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Poor dental health can lead to poor nutrition, and poor nutrition can lead to poor dental health. While that seems obvious to many of us, there are some things to be aware of to make sure that your teeth stay intact and healthy. Chronic HIV infection poses several threats to dental health. With chronic infection, bones tend to lose their density and teeth tend to be lost. With immune suppression, opportunistic infections can cause pain and other problems in oral health. Even aging and hormonal changes can lead to tooth damage and loss. If you have diabetes, your risk for tooth decay is higher. There are also other threats that have to do with lifestyle, like smoking and drinking. Both are detrimental to dental health, and even second-hand smoke can cause problems. Physical activity is also important to general bone health, including teeth. Then there is diet and dental hygiene. These two go hand in hand, and good practices can go a long way to prevent problems and keep your teeth healthy and in place. Starting with diet-related reasons for dental caries, check out this list of risk factors: (1) eating frequently, (2) eating sticky foods, (3) eating sugars and starches, (4) eating acidic foods, (5) eating foods or other sources of nutrients that stay in the mouth for a long time, (6) not eating enough of foods that provide calcium and vitamin D. While it is a good idea to eat small meals more frequently throughout the day, each time you eat, your teeth can be bathed in acids that cause damage for 20 to 40 minutes. So the more often you eat, the more often your teeth face an acid bath. Then there are those sticky foods that cling to the teeth. What may immediately come to mind are dried fruits, such as raisins and dates. But even chips and crackers stick to the teeth even more stubbornly than candy bars and toffee. How slowly a food dissolves is related to the damage it can cause. That means that granola bars could be more villainous than caramels and jelly beans. Carbohydrates'regardless of whether they are simple sugars or complex starches'cause acid production. If you thought apples are just good guys, you should know that apples and chocolates are fairly equivalent in their acid production. But what if you have carbs as part of a meal? Well, in that case saliva production is generally increased and can help to neutralize the acid and clear the slowly dissolving food from the mouth. And if you mix your foods, you will have some protective foods along with the carbs, such as cheeses and other dairy products; these can prevent dental caries problems. High-protein foods, such as meats, legumes, and nuts, tend to become alkaline in the mouth and can help to neutralize the acids. Even fat can help by making food less likely to stick in the mouth. So what is the secret mix to maintain dental health? Here are some basic recommendations: ''Make sure your diet is balanced, adequate in calcium and vitamin D, with meals and snacks mixed in carbohydrate, protein, and fat nutrients. ''Use good oral hygiene techniques, such as brushing your teeth with a soft toothbrush thoroughly twice a day (or more often if you eat frequent meals), use a fluoride toothpaste in brushing at least twice a day, floss your teeth daily or use an interdental brush. ''Visit your dentist regularly for preventive maintenance and to catch any problems early. Keeping your teeth healthy is essential to maintaining optimal nutritional health. Make the commitment to your smile. Fields-Gardner is the director of services for the Cutting Edge, an HIV nutrition company in the Chicago area. She is a member of the International AIDS Society and the American Dietetic Association's Dietetic Practice Group on HIV and AIDS. She has written a book on HIV medications and a guide to nutritional management of HIV for clinicians.
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