1. Module 6 Food and your teeth
Today we are going to be talking about how food and drinks affect teeth. We’ll be looking at:
The basic process of tooth decay
Which food and drinks can cause tooth decay
Which food and drinks are best for your teeth health
How you can make simple changes to your eating habits to prevent tooth decay
We get two sets of teeth in our life-time
We get our baby teeth around six months old and start to lose them at around six years of age to make way for our adult teeth.
Approximately 50% of Australian children will have some form of tooth decay by six years of age
It is important to care for the baby teeth as they are making spaces for the adult teeth
When baby teeth fall out - the spaces that are left behind are filled by the adult teeth. If the baby teeth are lost before they are supposed to be - there may not be enough space for the adult teeth to come through and this may cause over-crowding of teeth
An overcrowded mouth can make it difficult to clean teeth properly and this can lead to an increase in the risk of tooth decay in adult teeth
Good oral health is linked closely to overall general health and some of the same factors that influence general health also influence dental health. In addition, pain and discomfort can significantly impact on a person’s ability to socialise, eat, talk, sleep, work and go about their daily lives.

2. What is tooth decay? Tooth decay is the damage of the tooth.
Tooth decay is the damage of tooth enamel
It happens gradually and can occur in either baby teeth or adult teeth
Bacteria (or germs) live in the mouth and collect around the base of the gums in a substance called plaque. Plaque is a sticky colourless film.
Some bacteria are able to covert sugar to acid. If this acid is left on the tooth surface for a long enough period of time the acid may cause the top layer of the tooth (the enamel) to gradually become weak. This can lead to holes forming in the tooth which may be painful (but not always).
Saliva and fluoride (in toothpaste and tap water) can help to neutralise acid-forming bacteria.
It is important to realise that most tooth decay is preventable!

3. Food and drinks that can cause tooth decay
Honey
How to prepare tooth decay demonstration
Equipment
1 egg
1 cup of white vinegar
1 clear jar with a lid
Permanent texta
Method
Crack an eggshell in half
Place one half of the shell in a clear jar and pour vinegar over the top of the shell until at least half of the eggshell is covered
Clean and dry the other half of the egg shell and put aside
Place a lid on the jar and label the jar with the date
After two days holes should start to appear in the eggshell
For the demonstrations, compare the vinegar soaked eggshell with the eggshell that was not covered in vinegar
How to demonstrate the simulation of tooth decay
Half of an eggshell has been soaking in vinegar for 2 days
The other half has not been soaking in vinegar
Vinegar is similar to the acid produced in the mouth after a meal is eaten, especially one high in sugar. You will notice that the shell that was soaking in vinegar is discoloured and weaker than the other shell.
This simulates what can happen to tooth enamel over time when we constantly have food and drinks high in sugar.
Script
There are certain foods and drinks that can cause tooth decay, including:
Food and drinks that are high in added sugar such as lollies, cake, ice cream and soft drinks
Drinks that are acidic such as fruit juice, soft drinks, sports drinks and energy drinks. These include so-called ‘diet’ soft drinks.
Acidic drinks cause erosion which is different to the decay caused by sugary drinks. Sugary soft drinks can also be acidic. This includes drinks that contain phosphoric acid, citric acid or tartaric acid (at least one of these ingredients is in most soft drinks, including ‘diet’ soft drinks)
Sticky foods, such as dried fruit are more likely to stick to the surface of the teeth
Allowing the teeth to be constantly coated with food or drink is also a problem, such as when a child takes a bottle of drink to bed (including milk) and is allowed to fall asleep whilst sucking on the bottle.

4. Factors that increase the risk of tooth decay
1.Bacteria and teeth
2. Type of food or drink
3.Time
4. How many times you eat or drink over the day
5. Strength of tooth enamel
Bacteria in the mouth use sugar to produce acid. The acid and the sugar remnants stick to the teeth and begin to dissolve the top layer of the teeth (known as the tooth enamel). This happens for up to 30 minutes after eating. However, certain things can speed up the rate of tooth decay, these include:
Bacteria
The number of bacteria in the mouth varies between people, however regular brushing (morning and night) is an important process which helps to remove bacteria which produce acid.
Type of food or drink
The type of food and drink eaten is really important for the development of tooth decay. Food and drinks high in sugar such as confectionery, soft drinks and biscuits are broken down fast in the mouth and attract acid-causing bacteria.
Time
The longer the teeth are exposed to sugars the greater the opportunity to convert the sugar into acid, which then attacks tooth enamel. For example, sucking on a lollipop means that sugar remains in the mouth for a long period of time.
Frequency
The greater the number of meals over the day, the more times teeth are exposed to acid, particularly if meals are high in sugar. The more times teeth are exposed to this process over a day, the more likely it is that tooth decay will develop.
Strength of tooth enamel
The strength of tooth enamel is an important factor in the rate of tooth decay. The weaker the tooth enamel, the faster the rate of decay. Soft drinks (even ‘diet’ soft drinks) contain acid which can cause damage to tooth enamel.

5. Keep your teeth healthy
Breastfeed your baby
if possible
Swap snacks and drinks high in added sugar for fruit and vegetables
Have sugary food and drinks as part of a meal rather than on their own
Eat at set times rather than grazing
Drink plenty of plain tap water
Brush after breakfast and before bed
Don’t rinse after brushing
Have regular check-ups with the dentist
Once teeth are through – lift the lip once a month
There are some simple things that you can do to keep your teeth healthy:
Breastfeed your baby where possible. Breastfeeding is better for the baby’s dental health than bottle feeding. Breast milk contains a substance that kills the bacteria which produce acid. Also breast milk does not coat the teeth like bottle feeding does as the milk is released at the back of the throat. If a baby falls asleep at the breast, the milk flow stops. Whereas if a bottle is in the mouth when the baby is asleep, it continues to drip into the mouth and coat the teeth
Swap snacks high in added sugar for foods with no added sugar such as fresh fruit and vegetables.
Eat a balanced diet containing plenty of fresh fruit, vegetables and whole grains. Also include reduced or low-fat dairy products
Have sugary food and drinks as part of a meal rather than on their own. This is because our mouth makes more saliva during a meal, and saliva helps to neutralise acid
Eat at set times rather than grazing. By eating at set times, teeth get a break from acid and bacteria attacks. These breaks help to out minerals back in teeth
Drink plain tap water regularly throughout the day instead of acidic drinks such as soft drinks, juice and cordial.
Brush teeth after breakfast and before bed to reduce the bacteria that cause plaque and remove any food pieces from the mouth and have regular check-ups with the dentist
Spit toothpaste out – but don’t rinse. The fluoride in the toothpaste helps to protect the teeth.
Lift the lip. Once teeth have come through, lift your child’s top lip once a month to check for early signs of tooth decay. White lines along the gum line can be the beginning of tooth decay and should be checked out by a dentist

6. Tap Water  no sugar  safe to drink  contains fluoride
 flushes mouth of food and drink
 low cost
Why is water, especially tap water so important?
Plain tap water does not contain sugar and will not damage teeth like other drinks e.g. soft drink, juice and cordial
Plain tap water is a good drink to have after snacks as it contains added fluoride which helps to put minerals back in teeth and strengthen enamel
Fluoride occurs naturally and is also added to the water supply in very small amounts, at a level to protect teeth. The levels of fluoride are regularly checked to ensure they are safe
Drinking plain tap water can help flush away food or drink remaining in the mouth after eating or drinking – which means less opportunity for the bacteria to produce acid
South Australian tap water has been treated and is safe to drink without further treatment or filtering
Tap water is also one of the cheapest drinks available!

7. Snack Ideas
What are some healthy snack options for children and adults that are ‘tooth-friendly’?
Dairy foods (milk, yoghurt, cheese):
Milk provides protection against tooth decay
The protein in milk (casein) coats teeth with a protective film and stops the loss of two important minerals (calcium and phosphorus) from teeth, when teeth are exposed to acid
Lactose - the natural sugar in milk, is the least damaging of all of the sugars
Cheese and yoghurt have the same protective qualities as milk. Cheese has the additional benefit of promoting the production of saliva, which assists in neutralising acid and washing away pieces of food
When selecting dairy products, choose those with reduced or no added sugar – and choose mostly reduced or low-fat varieties.
Note: Reduced or low fat dairy foods are not suitable for children under 2 years of age.
Fruit with skins are a good snack, Unsalted roasted chickpeas or pumpkin seeds
Eggs are a snack full of protein and no sugar
Fruit bread, although it is NOT an everyday food because it is sticky and high in sugar - is still a better choice than lollies or chocolate. Spread it with cream cheese or have it with a glass of milk and rinse with water afterwards
Vegetable sticks and reduced-fat dip are a good choice (hummus, tzatziki, eggplant) or sushi rolls
Tap water is a good drink to have after snacks as it contains added fluoride which helps to put minerals back in teeth and strengthen enamel.
It is important to note that hard fruit and vegetables such as raw apple, carrot and celery should not be given to children under four years of age because of the risk of choking

8. Keep your teeth healthy
Breastfeed your baby
if possible
Swap snacks and drinks high in added sugar for fruit and vegetables
Have sugary food and drinks as part of a meal rather than on their own
Eat at set times rather than grazing
Drink plenty of plain tap water
Brush after breakfast and before bed
Don’t rinse after brushing
Have regular check-ups with the dentist
Once teeth are through – lift the lip once a month
There are some simple things that you can do to keep your teeth healthy:
Breastfeed your baby where possible. Breastfeeding is better for the baby’s dental health than bottle feeding. Breast milk contains a substance that kills the bacteria which produce acid. Also breast milk does not coat the teeth like bottle feeding does as the milk is released at the back of the throat. If a baby falls asleep at the breast, the milk flow stops. Whereas if a bottle is in the mouth when the baby is asleep, it continues to drip into the mouth and coat the teeth
Swap snacks high in added sugar for foods with no added sugar such as fresh fruit and vegetables.
Eat a balanced diet containing plenty of fresh fruit, vegetables and whole grains. Also include reduced or low-fat dairy products
Have sugary food and drinks as part of a meal rather than on their own. This is because our mouth makes more saliva during a meal, and saliva helps to neutralise acid
Eat at set times rather than grazing. By eating at set times, teeth get a break from acid and bacteria attacks. These breaks help to put minerals back in teeth
Drink plain tap water regularly throughout the day instead of acidic drinks such as soft drinks, juice and cordial.
Brush teeth after breakfast and before bed to reduce the bacteria that cause plaque and remove any food pieces from the mouth and have regular check-ups with the dentist
Spit toothpaste out – but do not rinse. The fluoride in toothpaste helps to protect teeth.
Lift the lip. Once teeth have come through, lift your child’s top lip once a month to check for early signs of tooth decay. White lines along the gum line can be the beginning of tooth decay and should be checked out by a dentist

9. Which is the better choice for your teeth?OR
orange juice
milk OR
eating sticky foods at a main meal
between meals
 OR
dried fruit
fresh fruit OR
crackers
wholemeal crackers & cheese
Distribute the ‘Which is the better choice for your teeth’ activity sheet to participants
Explain activity to participants
There are pairs of food and drink choices. Put a circle around the one in each pair that you think is a better choice for your teeth
Give participants about 3 minutes to complete the activity and then discuss the answers as a group (as per answer sheets)
Give participants ‘Keep your teeth healthy’ handout
  OR
bottled water
tap water

10. Which is the better choice for your teeth?OR
orange juice
milk OR
eating sticky foods at a main meal
between meals
 OR
dried fruit
fresh fruit OR
crackers
wholemeal crackers & cheese
Answers – click to reveal the answers one by one
click
Milk is the better choice for your teeth because it contains calcium and proteins that protect your teeth. The natural sugar in milk is also the least damaging to teeth of all the sugars
Fresh fruit contains less concentrated sugar than dried fruit and is not sticky
Plain tap water contains fluoride which strengthens tooth enamel. Bottled water is unlikely to contain fluoride
At the main meal as more saliva is produced. Saliva helps to neutralise acids produced from consuming sugary food and drinks
Wholemeal crackers & cheese. When crackers are eaten with cheese more saliva is produced which reduces acid production. Cheese also helps to reduce the loss of calcium and phosphorus from the teeth when exposed to acid. Wholemeal crackers are a better choice than white varieties because they are higher in fibre. Choose mostly reduced-fat dairy products for people over the age of two. This doesn’t mean you have to eat cheese every time. It’s about reducing damage to teeth: The occasional cracker on its own is alright, however if this is something you do on a regular basis:
Wholemeal is better than white
Having milk, cheese, yoghurt (or yoghurt based dips)with crackers is better than eating them on their own.
  OR
bottled water
tap water

11. What did you think of today’s session?
What do you remember most from today?
Do you think you know more about preventing tooth decay now?
What are you going to do differently?
Group discussion – these questions may need to be asked differently depending on your participants
What will you take away from the session?
Do you feel more confident about the ways in which you can prevent
tooth decay, than you did before the session?
What changes, if any, do you plan to make as a result of todays’ session?