How to Stop Tooth Decay

How to Stop Tooth Decay
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If sugar consumption is considered the one and only cause of cavities, how much is too much?

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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Dental cavities may be humanity’s most prevalent disease, affecting 35 percent of the global population. The average number of decayed, missing, and filled teeth has been estimated at more than two—by age 12. In the United States, the oral health of our elderly may also be in “a state of decay,” with one-fourth of elderly persons missing “all their teeth.” And an estimated hundred billion dollars of all that is due to sugar.

Sugar consumption is considered the one and only cause of cavities. Though often referred to as “a multifactorial condition,” the other factors—the bacteria, the plaque, the saliva, the brushing, the flossing—appear to just have mitigating influences. “[A]ll the other factors simply modify the speed” by which sugar causes cavities. “Without sugars, the chain of causation is broken, so the disease does not occur.” We might not even need all that stuff if we could just get rid of added sugar.

Studies dating back “decades ago showed that in countries where sugar consumption was very low, dental [cavities were] almost non-existent.” And: “New analyses show that the life-long burden of [cavities] increases as sugar intakes increase from [zero].” “The most comprehensive national data are from…Japan…before, during, and after World War II,” where the incidence of cavities tracked per capita sugar intake as it dropped from about 8 percent of calories down to just 0.1 percent—less than a teaspoon a week—before rebounding to about 14 percent. Such studies show that cavities continued to occur even when sugar intake comprised only 2–3 percent of caloric intake. Given that more extensive disease in adults doesn’t appear to manifest if sugar intakes are limited to less than 3 percent of caloric intake, a public health goal to limit sugar intake to below 3 percent has been recommended. This led to the suggestion that traffic light food labels mark anything above 2.5 percent added sugars as “high.” That would make even comparatively low-sugar breakfast cereals, such as Cheerios, “red light” foods.

The recommended 3 percent cap on total daily intake of added sugars wouldn’t even allow for a single average serving for young children of any of the top 10 breakfast cereals most heavily advertised to them. Obviously, soda is off the table. One can has nearly two days’ worth.

The American Academy of Pediatric Dentistry adopted the more pragmatic goal, recommending sugar intake stay below 5 percent for children and adolescents, matching to the World Health Organization’s conditional recommendations for both children and adults. That’s about where sugar dropped to in Iraq when they were under sanctions, and it cut cavity rates in half within just a few years. Of course, the sanctions may have cut other things, like children’s lives, short— though that was apparently fake news, a consequence of government manipulation.

Anyway, if we were really interested in minimizing disease, the ideal goal would be to drop the intake of free sugars to zero—meaning added sugars. They’re not talking about sugars naturally found in breast milk, or the intrinsic sugars found in fruit. But when it comes to added sugars, there does not seem to be a threshold for sugar intake below which there are no adverse effects; an exponential increase in cavity rates for sugar intakes even starting as low as 1 percent.

Yeah, maybe we could get rid of cavities “if there is no sugar in the diet,” wrote a Kellogg’s-funded researcher; “this ideal is impractical.” “[T]he dictatorial use of foods ‘friendly to the teeth”’ might promote “dietary celibacy…not…acceptable to all individuals.”

“Instead of recommending draconian reductions” in sugar intake, the sugar industry responded, “attention would be better focused on…fluoride toothpaste.”

You know, that’s the perfect metaphor for medicine’s approach to lifestyle diseases in general: why treat the cause when you can just treat the consequences? Like, why eat healthier to prevent and treat heart disease, when we have all these statins and stents?

Please consider volunteering to help out on the site.

Image credit: Suyash.dwivedi via Wikimedia. Image has been modified.

Motion graphics by Avocado Video

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Dental cavities may be humanity’s most prevalent disease, affecting 35 percent of the global population. The average number of decayed, missing, and filled teeth has been estimated at more than two—by age 12. In the United States, the oral health of our elderly may also be in “a state of decay,” with one-fourth of elderly persons missing “all their teeth.” And an estimated hundred billion dollars of all that is due to sugar.

Sugar consumption is considered the one and only cause of cavities. Though often referred to as “a multifactorial condition,” the other factors—the bacteria, the plaque, the saliva, the brushing, the flossing—appear to just have mitigating influences. “[A]ll the other factors simply modify the speed” by which sugar causes cavities. “Without sugars, the chain of causation is broken, so the disease does not occur.” We might not even need all that stuff if we could just get rid of added sugar.

Studies dating back “decades ago showed that in countries where sugar consumption was very low, dental [cavities were] almost non-existent.” And: “New analyses show that the life-long burden of [cavities] increases as sugar intakes increase from [zero].” “The most comprehensive national data are from…Japan…before, during, and after World War II,” where the incidence of cavities tracked per capita sugar intake as it dropped from about 8 percent of calories down to just 0.1 percent—less than a teaspoon a week—before rebounding to about 14 percent. Such studies show that cavities continued to occur even when sugar intake comprised only 2–3 percent of caloric intake. Given that more extensive disease in adults doesn’t appear to manifest if sugar intakes are limited to less than 3 percent of caloric intake, a public health goal to limit sugar intake to below 3 percent has been recommended. This led to the suggestion that traffic light food labels mark anything above 2.5 percent added sugars as “high.” That would make even comparatively low-sugar breakfast cereals, such as Cheerios, “red light” foods.

The recommended 3 percent cap on total daily intake of added sugars wouldn’t even allow for a single average serving for young children of any of the top 10 breakfast cereals most heavily advertised to them. Obviously, soda is off the table. One can has nearly two days’ worth.

The American Academy of Pediatric Dentistry adopted the more pragmatic goal, recommending sugar intake stay below 5 percent for children and adolescents, matching to the World Health Organization’s conditional recommendations for both children and adults. That’s about where sugar dropped to in Iraq when they were under sanctions, and it cut cavity rates in half within just a few years. Of course, the sanctions may have cut other things, like children’s lives, short— though that was apparently fake news, a consequence of government manipulation.

Anyway, if we were really interested in minimizing disease, the ideal goal would be to drop the intake of free sugars to zero—meaning added sugars. They’re not talking about sugars naturally found in breast milk, or the intrinsic sugars found in fruit. But when it comes to added sugars, there does not seem to be a threshold for sugar intake below which there are no adverse effects; an exponential increase in cavity rates for sugar intakes even starting as low as 1 percent.

Yeah, maybe we could get rid of cavities “if there is no sugar in the diet,” wrote a Kellogg’s-funded researcher; “this ideal is impractical.” “[T]he dictatorial use of foods ‘friendly to the teeth”’ might promote “dietary celibacy…not…acceptable to all individuals.”

“Instead of recommending draconian reductions” in sugar intake, the sugar industry responded, “attention would be better focused on…fluoride toothpaste.”

You know, that’s the perfect metaphor for medicine’s approach to lifestyle diseases in general: why treat the cause when you can just treat the consequences? Like, why eat healthier to prevent and treat heart disease, when we have all these statins and stents?

Please consider volunteering to help out on the site.

Image credit: Suyash.dwivedi via Wikimedia. Image has been modified.

Motion graphics by Avocado Video

165 responses to “How to Stop Tooth Decay

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  1. When I was “sweet” 16 I worked at a fast food restaurant for one summer. All of us teenage employees had a drink of some sort permanently based at our workstation that we’d sip constantly for the entire 8 hour shift. My staple was the BK strawberry milk shake. All day, every day that I worked there.

    Within a year my dentist found a cavity (my first ever) and drilled it out. After that I learned that bacteria start feeding on sugar stuck to your teeth almost immediately after eating it and begin to form plaque on your teeth after about 30 minutes. As I understand it, the acidity of those plaques is roughly 100 times the acidity of normal amylase… an unfavorable environment for tooth enamel. That’s what causes decay.

    So I cut way back on sugar consumption after that warning shot across my bow at age 16. I have not had another cavity since then.

    1. Your story needs to be in the curriculum of ever young school child. As per your example, knowledge became your power. And knowing that they could avoid the dentist’s drill is a very powerful anti-sugar choice for a young kid. Dentists were the boogieman back in my day… even the ones that gave out sugary lollipops before we left. ‘-(

    2. The person who first discovered tooth decay has just died. They laid him to rest and gave him a plaque. Thought I would just cheer you day. Richard

    3. Dr. Cobalt,

      You had such wisdom at 16 years old.

      I love that.

      I always listened to my grandmother talking about her sweet 16 where she wanted something special for dinner, but her family was poor and she had a baked bean sandwich and stomped out of the house and got a few steps away and thought, “What a spoiled brat, I am. What am I doing making Mom and Dad worried about me when they already have so much to worry about and I know we don’t have money.” and she turned around and walked back inside and became this calm, peaceful, grateful about every single thing person for the rest of her life.

      I always listened to that with amazement.

      I was a rebellious 16-year-old.

      It took me decades to learn things like those..

    4. My mother put sugar in about everything when we were growing up, even potato salad. I had fillings in most of my permanent molars by the time I left home. I have been off all sugar for about 40 years now, but still got several cavities in the last 10 years, it took that long. It seems that when your teeth are weakened in childhood, even if you get on a healthy diet later, some things catch up with you later.

      1. Hi Marcy, Regarding your continuing decay even though your prevention is good. And this goes for everyone; Dentistry does not have any permanent filling material, even gold. Once that first filling is put in a permanent tooth, that filling is destined to a lifetime of breakdown and repair. This results in ever larger fillings. eventually crowns, often times leading to root canal treatment and extraction for some. The cost has been averaged about $3000 per tooth over a lifetime. That’s well over $10,000 adjusted for low inflation. That cost is from Delta Dental the largest dental insurer with a gigantic data base.

        I don’t think most dentists realize this even though 75% of their clinical time is repairing and replacement of fillings they and others have placed.

        That is why it is so important to understand prevention of decay for our children and infants starting at age one when the first teeth appear in he mouth.

        Science and technology since the year 2000 have given us the ability to give our children a lifetime of free from any cavities or fillings.

        It is not a matter of thorough brushing and flossing. It is elimination of risk factors as found in medical prevention. In general it is not provided by the dentist any more than prevention of cardiovascular disease is provided by the cardiologist.

        1. “It is not a matter of thorough brushing and flossing. It is elimination of risk factors as found in medical prevention. In general it is not provided by the dentist any more than prevention of cardiovascular disease is provided by the cardiologist.”
          ——————–

          Well said, Larry– prevention is always the better alternative. But prevention is not without cost and effort, and demands both education and willingness to speak up at a “Teaching Moment”, helping friends and family understand what is at stake.

          1. Alpha, thank you for your encouraging an incite full comments.

            You bring up the “cost” of passing on this important health information to our patients and more important, to the public at large.

            I’d like to write about the cost of prevention. If you are a dentist you might disagree and even dislike my comments. But there is something about your writing that makes me think it is time for this perhaps controversial discussion. And what better place than amongst a group of people who are seeking the best medical information available. Furthermore this group is aware the role of the current medical complex which not only doesn’t care about prevention, but restricts competition from sources which can provide the prevention information we need. As we know restraint of competition always gives us higher prices and lower quality.

            The fact of the matter is than modern cavity prevention is not a dental procedure. Tooth decay is a medical problem with medical solutions. We use medicine, not drills, we combat bacterial infections, we do risk analysis and teach patients to eliminate risk factors. Dental decay is the most common chronic disease in the US. Like other chronic diseases, it is a lifestyle disease. Unchain the hygienists to treat this disease medically. The cost of prevention will plummet as success will skyrocket, Decay prevention does not need an expensive dental office with all the expensive dental infrastructure, drills,fancy chairs, etc. the only infrastructure needed is 2 straight backed folding chairs.

            Dental hygienist are specifically trained to prevent and treat early decay and to prevent and treat periodontal disease non-surgically. Hygienist are the perfect part of the work force to deliver decay prevention to the public. No need whatsoever for the much more expensive dentist who is mechanically trained to try’s to fix the result of tooth decay. But organized dentistry has Been able to keep the hygienists from delivering their services to the to the public. Independent hygienists are forbidden in the US. When this changes the cost of dental prevention will decrease dramatically. The situation as it now exists is analogous to the cardiac surgeon being in charge of prevention of cardiovascular diseases.

            1. Great post. You’re 100% right that independent hygienists should be allowed. It’s a scam of a profession trying to hold on as tight as possible to the entire scope of practice.

      2. My mother did the same when I was growing up. I shudder when I think about how much Kool Aid and soda and sugar cereal I consumed literally every single day when I was a child.

      3. Marci my mother also put sugar on our cereal and in just about everything too… 2 sugars in a coffee etc…. she thought it was ‘good for us’ the sugar industry advertised it as a good for energy source…
        I had so many fillings as a child in my permanent teeth .. the dentist treated my teeth with extra fluoride to try to prevent decay and told my I wasn’t cleaning my teeth correctly…
        Also the nhs paíd dentists in the uk every time they did fillings thus meant lots of unnecessary teeth were filled terrible times …

        1. If you mean “terrible times” because many teeth were filled unnecessarily for money, then terrible times continue here also. Many teeth are filled here unnecessarily for money also. What makes it so terrible is that fillings break down over time causing a lifetime of breakdown and repair with ever larger and more expensive repair, crowns root canals, etc. we actually have no permanent fillings.

    1. Sugar alone is not responsible for cavities though. When you’re chronically low in calcium, your bones and teeth begin to slowly deteriorate because your body is using its calcium stores to perform other functions, such as muscle contraction and forming new cell membranes.

      1. Calcium by itself doesn’t help. The people who take the most calcium have the most broken bones. We need broad spectrum nutrition: vitamin D, phosphorus, silica, and vitamin K2 are crucial as well.

      2. Sorry, that is totally wrong. I am a dentist with 30 years experience and I’m fed up with hearing this. Yes you’re right about your bones losing calcium if your diet is low in calcium because bone has vascularity. Your outer enamel has no vascularity. Therefore the body has no access to that calcium.

      3. What you said is common to read but it is totally impossible simply because enamel of teeth have no blood supply and no living cells unlike bones, thats why the body cant fix a broken tooth or a significant real cavity but it can for bones, every serious dentist know what you said is impossible and therefore nutrients have no way to reach the enamel from the inside and the body cant take minerals from enamel from the inside neither, teeth get slightly remineralized over time from the outside with saliva containing minerals, thats it.

        https://www.studiodentaire.com/questions/en/is-a-tooth-alive.php

      1. Angela N,

        Very true. And it goes further: Most people try to justify what they want to do anyway. Even if they know it is not good for them or in their best interests.

        Last night, at a meeting about climate change, folks I talked with all agreed that eating meat or animal products is bad for the climate and the environment. But then they offered all kinds of “reasons” (excuses, really) about why they couldn’t/wouldn’t stop: They were raised that way; eating animal products is cultural, traditional; messages all around them tell them that eating animal products is fine, healthy, even if they personally don’t agree, etc etc. And get this: this was a group of secularists, who have shed the religious beliefs with which they were raised. Saying that changing their patterns of behavior or thought was just not possible. SMH.

        1. It’s not the eating of meat that is the problem with climate change, it is the factory farming of meat. Proving your own point.

          If the Earth was reforested and animals were allowed to range again across the large savannahs and those animals were selectively harvested there would be an improvement in forestry, food, and health.

          1. Bruce K,

            I’ve heard the same thing — without any evidence of how this would happen, how much meat could be “harvested,” what human population such an environment could support, etc. btw, does your sylvian utopia include chickens, pigs, goats, sheep, etc?

            Meanwhile, I’m dealing with the world as it is today. Based on actual evidence. And eating a meat and all animal products IS a problem: it’s not sustainable, it degrades the environment, it’s cruel to the animals and the workers, and it contributes to antibiotic resistance. And it is unhealthy for us to consume them.

            1. I am not convinced that meat is bad for people in any dose at any time. I do not believe the evidence supports that idea, but this is probably not the venue to argue that. You true believers seem to think, or want to believe on faith, that you can live forever if you just do not eat meat. I don;t think it is so, I do think it is unhealthy to eat too much meat, and not enough plant-based diet, but meat is not poison.

              You guys tend to carry this to the ridiculous, and I am reminded of one thread about gardening where some vegans were claiming it is terrible to fertilize a garden with animal manure. The world’s environment would not exist without animal manure and the nutrients and bacteria that got eaten spread and distributed all over the world – plants depend on it.

              I think every belief system has the people who take it to extremes and to ridiculous levels, like the Atkins on the one side, and this on the other. But that’s just my opinion.

              1. Bruce, with respect, I say you haven’t spent any time on nutrition and the harmful effects of saturated fat/animal protein. It’s the source of most disease. The research is rock solid. I’m WFPB at 76 and healthier than ever. I’m not doing it for the animals but for my own health.

              2. Bruce

                I think the evidence that eating mammalian meat is unhealthy is incontrovertible. However, meat from insects, fish, poultry, frogs, snakes, snails etc may be OK in small quantities.

                However, you also need to be aware that there is an ethical dimension to this. Those of us living in wealthy developed countries don’t need meat to survive or to obtain optimal health so how can we justify slaughtering other living creatures purely for our pleasure?

          2. Bruce K is denying science including denying the impact of large populations of introduced and farmed animals on the land, change of land use patterns, displacement of native species, end release of climate altering gases by ruminants even in countries that mostly raise animals in fields not inside buildings. This makes him a troll. Ok now I will ignore the science denying troll.

            Ignore the troll

        2. Put the price up (eg by removing subsidies) and I suspect that many more people would conclude that it’s possible to change.

    1. Might be helpful if the idiots who design the typical foods found in a grocery would stop adding extra sugars? The organic spag. sauce I used to buy had added sugar. Growing up I often removed the icing from cake and was ridiculed for doing so….it still had lots of sugar. Kids are conditioned to like sugar from an early age….as adults they can’t get away from it.

  2. Point 1: It’s not just “added” sugar in junk food/sweets that is detrimental to oral health; but also starchy carbs like crackers and most snack food, along with conventional bread and the like. These contribute to the sticky plaque on teeth and contribute to decay; among other oral (and gut) problems.

    Point 2: Interesting that Dr. Greger noted at the end that the sugar industry said to use fluoride toothpaste …. noting that it is the answer to cavities. Nothing could be further from the truth! Fluoride is a waste product and causes much more harm than good, and is also a proven neurotoxin. Although fluoride is naturally-occurring in our environment; adding fluoride to drinking water and oral care products has been proven harmful. Just another government distortion.

    1. Woudl you care to explain why you say “Fluoride is a waste product”? Is this all fluoride? What is a waste product? Is there any fluoride that is not what you would consider a waste product? What makes you expert enough to declare the difference?

      1. I never professed to be an expert … however I have been studying and researching health for well over a decade, and I choose to share my knowledge with people when I see fit. On fluoride:

        “Dr. William Hirzy from the EPA has pointed out that if it goes into the air, it’s a pollutant. If it goes into the local water, it’s pollution. But if the public water utilities buy it and pour it in our drinking water, it’s no longer a pollutant. All of a sudden, like magic, it’s a beneficial public health measure.

        “So not only are we doing something quite unique, using the public water supply to deliver medicine … we’re using the public water supply to get rid of hazardous waste from the phosphate industry,” Connett says. “It makes a lot of money for them [this way, because otherwise it would cost] a lot of money to get rid of it as hazardous waste.”

        The following article appeared in the Huffington Post (which includes the above quote):

        https://www.chelseagreen.com/2010/dr-joseph-mercola-supports-the-case-against-fluoride/

        1. Citing Mercola as support for your beliefs doesn’t make them more credible. Quite the opposite I suspect. Quackwatch might be considered the polar opposite of Mercola and it puts the contrary case

          https://www.quackwatch.org/03HealthPromotion/fluoride.html

          Recycling though is usually considered a good thing. Calling fluoride a waste product or a recycled product puts a very different light on this matter..

          But yes fluoride is hazardous in large amounts. So is water and most things. There are therapeutic doses and there are toxic doses. Confusing the two only muddies the waters.

          The best discussion of this issue I have come across is quite old now but still largely valid. The UK Medical Research Council looked at this back in 2002 and concluded that there’s no evidence of harm but recommended continued monitoring

          https://mrc.ukri.org/publications/browse/water-fluoridation-and-health/

    2. BChristine,

      I read that sentence and thought they were saying that it is usually described as involving other carbs, but that the effect of everything else is negligible if you remove sugar.

      1. I believe they are saying that it is explained to be carbs, but if sugar is kept to less than 3% that the condition doesn’t manifest in adults.

    3. Thanks Christine glad someone said it. It is a neurotoxin people… wake up! Fluoride is a TOXIC waste byproduct of the chemical fertilizer industry. Watch Fluoride: Poison on Tap documentary. Sure if you live in Norway you’re fine… but in countries like the U.S where they fluoridate your water or in some countries with fluoridated salt, tap water is not safe. Use a Reverse Osmosis system that will take out 94-97% of the fluoride or drink bottled water in a glass but check the water reports (Voss in the glass is good but expensive)

      1. Danielle, I agree with everything you write including the avoidance of a fluoridated water supply.

        However I suspect that many people have and will switch to a non fluoridated tooth paste, based upon this good information.

        In fact switching to or using a non- fluoridated tooth paste is a costly mistake with real(evidence based) negative consequences.

  3. Processed foods are sticky aren’t they? Eat anything that has been powdered before preparing, and notice that your teeth do not “clear” themselves. Eat an apple or other fruit and notice now much cleaner your teeth are.

    All of those powdered carbs between your teeth are almost instantly converted into sugar, and it is sticky.

    Since becoming a vegan six years ago (after the wife got cancer) my periodontal score has been almost perfect. Before that it was in the mid eighties.

    WFPBD is bad for your cancer cells, good for the teeth. Wife is doing fine!

    1. Well, I would say that I am not thinking about processed food and that most of it has sugar and salt which makes it in that category unless less sugars are less than 3%

  4. While I %100 agree everyone should cut out added sugar from their diets, it is incorrect to say that sugar ALONE causes tooth decay. For example, if someone ate no extra sugar, but had a grilled veggie sandwich, the carbohydrates in the bread break down into simple sugars! Which then can cause tooth decay. You need exactly three things to have a decayed tooth. 1) a tooth 2) sugar 3) bacteria. You see the bacteria eats the sugar as it’s food source then excretes an acid. The acid breaks down the tooth structure in stages. First, decay shows up as a white spot, then yellow, then brown, then pitting, finally a hole. The other point that is incorrect is about fluoride. Fluoride does not treat decay as in a medicine. Fluoride is preventative in nature as it strengthens the tooth structure to resist the decay process. Fluoridated tooth structure is stronger than natural enamel. As I child is forming in utero, the mother takes in Fluoride that naturally occurs in water (added in others). This fluoride incorporates into the growing dentition making the newborns teeth more resistant to decay in the future. RDH in MA

    1. Please research the Vipeholm studies done by Dr. Bo Krasse in the 40’s and 50’s that definitively outlined the cause of caries. A steady diet of sticky toffee or coke is a thousand fold more acidogenic therefore cariogenic than bread because they contain simple sugars which stay around in the grooves. Bread is complex carbohydrates which must first be broken down by the bacteria to simple sugars then utilized. So the cariogenic potential of bread is minimal. No need to ring alarm bells over bread.

  5. I would be interested to hear opinions on the chapter “Primitive Control Of Dental Caries” ( particularly the first paragraph of page 295 ) in the book Nutrition and Physical Degeneration by Weston A. Price, D.D.S. which implicates shortage of fat-soluble vitamins and minerals.

    1. Why would you place any credence in the opinions of a dentist writing 80 years ago?

      Focussing on what modern science and the latest research shows would be much more informative. He gets so much attention now because his hypotheses are interpreted as supportive of counter-scientific theories and beliefs that are relentlessly promoted by vsrious cranks and internet marketers. If they can’t find modern scien tific support for their opinions,which they can’t, they necessarily have to resort to digging up 80-year old books to support them

  6. When industry governs government through buying power seats for those who are supposed to look for mental, physical, social, political health of all of us, the consequences are detrimental for those not part of the corporate officialdom. How do we bring about government of, for and by the people to force essential changes to make our system balanced again to serve all, not just the few in command and control of major corporations and public institutions?

  7. Perhaps Dr. Greger should apply the same rigorous standard of research to political issues as he does questions of nutrition. Better yet: Stay away from political questions all together, unless his care for saving lives will prove to not carry over to those savaged by US militarism. Shame for making light of the death of these children, behavior unbecoming of a doctor, much less one held in high-esteem.
    http://www.gicj.org/positions-opinons/gicj-positions-and-opinions/1188-razing-the-truth-about-sanctions-against-iraq

      1. Watch the video, again. A little before and after 3.00.

        I strongly demand that this video be taken down and re-edited.

        1. I think he was exposing an issue about how sanctions harmed children and how governments are saying it was fake.

          I don’t think he was saying that the death of children was okay.

          1. No, on the contrary, he is minimizing the UN report that studied how the sanctions killed children in favor of a biased report by the BMJ and calling the death of children fake news. Read the article that I linked. It is not humorous, it is not funny. Nor is it acceptable sarcasm. Take the video down.

            1. I have read it and, honestly, it is just like the diet wars. I know that Saddam Hussein was such a liar and a brutal man who did use psychological warfare and I also do know that so is our government and that makes it really hard to figure out who is lying. It is so likely that it is everyone.

              I hate politics and hate that leaders of every country and corporation often make decisions which cause such destruction.

              What I will agree on is that the reason I love Whole Food Plant-Based is that it is not political. It is a solution to problems oriented and life and health-oriented.

              Honestly, I am more in the charity and helps and missions end of things and I hate politics but do pray for righteous leaders to rise up.

              1. It is not appropriate in this context of nutrition science to belittle the deaths of children. Not bad temper, but expressing the same outrage that a Jew might feel to a holocaust denier, because in essence this too is genocide as economic sanctions kill the most vulnerable in targeted societies.

                I did not bring politics to this discussion, Dr. Greger did. You, however, reveal yourself to be a right-wing militarist apologist. Still wishing Great Britain was relevant, eh? – instead of just another US puppet.

                1. You are misrepresenting what Greger said because of your own political beliefs.

                  he didn’t belittle children’ss deaths. That is simply a lie.

                  As for the UN report, UN inspectors were carefully escorted by Saddam’s minders. This is the man who made genocidal attacks on Iraqi Kurds and the Marsh Arabs. And who also used poson gas against Iraqi Kurds and in the FAO Peninsula during the Iran Iraq War

                  If you really want to believe his claims about children’s deaths (via his spokespeople or a UN Report), rather than an independent report by a famous academic institution (LSE), then that says volumes about your bias …. not Greger’s.

        2. I understand what you are saying.

          I guess I watch so much political humor that I understand that much of the change of the world comes from that type of humor.

          But it does hit a nerve.

            1. I feel like what he was communicating is that kids are often used in the middle of these political situations and it is often both sides who ignore the plight of the poor.

              I feel like it is more likely because he put it there, someone who has never heard any of it might look it up.

              From my experience, that does happen.

              People don’t watch the news at all and then it is some Saturday Night Live or The Late Show or Late Late Show joke, which informs them and then they look it up.

              1. Maybe the good doctor should clarify, because from where I am standing it looks like he is calling the Iraqi government tellers of fake news and taking the position of the BMJ, that contradicted not the Iraqi government but the UN report.

                In the context of the current US regime minimizing in the media their deadly impact of economic sanctions on the innocent people of Syria, Iran, Venezuela, et al, it is exceedingly clumsy if not openly callous to call into question the innocent lives lost in Iraq.

                It recalls Madeleine Albright’s declaration in 1995 that the deaths of half-a-million Iraqi children from the U.S. and UN sanctions on Iraq were “worth it.” So, minimizing the impact of US aggression is nothing new. Today, Israel is pushing for war with Iran, their Defense Minister bragging about how they are already “killing Iranians in Syria”. I would hate to think that Dr. Greger is playing into the hands of these criminals that are rushing us into another war.

    1. José Roldan Thank you for your comments. I first saw this video on YouTube and was astonished at the thoughtless attitude expressed by Dr. Greger’s words. Between his previous attacks on marijuana, citing “studies” where participants were smoking five or more joints a day, and this dismissive rejection of reports that sanctions injured thousands of children in Iraq, just as they’re doing to the people of Venezuela, today, I have come to the conclusion that you suggest: Doctor, Stick with what you know and stay the hell out of politics. I used to be a donor and every day reader; I’m having real second thoughts, now. And those people who attacked your having expressed your opinion, by telling you, essentially, to go back to where you came from (sound familiar?), take your politics and get out! I wish to congratulate them for serving as a mouthpiece for the neo-colonial American zeitgeist. I look forward to Dr. Greger debunking the myth that the invasion and overthrow of Gaddafi destroyed the most vibrant, progressive country in Africa, and all due to the PetroDollar and Libya’s Gold Dinar proposal; maybe he could hook it up, in a Vitamin D vs sunshine review. I can’t think of a better way to attract new readers.

      José, otra vez, imuchísimas gracias!

      1. Thea, you left out North Korea and Myanmar from your defense of Totalitarian and butchering states and leaders. Gaddafi? the killer of the people on the Lockerbie flight.

        I could go on and on… o.k., I will. Venezuela?!!! Are you kidding me? Chavez started that whole mess and until the bus driver, driving the country into irreparable ruin today…

        Oh, I get it… you meant your post as sarcasm?

        I hope so ’cause the only other explanation that makes sense is you have one of those brain eating amoebas.

  8. You really missed the boat on this one. As a recently retired dentist (43 years in the business) and a forever student of science, sugar has never been the problem. You could soak a tooth in pure sugar for a million years in a vacuum and it would not cause a single cavity. It is the bacteria that eat the sugar that actually cause the cavity. Brushing twice a day, flossing once a day, and hopefully waterpicking once a day would almost eliminate decay, no drugs at all! Bottom line, you can have your cake and eat it too, if you just clean your teeth. I had plenty of cavities as an uninformed kid, but suck on jawbreakers all day long because I know that I can keep the bacterial plaque off my teeth with such little effort. Haven’t had any new cavities since dental school, 44 years ago. The dental profession doesn’t realize it by vilifying sugar, but we only perpetuate the myth because we know the average public will not commit to good oral hygiene. Banning sugar is a defeatist fall back position for laziness. Of course, self control has never been top on the list of typical Americans, just look at the epidemic of obesity.

    Glen

    1. Dr. Glen Meyer,

      They have done studies where less than 50% of people brush their teeth twice per day and fewer than that floss and fewer than that use waterpicks and those who do are not thorough.

      They have tried to change that behavior and have tried to get people to use timers to brush longer, but people aren’t doing it.

      The whole point of this one is that lowering sugar intake to less than 3% and the whole issue goes away. I don’t know that it is laziness or if brushing more is laziness about choosing healthier foods in diet.

      But since sugar is addictive and does more than hurt your teeth, I would rather see people eat better.

    2. Dr. Meyer, I am a dentist of 30 years experience. Congrats on your retirement. As you point out, most people just won’t make the commitment to oral hygiene year round (maybe for a few weeks after seeing us). So preaching decreasing sugar is definitely a good thing. Sorry to be a bit intrusive but if you’re a student of science you must be aware of Dr. Lustig’s (and many others) work stating too much sugar can cause non alcoholic fatty liver so I’m curious why you would suck on jawbreakers all day long.

  9. Dr. Greger, superb video! I’m a dentist of 30 years experience and I preach this everyday to my patients. It’s funny how many dentists and hygienists see patients with lots of cavities and tell them they need to floss more. By far more important is reducing the sugar in the diet. If you’re drinking lots of pop and coffee with sugar in it all day, it doesn’t matter if you floss 10 tens a day, you will get decay. Thank you for passing along this great information. And as another great doctor, Dr. Robert Lustig preaches in recent years, excessive sugar is toxic for the body too. In a future video please mention the stupidity of gummy bear vitamins.

    1. I am not impressed with Lustig (at all). He himself is a poor example of what he preaches He is overweight, fond (very) of alcohol, and his fav dessert is bread pudding. Pfft!

      A couple of years ago a dentist chimed in the conversation on food/sugar and teeth. His comment was that problem is not sugar per se, but that we tend to want sugar alll day in candies, gum, tea/coffee, dessert, etc which fosters the growth of bacteria. I had the worst troubles when I used artificial sweeteners, sugar alcohols.. when I quit the gum, (and toothpaste) the inflammation subsided.

  10. Why do certain people who are very healthy, ie fresh foods vegetarian diet, zero added sugars (always checking labels on breakfast cereals etc), no processed foods, and vigilant about cleaning teeth and flossing twice daily get cavities?

    1. Saliva is one thing that is a big part of it.

      People who are dehydrated or who snack all the time don’t give the saliva time to do its job.

      . “Spacing meals and beverages apart by at least two hours reduces risk of tooth decay,” Hultin says. The ADA explains that your mouth produces more saliva during a meal, which can help wash away food particles, than it does in between meals.

      Dates and honey are part of it. Sticky sweets.

        1. Fresh fruits rich in water leaves almot no residues in the mouth right but there is no way most dried fruits leaves no residues in the mouth, they are extremely sticky and rich in simple sugar, the more dry the worse.

      1. Do whole dates like medjool stick to your teeth? They are squashy but I’ve never noticed them stuck in my teeth, unlike my morning porridge which usually leaves residue around my teeth. Dates are very high in fibre.

    2. WFPB enthusiast,

      People who eat a lot of fruit, particularly dates, are the people in the vegan community who talk about teeth problems.

      Acid and sticky sweets both do it.

      I know dates were a big one. That was the one they mentioned.

  11. On his goal to fight sugar (which I applaud) Dr, Greger exaggerated when he said sugar is the only cause of tooth decay. Lynne Wholley’s comment was right on the spot. Evidence of that is that tooth decay was found in prehistoric remains; the poor in early history through middle ages probably had no access to sugar; nonetheless, they missed teeth due to tooth decay at an early adult age. My mom and her 3 siblings could not afford to eat sugary stuff when they were young but all four had tooth decay; I know people who eat the American diet and have never had a tooth decay. There is more to tooth decay than just sugar.

    1. Carolina,

      Dr. Greger quoted words from a study.

      To say the study was wrong, you have to have another study which shows that it was wrong.

  12. Cariogenic Potential Index of Food:

    “Foods with the lowest cariogenic potential indices were peanuts, gelatin dessert, corn chips, yoghurt, and bologna.

    Foods with the highest cariogenic potential indices were sucrose, granola cereal, french fries, bananas, cupcakes, and raisins.

    There was no simple relationship between food sucrose content and caries. Enhanced cariogenic potential was associated with
    foods containing approximately 1% or more hydrolyzable starch in combination with sucrose or other sugars.” [PMID: 2261606]

    Attention Dr. Greger: Beware bananas and raisins ! Just because these foods grow on trees (or plants) doesn’t necessarily make them good for your teeth. And fluoride is neurotoxic; please refer to work by Phyllis Mullenix. [PMID: 7760776] is just one of many studies.

  13. Seldom would I have anything to add to the comments of my nutritional hero Dr. Greger. But here I must.
    It is not just sugar but all refined carbohydrates which the bacteria can convert to the destructive acid.
    Secondly the frequency of ingestion is extremely important to cavity formation.

    A good example of both of these points is illustrated by the horrendous type of tooth decay caused by giving a baby a bottle to sleep with. Even though it has no added sugar the milk or juice, even breast milk constantly bathes the mouth in products converted to acid at a time when the baby has the lowest flow of saliva to neutralize the acids that are formed..

    The best published information I have seen for avoiding tooth decay can be found at the following site. The information is written by Dr. Margaret Fontana, a dentist and dental researcher with the history of contributions similar to Dr. Greger in quality and intent. I differ on her suggestion of water supply and pills and am totally against both. Fluoride works topically so one should be careful not to swallow it. But topical fluoride is essential for cavity prevention.

    For everything known about prevention see the following if interested, but ignore the suggestions for systemic fluoride ingestion.

    https://www.nidcr.nih.gov/health-info/childrens-oral-health/tooth-decay-process

    1. Thank you Larry Burnett for your comments and the link. All very interesting. I would like to ask a question if you don’t mind. Dr Greger did a video years ago about alkaline water in which he ended up recommended adding 1/2 tsp (?) baking soda per liter of water for drinking throughout the day. My question is, would sipping on this water help defray the damage from starches if we are frequently snacking? Eating a wfpb diet I find I eat often, but small meals. Thank you again

      1. Great question Barb. Baking soda would be an ideal prevention tool for you because of your frequent snacking. Baking soda has 2 qualities that make it ideal for tooth care. Primarily it is an excellent source of alkalinity which can neutralize the acid formed from your frequent snacking. It also has some anti bacterial property to help kill the bacteria that cause the problem.

        However there are much better ways for you to use it rather than drinking it. I don’t suggest drinking it. First of all it has the sodium content of table salt and you know that’s not good for you to ingest. Furthermore drinking it doesn’t get the baking soda where it is really needed, right under the gums around the tooth. But used as a paste delivered by your toothbrush it is almost a magic bullet to stop decay caused by frequent snacking.

        Whenever possible, within 5 minutes of eating something, brush with a paste made from baking soda. The easiest way to do this is to wet your toothbrush and then just dip it into the baking soda powder. It will pick up just the right amount to make a nice toothpaste for you. Work it under the gums around your teeth then rinse. It will neutralize the acid before the acid can take minerals out of the enamel.

        For anyone with a serious decay problem, the ideal magic bullet to stop decay would be to do exactly as I told you but instead of wetting the toothbrush with water before dipping it in the soda just put your normal amount of fluoridated toothpaste on the toothbrush and dip that into the baking soda powder to add the baking soda to your toothpaste. Doesn’t matter if your toothbrush is manual or electric. Do this twice a day and kiss tooth decay goodbye.

        This might be unhealthy for anyone on a really strict salt restricted diet because of blood pressure problems.

        I like the arm and hammer baking soda toothpaste but it doesn’t contain enough baking soda to help. But it is ideal to use dipping into the baking soda as I suggest because it is fluoridated.

        Before I get trashed by the fluoride haters let me add this. I am totally against fluoride in the public water system. Fluoride does it’s good topically on the tooth, not systemically throughout the body. Furthermore the possibilities of it being medically harmful are very real. Furthermore there are good reasons not to have the government mass medicating it’s citizens. But topical fluoride in the dosages available have been proven to be safe and effective without a doubt.

        I hope this helps. Thanks again for the thoughtful question.

        1. Are we supposed to wait 45 minutes before brushing after eating for saliva to remineralize the teeth enamel that brushing can slightly erode?

          cups of tea between meals with plant milk possibly leave deposits that cause caries as well? In that regard would nut milk be better than milk from a grain?

          What about just swishing baking soda in water around the mouth after snacking? Thank you for the information

          1. Hi Rob, I’ll try to use your questions to answer. Are we supposed to wait 45 minutes before brushing after eating for saliva to remineralize the teeth enamel that brushing can slightly erode? No

            cups of tea between meals with plant milk possibly leave deposits that cause caries as well? In that regard would nut milk be better than milk from a grain?

            No

            What about just swishing baking soda in water around the mouth after snacking? Definitely better than nothing. Same for rinsing with plain water

            1. Thanks Larry. This would have been the story that got me thinking you should wait before brushing, but rereading it now, it really only concludes that rinsing with water (or green tea) is the best knowledge we have to date https://nutritionfacts.org/video/plant-based-diets-dental-health/

              As an aside, my misreading of that exposes a need for a change I’ve mentioned before: that is the format of so many videos giving so much background information and sometimes coming in a series with cliffhangers and then updates that can be hard or time consuming to piece back together as a whole series later on. It would be best to give the best answer first, then the backstory explanation later in the video (especially for people who want to know what the evidence against their pet theory is). This also fits better with best evidence about adult learning (part of which is that we tend to remember whatever jumps out at us the most, not necessarily what we need to remember)

          2. Hi, WFPB enthusiast! You can find everything on this site related to dental health here: https://nutritionfacts.org/topics/dental-health/ It is a good idea to rinse the mouth with water after eating acidic foods, as these can soften the enamel on your teeth, and to wait awhile after eating them before brushing. Green tea includes naturally occurring flouride, and can make a good mouth rinse after eating. You may want to consider leaving the plant milk out of your tea for another reason. Some plant milks may interfere with the bioavailability of antioxidants from the tea. More on these topics here: https://nutritionfacts.org/topics/tea/ I hope that helps!

  14. Please stop showing disgusting images especially as the still image used to describe the video. We are not all medical doctors and we would prefer to get the “G” rated version of your medical findings. If I wanted to be a medical doctor and see these horrible ailments then I would not need nutritionfacts.org. Please remember your audience. Change the image for this video please.

    1. The disgusting images keep making me sick as well. please use a healthy image at least for the cover image as it sticks to the top of posts and email so we keep seeing it.

      Think of the power of positive suggestion and the placebo effect. if your mission is to share tips for maximising health then let the healthy image dominate

      1. Try to behave like a grown-up.

        We are grown-ups talking about tooth decay. What image could possibly be more appopriate?

        Television and films are full of images of murders and violence . Yet here you are complaining about an image of a persons’s mouth and a decayed tooth.

        1. Many Adults are sensitive Mr FF. Some deliberately avoid Television and films that are full of images of murders and violence.

          To paraphrase you:
          Please try to behave like you have even a modicum of empathy or tolerance that not everyone is keen to look at the worst images of disease with their evidence based health

          1. That, I am afraid, is an absurd statement. The claim that a picture of a single diseased tooth is one of ‘the worst images of disease’ is just, well, absurd.

            You only have to go to the mall or walk down the street to see the same or worse.

            Please let’s all try to behave like adults here. Adults deal with reality, they don’t avoid it. Do you people avoid going to the toilet because what you see (and do) is distasteful.?

            It’s not a matter of empathy, it’s a matter of common sense.

            1. You are the one demanding that Dr Greger censors what images are shown. To paraphrase you, it’s always delightful when someone with zero maturity declares what is unacceptable for everyone.

              Admittedly, some very young girl might go “Eeew” and turn away from such an image but I still find it hard to imagine that any adult could express outrage at a picture of a diseased tooth in someone’s mouth. It’s surreal..

      2. David F Rupe and WFPB enthusiast,

        I found the photo fascinating. And a cautionary tale.

        One of my young relatives had many of her baby teeth capped with silver colored caps: her mother left her to sleep with a bottle — of milk. Or juice. And her mother was a nurse, and should have known better. Luckily, they were baby teeth, and eventually fell out. I’m pretty sure they learned their lesson. But the dental procedures must have been painful, and expensive. And so unnecessary.

        An ounce of prevention is worth a pound of cure. And I think it’s worthwhile being reminded occasionally of just what we are trying to prevent.

    2. The eye shoots directly to that huge black blob. Am surprised the one with the so-called cavity didn’t have the sense to have it taken care of by a dentist — no symptoms, no pain? With a cavity that large, the dentist might say it would be better to just yank it.

      Wondering if the pic was Photoshopped.

      1. Trust me, your dental office sees cavities WAY worse than that one. Sometimes all that is left are the roots in the gum because the entire crown of the tooth has rotted off. Some people are afraid to go to the dentist, so much so that they NEVER go to the dentist, or will only go when their doctor refuses to write them any more prescriptions for antibiotics. Other people cannot afford to go to the dentist. And still others are ashamed to go, because they are embarrassed that they left it that long. There are people out there that do not brush their teeth. Ever. There are many people who make up this world, and we all have different priorities.
        PS. That looks like a baby tooth – more likely the caregiver didn’t notice it, or didn’t care.

          1. Hi YR, Here’s what I think is a more likely explanation of the high suicide rates for dentists: “A recent study by Business Insider claims that being a dentist is the #1 most dangerous job. In addition for sitting for long periods in awkward positions, dentists are exposed to high levels of heavy metals from dental amalgam. Nickel, tin, and of course, mercury, all pollute the air while a dentist is working. Unless they are using the IAOMT protocol, dentists, patients, and dental staff are all inhaling mercury vapor during the course of the appointment.
            You’ve probably heard that dentistry has the highest suicide rate of any profession. But that’s not because dentistry is a miserable job. A Swedish study found that dental professionals have 40x more mercury in their pituitary glands than the general population.”

            P.S. no worry about mercury in your own fillings unless they are removed unnecessarily.

        1. To say a care giver didn’t care is offensive. My academically and musically gifted daughter, 12 years old has had a wfpb diet her whole life. I didn’t notice that 3 of her six year old molars are so badly decayed that we are going to the orthodontist to see if she can have them removed. I care a lot and am devistated as to how this has happened. Our dentist thinks it happened because her tooth shape had very deep ridges and despite lengthy regular brushing and flossing her whole life, food residue remained. My husband and I have great teeth. So has her slightly younger brother. My fault that we didn’t get her to the dentist for three years as life became difficult caring for elderly parents in their nineties. One blind and the other a complete invalid with dementia, in nappies and on a gastric feeding tube. I have to prioritise needs. The dentist had said three years earlier that her teeth were great and I got a false sense of security because she was brushing, flossing and eating lots of fruit and vegetables. No lollies. We have fluoridated water and use fluoride toothpaste.
          I would say to you, don’t be so judgemental, I was doing everything right except I didn’t manage to get her to the dentist for the last three years. The beginnings of tooth decay would have surely been picked up. It happened very fast. All her other teeth look good and she never complained. Just have regular visits is my advice. Accusing care givers as not caring is mean. I’ve cried enough over this.

  15. A bit questionable analysis of Iraq child mortality by London school of economics staffers which conclude mortality in Iraq went down during and after the US invasion involving large scale military conflict, millions of refugees and internally displaced people, etc.

    “There has been no substantial reduction in child mortality in the period since 2003. (Of course not we invaded)

    “Child mortality in Iraq remains about twice the level of most neighbouring countries.” (Demonstrating no increase in child mortality?)

    Something clearly isn’t adding up, which would be no surprise considering the source.

    Dyson T, Cetorelli V. Changing views on child mortality and economic sanctions in Iraq: a history of lies, damned lies and statistics. BMJ Glob Health. 2(2):e000311.

  16. What their graph does show is that Iraq’s child mortality began sharply deviating upwards relative to all their neighbors, when the US helped Saddam get into power and subsequently greatly assisted his war with Iran. That pattern remained unbroken by sanctions and the US invasion and today is a glaring deviation.

    Trying to draw data about sugar and child mortality from this political mess isn’t likely to be meaningful. I’d say it’s a poor source.

    1. Agreed.

      Poor source.

      I think he mentioned the whole mess because it is a “tainted by politics” source and just using it as an example and not mentioning it would have been worse.

      No matter what, if it was going to be used as a source, I would want to know.

      1. I have noticed that a high percentage of vegans and vegan lights eat honey, molasses etc. So I feel my post is appropriate. Actually, I wonder if there are studies which specifically look at forms of sugar such as honey etc.

        1. I think ethical vegans do NOT eat honey. As I’m far from a vegan, I do mix a half teaspoon with my morning hot cereal (either that or molasses). I don’t think that’s as detrimental as eating it straight from the jar — which, I guess, would affect the teeth.

    1. Good for you, Sydney.

      I haven’t had bread in such a long time.

      Well, I guess I did have some on Memorial Day weekend but I don’t really eat it anymore.

      I pause and say that because I tasted Wasa flax crispbread and genuinely liked it, except that when I read the package, it said, “May contain trace amounts of milk.” and I don’t know what that means. That is a step worse than if it had been worded “Made in a plant which uses milk products.”

      I don’t trust companies. I want to know how the trace amount of milk might get in there.

      I think about the almond milk company, which had real milk in their almond milk and not trace amounts.

      How does that happen at all?

      I watch these shows and most food is not handled at all. It goes through long tubes and pours out spigots and I don’t understand how that could ever accidentally happen.

      Well, I guess I do, from when I used to drink soda. Some of the workers at 7-11 would mix up which syrup went where. Which only happened a few times but once it happened it would take forever to get rid of. Plus, kids would mix flavors and the other flavor would get on the spigot.

      But big companies making large quantities of Almond milk? Are they mixing which one gets nuts and which one gets the milk?

      1. Deb, “trace amounts of milk” is not written on the ingredients label that I can see https://www.wasa-usa.com/products/crispbread/flax-seed/ but sometimes companies write that if their product is manufactured or packaged in a factory that also processes products containing milk ingredients. I would think it is a liability issue if a consumer is allergic to milk and gets ill eating their product, hence the warning. 45 calories and 4 grams of fiber per slice… that’s good – I’ll have to try them.

  17. Dr. Greger, as an historian, I would advise you be careful delving into politics and history of war. You cite a single, right-wing western paper on the Iraq sanctions and call the mass deaths ‘fake news,’ whereas normally, for nutrition matters, you qualify everything with ‘may be.’ You should certainly do that when citing a single right wing western paper on a topic as charged as that. Pro-war westerners and nationalists always desperately seek to downplay their violence and the Iraq sanctions are a key example. If you read some books on this subject, such as Invisible War or A Different Kind of War, you’ll learn more about what occurred throughout the whole sanctions process. If you are going to comment on such matters, which you should not and are not qualified to do, you should at least do that first.

    1. If the item of news Dr. Greger cites were an actual falsification, it is “fake news”. Asking Dr. Greger or anybody else to stay in his corner and be quiet is the kind of authoritarian sanction even you should find abhorrent. As you may be aware, there are also fake historians, as well.

  18. Thank you for the video and the knowledge it contains. Please enlighten me to exactly what you mean by “sugar”. Are all sugars equal in their ability to cause cavities? Fructose and Glucose plus all the other sugars?

    1. As an example, babies who nurse frequently, especially at night, can get cavities. This is from breast milk or formula, no sugar added to their diet.

    2. Good question, Lawrence. If you pull up the transcript for this video you’ll see Dr. Greger clarified he was talking about “added” sugar. So no, not all sugars are equal in their ability to cause cavities. A more detailed explanation can be found here. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717883/
      Sugars and Dental Caries: Evidence for Setting a Recommended Threshold for Intake
      “Evidence suggests that sugars naturally present in grains, whole fruits, and vegetables and also in milk (14–16) do not make an important contribution to the development of dental caries (or other noncommunicable diseases). This is because of the innate characteristics such as fiber content, water content, and other protective factors such as polyphenolic compounds or calcium or both.”
      You might also want to view Dr. Greger’s video Do Raisins Cause Cavities?” for further reassurance that you can indeed enjoy foods with intrinsic sugars, like fruits (yes, even dried ones!) without worrying about causing cavities!

  19. This was a great video and discussion too. I’d like to point people to the book “Blabber Mouth…..” by dentist Susan Smallegan for loads of detailed info on how to prevent cavities and gum disease. It seems that longer, salt water, swishing/rinsing must be emphasized more along w daily regime. But we all know someone who eats whatever in the world they want to eat and has never had a cavity. What makes their teeth impervious to decay? Please don’t answer back that it’s their genes, of course it is, but how does that work? Is it their saliva, their teeth, or both? Morphology or physiology? Different enzyme ratios? Why hasn’t this been studied, or has it? Curious minds want to know.

  20. In order for sugar to cause decay, there must be bacteria to transform the sugar into acid, and it must be in contact with the tooth surface long enough to demineralize it. If you are a fastidious brusher and flosser, you are much less likely to get decay when you consume sugar. BUT, you should still try and get that sugar monkey off your back, because it’s addictive as anything!

  21. Another cause of excessive caries is the autoimmune disease Sjogren’s Syndrome. Since childhood I’ve always have tons of cavities -as did my mother. Finally figured out with onset of full-blown Sjogren’s that the reason I have had SO many caries is because of lack of saliva; trademark of Sjogren’s. From my reading I’ve found that some women (predominantly a ‘female’ disorder) are diagnosed by their dentists first; confirmed by a rheumatoogist or other medical professional with baseline labs.

    With the ongoing controversy about stannous fluroide, I’m hesitant to recommend Gel-Kam – now available OTC in the US – to combat Sjogren’s caries. Further research has taught me that without sufficient water in one’s mouth, the fluroide simply can’t “take”. So all those years that I methodically used Gel-Kam were for naught; until I read the research of Ava Wu, DDS, head of Sjogren’s dentistry/mouth issues @ UCSF.

    Just a heads up for folks who have had excessive caries despite excellent oral hygiene and healthy food consumption.

    1. Absolutely Amarantha, Hyposalivation is the most powerful risk factor for decay. Does it help at all to to stimulate your saliva flow with sugarless mints?

      It’s not cheap but if you can get a prescription for a high fluoride prescription of Fluoride toothpaste that would be your best defense. Colgate 5000 is an example of that. It contains 5000 parts fluoride per million as opposed to the routine toothpaste amount of about 1000 parts per million.

      I repeat of all the possible risk factors for decay hyposalivation is the strongest. The fluoride should help somewhat even with your low saliva problem.

      1. Way back in the day, I guy I was semi-dating asked me to marry him. He was okay, but nobody I’d want to “until death do us part” with. For starters, when he kissed, he was a too-much-saliva-in-his mouth type of dude. Why couldn’t he swallow his spit before pouncing? :-/ (TMI?)

        1. Oversharing YR. He probably has good teeth though. Hypo is too little saliva. Pity that problem can’t be fixed by eating the right kind of vegetable or fruit!

      2. thanks, larry, just moved up to a prescription only SF – 1.1% gel – hesitantly.    had two crowns ‘seated’ in december, 2018; no pain in that quadrant of my mouth until stress in my life went through the roof (sjogrens/raynauds/fibro/radiation poisoning).      direct correlation between stress (hsuband’s illnesses; then death; then ”contested’ will).       clear indicator of how sensitive autoimmunen folks are to stress.
        have found xylitol gum to be a literal lifesaver – healthier than sugarless gum as it is merely beech bark.

        1. Sorry to hear about all that stress. That puts you at high risk for gum diseases also.
          I like water pick appliances for prevention of gum diseases.
          I imagine teeth ranking low on your list of problems. I think your knowledge and Dr. Greger contributing a lot to help you.
          Very wise of you to switch to that high fluoride gel.

          1. larry, thanks so much for the support.  it’s has been and will be an incredibly difficult time in my life.
            so wish i were back in the bay area – where i could find quality representation and not have to contemplate going pro se.     so wish, at this point, i’d gone to law school rather than getting an MBA in finance.
            best to you,a

            1. I can cite any reference for this but I have a feeling your luck will change and you will have a happy future. I think this way because you are smart, have a good attitude and enjoy this wonderful knowledge base we all benefit from.
              Good luck!
              Larry Ps many lawyers change careers and MBA has a reputation of being one of the most desirable professions.

              1. larry, from wence comes your encyclopedic knowledge of dental health?    were you a practicing dentist or just someone who found this area of the human body worthy of research?
                thanks for your kind words but unfortunately when i got sick in 2005 (trifecta of genetic autoimmue illnesses) i moved to olympia , wa – i called it the gulag or paradise; depending on my mood.       as i say, ‘you can take the girl out of berkeley but you can’t take berkeley out of the girl.               lived in the east bay for almost 30 years……………….people are so very different.   yup; truly an elitist when it comes to brains…………seriously.    the average grocery bagger in the bay area has a higher IQ than the avg. MD or JD here in paradise.

                trying to find a quality JD or MD is literally impossible.    olympia, despite being WA’s capital, is a small town of about 44,000 people.     i’ve now talked to six (6) JD’s – i know more about the RCW (washington’s code) in this area of the law than any of them and i’ve only spent a couple of hours pursuing the code.
                luckily despite being ‘gob smacked’ with new will, new POA a few days before my husband died a miserable death (hardly the “pt. just wants to die quickly and easily” POLST we had prepared with his PCP),  remembered the only way to prove alzheimer’s is an autopsy.   so have one from one of the top pathologists in the country (OR health science med school); head of OR brain bank – delightful, heartfelt, humble man.  BRAACK scale l is the reference scale used by pathologists.   my husband was a high 5 – full-blown alzheimer’s; explains the significant changes i saw in him the last 18 months or so of his life.    now i know what a ‘community property state is’ – WA is one of 9.   you’ve got to have a ‘community property agreement’ in place (which i do) in order to have this law take effect.
                always been fascinated with brain science.    adored ollie sacks – plus he was a pianist………………me, conservatory trained pianeste as dexter gordon would say.  dan levitin – amazing musician and then researcher of the calibre of sacks.     they were actually very close friends.    first thing i lost was my hands; so jazz school in berkeley gave me a scholarship.   been so devistated by events of last six months haven’t noodled around on the piano at all……..or been able to utilize my treadmill.   got the treadmill when MERSA 4 popped – appears in gyms, anywhere where there are scads of people.  

                yet all JD’s want to pursue probate – which leaves me with less than half of a not very big estate – not enough to live on…….knew husband was suffering from alzheimer’s but made a promise to ‘honor and cherish in sickness and health’.    had NO idea his vulture children who we had not seen – literally – for almost a decade moved in when he almost died on valentine’s day (so wish the local Y had honored the pOLST – physicians orders for life sustaining treatment” – way beyond a DNR…..but they didn’t.   he was dead; no pulse; no respiration.
                Y called 911; revived him.              spent 4-5 days in the local hospital (i call it st. pathetic’s; catholic st. pete’s).    then on oxygen 24/7; in and out of the hospital.   we lived separately as i’m a ‘first world girl’ – need healthy, running water, heat provided by not burning painted wood……he lived 5 miles out of town in the ‘shack of shame’ – a rundown house on 5 acres.    larry, i’m not kidding you, bullet holes in the windows (so that the burglar alarm stopped working), mold in both bathrooms, front porch separating from the tiny, poorly built house…………he lived without running water for 6-8 month and developed a couple of really deep, nasty boils on his buttocks as a result.  sigh.  peenywise and pound foolish.    wouldn’t spend the $$ to drill a new well.  .
                i saw him every monday through friday; talked to him every night @ 8:30 to monitor all the things one does for someone in their mid-80s – med compliance, weight, personal hygiene, etc………………..when he let his meth abusing grandson move back in around 2/18, after kicking him out a decade before, and the kid of 32 literally walking out of our lives into town for a drug deal five years before when i was tutoring him for his GED, buying him healthy food, his grandfather bought him new clothes (big deal for Mr. pennywise and pound foolish), i knew there would be trouble husband almost immediately filed for a separation and, unbeknownst to me at the time, had a new, bogus will created 4/18 (leaving me nothing; giving the major asset – the house with five acres to his him/her/transgener/lesbian – ah, gender fluidity and the right to live in the house in perpetuity to the daughter who we wrote out of the will in 2013 (added a codicil) when he figured out she was cooking meth – seriously! – in the trailer she bought that saw behind the shack of shame.
                i got the separation dismissed in august, 2018.  at which time the will should have been revised but it wasn’t.   

                without every penny of the estate, i’m going to have to go to geneva………………sigh.           really do not want to represent myself (pro se) because stress aggravates autoimmune illnesses.   my mother was dead @ 53 – a sjogren’s leukemia………at a time when not enough research had been done.       she had ‘the best’ treatment @ barnes by the head of rheumatology and oncology, a teaching hospital, as the wife of a fairly famous surgeon.      my father had rickets, worked 40 hours a week AND went to medical school; graduated 3rd in his class @ temple; rode the rails from philly back to colorado; dug bauxite the summers between his time spent in med school……both parents were incredibly progressive (ah, how i hate what that word now connotes).   mother voted for henry wallace rather than FDR and was bi-racial (turkish and hungarian)

                father cared for ALL – made no difference if you had insurance or not – unlike the good catholic and lutheran MD’s who would not provide medical care to members of their congregations.    jaundiced view of organized religion did you say?    you betta believe it.
                unfortunately married my father, but without the earning capacity.    MIT undergrad; Boalt hall……………..lived the last few years of his life in his car.     ended up with a daughter badly damaged from the continual stalking through the courts by her father over custody.    turned out the judge on our  7 year odyssey was a friend of my daughter’s father – should have recused himself; hit him with sanctions but didn’t happen.
                so i survived one massive medical expense (in excess of $200,000) for my daughter’s residential care.   got sick and the rest is history.    was one of nader’s first female raiders, heavy duty law clerk experience on both coasts before deciding with the help of the only woman JD @ nuremberg, mary kaufman, who taught @ my alma mater for one quarter, “law and the limits of litigation”.   silly me, assumed the supremes would always be the warren court.    nope, that was an anomaly – as we’re seeing in BOLD, ALL CAPS.
                until i turned 65, my income was sufficient – social security plus a disability policy from UCBerkeley, my last employer.   i managed the humanities center but when that income stream ended – well, i was dependent on hubby………..the only modality that works for me is alternative care – specially a man named frank lowen.
                if you’ve delved into ‘alternative’ medical care perhaps you know the name john upledger?  difficult personality.   upledger institute in florida.    john was an osteopath, i think, broke open the door between western medicine and alternative medicine in the US.      barale did the same thing in paris.       lowen was both men’s star student – then went off and created his own health modality.    as my fabulous MD in seattle says (no longer fly every 3 months to bay area and UCSF – best for autoimmune on west coast; st. john’s (john’s hopkins) on the east coast) since i found erika.    UWA’s med school has had the no. 1 ranked GP residency in the country for the last 15 or so years.   erika’s professors told me she was “the most brilliant resident we have seen in two decades”.     

                we are quite a team.   she agrees that western and eastern medicine have nothing to offer me (trifecta of autoimmune illnesses plus radiation poisoning as i grew up south of st. louis.   downtown st. louis was where all the uranium for the manhattan project was processed – with MI river as the water source; my childhood drinking water – then the uranium was transported to fermi @ un. of chicago and went into the two dropped atomic bombs.

                the pictures of the slag heaps in the downtown st. louis are chilling.     i’m just so glad i’ve lived l ong enough to fi gure out WHY i’m so damned sick despite doing an hour of cardio for 40 years (yes, cardio is my drug of choice) but i didn’t want to die a miserable death like my mother.   little did i k now it was in my genetic code.
                so far more info than you could ever have asked for. . . . . . . . oh, also survived a double head-on where i was “the point of impact”, sitting in the death seat, as the surgeons call it, front passenger’s seat pre-air bags (thank you detroit), so no protection from the steering column.     concussion so massive had no recollection of the second collision.  head hit the backrest so hard it had to be stitched closed……..damage all the way down my body; ending with an almost severed right foot.     got almost no fun tickets $$) as both drivers who hit the ‘little car’ as the state trooper characterized it carried reasonable auto insurance; the bare bones, CA minimum o $15,000…………..so couldn’t run on the treadmill because of damaged foot but would truck al ong @ 4 MPH; just short of running.

                so will be donating my concussion head (7 and counting) to ann mckee who has done the ground breaking work with TBI’s, concussions, head trauma, etc. among the NFL players and our wounded warriors.   mckee managed to pry some pretty significant bucks out of the NFL to fund her amazing research with wounded warriors.   did you know that a SINGLE roadside bomb 100 yards away can cause permanent brain damage?   

                1. Amarantha, I was a practicing dentist and after retirement became seriously interested in the new science of early reversal of decay. I’m speechless about the rest of your story except to say I am also a musician playing early jazz bass and trombone.

                  1. jazz; the only american musical idiom.    i HIGHLY recommend anton schwartz…………….met him in the bay area; now works out of seattle and bay area.     in his early 50’s.   brilliant, brilliant musician (sax and composer) and human being.   was five years into his PhD in AI @ stanford (was 2nd chair in harvard’s jazz band when joshua redman was first chair; moved up when redman graduated {did you know redman was going to yale law school?  took the summer off to play music and the rest is history} anton’s first CD is named “when music calls”.   spent many a wonderful night @ his  oakland loft listening to some fabulous musicians.   his dad was tony schwartz – another ‘one of a kind’ mind…..remember the little girl counting the petals on a daisy while a nuclear bomb went off behind her?   (only aired once)     tony was the creator of that ad plus another incredible musician.   Tony Schwartz

                    | | | Tony Schwartz |

                    kind of far afield from dental decay but hope you enjoy.        after cecil taylor (macarthur genius winner) – ahem – permanently borrowed the biggest and bested steinway from my alma mater, the colllege cancelled the contract with betty carter (first woman to have her own record label).     ah, to have studied with her!   my music mentor in college introduced me to jazz and opera.  he was a friend of robert mondavi, a jungian, rare student of luigi dallipicolla – the anti-fascist and 12 tone composer.
                    wonder if this email will get to you.

                     — The ones among you that will be really happy are those who have sought and found how to serve.      Albert Schweitzer

  22. “In fact, recent reports have found that regular consumption of sugary drinks heightens the risk not only of tooth decay, obesity, fatty liver disease and Type 2 diabetes, but also of heart disease and premature death, even in people free of other risk factors.”

    From:

    https://www.nytimes.com/2019/07/22/well/eat/the-downside-of-having-a-sweet-tooth.html?te=1&nl=well&emc=edit_hh_20190724?campaign_id=18&instance_id=11137&segment_id=15523&user_id=df9ab8c6b9d3d163c54da27651a298df&regi_id=7483664920190724

  23. Thank you, Dr. Greger, for this video segment clarifying where dental decay arises– in the plaque that bacteria produce when fed sugar.

    Yet, there is still another obstacle to good dental health. Most people do not know their actual (non-whole food) sugar intake. Food manufacturers claim they add sugars to cereal, beverages and even food staples to make the food “taste better”, but obtaining a completely transparent list of ingredients is “like pulling teeth”.

  24. Eating zero sugar (only wipe) can still cause cavities. Especially if microbiome harvests some ‘not so good’ guys. I’ve had that experience before.

  25. See Remarks On The Influence Of A Cereal-Free Diet Rich In Vitamin D And Calcium On Dental Caries In Children
    Author(s): May Mellanby and C. Lee Pattison
    Source: The British Medical Journal, Vol. 1, No. 3715 (Mar. 19, 1932), pp. 507-510
    Published by: BMJ
    Stable URL: https://www.jstor.org/stable/25347520

    Apparently, oatmeal causes cavities.

  26. I’m going to put forward a completely radical idea: that sugar doesn’t cause cavities.

    The acids produced by bacteria is what causes tooth decay, and the important question is what causes the proliferation of bacteria?

    In a society which views everything as a physical phenomenon, the scientists say “it’s the chemicals”, thus it’s the molecules of sugar which are seen as the culprit.

    But, in reality, bacteria respond most of all to “vibration”. The bacteria in our gut, in our mouth, on our skin, in our scalp … all respond to the vibration of the person. That is, they respond to the emotional state of the person. Sure, chemicals and molecules exist and they interact with each other, but bacteria – which are simple organisms – respond rapidly to vibrations. One day the scientists will find ways of monitoring vibrations, but that day is not yet here.

    So I say that tooth decay is the result of negative emotional states of a person such as fear, shame or anxiety, and it just so happens that a person who has those negative emotional states is drawn to eating foods that contain sugar.

    1. And if you think I’m off with the pixies talking about “vibration”, consider the vibrations that make your cell phone work or the vibrations of light emanating from the sun.

    2. Heather, It’s not all bacteria. There are specific types of bacteria in people’s mouthsthat have been shown to turn it into acid. The acid is the exact initiator of the decay process

  27. Dr. Greger, I really like your videos and writing and your enthusiasm about spreading the news around world about nutrition for free. You’re doing an amazing job but a segment of this particular video really surprised me to see how quickly you drew a conclusion that Iraqi children’s death was hoax by reading one particular site without doing more research. We’re talking about innocent children’s death here, it should be taken very seriously even if the section caused much less death than ti was originally claimed. No children needs to suffer anywhere in the world caused by war and section. Would appreciate if you’re more sensitive making those types of comments in the future. Thank you.

  28. I am reading “The Longevity Diet” by Dr Valter Longo . He states that his studies have shown that even sugar from fruits spikes blood sugar and is aging. He recommends eating only 1 ior 2 a day. I have been waiting to ask Dr Greger what the science says about this as I could not bring myself to not eat plenty of fruits in the summer!

    1. Hi, Al Luck! I have also read that book. While there is some valuable information in it, I do not necessarily agree with everything the author writes. Fruits are among the most nutrient-dense foods. Some have higher glycemic impacts than others, but numerous studies have linked high fruit intake with positive health outcomes. Much of the research on negative effects of fructose have been done with high fructose corn syrup-sweetened beverages, and should not be extended to apply to whole fruits. You can find everything on this site related to fruit here: https://nutritionfacts.org/topics/fruit/ This may be of particular interest: https://nutritionfacts.org/video/if-fructose-is-bad-what-about-fruit/ I hope that helps!

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