1001 UsesFor Dental Floss #58- Sugar Really Is Bad For You, In So Many Ways

I recently came across this article in Medscape, a well-respected medical journal which is easy to access online. The contents of the article should make you worry. If you think about the processed and commercially-available restaurant food you may occasionally (or often) eat or take your kids to, you should be aware that sugar is an ingredient in very many of these foods, sometimes even surprisingly so.

It used to be that salt added to foods, and fat, whether saturated or unsaturated, was seen as the villain “eating away” at your health, and this has been promoted by the food industry and used as an excuse to cover up the role of added sugar, in all its many forms, in affecting nutrition and health. As it turns out, sugar is, according to research findings coming out more and more, a major cause of obesity and a contributor to, among other conditions, cardiovascular disease and diabetes. It should be a cause for concern. Just as tobacco was once defended by the companies who produced products such as cigarettes and cigars, industry involved in the use of sugar in its many forms and disguises are now fighting to retain their hold on its use in food production, denying its deleterious effects. Something to think about.

From a dentist’s point of view, sugar is well-known as a cause of tooth decay when combined with poor oral hygiene, because it feeds mouth bacteria, which produce acids. These acids at first etch tooth enamel (by dissolving its calcium-containing crystals), and in later stages eat away at its structure, making cavities (holes) in the tooth surface. Now, sugar is being linked to other disease processes.

Flossing is important, but let’s not forget that our teeth are part of our body. It’s all one, and it’s all that you’re got, really. Take care of it.

This is important reading.The original article can be found at: http://www.medscape.com/viewarticle/



Sugar Is the New Tobacco, so Let’s Treat It That Way
Aseem Malhotra, MBChB, MRCP

I was recently asked to speak at the UK parliamentary “Sugar Summit.” This event was convened by Rend Platings, a mother so disturbed by England’s chief medical officer’s revelation that, as a result of obesity, today’s generation of parents may be the first to outlive their children, that she launched a campaign, Sugarwise, to help consumers identify foods with added sugar.[1]

Keith Vaz, chairman of the All-Party Parliamentary Group for Diabetes, chaired the event, whose audience was made up of a number of representatives from such high-profile UK retailers as Tesco, Caffè Nero, and the Jamie Oliver Group, as well as such influential stakeholders as the UK Department of Health, Public Health England, the British Soft Drinks Association, and the Food and Drink Federation.[2]

I began by welcoming the UK government announcement of an introduction of a 20% tax on sugar-sweetened beverages in 2017. I similarly welcome the recent statement calls by the World Health Organization (WHO) to tax sugary drinks by at least 20% in order to curb the global epidemics of obesity and type 2 diabetes. We mustn’t forget that the substantial decline in tobacco consumption in the past three decades, which was the single most important factor driving a decrease in cardiovascular mortality during that period, only happened after legislative measures that targeted the affordability, availability, and acceptability of smoking.[3]

Health Effects

Oxford researchers have estimated that a 15% reduction in sugar consumption through such a tax would prevent 180,000 people in the UK from becoming obese within a year and a larger number from becoming overweight.[4] But the scientific evidence reveals that the positive health benefits for the whole population of such a tax goes beyond a mere reduction in calories:
• An econometric analysis of 175 countries (considered the highest quality of study with the exception of randomized controlled trials) revealed that for every additional 150 sugar calories available for consumption, there was an 11-fold increase in the prevalence of type 2 diabetes in the population. This is compared with 150 calories from another source such as fat or protein and independent of body mass index (BMI) and physical activity levels.[5]
• The prevalence of type 2 diabetes in the US population between 1988 and 2012 increased by 25% in both obese and normal-weight populations,[6] which goes to show that type 2 diabetes is not a condition related purely to obesity.
• A high-quality prospective cohort study revealed a trebling in cardiovascular mortality among US adults who consumed more than 25% of calories from added sugar versus those who consumed less than 10%, with consistent findings across physical activity levels and BMI.[7]
• The positive health effects of reducing sugar intake appear to be quite rapid. In a study of 43 Latino and African American children with metabolic syndrome, keeping total calories and calories from carbohydrate identical, a reduction from a mean of 28% of calories from added sugar to 10% significantly reduced triglycerides, LDL cholesterol, blood pressure, and fasting insulin within just 10 days.[8]

How Much Sugar Is Safe?

So, how much sugar do we need? For the purpose of health, the optimum consumption is zero. Added sugar has no biological requirement and is, therefore, not by any definition a “nutrient.” It is the fructose component (sucrose is 50% glucose and 50% fructose) that fulfils four criteria that justify its regulation: toxicity, unavoidability, the potential for abuse, and its negative impact on society.[9]
How much sugar is safe? The consumption of just small amounts of free sugar, which includes all added sugar and sugar present in fruit juice, syrups and honey, on a daily basis, has a deleterious impact on the most common noncommunicable disease globally: tooth decay. Treatment of dental disease is responsible for 5%-10% of health expenditures in industrialized countries, and in the UK, tooth decay is the number-one cause of chronic pain and hospital admission in young children.[10,11]
As pointed out by researchers from the London School of Hygiene & Tropical Medicine, there is a powerful argument that the WHO should recommend a maximum limit of sugar consumption to make up no more than 3% of daily calories (about three teaspoons).[12] The average UK and US citizen, however, consumes at least four to seven times that amount.[13,14] This is perhaps not surprising when one acknowledges that it has been almost impossible for the consumer to avoid sugar, as it is so prevalent in the food environment and much of it is hidden. In the United States, almost half of all sugar consumption comes from foods one wouldn’t normally associate as having added sugar, such as ketchup, salad dressings, and bread. A third of sugar consumption comes from sugary drinks, and a sixth from foods that people normally perceive as junk, such as chocolates, cookies, and ice cream.[14]
In the United States, there isn’t any reference dietary intake for sugar on food labels. In Europe, the labelling exists but doesn’t differentiate between children and adults. One can of regular cola contains nine teaspoons of added sugar, which is triple the 2009 upper limit intake suggested by the US Department of Agriculture for an 8-year-old child. The UK Guideline Daily Amount label describes these nine teaspoons of sugar as 39% of the guideline daily amount. On the basis of this false reassurance, it would be understandable for parents to believe that it is safe for their child to drink two and a half cans per day.[15]

The food industry often argues that the public should have a “personal responsibility” when choosing what foods to eat, which deflects blame from their own culpability in the obesity epidemic to the consumer. The truth is that the public lacks knowledge because of confusing food labels, and the public lacks choice because sugar is added to approximately 80% of processed foods.

Big Tobacco, Big Sugar

The fact that it took 50 years before the first links between smoking and lung cancer were published in the British Medical Journal and before effective regulation was introduced is testament to how Big Tobacco was able to defend its practices. Key to the strategy was denial, planting doubt, confusing the public, buying the loyalty of scientists, and giving ammunition to political allies.[16]

The similarities between Big Tobacco and the sugar industry are disturbing. As a recent publication in JAMA Internal Medicine showed, the sugar industry paid three influential Harvard scientists to downplay sugar’s role in heart disease and to shift the blame to fat.[17] Last year, the New York Times exposed that the Coca-Cola Company paid millions of dollars to fund research that downplayed the role of sugary drinks in obesity and push lack of exercise as the main factor.[18] And, according to one former UK shadow health minister, the incorrect advocacy of a low-fat, high-carbohydrate, and high-sugar diet by “morally corrupt scientists and politicians who allowed themselves to be manipulated by food suppliers” is to blame for global obesity.[19]
The recent calls by the WHO to tax sugary drinks are very welcome news for health campaigners. The public health messaging, however, has to be more clear. There is nothing wrong with the occasional treat, but sugar has no place as part of a “healthy balanced diet.” Similar to smoking, any further regulatory measures to reduce sugar consumption, such as banning of sugary drink advertising and dissociating sugary drinks with sporting events, will have a further impact on improving population health within a short time. The science is more than sufficient; the case against sugar is overwhelming. Sugar is the new tobacco, so let’s start treating it that way.



1001 Uses For Dental Floss #47- Plastic Beads In Toothpaste (What?!)

My daughter Rebecca found this article about tiny plastic beads in certain varieties of Crest toothpaste, apparently put there by the manufacturer to give the toothpaste its blue colour. As some of us may know, there is great controversy in the inclusion of plastic beads as an abrasive in some “invigorating” body wash soaps, supposedly as a scrub enhancement or exfoliating agent. They wash down the drain and into large bodies of water like the Great Lakes and our oceans.

These beads, made of the polyethylene, have been found in the bodies of plankton, tiny sea creatures which are an important part of the marine food chain, and have been adversely affected by them, as they may block their digestive tracts, causing them to starve to death. These little animals are eaten by larger creatures, such as fish, and the beads progressively work their way up the food chain. The plastic also has the sponge-like property of soaking up pollutants like motor oil and pesticides. On the positive side, polyethylene doesn’t contain bisphenyl A, so it seems to be safe from that standpoint (that is, it doesn’t contain this hormonal disruptor.)

Although the plastic beads in this brand of toothpaste are much smaller and so may be less of a threat to the aquatic ecosystem, we don’t really know. What we do know is that in people, these tiny plastic bits have been found in the gingival crevice, the narrow space between the gum and the tooth, and are difficult if not impossible to dislodge. This happened to my daughter.

Although regulators from the U.S. Food and Drug Administration have approved the use of these plastic beads, as there is no real evidence that they’re dangerous to health, no comment has been received from the Environmental Protection Agency, I guess because no one asked. On the other hand, they have no  health benefits. Many dentists, though, are questioning the possible effects of the beads retained below the gum, as they fear that they may form a surface which harbours oral bacteria, and so may endanger the health of the gums.  So far, no scientific inquiries have been carried out to test this possibility, which means that the effect is unknown, not that it is nonexistent. I don’t tend to be alarmist, but these plastics don’t  break down naturally, and they’re not biodegradable.

The use of these beads has been banned in Illinois.

Crest put out a statement recently that it has begun phasing out microbeads from its products, a process that will be completed by March 2016. A spokesman for the company told the Washington Post that the decision was made “months ago” in response to “changing consumer and dental professional preferences.” One questions why it should take so long to do this, but with no urgent threat to public health, economic considerations seem to be taking precedence.

“While the ingredient in question is completely safe, approved for use in foods by the FDA, and part of an enjoyable brushing experience for millions of consumers with no issues, we understand there is a growing preference for us to remove this ingredient. So we will.” the company said in a statement. “We currently have products without microbeads for those who would prefer them. We have begun removing microbeads from the rest of our toothpastes, and the majority of our product volume will be microbead-free within six months.”

The American Dental Association, which endorses some Crest products, stands behind the beads, citing a lack of clinical evidence questioning their safety. The ADA has not revoked their approval of these products, citing a lack of scientific evidence against them.
The ADA’ s statement is: “The American Dental Association’s (ADA) Council on Scientific Affairs, on an ongoing basis, monitors and evaluates the safety of all ADA Seal-Accepted products. If the council’s evaluation determines sufficient scientific evidence exists that an ADA Seal-Accepted product poses a health risk, the council has the authority to withdraw the Seal from that product. At this time, clinically relevant dental health studies do not indicate that the Seal should be removed from toothpastes that contain polyethylene microbeads.”

Anyway, remember to floss. Floss contains no microbes. So far.

This article is based on one by Abby Philip found in the Washington Post, dated September 14, 2014.


1001 Uses For Dental Floss #24- Maybe They Should Promote It?

Art by Jackie Rae Wloski

Warning: this is a rant.

I was at a dental convention today, here in Montreal, where I hang out. The commercial exhibits were busy selling everything dental under the sun, including lasers, digital radiography, fancy equipment, and, of course, the staples: toothbrushes and toothpaste. I walked up to the two booths that sell these last items, well-known brands both starting with the letter C. No floss on display! None.

I had to ask for it and then they suggested I buy some and give samples to my patients, which I do anyway (why I should have to pay these companies so I could do their marketing for them is a different question.) So I said: “Why do I never see your company ads ever (EVER!) mention floss, since you’re supposedly promoting good dental health. I see ads on television and in magazines for your all-in-one toothpastes that do everything: protect against plaque, tartar, bad breath, stain, decay, and anything else you can think of, except bring you on a better vacation or promote world peace, your fancy electronic, ultrasonic, super-vibrating toothbrushes with faster-to-accelerate-than-a-Italian-sports-car motors, but nary a mention of floss, which is probably the most effective means of keeping teeth and gums in good shape for a lifetime, with all the health benefits associated with that.” (See previous posts on this blog.)

I sometimes feel like a lone voice in the wilderness. I don’t have a big advertising budget like C and C. And it’s not like these companies would benefit in any way by people not flossing, since that’s what they sell and make money by. It is dental hygienists and dentists who have to pick up this ball and run with it, pushing this product, and are the ones who stand to lose out by having patients with good oral hygiene not needing their services as a consequence. Does this picture really make any sense?

In the pharmaceutical industry, there are a number of diseases not being addressed by research, because they affect few and the potential for profit is low after all the investment in time, money, and paperwork that’s required to develop a new drug. They’re called “orphan diseases”. Maybe floss is the “orphan drug” of the dental industry, not worth the effort of the manufacturers because their profit margin isn’t big enough, even though dental decay is the most prevalent infection in the world and could do with a little prevention.

The tobacco, fast food, corn syrup and sugar industries all try (or have tried in the past) to deny that their products are detrimental to health because their bottom lines depend on people continuing to buy them. The exact opposite is true for the makers of floss- their products are good for our health. So, whether you’re a capitalist (hooray for profits!) or a socialist (hooray for the people!) promoting floss is good for everyone (except maybe your dentist.)

So, C and C, and you know who you are and so do we, get out there. Make flossing the thing to do. You know how. Make us smile.


1001 Uses For Dental Floss #3 – Longer Life With Floss

1001 Uses For Dental Floss #3 – Longer Life with Floss
Hidden among his usually more faddish recommendations, Dr. Oz says something that seemed indisputable: flossing daily can add to your life expectancy (6.4 years, it seems) by reducing complications of inflammation, such as heart disease and complications during pregnancy. This applies even more so for diabetics. This statement about a direct link was later retracted because of criticism from the American Heart and Stroke Association and the American Dental Association. Nonetheless, using dental floss regularly fits well in a basket with other good preventive health practices, such as eating well, regular exercise, and not smoking: individuals practicing these good habits tend to live longer, healthier lives.
And  you get to keep your teeth! Live longer and better. Floss every day, but also do all the other good stuff. If you don’t know how to floss, ask your dentist or dental hygienist.




1001 Uses For Dental Floss #2– Radium Toothpaste

http-inlinethumb23.webshots.com-43798-2706452680102347975S600x600Q85During World War II, a German company, Auergesellschaft of Berlin, marketed a radioactive toothpaste, Doramad. On the back of the toothpaste tube it was stated that, ‘radioactive radiation increases the defenses of teeth and gums… cells are loaded with new life energy, the destroying effect of bacteria is hindered… it gently polishes the dental enamel and turns it white and shiny.’ The description failed to mention that the radiation could cause mutations and cancer in the mouths of the users and, when swallowed, many other organs of the body. The popularity of this toothpaste is unknown, likely because Germans were more concerned with surviving the war and “following orders” at the time.