek words for “single” and “sugar,” and monosaccharides are the sugars we mean when we talk about “simple sugars.” Why are they simple? Because a monosaccharide is a single molecule which can’t be broken down into smaller carbohydrates.

While there are several types of monosaccharides, the three major simple sugars are:

• Fructose—the sugar we get from fruit.
• Galactose—the sugar found in milk.
• Glucose—the sugar our bodies use the most. It’s found in plants, and also produced when our bodies break down other carbs. Fun fact—this is the only sugar essential for brain cell function.

When two monosaccharide molecules join together, they form a disaccharide (not surprisingly, from the Greek for “two sugars”). Again, there are quite a few disaccharides, but we tend to concentrate on three in our diets:

• Lactose (glucose + galactose)—found only in milk and dairy products.
• Maltose (glucose + glucose)—the sugar chiefly produced by grains.
• Sucrose (glucose + fructose)—produced in plants. These plants include sugar cane and sugar beets, from which we get our refined table sugars.

The reason sugar molecules are so important is because of how our bodies use them.

Biology

Our bodies use the glucose in carbs for energy. As foods break down, first through digestion and then in the cells, the chemical bonds which hold glucose molecules together break as well. This action releases energy, and this energy fuels all our bodily functions.

But even though we need carbohydrates to keep our bodies going, and even though sugars are the easiest carbs to use for energy, there’s a reason no one recommends a diet filled with extra sugar.

Our bodies get all the sugar they need from the natural sugar in the foods we eat. Natural sugars are found in fruits, dairy products, even some vegetables and grains. Along with that sugar come vitamins, minerals, antioxidants, fiber, and/or protein.

Extra sugars added during baking or mixing or processing for flavor and sweetness provide none of these nutrients. These sugars are known as “added sugars,” and have more serious consequences than just empty calories.

Once we have the sugars we require, there’s no need for more. Extra sugars are stored in liver, muscle, and fat cells for later use. When we eat too much sugar, this carefully balanced system is upset, with negative effects for, among other things, weight, blood sugar, insulin levels—and our dental health.

Nutrition and Dental Health

You know that a sugar-filled diet often means a cavity-filled checkup. Why? Because it’s not just our bodies that break down sugar for fuel.

The oral bacteria in plaque also need sugars for food, which they use to make acids. An acidic environment in the mouth weakens and dissolves the minerals which keep tooth enamel strong. And these weak spots are vulnerable to decay. A steady diet of sugar-filled foods means that your enamel is constantly under acid attack.

Cutting down on added sugars is one of the easiest and best ways to cut down on added cavities. Reading recipes, checking out labels, learning to recognize added sugars—this is nutritional research which has sweet results.

How to recognize added sugars? Here’s where language gives us plenty of words to fill our linguistic sugar bowl. Whether the ingredients are called agave nectar, honey, molasses, syrups, treacle, or table sugar, they’re really just sugar. More specifically, they’re all sugars made up of glucose and fructose, with at best a trace amount of vitamins and minerals—and usually not even a trace!

To make our lives easier, labels on food packaging now let us know exactly how much of the sugar in any product is “added sugar.” You expect to find a high percentage of sugar on dessert labels, but you might be surprised to read how much sugar is added to foods like energy drinks, sports drinks, flavored yogurts, cereals, spaghetti sauce, and many more of the items in your grocery cart. Spend an extra minute examining the label, and save yourself many empty calories.

Monosaccharides, disaccharides, glucose, fructose, maltose, agave syrup, treacle, and on and on—so many words for so many kinds of sugar. When it comes to dental health, let Dr. Werner have the last word on sugar science. During your next visit to our Los Gatos, CA office, talk to us about reducing unnecessary sugars in your diet for a future filled with the sweetest of healthy smiles.

Sugars are the simplest carbohydrates, and are found naturally in fruits, vegetables, grains, and dairy products. Our bodies require these simple carbs for energy. (Even better, we don’t just get energy from fruits, vegetables, grains, and dairy—we also get healthy amounts of vitamins, minerals, antioxidants, fiber, and even some protein!)

Problems arise when we get too much of this good thing. Once our bodies have all the sugar they need for immediate energy, they store extra sugars in liver, muscle, and fat cells. Over time, excess dietary sugars can affect weight and blood sugar levels, with potentially damaging results.

And, of course, sugar has an immediate effect on our oral health. The oral bacteria in plaque also need sugars for energy, which they use to make acids. An acidic environment in the mouth dissolves the minerals, which keep our tooth enamel strong. And these weak spots are vulnerable to decay. A steady diet of sugar-filled foods means that your enamel is constantly under acid attack.

So it’s really no wonder we hear a lot about avoiding “added sugars” in our diets, for both our general health and for our dental health in particular. But the concept of “added sugar” can be a bit misleading. If you’re not putting five spoons of sugar on your breakfast cereal, or pouring half a jar of honey in your tea, or using a recipe that calls for a cup of corn syrup, you might think you’re avoiding added sugars altogether. And that’s just not the case.

When dieticians talk about added sugars in our foods, they mean additional refined sugars (like white and brown sugars and corn syrup) that are used in preparing or processing foods.

Unlike unprocessed foods, which have been minimally treated to keep them as natural as possible, processed foods have been baked, or frozen, or mixed with other foods, or somehow changed from their natural state. This is where “added sugars” come in. Both home cooks and commercial processors use sugar to improve flavor, provide sweetness, and extend shelf life when preparing food.

What are some of the worst offenders? Store bought or homemade desserts like cakes and ice cream are prime candidates. Sodas? Most definitely. But it’s not just the obvious culprits. Added sugars are found in many foods we usually think of as healthy, including:

• Smoothies
• Fruit Drinks
• Energy Drinks
• Granola Bar
• Power Bars
• Breakfast Cereal
• Flavored Yogurt

While eating unprocessed foods is one way to make sure you get no added sugars, you can also eliminate many grams of sugar from your daily diet by trying out low-sugar recipes and choosing processed foods with little or no added sugar.

How to avoid unexpected added sugars? Fortunately, new labelling on food packages lets us know not only how much sugar is in any product, but how much added sugar has found its way into our grocery cart. Take a moment to check out labels, and avoid sugary surprises.

Your body can get all the natural sugar and carbs it needs for energy from a healthy, well-balanced diet. Lowering your added sugar intake won’t deprive your body of necessary nutrients, but it will deprive oral bacteria of their most convenient food source and reduce the amount of acids, which threaten your enamel. In fact, subtracting extra sugars is one of the easiest and most effective ways to add to your dental health!

If you have any questions about reducing your sugar intake, be sure to ask Dr. Werner the next time you visit our Los Gatos, CA office.