In this interview of «Talks with health», I interview Neus López Nogueroles, a dentist at the Pfaff Clinic in Barcelona. With her we will talk about nutrition and oral health . I hope you find it interesting and don’t forget to subscribe to our Youtube channel so you don’t miss any of our videos.
Hello Neus, I would like to take advantage of the fact that I am with you to talk about the relationship between food and oral health. Everything we eat passes through our mouths and will surely influence. However, we usually don’t realize the importance of this until we are unhealthy and the discomfort begins.
Of course we do, because everything we eat passes through our mouth and affects our teeth, but not only is this the case, but also the state of our teeth or the occlusion itself affects how we chew and therefore, the digestion of food.
When they come to your consultation, do patients ask you questions about food to have a healthier mouth?
Yes, there are many questions they ask us about food and its relationship with teeth. Now the star question is, how does sugar affect my teeth or my children’s teeth? And then there is the field of aesthetics where the questions revolve around how certain foods affect the staining of the teeth.
How do coffee or tea stain teeth? Is this true?
Yes, coffee or dark tea have pigments, tannins, which make the tooth darker. When they come into contact with the tooth, they create a reaction that darkens the tooth.
And it won’t go away when washing them?
If it goes to wash them, but we must not abuse. Just don’t stop drinking coffee, but don’t abuse it. For patients who have undergone whitening, we recommend drinking coffee with a straw so that it does not come into contact with the teeth, in addition to brushing them of course.
Can taking acidic foods like lemon or tomato damage your teeth?
Acids when they come into contact with the tooth produce a chemical reaction that produces dental erosion that, if severe, produces sensitivity because the dentin is exposed. Of course we should not stop taking healthy foods such as fruit, but we must know that we should not abuse, for example, lemon water. We must also bear in mind that carbonated soft drinks, even if they are 0 sugars, do have acids that cause dental wear.
I love that you brought up the topic of lemon water because so many people prepare lemon water every day on an empty stomach. This from a nutritional point of view does not make any sense and now we see that from a dental point of view it would also be contraindicated.
Exactly, people believe that they can drink diet sodas between meals, very often and without brushing afterwards just because they do not contain sugar. In contrast, acids in contact with the tooth continue to cause dental demineralization, which is not good at all.
Why do people have cavities often or easily and others who have never had cavities?
This occurs because caries disease is multifactorial, that is, several things have to happen for it to appear. First of all, there must be a proliferation of bacteria in the mouth, on the other hand a diet rich in sugars, a time in which these sugars come into contact with the tooth and then the individual susceptibility of each person and each tooth. A molar where it is easier for the sugar to adhere is not the same as a flatter incisor.
But could we say that people who consume sugars in their day to day are more prone to tooth decay?
Indeed, since sugar is essential for the formation of cavities. When these sugars are metabolized, acids are created that remain in the tooth and destroy the mineral part of the enamel, thus causing cavities.
Now I want to talk about a topic that touches you and me closely since we are both mothers. I refer to the so-called bottle tooth decay. What about children who fall asleep on their mothers’ breasts or take a bottle at night? How is it related to cavities and what should be the correct practice
Luckily this is a topic that is seen less and less, since people are more aware of the subject, but it is true that it is a very frequent question in mothers. It is a type of tooth decay, which can occur both through the bottle, breastfeeding or pacifiers. When we put sugars or honey in the pacifier so that the child calms down or fruit juices in the bottles or most often it is to take advantage of the pull of the bottle so that the child falls asleep. When children are young, we must take care of cleaning their teeth, without this correct hygiene, sugar stays in the tooth and can cause cavities.
The same thing happens with breastfeeding, although it is true that with the nipple of the bottle, the adhesion of lactose is greater. What we must bear in mind is that in breastfeeding, milk is not the same at one time as another. Maintained milk, when the child is a few months old, has a high amount of carbohydrates, more than cow’s milk, this is what is then fermented producing cavities. Breastfeeding of course is very good, but we cannot think of a prolonged lactation in time to induce the child’s sleep. This is very comfortable and I understand it because I am a mother, but then we must clean the child’s teeth to avoid an infectious picture of cavities that can become very serious.
Now that we talk about brushing, I am very struck by the number of people who, when brushing their teeth, see that they bleed. Could this have something to do with eating? Could this be the effect of a lack of vitamin C or another nutrient?
Nowadays, seeing scurvy in Spain, which is a severe deficiency of vitamin C, is very rare. It is true that in any malnutrition, there will be fewer defenses and dental problems can increase. However, it would be very strange if the bleeding took place only because of this deficit. Each specific case would have to be studied to assess the causes.
Are there any nutritional deficits that we can see directly in the mouth?
We would have to speak of severe malnutrition, but it is true that a deficit in calcium, phosphorus and vitamins A and D can cause alterations in the development of teeth. It is not something that we see every day, but it is true that malnourished children take longer to erupt their teeth or the enamel is not of good quality.
Is there a specific food that can help us maintain a healthier mouth? Or one that you recommend eating every day or every week for being a source of health for our mouth?
We must eat a healthy diet, avoid sugars and try to include foods that provide us with calcium, phosphorus … Yogurts, milk, cheese, green leafy vegetables, eggs, legumes, fish …
A difficulty that I find in consultation when dieters come, appears when people who wear orthodontics visit and they tell me “I can’t eat this” “don’t give me a breakfast sandwich, because I won’t I can bite ”… etc. What is true in all this? What foods cannot a person who wears orthodontics eat?
If it is true that, for example, in the case of braces, we recommend that you avoid taking very hard things that can lower the braces. This is due to the fact that the treatment is not prolonged. Food that sticks and is difficult to clean should also be avoided. I always say eat everything but with common sense
I have also encountered a patient who feels some pain when chewing or when eating hard food, some noise. What could this be due to?
Every day we see it more, it is about TMJ problems, which is the temporomandibular joint. What happens in many cases is that patients come to the consultation desperate, after having gone to many specialists without finding the cause of the problem. It is a pain that usually worsens when eating and radiates to the neck and head. Often people are not even clear that the source of the problem is in the mouth. When these cases come to us, we recommend a soft diet while we carry out a joint study to see what happens. What usually happens is that the jaw joint is not in place when it is at rest and this causes pain. The treatment would consist of focusing the occlusion where the joint is at rest so that they can lead a normal life without pain.
One of the things that makes parents very desperate – before we talked about children – is their children eating excessively slowly and they need a lot of time and patience to finish a plate. Is this normal or when would we have to worry about the child having difficulty chewing?
Here we would have to see what type of occlusion the child has because it is true that malocclusions affect the time of biting. It is not the same when, for example, biting a piece of meat, a child who has a perfect occlusion and bites with all his teeth and teeth to a child who has an open occlusion and bites with only four teeth. It remains to be seen if this could be the reason why it takes so long to eat.
Once, in a conversation, you explained to me something that as a nutritionist caught my attention and that is that you, with a normal, routine check-up, are able to detect if someone has an eating disorder in function of the health of your teeth Can you explain this a bit?
Not in all cases. But for example in patients with bulimia or with repetitive vomiting, these acids occur as in the case of soft drinks, with the difference that in this case the acid comes into contact with the inside of the teeth producing dental erosion and exposing the dentin.
So a person who has a hiatal hernia or chronic gastritis could also be affected?
Exactly. In these cases, people must pay special attention to brushing their teeth. The problem is that brushing does not remove all of this acid. This enamel can no longer be recovered and we should restore it with repair techniques or prosthetics depending on the severity of the case.
The last question. For children who eat candy. What advice can you give parents? To what extent does it influence oral health?
Keep in mind that sweets are the main source of cavities, so you have to know that the sweet foods that affect the most are sticky solids, then solids and then liquids. But the problem is not only in sweets, but also in sugary juices and other high-sugar products. The frequency with which they are taken is also very important. It is preferable for a child to eat 20 trinkets a day than to eat 3 a day. The less frequency of candy they drink, the better. Let’s not forget that bread, pasta, rice are also starches that produce fermentation sugars that also cause cavities. Another possible source is the medications we give them that often have a very high dose of sugar. Sugar is everywhere and therefore we must be careful.
It is very important to also incorporate habits. Introduce brushing as a game to the child, brushing with them daily … Parents should also avoid habits such as tasting food from the child’s spoon or cleaning the pacifier with our mouth. In this way they are not protecting their children but quite the opposite, since they are introducing their careogenic bacteria in their mouth.
Thank you very much Neus for clarifying all these doubts.
Thank you very much Júlia