Opinion: “Not just about how you brush, but also about what you eat”

Editor’s note: This opinion piece was penned by Schweitzer Fellows Jeanie Chung and Esther Lee as part of their required activities. The NC Albert Schweitzer Fellowship is a one-year interdisciplinary, mentored fellowship program focused on health-related community service and leadership development.

You go to the dentist twice a year, brush two times a day, and floss regularly. Despite following the usual regimen, you visit your dentist and hear those dreaded three words: “you have cavities.” According to the World Health Organization, dental caries is the most common disease worldwide in both children and adults.

However, nutrition and diet play an important role in your oral health. As dental students, we are taught the importance of asking questions about health history when meeting patients. The questions we ask are not limited to “How often do you brush?” but also include “What do you eat?”

We are told that “in moderation” is key, which is true when it comes to sugar intake. Yet we should also be thinking about other foods we eat that may increase tooth decay, how often we snack throughout the day and when we are eating.

Consider the following: a 56-year-old patient comes in saying that they snack throughout the day, eat chips and grapes in between meals, and drink soda for lunch and dinner. They also brush twice a day, floss and use mouth rinse. After completing a thorough clinical exam and receiving X-rays, the patient was shown to have active cavities on multiple teeth. As health care providers, it is our role to educate patients on good oral hygiene, including the discussion of nutrition. If the patient is eating snacks throughout the day, this increases the chance of bacteria and plaque accumulation occurring from components of saliva binding rapidly to the teeth surface. Lack of regular oral hygiene also can contribute to the problem by causing what researchers call “ecological succession” of cariogenic bacteria, which means biofilm accumulation will lead to more bacteria, which perpetuates the problem with time. Studies show that soda and juice consumption leads to increased tooth decay. For children ages 1-5, the American Academy of Pediatric Dentistry recommends drinking no more than 0.5 cup or 4 oz. of 100% juice per day. Another recommendation is to not eat or drink after you brush your teeth and before you go to bed, except for water. Imagine all the different salivary components that may adhere to your teeth throughout the night if you eat before you sleep.

So does this mean that you cannot eat any snacks or need to stop drinking all sugary beverages? No! Rather, our suggestion is that you take into consideration what you eat regularly and follow up with your dentist about your diet. Some changes that we might suggest are: limiting soda, sports drinks, and juices to meal times to lessen the frequency of exposure to sugars throughout the day. If you are a snacker, perhaps try to eat snacks that are lower in carbohydrates.

The next time you visit your dentist, talk with them about your nutrition and diet. Make nutrition a regular conversation in your dental appointments. Ask questions! And don’t forget, it is not just about what you eat, but also when you eat it, and how frequently you consume those carbohydrates!

Jeanie Chung, DDS ’25 and Esther Lee, DDS ’25

BCBS N.C. Schweitzer Fellows 2023-2024

UNC Adams School of Dentistry