Children and teenagers, whose teeth mature pre and posteruptively,  have a special vulnerability to dental caries. At the same time, the young tooth enamel has a 10 times higher capacity to absorb minerals (Ca and PO4 or fluoride) from the oral environment than the adults, in order to repair and remineralize. Due to the influence of oral hygiene and diet on the process of karyogenesis (in the absence of minerals and caryoprotective nutrients) and/or dental remineralization (in their beneficial presence) – these factors must be taken into consideration when providing guarantees for dental repairs and when avoiding other new caries. From the literature studied in the PubMed 2018 database, as well as from the experience in Pediatric Dentistry within HappydentClinic Cluj Napoca for 10 years we were able to identify some nutritional errors due to the lack of consumer education and also to popular food myths that contain unverified or out of date information, therefore:

1.To completely eliminate sugar from your diet can never be a realistic goal for two reasons: 

a) The “forbidden fruit” reason, as you are not allowed to eat so much chocolate involves the negation (psychological concept) and therefore induces frustration and indecision in changing the eating behavior.

b) To repeat the same message : you are not allowed sugar- induces the eclipse of the goal of a caryoprotective nutrition – which are the nutrients that the dental structure needs – and which, if consumed regularly have the potential to protect tooth enamel even when occasional (not excessive) sugar is consumed.

2. Reducing the concentration of added sugar does not correlate with reducing the incidence of dental caries. In Wei Zhao’s 2016 study, there are significant differences between the group consuming a 1% sucrose solution and the other groups consuming 5%, 10%, 20% solutions. But there are no significant differences between the groups consuming 5%, 10,%, 20% which means that beyond the concentration of 5% (whether it is 90% or 20%),  the cariogenic effect is almost similar.

3. Natural fruit juice. Specialists warn us that a fruit’s natural juice contains more sugar than the whole fruit. Thus, it is recommended to eat the whole fruit, together with its skin. On the other hand, even if natural juices or fruit purees have an erosive potential on tooth enamel, their important nutritional value is significantly higher and not to be neglected – especially for children;

4. Fruit or light yogurts. What we usually find in a fruit yogurt is an addition of refined sugar that replaces the absence of the promised fruit from the label, and diet yogurts contain sugar, even though they also contain less fat. See Milk and oral health : Andrew Rugg-Gunn and Margaret Woodward.

5. Excessively refined foods, such as: ketchup, mayonnaise, mustard, salad dressings, etc. Although we do not expect to find sugar in these foods, they still have a relatively high concentration of sugar.

6. Cereals consumed at breakfast with milk or its derivatives contain variable concentrations of sugar. Check the label. „Sugar free” or foods without sugar, especially those which contain sorbitol should be recommended for children over three years, otherwise they can cause diarrhea for children under 3 years.

7. Sucrose (caster sugar) is the most cariogenic carbohydrate. About the other carbs– epidemiological studies have shown that foods which contain starch, lactose from milk and even fructose from fruits can also be significantly associated with high indices of tooth decay. (Tissi; 2014). A warning sign should we drawn when it comes to natural sugars (brown or candel) like honey or molasses are considered as cariogenic as refined CHO. (Cynthia 2015)

8. Mentes (2001) demonstrated the cariogenic potential of pediatric medication, this one being most often sweetened with sucrose (caster sugar), rarely unsweetened but less often sweetened with non-cariogenic substitutes (sorbitol, aspartame). Therefore, pediatric medication cariogenic effect should not be neglected, even though it may also have a beneficial effect due to its analgesic or antipyretic potential.

9. Chocolate – although it is incriminated as the queen of dental karyogenesis-due to its cocoa butter content – it has a caries-protective potential – especially if it contains a low sugar level – dark chocolate.

10. In the economy of dental caries, not only carbohydrates (cariogenic factors) are important in dental caries but also other micro and macronutrients (which are karyoprotectants): proteins (are karyoprotective) (see PEM), fats, lipo and water-soluble vitamins (karyoprotective). [Carvalho et al., 2001; Crooks, 1999; Wiecha and Casey, 1994].