A dynamic relation exists between
sugars and oral health. Diet affects the integrity of the teeth; quantity, pH, and composition of the saliva; and plaque pH.
Sugars and other fermentable
carbohydrates, after being hydrolyzed by salivary
amylase, provide substrate for the actions of oral bacteria, which in turn lower plaque and salivary pH. The resultant action is the beginning of
tooth demineralization. Consumed
sugars are naturally occurring or are added. Many factors in addition to
sugars affect the caries process, including the form of food or fluid, the duration of exposure, nutrient composition, sequence of eating, salivary flow, presence of
buffers, and
oral hygiene. Studies have confirmed the direct relation between intake of
dietary sugars and
dental caries across the life span. Since the introduction of
fluoride, the incidence of caries worldwide has decreased, despite increases in
sugars consumption. Other dietary factors (eg, the presence of
buffers in dairy products; the use of sugarless
chewing gum, particularly gum containing
xylitol; and the consumption of
sugars as part of meals rather than between meals) may reduce the risk of caries. The primary public health measures for reducing caries risk, from a nutrition perspective, are the consumption of a balanced diet and adherence to dietary guidelines and the dietary reference intakes; from a dental perspective, the primary public health measures are the use of
topical fluorides and consumption of fluoridated water.