Along with regular brushing, flossing and dental check-ups, cutting down on free sugars (the sugar added to food and drink by manufacturers) is one of the best things you can do to keep your teeth and gums healthy. So how much sugar is too much?
The recommended daily sugar intake, according to the World Health Organization (WHO), is around 6 teaspoons or 24 grams of free sugar. If that sounds like a lot, know that the average Australian consumes 14 teaspoons of free sugar every day in food and drink – more than double the recommendation!
Young people are more likely to have too much sugar in their diets. According to Australia's Oral Health Tracker, compiled by the Australian Dental Association (ADA) and the Australia Health Policy Collaboration (AHPC), 70.3% of kids and teenagers aged 9 to 13 and 73.1% of teens aged 14 to 18 consume too much free sugar, along with 47.8% of adults.
Even if you take care to avoid sugar when shopping, your hard work may be getting undone by 'hidden' sugars that are present in many processed foods, including some that are marketed as healthy. This year's Dental Health Week (3–9 August 2020) is dedicated to shining a light on these hidden sugars and educating Australians about how to lower their risks.
Knowing what sugar actually does to your teeth can help you to protect them more effectively and give you the motivation to make positive changes. The hazards of sugar don't end at your teeth either, as oral health can impact on general health and wellbeing in many ways.
Sugar is the main contributing factor to tooth decay (dental caries). When you eat or drink something containing sugar, this feeds bacteria living in dental plaque on the surface of your teeth. These bacteria release acids as a waste product, which break down the enamel over time to weaken teeth and create cavities. These usually require a filling or dental crown to repair.
Tooth decay is the most common dental problem in Australia, with almost 90% of people experiencing it at some point in their lives according to Australia's Oral Health Tracker. Worse, more than a quarter of young children and almost a third of adults have untreated tooth decay. If tooth decay isn't treated, it could eventually lead to more serious problems such as a tooth infection (requiring root canal therapy), a dental abscess or even tooth loss.
Possible signs of tooth decay include toothache, sensitivity to temperature and a white or dark spot on the tooth, near to the gum line. Tooth decay can also be present without obvious symptoms, so it's important to have regular check-ups with your dentist so they can catch these problems early. You should also follow your dentist's oral hygiene advice to keep your teeth clean and free from plaque as much as you can.
The bacteria that feed on sugar and cause tooth decay can also irritate or infect the gums. Gum disease (periodontal disease) affects 28.8% of adults, according to Australia's Oral Health Tracker. Like tooth decay, gum disease is also on the rise in Australia and is the leading cause of tooth loss for adults.
The early stage of gum disease is gingivitis. You might have gingivitis if your gums are red, swollen, itchy or bleed when you brush your teeth. Also like tooth decay, the early stage of gum disease can sometimes be reversed by improving your oral hygiene.
If gum disease isn't treated in time, it can develop into periodontitis, which can damage the jaw bone around the roots of teeth and lead to tooth loss. Advanced gum disease requires treatment from a dentist.
The links between sugar and obesity are less direct than for tooth decay, but if the body consumes more carbs (including sugar) than it requires for energy, these are stored as fat. Studies have found that children who consume more than the recommended amount of sugar from soft drinks and other sources are more likely to be overweight.
Obesity can be prevented or managed by cutting down on food and drink with free sugars and fats, following a balanced diet and getting more exercise.
High-sugar diets may also indirectly increase the risk of developing other health problems, including:
While these are not a direct result of sugar, having a related health condition such as gum disease or obesity can increase your risk factor for general health problems, as well as affecting psychological wellbeing and quality of life.
Sugar's bad reputation is thanks to food processing, but if you manage to stay within your limits, sugar can be a healthy source of energy to keep your body going. It's also important to note that some sugars are better for you than others.
Unprocessed foods such as fresh fruit, milk, natural yoghurt and other dairy products contain natural sugar. On the chemical level, these sugars are part of the structure of the food, so they have less impact on teeth than artificially added sugars. The foods that contain these sugars are also rich in vitamins and minerals such as calcium that can help to strengthen and rebuild teeth enamel.
However, even natural sugar can become harmful if fruit is juiced or blended and the sugar becomes 'free.' Combined with natural acidity that can erode tooth enamel and make it more vulnerable to decay, it's no surprise that fruit juice is a major contributor to tooth decay in children, especially when it's drunk frequently.
Sugar is added to many processed foods and drinks for taste, thickening and to help it last longer in storage.
While processed sugars still provide energy, they're lacking in other nutrients compared to natural sugars. The WHO recommends that no more than 10% of your body's daily energy intake should come from refined sugars.
Being able to tell how much sugar is in food and drink at a glance isn't as simple as it should be, thanks to the often devious ways companies list sugar on packaging. If you want to stay under the recommended limit to protect your teeth and your general health, here are the main things you need to know.
This isn't the same as saying 'sugar free.' The wording indicates that the item already includes natural sugar – it may even be high in sugar!
In the case of some products such as fruit juices, this natural sugar can be just as harmful for teeth as processed sugars, so make sure you check how much is present.
Food and drink packaging often lists the amount of sugar per serving. As serving sizes can vary according to the type of food or drink and your preference, this isn't the most reliable guide. It's usually better to compare the amount of sugar per 100 grams.
If you're aiming for 10% or less of your daily energy intake from added sugar, choose products with 10g or less per 100g (2.5 teaspoons). Food and drink with more than 15g sugar is considered unhealthy.
If you're only checking for 'sugar' in the ingredients list on food and drink packaging, you're not getting the full story. Many added sugars are listed under more specific names, and some might not be obvious. These are what's known as hidden sugars.
If a product lists fruit juice, caramel, honey, malt or any type of syrup among its ingredients, these are all high in sugar. More technical terms for 'sugar' to look out for include:
There are more than 50 names for sugar in all, and all of them contribute to tooth decay. Remember: the higher an ingredient is listed on food or drink, the more presence it has.
The Daily Intake Guide is a voluntary scheme that food and drink manufacturers in Australia can adopt to inform customers about the nutritional value of their products on the front of the packaging.
While it's still important to check the ingredients list and quantities, this can be a handy guide to energy and sugar levels at a glance. Since the labelling is voluntary, it can also give shoppers some peace of mind that a company is confident about its products.
If you're worried about tooth decay, or you or your family are due for a check-up and clean, contact our Gold Coast dentists to make an appointment at Robina Town Dental.
Australian Dental Association. Dental Health Week 2020 [Online] 2020. Available from: https://www.ada.org.au/Dental-Health-Week-2020/
Australian Health Policy Collaboration and Australian Dental Association. Australia's Oral Health Tracker [Online] 2018-20 [Accessed July 2020] Available from: ada.org.au/oralhealthtracker
Better Health Channel. Sugar [Online] 2011 [Accessed July 2020] Available from: https://www.betterhealth.vic.gov.au/health/healthyliving/sugar
Healthdirect. How to cut down on sugar [Online] 2018 [Accessed July 2020] Available from: https://www.healthdirect.gov.au/cutting-down-on-sugars