The Power of Proper Nutrition

Frequency beats quantity

Every time sugar reaches the teeth, the bacteria in plaque produce acid for roughly twenty to thirty minutes. During that window enamel loses minerals. Saliva then neutralises the acid and puts some of those minerals back.

Eat a whole packet of biscuits in one sitting and you get one acid attack. Eat one biscuit every hour for six hours and you get six, with barely any recovery time in between. The second pattern is far more destructive even though the sugar total is lower.

This is why sipping sweet tea, coffee with sugar or soft drinks through the afternoon does more damage than dessert after dinner. If you are going to have something sweet, have it with a meal and be done with it.

The foods that help

Dairy is genuinely protective. Milk, curd, paneer and cheese supply calcium and phosphate, and cheese in particular raises the pH in the mouth after a meal. A small piece of cheese after something sweet is an old trick that actually works.

Crunchy raw vegetables and fruit stimulate saliva, which is the body's own buffer. Water between meals rinses food debris away and keeps saliva flowing. Green leafy vegetables, nuts and fish support the bone that holds the teeth in place.

• Milk, curd and cheese for calcium and phosphate
• Crunchy fruit and raw vegetables to stimulate saliva
• Plain water between meals rather than sweetened drinks
• Nuts and fish for the bone supporting your teeth

The hidden acids

Sugar is not the only problem. Acidic drinks dissolve enamel directly without any help from bacteria. Lemon water, aerated drinks, packaged fruit juice and sports drinks all sit low on the pH scale.

If you drink them, use a straw so the liquid bypasses the front teeth, and do not brush for at least thirty minutes afterwards. Enamel is temporarily softened by acid, and brushing during that window scrubs it away.

What we see in Anakaputhur

Two patterns come up repeatedly in our chairs. The first is children who go to sleep with a bottle or after a sweet, so sugar sits on the teeth all night when saliva flow is at its lowest. The second is adults who chew tobacco or areca nut, which damages both the gums and the soft tissue lining of the mouth.

Neither is fixed by better brushing alone. Both are worth raising at a check up so we can look at the specific pattern rather than giving generic advice.