Dental pain may be a warning that the high-glycemic diet that can cause dental problems in the short term may, in the long term, lead to potentially serious chronic diseases, according to researchers from the University of Washington School of Dentistry.
Philippe Hujoel, D.D.S., Ph.D., M.S.D., M.S., a professor of dental public health sciences, reviewed the relationships among diet, dental disease, and chronic systemic illness in a report published July 1 in the Journal of Dental Research. He weighed two contradictory viewpoints on the role of dietary carbohydrates in health and disease.
The debate surrounds fermentable carbohydrates, foods that turn into simple sugars in the mouth. One viewpoint is that certain fermentable carbohydrates are beneficial to general health, and the harmful dental consequences of such a diet should be managed by the tools found in the oral hygiene section of drugstores.
A contrasting viewpoint suggests that fermentable carbohydrates are bad for both dental and general health, and both dental and general health need to be maintained by restricting fermentable carbohydrates.
The differing perspectives on the perceived role of dietary carbohydrates have resulted in opposing approaches to dental disease prevention, Dr. Hujoel noted, and have prompted debates in interpreting the link between dental diseases and such systemic diseases as obesity, diabetes, and some forms of cancer.
Over the past 20 years or so, people have been advised to make fermentable dietary carbohydrates the foundation of their diet, according to Dr. Hujoel. A high-carbohydrate diet was assumed to prevent a number of systemic chronic diseases. Unfortunately, such a diet -- allegedly good for systemic health -- was bad for dental health. As a result, cavities or gingival bleeding from fermentable carbohydrates could be avoided only by conscientious brushing, fluorides, and other types of dental preventive measures.
Dr. Hujoel observed that the dental harms of fermentable carbohydrates have been recognized by what looks like every major health organization. Even those fermentable carbohydrates assumed to be good for systemic health break down into simple sugars in the mouth and promote tooth decay. All fermentable carbohydrates have the potential to induce dental decay, he noted.
But what if fermentable carbohydrates are also bad for systemic health? What if dietary guidelines would start incorporating the slew of clinical trial results suggesting that a diet low in fermentable carbohydrates improves cardiovascular markers of disease and decreases body fat?
Such a change in perspective on fermentable carbohydrates and, by extension, on people's diets could have a significant impact on the dental profession, as a diet higher in fat and protein does not cause dental diseases, Dr. Hujoel noted. Dentists would no longer be pressed to recommend to patients diets that are bad for teeth or remain mum when it comes to dietary advice. Dentists often have been reluctant to challenge the prevailing thinking on nutrition, according to Dr. Hujoel. Advising patients to reduce the amount or frequency of fermentable carbohydrate consumption is difficult when official guidelines suggested the opposite.
Eating sugar or fermentable carbohydrates drops the acidity levels of dental plaque and is considered an initiating cause of dental decay, Dr. Hujoel stated. Eating these same foods is also associated with spikes in blood sugar levels.
"There is fascinating evidence that suggests that the higher the glycemic level of a food, the more it will drop the acidity of dental plaque, and the higher it will raise blood sugar," he stated in a press release. "So, possibly, dental decay may really be a marker for the chronic high-glycemic diets that lead to both dental decay and chronic systemic diseases. This puts a whole new light on studies that have linked dental diseases to such diverse illnesses as Alzheimer's disease and pancreatic cancer."
The correlations between dental diseases and systemic disease provide indirect support for those researchers who have suggested that Alzheimer's disease and pancreatic cancer are due to an abnormal blood glucose metabolism, he added.
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