By Col. Georgia Rogers, DMD, MPH
Consultant to the Surgeon General for Dental Public Health
Sugar is being called “the new tobacco.” Its many forms have been linked to the increasing rates of diabetes, heart disease, nonalcoholic fatty liver disease, and other chronic diseases in the U.S.
Army dentists have been fighting on the front lines against sugar for decades. Despite their best efforts, tooth decay continues to be the main cause of dental disease and non-battle injuries among deployed Soldiers. From 2000 to 2008, the oral health of DoD recruits worsened. The 2008 Tri-Service Oral Health Survey revealed that Army recruits have higher numbers of untreated cavities compared to other DoD recruits. A study at the largest Army installation showed that about one third of Soldiers develop new treatment needs every year.
Army Soldiers have better access to education about oral hygiene and proper nutrition, fluoridated water, fluoride toothpaste, and dental care than many Americans. But Army dentists report that these defenses can’t compensate for Soldiers’ frequent snacking habits and the popularity of soft drinks, sports drinks, energy drinks, sweetened coffee, sweet tea, and coffee boutique drinks (frappacinos, etc). Army dentists are all too familiar with the rampant decay that results when a Soldier sips on sugary drinks throughout the day. Drinks that contain high amounts of sugar, caffeine and citrus flavors often cause extensive tooth decay, likely due to the combination of high sugar content and organic acids.
Young Soldiers often don’t pay attention to the sugar, calories, or caffeine in their drinks. One large iced coffee can have 11 teaspoons of sugar. But even if they check the label, looks can be deceiving. The amount of sugar, caffeine, and carbohydrates per serving listed on a single can of an energy drink may not seem that bad, but the can actually contains two servings so you must multiply by 2. The most popular Energy drink purchased at AAFES stores, 16 oz Monster, has 13 teaspoons, and the most popular soda, 20 oz Mountain Dew, has over 18 teaspoons of sugar.
Caffeine and sugar have both been shown to be addictive, and Soldiers are just as vulnerable to the caffeine rush and sugar high as other Americans. During deployment or intense training courses, Soldiers can come to depend on these drinks to stay awake and alert, or to relieve boredom. They return home with souvenirs that they would rather not have – a mouthful of new cavities.
Col. Johnette Shelley, director of Health and Wellness at DENCOM, recommends Soldiers practice the following countermeasures to protect themselves from decay:
1) Replace sugared beverages with sugar-free alternatives, plain water, mineral water, or unsweetened coffee or tea.
2) Fruit juice contains sugar and acid also, so limit juice to 6 ounces of calcium-fortified juice per day. Eat fresh fruit to meet daily fruit intake goals.
3) Drink sugary or acidic drinks quickly, within 15 minutes, rather than sipping on them for an extended period of time.
4) Limit meal, beverage and snack intake to no more than five times per day. Combine sugary beverages or juice with a meal, ideally near the beginning of the meal.
5) Try to drink sugary, erosive drinks cold to minimize the acidic effects.
6) Use a straw that reaches to the back of the tongue to keep the drink away from your teeth.
7) Drink plain water immediately following the sugared drink to ‘wash’ it off of the teeth and neutralize the acid from the drink. Chew sugar-free or xylitol gum to help neutralize acid also.
8) Wait at least 20 minutes after drinking sugary beverages or 100% fruit juice before brushing teeth with fluoridated toothpaste.
9) Do not rinse your mouth after brushing. Just spit several times to remove the excess toothpaste. Also, don’t eat or drink anything for at least 20 – 30 minutes after you brush so the fluoride will stay on your teeth as long as possible and protect them better.
Remember, sip all day… Get decay!