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Sugar and teeth – an unhealthy relationship

It is irresistibly sweet, has many names and makes you addicted to more: sugar. Around 1,000 years ago, the crusaders imported it to Europe as a valuable foodstuff, spice and medicine. Today it is hidden in 80 percent of all processed foods. In the lists of ingredients, for example, it appears under the pseudonyms sucrose, barley malt extract, fructose, glucose syrup, cane sugar or lactose. Regardless of what name it is given, one thing you can be sure of: it is our teeth’s worst enemy and the main cause of tooth decay.

what is sugar

Sugar is one of the carbohydrates and is a crystalline, sweet-tasting food. It is obtained from plants (sugar cane and sugar beets) and consists mainly of sucrose. Sugar is an important source of energy for muscles and brain. During digestion, the body splits off tiny sugar components and supplies them to the cells that need energy via the bloodstream. The hormone insulin helps here: the insulin level rises when we have consumed sugar and then regulates itself again.

Sugar is cheap, preserves food, binds water and is a flavor enhancer. In the brain, the sweetener triggers a similar feeling of well-being as drugs, but sugar does not cause physical dependence. Excessive consumption promotes obesity, tooth decay and health problems such as diabetes (type 2) and cardiovascular diseases.

Incidentally, brown sugar is not a healthier alternative to white crystalline sweetness and has just as many calories. The vitamin and mineral content of sugar can only be detected in traces anyway and is not relevant for nutrition. Brown sugar has not been cleaned as often after being extracted from the sugar beet and still contains residues of the syrup that give it its dark colour. With its malty, slightly caramel-like taste, however, it can score points compared to the perfectly bleached white version.

How does sugar damage teeth?

To save the honor of table sugar and all other types, one thing must be said: it is not the sugar itself that destroys the teeth. The caries-producing bacteria in plaque love sugar, and the caries-causing germ Streptococcus mutans is particularly fond of sugar. When the sugar is digested by the bacteria, it produces acid. This acid even attacks hard tooth enamel. When we consume sugar, the pH value in the mouth also changes in an acidic direction. The normal value – between 6 and 7 – drops to 5 or 4. The acidic environment causes minerals to be leached out of the tooth enamel, making it vulnerable and causing cavities over time: this is how caries develops. Incidentally, the teeth don’t care what kind of sugar you eat, the demineralizing effect of the acid is always the same.
Hidden sugars in food

Ready-made and processed foods must disclose their ingredients in a list of ingredients that is printed or affixed to the packaging. The first ingredient in the list is always the one that has the most in the product. The sugar it contains is therefore not easy to discover: only sucrose, i.e. beet, cane and table sugar, must also be listed as sugar. Food manufacturers like to use the trick of hiding many different types of sugar in the product. Due to the lower proportions, the sweetening ingredients are usually at the bottom of the list and appear harmless.

You can also recognize added sugar by the following non-suspicious-sounding names on the ingredient list of foods and beverages:

  • Glucose-fructose syrup (glucose-fructose syrup, fructose-glucose syrup)
  • Glucose syrup (glucose syrup)
  • Corn Syrup, Corn Syrup
  • (Oligo) fructose (fructose, fruit sugar)
  • Maltose (malto extract)
  • Maltodextrin
  • Dextrose (grape sugar)
  • Raffinose
  • Lactose (milk sugar)
  • Barley malt extract
  • Sweet whey powder
  • Fruit sweetness
  • Agave syrup

Which foods contain hidden sugars?

Some sugar bombs among the foods might surprise you. At first glance, ketchup is not associated with sweets, but a bottle can contain up to 27 grams of sugar. The popular ready-made pizza also contains up to 14 grams of sugar, ready-to-eat coleslaw up to 12 grams. Ready-to-eat canned red cabbage, spreads, sauces, yoghurt with fruit, dressings and ready-made muesli mixes are sugar traps. Some drinks, such as lemonade or energy drinks, and fruit juices such as orange juice or apple juice not only taste sweet, they also contain a lot of sugar. People who want to save calories in their diet should be particularly careful with low-fat light products: the proportion of fat in these foods is reduced, but the sugar content is often greatly increased, otherwise the flavor carrier is missing.

Does the sugar content in fruit also damage your teeth?

Fresh fruit and vegetables are important for a balanced diet. Highly sugared canned fruit is of course not an alternative to unprocessed fruit. But even with a tooth-healthy diet, consumers can fall into the sugar trap: fruit contains fructose (fruit sugar), and some varieties even contain large amounts of it. Grapes, apples, bananas or plums contain a lot of sugar, while berries, watermelons or oranges contain less. Not only minerals and secondary plant substances are concentrated in dried fruit, but also the sweetness of the fruit. For example, a handful of dried apricots has three times the sugar content of a handful of fresh apricots. Fructose is no healthier than refined sugar, even though it’s naturally present in fruit. Research suggests that too much fructose can lead to fatty liver.

Sugar substitutes

In order to avoid high sugar consumption, numerous sweeteners or sugar substitutes are available. The latter include, for example, xylitol, erythritol, sorbitol, mannitol, isomalt, maltitol and lactitol. These substances are obtained from fruit, corn cobs or wood, their sweetening power varies, and the number of calories is significantly lower than that of conventional sugar. Xylitol is even said to be good against tooth decay. They often have a laxative effect and can cause diarrhea and gas. Artificial sweeteners such as aspartame, acesulfame are non-caries and do not raise blood sugar levels. They are not digested by the body and are simply excreted. The sweetener Stevia is obtained from the plant of the same name and is sweeter than sugar, but has a metallic, slightly bitter aftertaste.

Studies have shown that the body is difficult to trick and reacts with disappointment after the taste of sweets without sugar: the reward center in the brain is not addressed, the feeling of satiety is absent, and cravings can quickly develop again.

How to protect teeth from tooth decay?

A completely sugar-free diet is unimaginable for many people. But there are measures you can take to keep your teeth healthy, even though you like to drink orange juice for breakfast or always have chocolate to hand. It also depends on how often sweets are eaten or drunk throughout the day. In short, it’s healthier for your teeth if you eat the chocolate all at once, rather than just nibbling bits at a time. The teeth can cope better with a single acid attack than with repeated attacks. The saliva ensures the remineralization of the tooth enamel. Rinsing the mouth with water or chewing sugar-free gum helps to neutralize harmful acids more quickly after a sugary or acidic meal. You should wait half an hour after eating before brushing your teeth, otherwise there is a risk that the softened tooth enamel will be damaged during brushing.


As always, the dose makes the poison. Too much sugar is not healthy for the body or for the teeth. On closer inspection, many foods and drinks often turn out to be real sugar bombs and are just bursting with hidden sugar. With good oral hygiene and a low-sugar lifestyle, the bacteria in the mouth can be kept in check and tooth decay avoided.

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