There Is More To Sugar Than Tooth Decay

By John Utama

We all know the harmful effects of sugar on teeth, the bacteria metabolize
the carbohydrates releasing acid by- products, and in a short period of
time, combined with poor oral hygiene, holes develop in the enamel.
Spoiled by numerous campaigns, the Australian public and other developed countries have been educated over the last 4 to 5 decades, dental decay is now largely under control(1), but by no means eliminated. Dentists
are still being kept busy managing dental decay in their practices and will
not be out of a job for a while yet.
However, a more insidious and less known consequences of sugar is its effects on facial growth and airway.

Carbohydrates are essentially made up of multiple chains of sugar molecules. Once ingested, all carbohydrates are broken down into these simple sugar molecules. Carbohydrates are mostly found in processed foods
and they are not necessarily sweet, such as bread, potatoes, pastas. Some
foods such as tomato sauce is laden with sugar, but the sweetness is
masked by salt. Many people still believe only sweets cause dental decay.
The bottom line is that, whenever carbohydrates are consumed, sugar is
pumped into the body.

Before we discuss the other effects of carbohydrates and therefore sugar,

let me share with you the studies done by Weston Price.
Dr Price was a dentist from Cleveland, USA, in the 1930s, he observed at
his own practice that increasing number of his patients were suffering from
chronic diseases and the younger children in particular had high incidence
of deformed arches, crowded teeth and dental decay. He pondered why this
was happening, as he did not see cases like these 15 years ago.
He has also heard reports that native people who lived in isolated areas did
not have any of these chronic conditions. He then travelled to some of
these isolated villages to satisfy his own curiosity, why are these people so
healthy? And why are so many people back home so unhealthy?

Dr Price visited isolated places in the Swiss Alps, cold and blustery islands
off the coast of Scotland, to the Andes mountains in Peru. In total he visited 14 groups of native people.
He also found that less than 1% of the population had dental decay and
the majority had well formed dental arches and facial features. These native people ate what mother nature has provided for them, they ate food
from the ocean and from the ground, absolutely zero refined sugar and
only whole-grain and other unrefined foods.

Fast forward to today, I am seeing not too dissimilar cases at my own

practices from those Dr Price observed in the 1930s. I dare say I am seeing more than he did then.





Here is a typical consultation at my office for young children.

A 10 year old sits in the dental chair. Mum is concerned about the childs
crooked teeth, if and when he/she needs to wear braces.
With these patients, almost without exceptions, I see a small and narrow
jaws, crowded teeth, and there is always a certain degree of mouth breathing. Note that some parents may not be aware that their child has been
mouth breathing (nor themselves). A healthy person breathes through the
nose 100% at rest, the lips are closed together and should only be apart
when eating, talking or while taking breathes after an episode of heavy exercises.



The picture above shows a chronic mouth breather, typically, the chin
tends to be positioned too far back.
The mouth breathing varies from a subtle opening between the upper and
lower lips to an opened mouth large enough for a Coke can to pass
through.
At rest, the nose is designed for breathing, its tiny hairs inside tend to filter
microbes, furthermore, it warms and humidifies the air. Chronic mouth
breathing tends to bypass the natural protection and consequently the
bodys immune system has to work harder.





In many cases, I am also seeing the glazed eyes, dark circles under the
eyes and the creased tip of the nose as illustrated in the photo above. The
picture shows the typical allergic salute, due to chronic irritation of mucus build up in the nasal passages, the child repeatedly rubs the nose accompanied by the sniffing.

The tonsils and adenoids, as parts of the immune system become enlarged
and therefore constricting the airway further.


Left untreated, the airway progressively narrows, reducing the amount of
air passing through the nasal passages, compromising the growth of the
upper jaw and midface (nasal bones, cheek bones and other bones supporting the face), its the use it or lose it principle at work.
Mouth breathing also causes the tongue to drop down, unfavourably modifying the ideal horizontal growth to a less favourable vertical growth of the
face, affecting the balance and beauty of the childs face. As discussed in
The hidden dangers behind snoring, the effects of mouth breathing are
still being felt much later on in life. In essence, as shown by the native villagers in the Dr Price study, the oral muscles such as the lips and cheeks
on the outside and the tongue in the inside, are our very own orthodontic
appliances, IF they function properly.
For proper jaw and facial development the child must develop these most
important habits:

Breathe through the nose

Lips closed together
Proper swallowing

Whats happening?
In 2014 Grimshaw(2) and associates collected food diaries from the parents of 1,140 babies to see if different types of foods have any influence on
food allergies,
They found that babies without food allergies had a diet that was rich in
healthy, often homemade, foods including fruits, vegetables, poultry and
fish, and low on processed foods such as pre-made meals, potato chips,
sauces and bacon.
The analysis showed that the infants who were having more fruits and
vegetables and less commercially produced baby foods and also less adult
foods were the ones who were less likely to develop an allergy by the time
they were two, Grimshaw said.
A landmark study in 1973(3) by The American Society for Clinical Nutrition showed the effects of sugar on the immune system. When 100 grams
of sugar is ingested, (amount equivalent to 1 litre bottle of a soft drink),
the white blood cells are 40 percent less effective at killing germs for at
least 5 hours after sugar consumption! Conversely, they found that fasting

for 36 hours significantly boosted the immune system, when the sugar levels are at their lowest.

The results of these studies are consistent with Dr Prices findings, processed foods tend to cause havoc on the immune system. Allergies cause
mucus build up in the nasal cavities, hindering nasal breathing. The soft
tissues lining the airway have the tendency to swell up, constricting the
airway further, which leads to mouth breathing. The more severe the airway obstruction, the wider the mouth opens.

A recent study(4) also shows some babies are born with heightened response to certain types of foods such as peanuts and even pizza. The authors could only speculate the reasons behind this allergic predisposition,
but they did consider the possibility of environmental causation.

It is therefore feasible to conclude that consuming diet high in processed

foods, contribute to increasing incidence of allergies in the developed
countries. Allergies are most complex human conditions, there are still a
lot of unanswered questions, however, I believe its combination with stress
and environmental (chemical) toxins plays a major part.

How do you suspect if your child has compromised airway?

Mouth Breathing Lips apart. Observe if the lips are apart while at rest, or
while asleep. The further the lips are apart, the narrower is the upper jaw.
Chapped Lips dry lips
Dry mouth
Gingivitis- bleeding gums
Orthodontic issues Crooked teeth, cross bite, overbite, bucked teeth.
Loud grinding of teeth during sleep
Dark circles under the eyes
Change in Head Posture Posturing the head forward and/or tipping the
forehead backwards
Enlarged Tonsil and Adenoid Chronic sinus problems, throat problems
Snoring Children do not usually snore
Chronic allergies, nasal passages are continuously blocked.
Bed wetting
Reflux in the Eustachian Tube Leads to inner ear infections

Management
Now we see the signs of allergies and their effects, what can we do?
The objective is to create the ideal environment for the child to grow optimally. When the environment is right, nature will do its magic in developing the human body; things start to go wrong when we eat processed
foods from birth. The good news is that its never too late to treat problems later in life, once the problems are recognised and identified, we can
facilitate nature to carry on with its work.

At the dentist
Medical History
Asthma, allergies to foods and medications, medications taken, sleep pattern, snoring, bedwetting, headaches.

Examination (outside and inside mouth)

Check facial features retruded lower jaw (weak chin), black rings under
eyes, flat or concave mid and lower face, facial asymmetries, enlarged
adenoids, crowded teeth.

Records
Photographs to check profile
Impressions study models
Xrays to check dental development
3D scans to check airway

Referrals to Specialists
ENT (Ear Nose and Throat) surgeons
Allergists
Myologists
Nutritionists
Physiotherapists

Extraoral aids
Sleep Angels and Breathe Right strips are two of several extraoral aids that
can be helpful in facilitating nasal breathing while asleep.
Sleep angels



Breathe Right Strips



Orthodontic treatment
Myotrainer to train the oral muscles to function optimally and to facilitate nasal breathing



Tongue exercises recommended by Myologists can also be useful in developing a correct swallowing habit.

Full tongue training movie



Functional appliances
Functional appliances are designed to expand the jaws both anterio-posteriorly (forward) and laterally (side ways). Expanded jaws allow more
space for the tongue and improve the bite.



Braces
Braces can either be done in conjunction with the functional appliances or
after, depending on the age of the patient.



Summary
Everyone knows sugar causes dental decay, but its effects on the development of the face, jaws and teeth are much less known. Anthropological
findings by Dr Weston Price and recent studies indicate that sugar and processed foods may play a big part in the increasing incidence of allergies in
the modern society, which in turn cause many dental problems that dentists
are seeing today at their office.
This information is most useful for parents, it motivates them to give their
children healthy whole foods, to recognize early signs of problems and to

be aware of the relevant treatments available so that the conditions can be

managed accordingly at any age. Early management can prevent more difficult or unnecessary treatments later in life such extractions and jaw
surgery.

This article may be used with permission by Dr. John Utama,

(1) Produced by the AIHW and the Dental Statistics and Research
Unit,Australian Research Centre for Population Oral Health, University of
Adelaide.
(2) Diet and food allergy development during infancy: Birth cohort study
findings using prospective food diary data
February 2014Volume 133, Issue 2, Pages511519
Kate E.C. Grimshaw, PhD, RD Joe Maskell, MSc Erin M. Oliver, MSc
Ruth C.G. Morris, Dip HE, RN(Child) Keith D. Foote, MBBS, FRCPCH
E.N. Clare Mills, PhD Barrie M. Margetts, PhD, FFPH Graham Roberts,
DM, MRCPCH
(3) Am J Clin Nutr197326:111180-1184 http://ajcn.nutrition.org/content/
26/11/1180.full.pdf+html
Role of sugars in human neutrophilic phagocytosis Albert Sanchez, J. L.
Reeser, H. S. Lau,P. Y. Yahiku,R. E. Willard,P. J. McMillan,SY. Cho,A.
R. Magie, andU. D. Register
(4) Cord blood monocytederived inflammatory cytokines suppress IL-2
and induce nonclassic TH2-type immunity associated with development
of food allergy Yuxia Zhang1,2,3,*, Fiona Collier4,5, Gaetano
Naselli1,Richard Saffery2,6,Mimi LK. Tang2,6,KatrinJ. Allen2,6,AnneLouise
Ponsonby2,6, Leonard
C.
Harrison1,2,*,, Peter
Vuillermin2,4,5,6,*,,on behalf of the BIS Investigator Group

John Utama BDS MBA

Robina Town Dental
Dentists @Capri
Gold Coast Australia
www.thewholedentist.com

johnutama@me.com