Patient Education 2

Bad Habits

August 17, 2021

By Dr. Jeff Shnall

In this article we’ll discuss poor eating and drinking habits and how they damage our teeth.

We’ll discuss habit prevention and how to prevent and repair the damage that may already be done by these habits.

We will also discuss bruxism, which is the habitual clenching and/or grinding of one’s teeth. Bruxism can cause serious wear and tear of your teeth as well as chronic jaw pain and headaches. We’ll discuss its prevention and treatment.

Some of the material I will present today is common sense and common knowledge, but some of the things I will share with you may surprise you.

If we take care of our teeth they truly can last a lifetime. I have seen many patients in their eighties and nineties who have all of their own teeth. However, you do have to take care of them.

Unfortunately however many times a week I see patients both young and old with damage to their teeth caused by bad habits and in all cases the damage was preventable.

First, let’s start with poor dietary habits that can affect children’s teeth.

This first habit we’ll talk about example is known by most new parents but it warrants a mention because occasionally I do see this problem in my practice. A serious cavity problem can develop if parents give infants and toddlers a baby bottle filled with milk or juice to use as a pacifier.

Some young children are allowed to keep bottles with milk or juice in their mouth for many hours a day or all through the night while sleeping. Infants and toddlers may find it soothing to suck on a bottle of milk or juice but if left in the mouth for long periods of time this can cause severe tooth decay.

How does this happen? Well, whether young or old, our mouth is home to millions upon millions of bacteria. These bacteria cover our teeth with a thin film and especially like to live in the deep grooves of teeth. When you wake up in the morning you may feel a fuzzy film on your teeth…that is the bacteria that I am talking about. If these bacteria are fed sugar they will convert this sugar to acid. This acid, if allowed to sit on the surface of a tooth long enough will dissolve the enamel of the tooth causing a cavity.

The bacteria responsible for cavity formation is called streptococcus mutans. Both milk and juice contain sugars that can cause cavities. So it is not the sugar alone in the milk or juice that causes the cavities…it is interaction between the bacteria on our teeth and the sugar in our diet causes the decay to occur.

Studies have shown that if you raise germ free mice in a lab, that is, mice that have no bacteria at all on their teeth, and you feed them large amounts of sugar, these mice will not develop cavities. No bacteria on the teeth means no acid production on the teeth even if the teeth of these mice are exposed to great amounts of sugar.

Getting back to children, It is perfectly fine for a child to have milk or juice with a meal or a snack, or to drink from a baby bottle for food or comfort for reasonable amount of time. While eating or drinking foods that contain sugar, the bacteria on the child’s tooth will produce acid. However after the meal the child’s saliva will wash the acid off the tooth and bathe the child’s teeth in calcium (which is found in our saliva).

This calcium is deposited into the surface of the tooth where cavities start, rebuilding the damaged tooth. The calcium also serves as a buffer, neutralizing or eliminating the acid on the tooth surface.

Problems develop however in the case of infants or young children that are allowed to have a milk or juice bottle in their youth for hours at a time during the day or all through the night.

In this case the bacteria that cover the teeth have a steady supply of sugar and readily convert this sugar into acid. The acid sits on the teeth for hours and there is not a chance for the surface of the teeth to recalcify.

The continuous production of acid on the tooth overwhelms the ability of the child’s saliva to buffer it. Cavities result.

An infant sucking on a baby bottle (or drinking from a sippy cup) full of milk or juice for hours during the day or night can develop a severe cavity problem that can affect many and sometimes every tooth in their mouth.

This can result in the need for extensive fillings, root canal treatment of even extraction many of the child’s teeth.

What is the solution to this habit?

Infants and young children can be given pacifiers instead of bottles to suck on for comfort.

Pacifiers won’t harm a child’s tooth development in the first few years of life. It is best to consult with your pediatrician or physician, or do a little more research yourself to decide whether a pacifier is right for your child.

Outside of mealtime you can try giving the child water instead of milk or juice in the bottle or cup.

Good tooth brushing of the infant’s teeth is helpful in preventing cavities and should be done at least twice a day.

Taking your infant to the dentist from an early age for a brief exam can detect cavities, and is recommended by both the American and Canadian dental associations.

These check-ups are recommended to start within the first six months of the eruption of the first tooth, so this is when the child is between 6 months to one year of age.

These brief appointments also gives the dentist a chance to advise new parents on how to care for their infant’s teeth.

Let’s move on to another habit. I will only touch on this one briefly because it is so widely known. This is overdoing the amount of sugar in our diets.

This habit can affect people of all ages.

The biggest problem foods are sugary foods that stay in the mouth for long periods of time, for example lollypops and candies people suck on , sticky snacks such as dried fruit, caramels and gummie bears and as well, chewing gum that contains sugar.
Any of these sweets are okay once in a while; however when they are part of the regular daily diet of a child or adult often the result is cavities.

Again, the bacteria that is found on kids and adult’s teeth converts the sugar from the candy into acid which decays the tooth.
The amount of candy consumed as well as the length of time that the candy stays in the mouth is a major factor that determines whether a cavity will start. Sticky sweets such as caramels stay on the tooth long after the candy is finished, allowing for more acid production on the tooth and a greater chance for cavities to start.
Chewing gum containing sugar as well as sucking on candies and mints also exposes our teeth to sugar for longer periods of time, leading to a greater chance for cavities to start.

This is not only a problem of the young. I have seen many a time older adults and elderly patients developing severe cavity problems due to diets too high in sugar.This problem is sometimes compounded in older patients because some of them have decreased amounts of saliva production. This is often a side effect of certain medications that older patients are likely to be on, for instance certain heart and blood pressure medications.

As well, some elderly patients can’t clean their teeth as well as they could when they were younger due to decreased strength, dexterity and sometimes cognitive deficits, that is, they forget to brush.

How to beat the cavity problem created by excess sugar?

Lollypops and candies containing sugar can be substituted for sugar-free lollipops and sugar-free candies that are usually readily available in supermarkets and bulk food stores.
Sugary, sticky candies are best avoided altogether or eaten rarely. Sugarless gum is the only gum a child or adult should be chewing and it can be a substitute for the sugary, sticky candies.

Sugarless gum actually can help fight cavities. Chewing sugarless gum stimulates saliva flow, bathing the teeth in more saliva.
The saliva washes the cavity causing bacteria and their acids off the teeth. As well, because saliva delivers calcium to our teeth, the increased flow of saliva that gum stimulates can remineralize the tooth and reverse the decay process.

If you give your child a stick of sugarless gum after the sticky candy or brush their teeth right after the candy is eaten it can limit cavity formation. Popcorn, pretzels or other non-sugar containing treats can also take the place of sugary snacks foods.

Now let’s talk about another habit that I often see in my day to day practice that can cause significant damage to your teeth.

This is a habit related to the beverages that we drink.

Most kinds of drinks, in moderation won’t damage our teeth. However, when consumed too often or for excessive periods of time certain drinks can cause great harm.

Once in a while a patient will come into my office with a severe cavity problem, that is decay or cavities in many and sometimes every tooth in their mouth. The cause? Drinking either excessive amount of soft drinks or juice or by drinking
fairly small amounts of soft drinks or juice but for long periods of time each day.
Often these patients need many fillings, root canals or extractions of many teeth.

There are several kinds of drinks that can lead to cavity problems. What these drinks have in common is that they contain some form of sugar. This can be refined sugar also known as known as or sucrose, or the sugar found in fruit also known as fructose or the sugar found in milk, called lactose. Therefore, Beverages that can lead to cavities if over consumed are: soft drinks that contain sugar, certain brands of iced tea, fruit juices such as apple, orange or grape juice, lemonade, and as well milk.

If you drink any of these beverages with a meal or a snack and providing you are limiting these drinks to a few glasses a day you are not likely to harm to your teeth.

However, if you drink large quantities of these drinks each day cavities can result. As well if you keep a glass of pop, milk or juice by your side while you watch an hour or two of television each night, or for several hours each day at work, taking little sips from your drink, this is exposing your teeth to sugar for fairly long periods of time and this can lead to big cavity problems.

A group of patients I see this happening to are students, especially college and university students. Some students, while putting in long hours while they study will sip on a can of cola or some other soft drink or energy drink containing sugar (and in some cases caffeine) to help keep their energy up. If they take little sips on the soft drink over several hours each day or night on a regular basis again this can lead to multiple cavities in young people who never had cavity before starting college.

Unfortunately drinking diet pop, which contains no sugar can also be damaging to your teeth if consumed unwisely. Almost all soft drinks, whether they are diet or those that contain sugar, contain either citric or phosphoric acid. IT’S RIGHT ON THE LABEL. Manufacturers add these acids to soft drinks to improve their flavour and as well to act as a preservative.

The citric and phosphoric acid in soft drinks can cause severe tooth erosion if you are drinking large amounts of these drinks or sipping on a can of diet pop long periods of time each day or night, while at work, while watching TV or while driving.

I have seen cases where the patient has lost very large areas of enamel from the fronts and tops of their teeth, areas of the tooth that the diet soft drink pop comes into contact with.

Citrus drinks such as lemonade, grapefruit juice or ice tea with lemon can also result in a lot of tooth wear due to the erosive effect the vitamin c found in these drinks.
Vitamin C is also known as ascorbic acid, and if not taken in moderation these drinks can cause gradual but severe wear of our teeth.

When I see patients with cavities or erosion to their teeth I try to help them as follows. First, I discuss diet with these patients and we try to uncover if there is anything in their diet that could be causing their cavity or wear problems.

I ask patient’s to keep a three day diary listing everything they eat or drink so we can see if diet is a factor in their dental problem. It most often is. Once we have pinpointed diet as a source of their dental problem we give suggestions on how the patient can modify their diet to prevent or minimize further tooth destruction.

Some of these suggestions are:

Limit drinks containing sugar to meal or snack times only and keep the duration of snack times to reasonable periods of time.
Drinking pop or fruit juice for ten or fifteen minutes is a lot better for your teeth than drinking a glass of pop or lemonade for an hour or two at a time, especially if done on a daily basis.
If you want or need to drink in between meals try switching to water, coffee or tea without sugar. Drinking green tea has the added health benefit of having anti-cancer properties.
Chewing sugarless gum or sucking on sugarless candies can keep our mouths lubricated. They stimulate saliva flow. This can reduce your need for drinks to prevent dry mouth.

Bruxism (Clenching and grinding)

Clenching is when we squeeze our teeth together similar to the way we would clench our fist, while grinding is when we rub or teeth from side to side , in any or all directions. We often clench or grind our teeth when we are under stress.

Stress is a major cause of bruxism.

Bruxing can occur while we sleep or while we are awake.

How do you know if you clench or grind your teeth while you sleep?

You maybe doing this if you often wake up with sore teeth, sore jaws or headaches. There are strong muscles that wrap around the top of our head, our temples and cheeks that open and close our jaws. People who clench and/or grind at night
can over-work these muscles often for many hours a night.
This can cause these muscles to become sore and fatigued, the same way that a marathoner’s legs would get tired after running all night.

Bruxers also can wear their teeth down, in some cases quite severely. I have seen patients who, through years of bruxing, have ground down their front teeth to little stumps that no longer resemble teeth.
Night time or daytime clenching and grinding can cause sore or even cold sensitive teeth; it can also cause teeth that are painful to chew on.

For some people clenching or grinding can be a short term activity. It can start when something in their life starts to cause them stress or emotional upset…and once things calm down in their life the clenching or grinding stops.

For others, clenching or grinding can be a long term, chronic condition. People do not have to live with the unpleasant symptoms and consequences of clenching and/or grinding.

Some solutions to bruxism are:

Seeing you family doctor for stress counselling. Your doctor can suggest ways to better handle stress.
Regular exercise, proper diet and rest, relaxation and breathing exercises can all be ways to reduce stress and thus reduce clenching/grinding.
Dealing with the source of the stress in your life can be very helpful.
Your dentist can help with clenching or grinding symptoms by providing you with a dental appliance that goes by various names such as night splint or night guard.

A night guard resembles a sports mouth guard and protects your teeth and jaws from the harmful consequences of clenching and grinding by acting as a cushion for your teeth.
Instead of squeezing or grinding your upper teeth against your lower teeth while you sleep, instead your teeth will grind against the acrylic material of the night guard.

The night guard can prevent you from generating high biting forces that cause muscles fatigue and also prevent your teeth from wearing down.

Well, these are just some of the habits that can have a detrimental affect on our teeth and their proper function. If you have any questions or would like to set an appointment in our office we would be happy to hear from you!

Dr. Jeff Shnall

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