Sugar Shock Hidden in seemingly innocuous foods is your pearly whites’ worst enemy

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Walking into Dr. Mark Lausier’s waiting room, patients will find the usual stack of well-thumbed magazines and benign wall art found in most dentists’ offices. One thing, however, will catch the eye.

A shadow box – the size of a small bulletin board – hangs prominently on the wall. It contains several shelves stocked with common foods and drinks. In front of each is a small plastic bag containing the amount of sugar found in that item. For instance, such seemingly healthful choices as a bottle of Kraft Catalina fat-free salad dressing or a pouch of Capri Sun fruit drink actually have a high sugar content. Even chalky-tasting Tums antacid tablets are largely made of sugar.

Lausier, who has been in private practice for 28 years, and his staff put up the graphic display to boldly drive home the correlation between sugar and tooth decay.

“We’re seeing a big upturn in cavities from young children to teenagers now,” the dentist said. “There was less decay 10 to 15 years ago than now, so we’re assuming it’s dietary in nature. We started looking at how much sugar is in different products, and we were surprised.”

Lausier and other dentists see the phrase “sweet tooth” as an oxymoron.

For years, dental professionals have sought to inform their patients about the causal link between sugar, both refined and natural, and tooth decay in children.

Before examining this sticky situation further, it’s necessary to understand sugar’s relationship to tooth decay. Like many people, the bacteria inside people’s mouths enjoy eating sugar, and when they digest it, they secrete acid onto the tooth’s surface, or enamel. Plaque on the enamel helps to amplify the effect of that acid, keeping it trapped against the tooth rather than allowing it to be washed away by saliva. Too much acid leads to cavities in the enamel, and if the acid gets past that protective layer, then it will eat away at the dentin layer inside, which can result in even more extensive dental repairs.

So the solution to tooth decay comes down to prevention, either by not eating the offending sugars in the first place or, failing that, brushing and flossing the acids away before they have the chance to set and damage the tooth.

Sugary products are everywhere these days, with TV shouting out their merits at every turn. This has led, over the past decade, to an increase from 120 to 150 pounds of sugar per child consumed annually.

There’s plenty of blame to go around for this situation. Just ask Dr. John Frachella, who for the past 32 years has been a pediatric, public-health dentist at the Bangor Children’s Dental Clinic. As such, he ends up treating difficult-to-manage cases of patients who haven’t the means for regular, private dental care.

With Frachella’s constituency, the biggest problem is “soda, soda, soda – it’s all about soda. It’s become a daily habit for kids and young adults who keep it in their mouths all the time.”

Common sense tells us that nondiet soda has plenty of sugar in it. But that’s only part of the equation, Frachella said, as its acidity must be considered as well. Pure water has a pH of 7, while battery acid has a pH of 1. Here’s where some popular drinks fall: Coke Classic, pH 2.3; Hawaiian Punch, pH 2.82; Gatorade, pH 2.95.

“The soda bores a hole in the tooth, then pours sugar into it,” Frachella said. “There’s not enough fluoride in the world to combat that.”

As an example, he talked about a recent 16-year-old patient: “His teeth looked good, but when I took X-rays, they were literally shells, hollow with decay and riddled with tiny pinholes. I asked him how much soda he drinks, and he said a fair amount, up to 3 or 4 liters a day in the summer.”

When he started out, Frachella thought that fluoride would be a miracle drug for dentistry: “I thought if we optimized topical and systemic fluoride, that we would eliminate tooth decay in 30 years. I was naive, and didn’t foresee that we would be drinking battery acid by the tens of thousands of liters, thanks to the sugar lobby in the United States. And the American Medical Association and the American Dental Association have caved to them, taking grant money from the sugar industry.”

Even those profitable soda and snack vending machines at schools are part of the problem: “In the long run, what are those costing the parents and the kids, in terms of not just tooth decay but diabetes and obesity,” Lausier pondered.

Parents try to do right by their children, but don’t always follow through or even know what direction right is.

“Fruit is good for you, so juice must be too,” said Dr. Jonathan Shenkin, a pediatric dentist in Bangor, explaining parents’ reasoning. “Give them a sippy cup of juice and they’re quiet. But the American Academy of Pediatrics recommends only 4 to 6 ounces of juice a day for children ages 1 to 6. Also, parents are unwillingly to make children brush. But kids who have early decay are more at risk later. That path of least resistance is getting a lot of kids in trouble.”

Lausier added, “There’s things our parents wouldn’t allow us to do that we allow our kids to do. There’s a lot more choices now.”

One place for parents to start is by reading labels on foods, keeping an eye peeled for ingredients such as high-fructose corn syrup, a very common form of sugar.

“It’s what people put in their grocery carts,” Lausier said. “The American diet has changed over time. There used to be less prepared foods. We’ve lost track of what they’re putting into the food.”

As in many other areas, parents need to set a good example.

“[Sugar] is a bad way to fuel your body,” Frachella said. “You get a quick burst of energy, then you hit the wall. Until parents understand that for themselves, they can’t help their kids, because their heart isn’t in it.”

Cutting back on sugar is beneficial.

“Watering down the juice can help, as can limiting the amount of exposure,” said Shenkin, one of two board-certified pediatric dentists in Maine. “If you give a child juice with a meal, give them water in between meals.”

Adjusting children’s diets would be the best way to reduce tooth decay. Those unwilling to make that change need to be religious in their brushing.

“If they’re going to eat this kind of food, they have to be much more careful in their dental hygiene,” Lausier said. “They should brush three times a day. Also flossing gets overlooked a lot. Where the two teeth touch is where cavities start in kids.”

The dentists interviewed said that advancements such as sealants and fluoride varnish aren’t enough to overcome bad dental habits.

“Fixing the teeth is treating the symptoms,” said Shenkin, an assistant clinical professor of health policy, health services research and pediatric dentistry at Boston University. “The disease process still exists.”

Frachella added succinctly: “It’s a pandemic. We have met the enemy, and it is us.”

What’s the solution? There isn’t any easy one, Frachella said.

“It means changing the entire social structure,” he said. “Kids are going to have to figure it out themselves, in a revolution that generates from pain and discomfort. That social consciousness is going to have to happen from inside.”

Good habits taught early will serve children well as they grow older.

“The worst time is ages 8 to 20,” Lausier said. “If you can get through that time, you’ll probably do all right as an adult. I’m seeing a lot more cases of breakage and wear and tear [among adults], because people are keeping their teeth longer.”

Dale McGarrigle can be reached at 990-8028 and dmcgarrigle@bangordailynews.net.