By Lacy Walker, RDH, BS, CDA, FAAOSH
Sugar consumption is a well-known factor that affects oral and systemic health. Many holidays provide the opportunity for the consumption of added sugars, including the most recent holidays, Valentine's Day, and Mardi Gras.
Appreciation on Valentine's Day is often expressed with sweets, and it's tradition to give chocolates or other sugary desserts as a heartfelt gift. Meanwhile, Mardi Gras, also known as Fat Tuesday, is a day of overindulging by eating more decadent, sugary, and fattier foods.
Traditionally, store aisles are stocked with sugar-filled sweets and treats to give loved ones to support these types of holidays and traditions. But holidays such as Valentine's and Mardi Gras also provide an opportunity for dental clinicians to continue to educate themselves and their patients about the variety of ways sugar is involved in daily life.
The following sugar facts can help you deliver timely nutritional and dental health advice that extends beyond the operatory.
1. Sugar isn't the only culprit for carious lesions
Patients need to understand the difference between the types of sugars and the importance of how sugar affects them systemically. Consuming sugar results in harmful oral bacteria-producing acids that can lower the oral cavity's overall pH, a process that results in the demineralization of the dentition.
However, the prevalence of dental caries depends on more than just the frequency of sugar consumption. Medical conditions, radiology treatments, and medication-induced xerostomia can all affect the development of carious lesions.
2. Xylitol has some sweet oral health effects
Sugar alcohols, also known as polyols, are commonly referred to as sugar substitutes. Xylitol is just one of many sugar substitutes on the market that are commonly added to processed foods labeled as "sugar-free" or "no sugar added" to increase consumer buying and consumption.
However, xylitol is also naturally found in fruits and vegetables. This popular sugar substitute has a sweetness similar to table sugar and has only two calories per teaspoon, unlike sucrose, which has 16 calories per teaspoon.
Xylitol has been shown to prevent bacterial growth, does not encourage yeast growth in the gut, and has little effect on insulin. It can also increase bone mineral density and stimulate saliva, while simultaneously having inhibitory effects on Streptococcus mutans, a significant contributor to tooth decay.
The sugar substitute also has antimicrobial activity -- an essential consideration during the COVID-19 pandemic. Xylitol has been shown to reduce numerous types of infections, and an article published in 2020 indicates a nasal spray containing xylitol could reduce SARS-CoV-2 infection risk.
While promising, xylitol has its drawbacks. Overconsumption of this particular sugar alcohol can cause gastrointestinal discomfort in some individuals. It is also extremely toxic to dogs and other nonprimate species.
3. Sugar can contribute to disease
Sugar is linked to numerous chronic diseases, such as diabetes, obesity, and cardiovascular disease. According to the U.K. Stroke Association, consuming high amounts of sugar can damage blood vessels, causing them to become stiff and build up fatty deposits.
Furthermore, a U.S. National Health and Nutrition Examination Survey (NHANES) data analysis showed that sugar consumption might result in insulin resistance, a risk factor for periodontal disease, and a key factor in diabetes.
Overconsumption of added sugars can also cause inflammation. Added sugars have been associated with rheumatoid arthritis and inflammation of the blood vessels, periodontium, and skin.
4. Sugar can help (and hurt) your skin
Overconsumption of sugar can cause skin problems, such as acne and accelerated aging. For instance, consumption of too many added sugars can lead to wrinkles through a process called glycation. Glycation occurs when sugar enters the bloodstream and binds to proteins to form molecules, ultimately causing fibers in the skin to weaken.
Although sugar has a negative reputation in sweet treats, it can be an excellent ingredient in skin-care and other hygiene products. Sugar is a natural humectant -- a type of substance commonly added to shampoos and lotions to help draw in moisture for hydration. Humectants can even be found in toothpaste to help retain water.
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