A Look Back at…”Healthy” Smoothies & Your Teeth

Updated from the original post for July 11, 2013

Drink Your Fruit & Veggies?

smoothiesThink you can just drink your fruit and veggies in a delicious fruit smoothie? Research from the BDJ might make you think twice – at least if you care about your teeth.

Researchers found that smoothies can, in fact, be quite damaging to enamel – the hardest tissue in the body, protecting the softer tissues within. But a number of things contribute to erosion, including dry mouth, medications, bruxing (habitual grinding and clenching) and sugars and acids like those you find in the typical smoothie.

Damaged enamel means sensitive teeth and a heightened risk of cavities.

While certain fruits proved to be more damaging than others, the BDJ study found that “some fruit smoothies have the potential to bring about dental erosion if consumed irresponsibly.” To lower the risk, the authors suggest eating while enjoying your smoothie (which, you may argue, may defeat the purpose of having a smoothie, but we urge you: read on).

The trouble with smoothies – as with fruit juices – is their reputation of being “healthy.” There are those who, instead of eating fresh fruit and veg, drink lots of such beverages for a nutritional boost – or, more worrisome, give them to kids instead of whole produce. The drinks’ sweetness makes them especially appealing. Like other animals, we’re evolutionally partial to sweets since they’re associated with high energy foods. (Cats, in fact, may be the only animals that grew out of the sweet tooth.)

Although the sugar in smoothies can be a problem – and there can be a lot of sugar (see this and this, for instance), as as much or more than in most sodas – the BDJ study was concerned more with acidity. Food and drink with a pH value lower than the critical pH of tooth enamel (5.5) are erosive. Most smoothies have a pH value around 2 or 3. Most sodas do, too.

This PSA from the Wisconsin Dental Association pounds the point home:

What about using a straw? Some say it helps get the beverage past the teeth while getting nutrients into the consumer, but that skirts a related issue. As Dean Kathryn Harley of the Faculty of Dentistry at the Royal College of Surgeons has suggested, if kids are constantly exposed to sweet foods like juice, candy and desserts, they may increasingly reject lesser sweet foods such as whole fruits and vegetables.

Remember that the easiest way to get your fruit and veggie intake up is by eating them, not drinking them. To get kids to eat vegetables, try serving them alongside foods you know they enjoy, or serve fresh vegetables as a snack. In her excellent post on “11 Proven Ways to Get Kids to Eat More Vegetables,” blogger Darya Rose suggests using the one bite rule: require your child to try one bite of an unfamiliar food before rejecting it altogether – along with 10 other great ideas.

None of this is to say that you have to cut out smoothies or juices completely. If you like them, enjoy them once in a while. But here’s an added plus of opting for more whole fruit and veg over smoothies and juice: Not only do you avoid the sugars and acids, the more complete nutritional intake can help remineralize your teeth, keeping them strong and healthy. Foods rich in nutrients such as calcium, antioxidants, Vitamin D and phosphorous are especially beneficial.

Image by Ken Hawkins

The Impact of Drinking Sugar

You may have seen this image making the rounds on social media lately – a powerful reminder of soda’s impact on your health:

impact of soda

But one thing it neglects to mention happens within the first 30 seconds of drinking pop: It damages the enamel covering your teeth. Enamel. The hardest tissue in the human body. The one tissue your body has no way of making more of.


Zoom into a Tooth by Weird_Weird_Science

As enamel is worn away and the more delicate dentin is exposed, the teeth become sensitive and more vulnerable to decay. Research has shown that among heavy soda drinkers, the damage can be as severe as that wreaked by meth and crack.

Of course, soda is merely among the worst offenders. All similarly sugary and acidic drinks are the issue: fruit juice and juice-based drinks, sports drinks, energy drinks, sweetened teas, flavored waters. So even as soda consumption has finally started to go down, enamel erosion continues to be a big problem.

According to research published earlier this year, nearly 80% of adults show some sign of it. Most cases are mild, but 15% had signs of moderate to severe erosion. As we noted before, this is one reason why tooth decay is eventually an issue for virtually all adults.

Along with sugary and acidic snacks, sweetened beverages are a terror for teeth – a fact most recently confirmed in a study published right at the start of this month. This meta-analysis of past studies found that the more sugary, acidic products you consume, the more erosion. They also found that milk and yogurt “had a protective effect.”

And that only makes sense. For one, dairy has also been shown to have a neutral or alkalinizing effect in the mouth. Cheese, especially, may help prevent cavities, according to research published in General Dentistry. It also provides something those other products inherently lack: the nutritional building blocks for remineralizing teeth and bone, keeping them strong and resilient.

There’s a choice that, consciously or not, each of us makes repeatedly each day: Do we give our body what it needs to do its job or do we confound it by throwing up roadblocks to optimal health? Do we support the body’s self-regulating, self-healing capacities or undermine them?

Give your body the nutrition it needs, it knows what to do.

Acids & Sugars & Restaurants – Oh, My!

shocked expressionEarlier this summer, a couple studies were published that rocked the dental world.

Well, not really. In fact, the findings leaned a bit toward the obvious. Yet each study did add a little something new to the old story of unhealthy habits.

Let’s start with the first, published in the Journal of Dentistry. Researchers confirmed that soda is bad for your teeth. The twist? They found that the damage begins within 30 seconds of exposure. Thirty seconds!

That’s all the time that acids in sodas, fruit juices, and energy drinks need to harm your teeth. And as one of the study’s authors put it,

If high acidity drinks are consumed, it is not simply a matter of having a child clean their teeth an hour or 30 minutes later and hoping they’ll be okay – the damage is already done.

Of course, that damage is entirely preventable, simply by avoiding soft drinks, fruit juice and other highly acidic beverages – or, barring that, at least consuming less.

For more on the problem of acidic and sugary drinks, see our previous post.

The second study — this one published in Public Health Nutrition — showed that fast food is less than healthy. What else is new, right? But did you realize that full-service, sit-down restaurants aren’t all that much better? Eating out typically means more calories, more sugar, more saturated fats and more sodium.

The study found on days when eating at a fast-food restaurant, there was a net increase of total energy intake (194.49 kcal), saturated fat (3.48 g), sugar (3.95 g) and sodium (296.38 mg). Eating at a full-service restaurant was also associated with an energy intake (205.21 kcal), and with higher intake of saturated fat (2.52 g) and sodium (451.06 mg).

Too often when people go out to eat, they treat it as a “when in Rome” experience and order indulgently, with little consideration given to its healthfulness. You can easily wind up loading your body with foods that taste great but hardly substantial nutrition. (And consider how common it is to wash down those meals with a perpetually refilled glass of soda!)

Sure, the occasional meal out is fine. Sometimes it’s necessary. But day in and day out, preparing meals at home is the best choice you can make for consistently healthful eating. By preparing the food yourself, you know how much (if any) sugar or salt has been added. You know your ingredients. You control the portion sizes.

And then eating out once again becomes the nice indulgence it once was.

Image by Nicolas Connault

Obesity & Oral Disease: A Weighty Connection

Though you often hear people talk about “science” as kind of a single, solid body of fact, it’s actually a process and a way of understanding the world. Ideas are tested and retested. Evidence builds up – sometimes in support of a hypothesis, sometimes against – but until it reaches critical mass on one side or another, the mixed results of scientific research can sometimes seem confusing.

Consider a trio of studies published over the past several months on the long-observed relationship between oral health and obesity.

One study, published in the Journal of Evidence-Based Dental Practice, found that obese children tended to have more cavities, though results varied according to socio-economic status. Parents’ income levels seemed to predict preventive oral health practices such as home hygiene and regular dental visits.

Another study – this, in PLoS ONE – came to a contrary conclusion, finding that Kuwaiti children who were obese actually had fewer cavities than their slender peers. No explanation was given for this surprising result.

The finding of an inverse obesity-dental decay relationship contradicts the obesity-sugar and the obesity-dental decay relationship hypotheses. Sugar is well recognized as necessary and sufficient for dental decay. Sugar is also hypothesized to be a leading co-factor in obesity. If the later hypothesis is true, one would expect dental decay to increase with obesity. This was not found. The reasons for this inverse relationship are not currently clear.

Then there was the research published in the European Archives of Paediatric Dentistry. This study found that while obese children don’t necessarily have a higher risk of tooth decay, they do seem to have a higher risk of dental erosion.

5411920162_852d19475c_bOf course, as enamel is lost and dentin is exposed, the affected teeth become much more vulnerable to decay.

Overall, though, the research generally supports some connection between obesity and caries (that’s the dentist’s term for cavities). And if you think about it, this makes a lot of sense. After all, the mouth is where eating begins, and the foods most prone to add to your fat stores – sugary, starchy, hyper-processed carbs – are the exact same foods that can lead to dental problems.

Some, of course, are more damaging than others. Soda may be one of the worst offenders, though fruit juice is not so much better. A single 12 ounce serving of pop can contain more than 50 grams of the stuff; juice-based drinks fall into the same range. (Tropicana Farmstand, for instance, contains just a half teaspoon less than a regular Coke.)

This sugar is the preferred fuel of the microbes that colonize into the tooth-coating biofilms we call “plaque.” The metabolic waste they produce is highly acidic, and that’s what ultimately damages teeth, making them vulnerable decay.

Add to that the phosphoric acid found in soda, and you get a real recipe for disaster.

But it’s not just soda that’s the problem. All highly processed carbs and sugars tend to stick to the teeth, especially along the gum line, feeding those oral pathogens, helping them to thrive.

These are also the kinds of foods that fuel chronic inflammation – a key player in both obesity and gum disease. Not only are they themselves triggering but they also often displace healthier foods from the diet, such as vegetables, whole grains, unprocessed meats and healthy fats such as omega 3s. In light of this, it’s not especially surprising that research has found obesity to be a predictor of periodontal disease.

That said, being obese doesn’t necessarily doom you to oral health problems – or vice versa. But the presence of both together does suggest that the reason may be shared triggers such as diet.

Even though there may not be a causal connection, healthy choices can impact both. This doesn’t mean that one solution exits, but changing your diet and exercising more are fantastic steps towards better oral, heart, and overall health.

For starters, instead of eating sugars, refined flours, and starches, fill your diet with:

  • Vegetables
  • Fresh fruits (not canned)
  • Natural fats from foods like like nuts, avocados, fish, and olive oil
  • Unprocessed meats (found in the meat aisle, not the deli)
  • Whole grains

Finally, remember to clean your teeth and gums regularly. No matter what you eat, your teeth need brushing at least twice a day and flossing once a day.

Image by Jacob Deatherage, via Flickr

Drink Your Fruits & Veggies?

smoothiesThink you can just drink your fruit and veggies in a delicious fruit smoothie? A recent study in the British Dental Journal might make you think twice – at least if you care about your teeth.

Researchers found that smoothies can, in fact, be quite damaging to enamel – the hardest tissue in the body, protecting the softer tissues within. But a number of things contribute to erosion, including dry mouth, medications, bruxing (habitual grinding and clenching) and sugars and acids like those you find in the typical smoothie.

Damaged enamel means sensitive teeth and a heightened risk of cavities.

While certain fruits proved to be more damaging than others, the BDJ study found that “some fruit smoothies have the potential to bring about dental erosion if consumed irresponsibly.” To lower the risk, the authors suggest eating while enjoying your smoothie (which, you may argue, may defeat the purpose of having a smoothie, but we behoove you: read on).

The trouble with smoothies – as with fruit juices – is their reputation of being “healthy.” There are those who, instead of eating fresh fruit and veg, drink lots of such beverages for a nutritional boost – or, more worrisome, give them to kids in lieu of real produce. The drinks’ sweetness makes them especially appealing. Like other animals, we’re evolutionally partial to sweets since they’re associated with high energy foods. (Cats, in fact, may be the only animals that grew out of the sweet tooth.)

Although the sugar in smoothies can be a problem – and there can be a lot of sugar (see this and this, for instance), as as much or more than in most sodas – the BDJ study was concerned more with acidity. Food and drink with a pH value lower than the critical pH of tooth enamel (5.5) are erosive. Most smoothies have a pH value around 2 or 3. Most sodas do, too.

This PSA from the Wisconsin Dental Association does the pounds the point home:

What about using a straw? Some say it helps get the beverage past the teeth while getting nutrients into the consumer, but that skirts a related issue. As Dean Kathryn Harley of the Faculty of Dentistry at the Royal College of Surgeonssays, among others, has suggested, if kids are constantly exposed to sweet foods like juice, candy and desserts, they may increasingly reject lesser sweet foods such as whole fruits and vegetables.

Remember that the easiest way to get your fruit and veggie intake is by eating your fruit and veggies, not drinking them. To get kids to eat vegetables, try serving them alongside foods you know they enjoy, or serve fresh vegetables as a snack. In her excellent post on “11 Proven Ways to Get Kids to Eat More Vegetables,” blogger Darya Rose suggests using the one bite rule: require your child to try one bite of an unfamiliar food before rejecting it altogether – along with 10 other great ideas.

None of this is to say that you should cut out smoothies or juices completely. If you like them, enjoy them in moderation. But here’s an added plus of opting for more whole fruit and veg over smoothies and juice: Not only do you avoid the sugars and acids, the more complete nutritional intake can help remineralize your teeth, keeping them strong and healthy. Foods rich in nutrients including minerals like calcium, antioxidants, Vitamin D and phosphorous are especially beneficial.

Image by Ken Hawkins, via Flickr