2016 Sweet Tooth Obsession ODA - Karen...

KarenDavis,RDH,BSDH*646GoodwinDriveRichardson,TX75081*972.669.1555*[email protected]*www.karendavis.net

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SweetToothObsession&ItsImpactonOral&SystemicHealth

KarenDavis,RDH,BSDH Sucrose:50%Fructose/50%GlucoseHighFructoseCornSyrup:55%Fructose/45%GlucoseOtherNamesforSugar:HFCS,Coconut/Palmsugar,MapleSyrup,EvaporatedCaneJuice,Honey,BrownRiceSyrup,AgaveSyrup,JuiceConcentrates,Maltose

WorldHealthOrganization

• Freesugars=<10%totalenergyintake• 5%or25gperday=additionalhealthbenefits

AmericanHeartAssociation2009DietarySugarIntake&CardiovascularHealthScientificStatement

• Limitdailyintake:Women=24g/Men36gCanadianStats:

• StatisticsCanadapublished2011basedupon2004data:Added,naturalandfreesugars:110g/dayor21%oftotalenergyintake

• CanadianSugarInstitute(CSI):Addedsugar=11-13%oftotalenergyintake• HeartandStrokeFoundation:Freesugars(100%fruitjuice,syrupand

honey)notincludedinaddedsugarpercentagefromCSI.Estimatedconsumptionishigher.

• EuromonitorResearchGroupReportedinWashingtonPost2015:Addedsugarconsumption89.1g/day

www.fooducate.com-makebetterfoodchoices/tracksugargramsdaily

www.coheso.com-Labelinformationon9000+foods


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DRINK SIZE SUGAR pHAMP 8oz. 31g 2.77-Up 12oz. 37g 3.2Coke 12oz. 40.5g 2.5Mt.Dew 12oz. 47g 3.2AZGreenTea 16oz. 50g 3.4LangerAppleJuice 16oz. 52g 3.2Monster 16oz. 54g 2.7NesteaGr.PeachTea 20oz. 57.7 2.9RockstarEnergy 16oz. 62g 1.5SobeMango 16oz. 70g 3.5TropicanaTwist. 20oz. 87.5 2.9

www.ycchololate.com-Steviasweeteneddarkchocolatebars

www.lilysweets.com-Steviasweeteneddarkchocolatebars

www.1netrition.com-ErythritolsweetenedHazelnut/chocolatespread

www.CocoaVia.com-Unsweeteneddarkcocoahighinantioxidants

www.drjohns.com-Xylitolchocolatebarsandassortedcandies

www.sweetleaf.com-Steviaflavoreddrops

LowFructose/LowGIBlackberryGrapefruitLemon/LimeNectarineRaspberryWildStrawberry

HighFructose/HighGIRipeBananaGrapesDatesRaisinsMangoCustardApples

SugarAlcohols:Carbohydratescalled“polyols”OccurnaturallyinplantsNotcompletelyabsorbed

LowerGlycemicIndexthansucroseFewercaloriespergramDonotpromotedecay(mostly)


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SUGARSUBSTITUTESANDSWEETENERS

Non-NutritiveSweetenersSACCHARINSweet-n-Low

ASPARTAMENutraSweet

Equal

NEOTAME SUCROLOSESplenda

ACELSUFAMEPOTASSIUM

STEVIATruviaPurvia

1879 1981 2002 1998 1988 2008300X’ssweeter

200X’ssweeter

7000–13,000sweeter

600X’ssweeter

200X’ssweeter 200-300X’ssweeter

100countries Greatestuseworldwide

US,AK,UK 80+countries 30+countries Worldwideuse

Bitteraftertastehighconc.

Mostcontroversialsweetener

CousintoAspartame

Chemically-alteredsucrose

Bitteraftertastehighconc.

BitteraftertasteHighconc.

Heatstable Notheatstable Heatstable Heatstable Heatstable HeatstableAddedtoAspartameinsoftdrinks

MustbeavoidedbythosewithPKT

NoaminoacidconcernforthosewithPKT

Tri-chlorinationprocess

Blendedwithothersweeteners

Nodailylimit

Substitute&commercial

Substitute Commercial Substitute&commercial

Commercial Substitute&commercial

SugarAlcoholsISOMALT SORBITOL HSH MANNITOL/

MALTITOLERYTHRITOL XYLITOL

1990Derivativeofbeetsugar

1960’sStonefruits

1960’sCorn,potato,wheatstarch

1986Maltose,glucose,cornstarch

1996Fruits,cornstarch

1963Berries,Birchwoodtrees,corncobs

2kg/cal45-65%

2.5kg/cal60%

Blend40-90%

2.1kg/cal75-90%

kg/cal70%

2.4kg/cal100%

Hardcandies,jams,coughdrops,commercial

Gum,candies,coughdrops,bakedgoods,commercial

Bulksweetenercommercial

Candy,chocolates,icecream,commercial

Bakingconfections,beverages,commercial

Gums,candies,lozenges,syrups,vitamins,dentalproducts

Lrg.Amt.Laxative50g/day25g/day

Lrg.Amt.Laxative>50g/dayIBSCaution

Lrg.Amt.Laxative

>100g/dayLaxative

KindertoGItractthanmost

>50g/dayKindertoGItractthanmost

Caution:Xylitolistoxictodogs!

Cautionregardingprolongeduseofsorbitol,isomalt,HSHfoundinhardcandies,mintsandlozenges!Potentiallybecomescariogenic!


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www.xylitol.org-Xylitolclearinghouseandproductguide

www.xylimart.com-RDHbasedclearinghouseforXylitolproductsonsalewww.xlear.com-XylitolMints,gum,sweetenertoothpaste,rinse,nosespray,etc.www.drinkxywater.com-Xylitolinfusedwaterwww.orahealth.com-Xylimeltsdiscswww.quantumhealth.comOraMoistdiscswww.carifree.com-Xylitolproductsforinfants&children&adultswww.3MESPE.com-XylitolTheramints&Theragumwww.epicdental.com-Xylitolgum,mints,toothpaste,mouthrinse,sweetenerwww.icechips.com-exoticflavoredXylitolhardcandieswww.sweetbites.com-AffordableXylitolgummissionwww.forevermints.com-longlastingXylitolmints

ObesitybytheStats

• >60%oftheglobaldiseaseburdenwillbeassociatedwithobesityby2020• 2011–20121-4adultCanadiansobeseinaccordingtoStatisticsCanada

(17.5%increasesince2003)• 201454%ofself-reportedCanadiansareoverweight(BMI25)orobese(BMI

30+)• 85%ofchildrenwithTypeIIdiabetesareobese:“Diabesity”• 201331%ofCanadianchildren2–17wereoverweightorobese(ages5-11

26%)(ages12-1737%)• LowestproportionsofobesityfoundinToronto,Montreal&Vancouver.• HighestinAtlanticCanada,ThePrairies,TheTerritories,&smallercitiesin

Ontario CurrentGenomics9:239,2008 www.statcan.gc.caaccessedApril4,2016

LiteratureSupportsSystemicImpactofChronicallyHighSugarConsumption

• AdverseeffectsonHDL&Triglyceridelevels• IncreasedBPlevels• Compromisesintakeofdietaryvitamin&mineralintake


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• Increasedriskofdiabetes&decreasedinsulinsensitivity• Diabetes+poorglycemiccontrol=cognitivedecline• Increasedvisceralfatmass• BMIincreasescancerrisk&kindergartner’sweightstrongpredictoroflater

childhoodobesity• IncreasedriskforNon-alcoholicFattyLiverDisease(NFLD)• Increasedriskforgout• Increasedproliferationofpancreaticcancercells

Dietarysugarsandbodyweight:systematicreviewandmeta-analysisofradomisedcontrolledtrialsandcohortstudiesBritishMedicalJournal2012Fructose:“Itsalcoholwithoutthebuzz”AdvancedNutrition2013ReviewArticle:FructoseinNon-AlcoholicFattyLiverDiseaseAlimentaryPharmacologyTherapeutics2013www.medscape.comSugarconsumption,metabolicdiseaseandobesity:ThestateofcontroversyClinicalReviewsinClinicalLaboratorySciences2015http://dx.doi.org/10.3109/10408363.2015.1084990GrainBrainbyDavidPerlmutter,MD

Remineralizationisthenaturalrepairprocesswherecalciumandphosphateformanewsub-surfacemineralcoating,whichislesssolublethantheoriginalsurface,especiallyinthepresenceoffluoride. DimensionsofDentalHygieneApril2010

AMORPHOUSCALCIUMPHOSPATE

• Fillsdefects• IncreasesFL2bioavailability• Increasesluster

TRI-CALCIUMPHOSPHATE• Calcium&phosphateworksynergisticallywithFluoride• EffectiveinneutraloracidicpH• Enhancessurface&subsurfacemineralization

NOVAMIN• RaisespH>7• Createslayerofhydroxyapatite&reducessensitivity• Antimicrobial


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CALCIUMPHOSPHOPEPTITE&AMORPHOUSCALCIUMPHOSPHATE–RECALDENT®

• Bindstotooth&plaque• Remineralizessub-surfacelesions• Removeswhitespotlesions

FLUORIDE• Adherestopartiallydemineralizedcrystallites• Attractscalcium&phosphate• Inhibitsacidproduction• Antimicrobial

HYDROXYAPATITE• Naturalcalciummineral• Crystallinelatticestructure• Hardenstoothstructure

CHLORHEXIDINETHYMOLVARNISH• HardenstoothstructureHelpscontrolestablishedlesionsonexposedroots

ARGININE+CALCIUMCARBONATE+FLUORIDE• Synergisticeffecttopreventcariesandreducesensitivitywww.basicbites.com

-AlkaGenTechnologytoraisethepH&coattheteeth

Periosciences®–topicalantioxidants(anti-bacterial,anti-inflammatory,hydrating)

CAMBRAResources

www.cdafoundation.org/journal-PartIOctober2011&PartIINovember2011

www.philipsoralhealthcare.com-C.A.R.E.riskassessments

Bacterial&SalivaTestingCRT®BacteriabyIvoclarVivadentwww.ivoclarvivadent.usTestsforStrep

Mutans&LactobacilliCultureresultsin2daysCariScreenSusceptibilityTestingMeterbyCariFree®www.carifree.com

ChairsidedetectionofStreptococcibacterialloadSaliva-CheckMutansbyGCAmericawww.gcamerica.comChairsidesalivary

testforStrepMutansSaliva-CheckbyGCAmerica

Measuressalivaryproduction&bufferingcapacityResting&chewingpH


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REMINERALIZATIONREALTITYFORTHEMODERATECARIESRISKPATIENTØ Xylitol6-10gdaily(3-5timesdaily)Ø OTCFluoridetoothpastetwicedailyØ OTCSodiumFluoriderinsedailyØ CalciumPhosphatepasteforexposedrootsforsensitivityØ Sealantsonpits&fissuresatriskØ Every4-6monthsFluoridevarnish,orchlorhexidinethymolvarnishonrootsØ AssesssalivaryflowandpHifhyposalivationissuspectedØ Every4-6monthsre-examtoevaluateriskØ Bitewingsevery12-24monthsØ Powertoothbrush&interdentalcarefordailyplaqueremoval

AdaptedfromDimensionsofDH2010&JournalofEvidence-BasedDentalPractice2014

REMINERALIZATIONREALTITYFORTHEHIGHCARIESRISKPATIENT(Modificationsinitalics)

Ø Xylitol6-10gdaily(3-5timesdaily)Ø Chlorhexidinerinse0.12%10mldailyfor1weekpermonthØ 5000ppmFluoridepastetwicedailyØ CalciumPhosphatepasteseveraltimesperdayforexposedrootsor

sensitivityØ SealantsonpitsandfissuresatriskØ Every3-4monthsFluoridevarnish,orchlorhexidinethymolvarnishonrootsØ Assesssalivaryflow&pHifhyposalivationissuspectedØ Every3-4monthsre-examtoevaluateriskØ ObjectivemeasurementofacidogenicbacterialloadØ Bitewingsevery6-18monthsØ Powertoothbrush&interdentalcarefordailyplaqueremoval

AdaptedfromDimensionsofDH2010&JournalofEvidence-BasedDentalPractice2014“10WaystoTreatToothDecay”AccordingtoBrianNovy,DDSwww.whollymolar.com

AllCAMBRAshouldincludedietarymodificationsoffermentablecarbsandreductioninamount&frequencyofsugar

www.brushdj.com


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TipsforGainingControloftheSugarBingeforImprovedHealth1. Bealabeldetective&decidewisely!2. Eliminatesugarydrinks!3. Substitutesugaralcoholsforsugarinfoods&beverages–Integrateslowly4. Countsugargramsthroughouttheday(Fooducate)5. UseXylitolgumormintsfollowingmeals–strivefor5+exposures6. Reducecravingswithsubstitution◦almonds,walnuts,cheese&freshfruitfordesserts

7. Preparefoodswithfreshherbstoincreasesatisfactionwithmeals8. Enjoythedelectableinmoderation,onoccasion(3biterule)9. Movemoretoburnmore!10.Drinkmorewater!(XyWater)


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UsedbypermissionfromtheHeart&StrokeFoundation4.15.16

Date post:	21-Apr-2018
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2016 Sweet Tooth Obsession ODA - Karen...

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