Chew gum containing xylitol to reduce the activity of cavity-causing bacteria
Inhibit cavity-causing bacteria by adding lactobacillus GG to children’s milk
Cut down on cavity-causing bacteria by avoiding sugary foods that stick to your teeth or stay in the mouth for a long time
Tooth decay is the gradual breakdown of the tooth, beginning with the enamel surface and eventually progressing to the inner pulp.
Tooth decay is caused by acids produced by certain mouth bacteria in dental plaque. Factors that affect this process include oral hygiene, diet, meal frequency, saliva production, and heredity. Teeth with significant decay are said to have caries, or cavities.
People with tooth decay may have tooth pain, including sensitivity to cold food and drinks.
The ADA recommends regular tooth brushing—daily brushing, ideally after each meal.1 Although thorough brushing varies from person to person, five to ten strokes in each area should be adequate.2 Toothpastes containing 1,000 to 2,500 ppm (1 to 2.5 mg per gram) of fluoride have been shown to reduce caries risk.3
A recent population survey found blood lead levels were associated with the amount of dental caries in children and adults. The authors estimated that lead exposure is responsible for roughly 10% of dental caries in young Americans.4 For this and other health reasons, known and potential sources of lead exposure should be avoided. Common sources of lead exposure may include paint, foods grown near roadways, and water from lead pipes.5
|Choose whole grains and unprocessed foods||
A diet high in whole grains and low in processed foods is a healthful choice that probably helps defend against tooth decay.
It has been noted for over 50 years that the incidence of tooth decay is low in people of traditional rural societies, such as Eskimos and African Bantus. However, the incidence of cavities increases as their diets begin to include more “westernized” processed foods.6 Although many different factors have been implicated in this observation, including refined flours,7 , 8 inactivation of vitamins by heating foods,9 and sugar intake,10 no single agent has been found responsible. Nevertheless, a diet high in whole grains and low in processed foods is a healthful choice that probably helps defend against tooth decay.
|Pass up sticky sweets||
Cut down on cavity-causing bacteria by avoiding sugary foods that stick to your teeth or stay in the mouth for a long time.
Sugar, especially sucrose (table sugar), appears to be required by the oral bacteria for the production of tooth decay. This finding has caused sugar to be widely blamed in the popular press as the primary cause of dental caries. However, caries incidence has recently declined in a time of increasing sugar intake.11 This has led to a reevaluation of caries causation, and sugar is now understood to be only one of the factors in the development of tooth decay.12 Nearly as important as the total amount of sugar intake seems to be the consistency of the sugary foods and the length of time they are in contact with the teeth. Dry and sticky foods tend to stay in contact longer, causing more plaque formation.13 Still, reduction of total dietary sugar is probably the most accepted dietary recommendation for the prevention of dental caries.14
Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.
For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.
3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
Add 5 to 10 x 10e5 CFU per ml to milk or formula
Supplementing with probiotics may inhibit cavity-causing bacteria.
In a double-blind study of children aged 1 to 6 years, supplementation with Lactobacillus GG five days a week in milk for seven months reduced the incidence of cavities by 49%, compared with unsupplemented milk.15 The amount of Lactobacillus added to the milk was 5 to 10 x 10e5 CFU per ml.
Chew gum containing xylitol regularly
Chewing gum with xylitol, a sugar substitute, may reduce the activity of cavity-causing bacteria.
Certain sugar substitutes appear to have anti-caries benefits beyond that of reducing sugar intake. Children chewing gum containing either xylitol or sorbitol for five minutes five times daily for two years had large reductions in caries risk compared with those not chewing gum. Sorbitol is only slowly used by oral bacteria, and it produces less caries than sucrose.16 Xylitol gum was associated with a slightly greater risk reduction than sorbitol gum.17 Bacteria in the mouth do not ferment xylitol, so they cannot produce the acids that cause tooth decay from xylitol.18 A double-blind study found 100% xylitol-sweetened gum was superior to gum containing lesser amounts or no xylitol.19 Another study found xylitol-containing gums gave long-term protection against caries while sorbitol-only gum did not.20 Other research has confirmed the anti-caries benefits of xylitol in various forms, including gum,21 chewable lozenges, toothpastes, mouthwashes, and syrups.22 Mothers typically transmit one of the decay-causing bacteria to their infant children, but a double-blind trial found that the children of mothers who regularly chewed xylitol-containing gum for 21 months, starting 3 months after delivery, had a greatly reduced risk of acquiring these bacteria,23 , 24 and also had 70% less tooth decay.25 , 26
3 tsp per day of cod liver oil
One trial showed that children given cod liver oil for an entire school year had over 50% fewer new cavities.
1 gram of leaf extract in gel applied to teeth twice per day
Neem leaf extract has been shown to reduce plaque and bacteria levels in the mouth.
In a double-blind trial, 1 gram of neem leaf extract in gel twice per day was more effective than chlorhexidine or placebo gel at reducing plaque and bacteria levels in the mouth in 36 Indian adults.28 A similar trial found neem gel superior to placebo and equally effective as chlorhexidine at reducing plaque and bacteria levels in the mouth.29 These promising early studies should be followed by studies regarding prevention of cavities and relief from gingivitis or periodontal disease.
For adults: 20 mg per day in capsules or lozenges; for children: 9 mg daily
Vitamin B6 appears to increase growth of beneficial mouth bacteria and decrease growth of cavity-causing bacteria.
Test tube studies show that vitamin B6 increases growth of beneficial mouth bacteria and decreases growth of cavity-causing bacteria.30 A double-blind study found that pregnant women who supplemented with 20 mg per day of vitamin B6 had significantly fewer new caries and fillings during pregnancy.31 Lozenges containing vitamin B6 were more effective than capsules in this study, suggesting an important topical effect. Another double-blind study gave children oral lozenges containing 3 mg of vitamin B6 three times per day for eight months, but reported only insignificant reductions in new cavities.32
Add 5 to 10 x 10e5 CFU per ml to milk or formula
Chewing gum with sorbitol, a sugar substitute, may reduce the activity of cavity-causing bacteria.
Certain sugar substitutes appear to have anti-caries benefits beyond that of reducing sugar intake. Children chewing gum containing either xylitol or sorbitol for five minutes five times daily for two years had large reductions in caries risk compared with those not chewing gum. Sorbitol is only slowly used by oral bacteria, and it produces less caries than sucrose.33 Xylitol gum was associated with a slightly greater risk reduction than sorbitol gum.34
Refer to label instructions
Communities with strontium in their water supply appear to have a reduced risk of dental caries.
Levels of strontium in the water supply have been shown to correlate with the risk of dental caries in communities with similar fluoride levels.35 Compared with children with fewer cavities, enamel samples from children with high numbers of caries have been found to contain significantly less strontium.36 However, supplementation with strontium has not yet been studied as tooth decay prevention.
1. Fure S, Gahnberg L, Birkhed D. A comparison of four home-care fluoride programs on the caries incidence in the elderly. Gerodontology 1998;15(2):51–60.
2. Petersson LG, Svanholm I, Andersson H, Magnusson K. Approximal caries development following intensive fluoride mouthrinsing in teenagers. A 3-year radiographic study. Eur J Oral Sci 1998;106:1048–51.
3. Driscoll WS, Nowjack-Raymer R, Selwitz RH, et al. A comparison of the caries-preventive effects of fluoride mouthrinsing, fluoride tablets, and both procedures combined: final results after eight years. J Public Health Dent 1992;52:111–6.
4. Ellwood RP, Blinkhorn AS, Davies RM. Fluoride: how to maximize the benefits and minimize the risks. Dent Update 1998;25:365–72 [review].
5. DePaola DP, Faine MP, Palmer CA. Nutrition in relation to dental medicine. In: Shils ME, Olson JA, Shike M, Ross AC, eds. Modern Nutrition in Health and Disease. 9th ed. Baltimore: Williams & Wilkens, 1999, 1110–2.
6. Harris NO, Garcia-Godoy F (eds.). Primary Preventive Dentistry, 5th ed. Stamford: Appleton & Lange, 1999, 93–5.
7. Harris NO, Garcia-Godoy F (eds.). Primary Preventive Dentistry, 5th ed. Stamford: Appleton & Lange, 1999, 93–5.
8. Ellwood RP, Blinkhorn AS, Davies RM. Fluoride: how to maximize the benefits and minimize the risks. Dent Update 1998;25:365–72.
9. Moss ME, Lanphear BP, Auinger P. Association of dental caries and blood lead levels. JAMA 199;281:2294–8.
10. Matte TD, Reducing blood lead levels: benefits and strategies. JAMA 1999;281:2340–1.
11. Price WA. Nutrition and Physical Degeneration. New York: Hoeber, 1939.
12. Jenkins GN, Forster MG, Speirs RL, et al. The influence of the refinement of carbohydrates on their cariogenicity. In vitro experiments on white and brown flour. Br Dent J 1959;106:195–208.
13. Cook HA. Phosphates and caries. Lancet 1968;i:1431.[letter]
14. Strean LP. The importance of pyridoxine in effecting a change in the microflora of the mouth and intestines. NY State Dent J 1957;23:85–7.
15. Nase L, Hatakka K, Savilahti E, et al. Effect of long-term consumption of a probiotic bacterium, Lactobacillus rhamnosus GG, in milk on dental caries and caries risk in children. Caries Res 2001;35:412–420.
16. Harel-Raviv M, Laskaris M, Chu KS. Dental caries and sugar consumption into the 21st century. Am J Dent 1996;9:184–90 [review].
17. Harel-Raviv M, Laskaris M, Chu KS. Dental caries and sugar consumption into the 21st century. Am J Dent 1996;9:184–90 [review].
18. Trahan L. Xylitol: a review of its action on mutans streptococci and dental plaque—its clinical significance. Int Dent J 1995;45(1 Suppl 1):77–92 [review].
19. Touger-Decker R. Nutrition in dental health. In: Mahan LK, Escott-Stump S, eds. Food, Nutrition, and Diet Therapy. 9th ed. Philadelphia: Saunders, 1996, 585.
20. Touger-Decker R. Nutrition in dental health. In Mahan LK, Escott-Stump S, eds. Food, Nutrition, and Diet Therapy. 9th ed. Philadelphia: Saunders, 1996, 583.
21. Edgar WM. Sugar substitutes, chewing gum and dental caries—a review. Br Dent J 1998;184:29–32 [review].
22. Edgar WM. Sugar substitutes, chewing gum and dental caries—a review. Br Dent J 1998;184:29–32 [review].
23. Soderling E, Isokangas P, Pienihakkinen K, et al. Influence of maternal xylitol consumption on mother-child transmission of mutans streptococci: 6-year follow-up. Caries Res 2001;35:173–7.
24. Soderling E, Isokangas P, Pienihakkinen K, Tenovuo J. Influence of maternal xylitol consumption on acquisition of mutans streptococci by infants. J Dent Res 2000;79:882–7.
25. Isokangas P, Soderling E, Pienihakkinen K, Alanen P. Occurrence of dental decay in children after maternal consumption of xylitol chewing gum, a follow-up from 0 to 5 years of age. J Dent Res 2000;79:1885–9.
26. Milgrom P, Ly KA, Tut OK, et al. Xylitol pediatric topical oral syrup to prevent dental caries: a double-blind randomized clinical trial of efficacy. Arch Pediatr Adolesc Med 2009;163:601–7.
27. McBeath EC, Zucker TF. The role of vitamin D in the control of dental caries in children. J Nutr 1938;15:547–64.
28. Pai MR, Acharya LD, Udupa N. Evaluation of antiplaque activity of Azadirachta indica leaf extract gel—a 6-week clinical study. J Ethnopharmacol 2004;90:99–103.
29. Pai MR, Acharya LD, Udupa N. The effect of two different dental gels and a mouthwash on plaque and gingival scores: a six-week clinical study. Int Dent J 2004;54:219–23.
30. Palazzo A, Cobe HM, Ploumis E. The effect of pyridoxine on the oral microbial populations. NY State Dent J 1959;25:303–7.
31. Hillman RW, Cabaud PG, Schenone RA. The effects of pyridoxine supplements on the dental caries experience of pregnant women. Am J Clin Nutr 1962;10:512–5.
32. Cohen A, Rubin C. Pyridoxine supplementation in the suppression of dental caries. Bull Phila County Dent Soc 1958;22:84.
33. Harel-Raviv M, Laskaris M, Chu KS. Dental caries and sugar consumption into the 21st century. Am J Dent 1996;9:184–90 [review].
34. Harel-Raviv M, Laskaris M, Chu KS. Dental caries and sugar consumption into the 21st century. Am J Dent 1996;9:184–90 [review].
35. Strontium and dental caries. Nutr Rev 1983;41:342–4 [review].
36. Strontium and dental caries. Nutr Rev 1983;41:342–4 [review].
Last Review: 05-01-2013
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