Thursday 17 August 2017

Hidden hazards... dental rot

We pay lip service to dental care, but we are taking the durability of our teeth for granted, says one oral surgeon.

How much sugar is in your fizzy drink?
How much sugar is in your fizzy drink?

Ailin Quinlan

The sight of children and teenagers gulping sweet drinks is so common most of us hardly notice it any more.

But to some, it's like a red rag to a bull. Consultant endocrinologist and anti-obesity campaigner Donal O'Shea has publicly warned that sweet drinks are one of the biggest factors in childhood weight gain and has called for a sugar tax to be slapped on them.

Now, another expert has come out against these drinks, warning that regular consumption of them attacks the teeth in not one, but several different ways.

Professor David Harris, a specialist oral surgeon in Blackrock Clinic Dublin and an associate professor in the field of implant dentistry in Trinity College, has added his voice to the growing opposition to the casual consumption of sweet drinks.

There are three reasons why fizzy drinks are terrible for our teeth - bubbles, sugar and intermittent daily consumption - warns Harris, who has just written a book about the issue of tooth loss, The Dental Amputee: What Everyone Who Loses their Teeth Needs to Know.

Think about it. Your teeth basically consist of a hard mineral called enamel. When enamel comes into contact with anything acidic, it starts to decay.

The fizz in fizzy drinks is a gas called carbon dioxide.

In the mouth, explains Harris, this gas dissolves to form an acid called carbonic acid, which attacks the tooth enamel - and this is the first tranche of the attack.

The second reason lies in the sugar contained by the drinks - sugar 'feeds' the bacteria which cause decay:

"If these fizzy drinks also contain sugar, they are even more harmful as this encourages the growth of types of bacteria that will cause decay," he explains.

The third problem lies in the intermittent daily consumption of such drinks - in other words, sipping them at different times during the day.

Although the acidity of the mouth is kept under control by saliva, this natural protection is undermined if fizzy drinks are taken at regular intervals throughout the day.

"It is the intermittent consumption of sugars and starches throughout the day that causes most problems," says Prof Harris, who explains that starches break down into the sugars that the bacteria feed on.

When consumption of such products is restricted to meal times, it is less harmful.

The problem is, he believes, although parents and teenagers alike are aware that fizzy/sugary/starchy snacks and drinks are bad for the teeth, they may not understand how or why, so the message about not drinking or eating them simply doesn't 'go in'.

"If you walk through a park, you'll see school students drinking fizzy drinks and eating crisps and chocolate.

"Crisps, for example, are high in starch, which breaks down into the sugars that promote the growth of bacteria causing tooth decay," he warns, adding that if people knew what it was like to live without their teeth, it might motivate them to take better care of them.

"If you lose several or all of your teeth, you'll have to convert to dentures.

"But although there's the impression out there that dentures are the end of all your problems, they're only the beginning."

If you don't look after your teeth, you may slowly begin to lose them, he warns. "And if, over a period of time, you're continually having teeth extracted, you're essentially starting out on a path which results in the other teeth starting to move."

This upsets the balance in your mouth and can lead to further deterioration, he warns.

"If tooth loss happens in a front tooth, people will do something about it. Often, however, people don't think back teeth matter, but they do. If you start losing back teeth, the teeth will start to move in the front of the mouth, and this can lead to premature loss of other teeth."

While you might lose several teeth and suffer little or no impact, tooth extractions can also spark off a chain of discomforting events where the other teeth "start to drift" - and a few years later, more teeth have to come out.

Most of the young people Harris sees are those who may have lost their teeth through a trauma of some kind, such as an accident.

But not all.

People are now living longer - and eating more sugar - than ever before.

"Teenagers and people in their 20s think this could never happen to them, but it can and it does - we see people in their 20s and 30s who had to get dentures because of neglect in earlier years.

"Young people cannot imagine wearing dentures, but one of the most common psychological aspects is that they worry about playing sports and have to take their dentures out."

They worry that it's noticeable to others, he says, adding that there's little or no public sympathy for people who have lost their teeth.

"People see it as a joke."

Those who seriously neglect their teeth will suffer the consequences, he warns, adding that many elderly people who have lost all their teeth have discovered that quality of life without teeth is "hugely different to quality of life with teeth."

"One of the things that people fear is that other people will laugh at them. Young people can be very diminished by this and worried if they are starting a relationship that this will interfere with it so they feel insecure about it.

"We have patients who have stopped doing all sorts of things - playing sports because they had to get dentures."

Some will continually put their hand over their mouth when they speak for fear that the dentures will move or will be noticeable, while others have even given up swimming.

But there are other, even more intrusive, lifestyles issues.

"If you have a large denture it can affect your ability to chew food so it can affect what you eat. Eating can become about what you can manage to chew rather than what you would like to eat.

"We have loads of people in their 40s who would be in this situation through a combination of factors; neglect, lack of access to dental care or gum disease which is a very common disease and, if left untreated, can progress and lead to loss of teeth."

Bleeding is the first sign of gum disease he warns - although some people may not spot it if they don't brush their teeth regularly, or if they are using coloured toothpaste.

The bleeding will eventually stop, but all that indicates, he warns, is that the problem has gone deeper.

"If you go to the dentist in the early stages it will simply be about having the gums cleaned.

However, if it is ignored it can lead to tooth loss, as advanced gum disease can result in a complete loss of teeth.

"The cost of neglecting your teeth is very high, and people don't realise that," warns Harris.

If you lose a "critical mass" of teeth it can result in visible physical changes - your jawbone shrinks, which can potentially change the shape of your face.

* 'The Dental Amputee' by Professor David Harris is published by Londubh Books priced at €14.99.

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