THE COLGATE® CAVITY REPORT Drilling into the UK’s Tooth Decay Epidemic

A FOREWORD BY ANOUSHEH ALAVI, DENTIST AND SCIENTIFIC AFFAIRS MANAGER, COLGATE-PALMOLIVE UK

FILLING BRITS IN ON TOOTH DECAYWhile tooth decay has declined globally since the 1970s, recent studies reveal that tooth decay is still one of the most widespread health problems in the UK.2

What is tooth decay?Tooth decay is a process that can result in a cavity in a tooth if not treated early.

The outer layer of the tooth is made up of enamel. When plaque bacteria remain on teeth, acids produced by plaque bacteria cause the enamel’s minerals to be lost. These are tiny lesions which over time get larger and penetrate deeper into the enamel structure.

These acids are formed by plaque bacteria when they break down refined sugar from the foods and drinks we consume.

So what is the British attitude towards tooth decay? Whilst 74% of Britons aged 18 years and over wish that they had taken better care of their teeth, almost half (49%) believe that tooth decay is inevitable and 59% believe that everyone gets cavities.

Tooth decay is preventable but if it occurs and is left untreated, it can lead to dental pulp (nerve) damage, infection and loss of teeth.

Tooth decay can destroy the delicate tissues at its centre, which can cause severe pain and may result in an abscess, an area of infection at the root tip. Once an abscess forms, it can only be treated with root canal therapy, surgery or by extracting the tooth.

With such potentially painful effects, why is tooth decay one of the UK’s most common health problems? One reason could be that over half (53%) of Brits admit they aren’t sure what causes tooth decay.

What’s in your mouth? To understand what happens when you get tooth decay, it’s helpful to know what’s in your mouth naturally.

Saliva: Saliva is the mouth’s best natural defence against tooth decay. It works to wash away food and buffer any acids in our diet or produced by bacteria.

Plaque: Plaque is the sticky layer of bacteria that forms on your teeth every day. It starts off being colourless. Some plaque bacteria thrive on the sugars in your daily diet.

The difference between tooth decay, caries and cavitiesTooth decay: Tooth decay is a process in which the hard mineral structure of a tooth is destroyed due to the action of bacteria. The first stage is tooth enamel being dissolved by acids produced by bacteria in dental plaque.

Caries: Dental caries is simply the dental term for tooth decay.

Cavity: Cavities are holes in teeth that develop when tooth decay extends to underlying tooth structures.

CARIES

TOOTH BACTERIA

SUGAR

While many of us understand the importance of good oral health, there are some compelling facts that we simply cannot ignore; 84% of UK adults with natural teeth have at least one filling1.

This is why Colgate has commissioned a report conducted by One Poll amongst 2,000 adults and 1,000 children in June 2014, to uncover Britain’s understanding about cavities, how and why they occur and how to prevent them.

As a clinician, I have seen the effects of tooth decay first-hand, from the suffering caused by cavities to the impact of patients requiring immediate and urgent treatment. In some cases, this has included hospital treatment, and all due to a disease that is almost entirely preventable.

If we are to all work together to prevent this disease, we need to ensure that we have the right daily oral hygiene habits, dispel any long-held generational beliefs, and know the facts about healthy diets and dietary patterns especially the regular consumption of sugary foods and drinks. Why? It is simple. Sugar is the cause of cavities. Bacteria turn sugar to acid which over time cause cavities.

Dental professionals will continue their efforts in promoting good oral health and educating Britons about tooth decay. Tooth decay is largely preventable and at the very early stages, can be reversed.

Colgate is committed to developing new technologies to effectively combat this health issue and is helping to educate the public about better oral health. We need to work together towards a cavity free future.

Toothpastes with appropriate levels of fluoride have played a key part in preventing tooth decay. Developing new technologies to complement the effect of fluoride can now help us achieve this goal.

I hope that this report provides families around the UK with further information and advice to enable them to take action to prevent this common disease.

Dr Anousheh Alavi Scientific Affairs Manager Colgate-Palmolive UK

The Next GenerationTooth decay is the most common chronic disease in children. In fact, two out of five British parents (39%) admit that their child has experienced symptoms of tooth decay in the past 12 months.

While 68% of British parents do worry about the appearance of their children’s teeth, 35% still believe that getting a cavity happens to all children and 34% believe it is inevitable.

Children are at risk of tooth decay as soon as their baby teeth begin to erupt. So, one of the most important healthy lessons you can give them is teaching them good daily oral care habits as well as supervising their daily oral care routine. What is concerning is that 39% of parents find it difficult to get their children to brush their teeth twice a day, with a third (30%) of parents believing that they themselves need to set a better example for their kids when it comes to daily routines.

don’t know that cavities are preventable

Three in five (64%) Britons feel self-conscious about the appearance of their teeth

of British parents believe that they are doing everything they can to prevent their child from getting tooth decay

59% 70% of Brits have at least one filling1, yet the disease is completely preventable

Almost

25 million Brits don’t know the

causes of tooth decay3

84%

think that nothing looks worse than bad teeth

87%

THE ROOT OF THE PROBLEM

PRACTISING PREVENTION

An early sign of tooth decay is the appearance of white spots or patches on the enamel. These are areas where the enamel has lost some of its essential minerals. It is difficult to see these areas when they are in hard to reach places, for example in between teeth.

As tooth decay progresses, you may see cavities in your teeth, feel pain or sensitivity when eating and drinking, experience toothache, or develop an infection.

Tooth decay occurs due to the combination of a high sugar diet and a daily oral care routine that is incomplete, not twice a day, or missing the right levels of fluoride in daily toothpaste.

In fact, the number one cause of tooth decay is the consumption of sugary foods and drinks on a regular basis.

Why? Sugary foods and drinks provide the sugars for decay causing plaque bacteria to thrive. The acids these bacteria produce cause tooth decay. Yet, only one in ten (12%) Britons believe that the major cause of tooth decay is the consumption of sugary food and drinks.

Research revealed a huge gap in understanding about the sugar content in certain foods with people rating flavoured waters and processed savoury foods such as pasta sauces and ketchup as having low sugar content, which is not the case.

We commonly associate sugary food and drinks with sweets, chocolates and fizzy drinks, however, often the culprits are derived from natural sources such as juices made from concentrate or dried raisins. Processing natural fruits refines their sugar making it easier for bacteria on teeth to produce acids.

Do Britons know, and maintain, good oral hygiene habits? If you brush your teeth fewer times than twice daily, miss the hard-to-reach areas at the back of your mouth and skip flossing, it is likely that you are at increased risk of tooth decay.

Initially, tooth decay develops on the surface of the tooth and at this very early stage it can be stopped. However, once a cavity forms, a filling will be required to repair the damage and to restore the tooth. So, there are a number of basic principles Britons can follow to reduce the risk of tooth decay:

• Brushing teeth twice a day, one being last thing at night, with fluoride toothpaste

• Limiting the amount and frequency of intake of sugary and starchy foods

• Reducing the number of times you snack between meals

• Scheduling regular visits with their dentist to look for signs of early tooth decay and following their advice on what to do on a daily basis

Moreover, no one should expect to get tooth decay or accept that the condition is inevitable as it can be prevented with a healthy balanced diet and effective daily oral care routine, yet 84% of adults in the UK have at least one filling.1

The average world daily consumption of added sugar per person is 17 teaspoons – this is up 45% compared to 30 years ago4

The Scientific Advisory Committee on Nutrition (SACN) says that no more than 5% of daily calories should come from sugar. That’s more than 25g for woman and 35g for men.5

of parents find it difficult to get their children to eat less sugary foods

of parents use sweets as a bribe

Consumption of sugary soft drinks in 11-12 year olds doubled in the last 20 years6

Only one in four people (26%) believe that the major cause of tooth decay is sugary food yet the consumption of sugary foods and drinks on a regular basis is the number one cause of tooth decay

55%

30%

62%

30%

x2

of parents say that they should be doing more to prevent their

child from getting tooth decay

of Britons forget to brush before bed

48%

of British parents find it difficult to get their children to brush their teeth at night

36%

48% feel very guilty that they are not looking after their teeth well enough

48%

Nearly a quarter (23%) of UK parents admit that their children clean their teeth just once a day or sometimes not at all

x123%

of people bite into a chocolate bar and 43% are sipping energy drinks two to three times a week or more

LOUISE REDKNAPP, COLGATE BRAND AMBASSADOR, PRESENTER AND MUM OF TWO

“Personally, I’m passionate about keeping my teeth looking good. People are constantly judged on the appearance of their teeth, especially in the Entertainment industry, and we try to teach the boys about how important it is to have healthy teeth!

“I try and make my boys adopt my good habits too, as a busy mum it’s my job to make them understand how important it is, but in our house it’s a daily struggle to get the boys to clean their teeth, it takes about 20 minutes morning and night. They don’t have any cavities, but my youngest Beau (5) always says, “Mummy, my teeth are going to fall out anyway, don’t worry, I will take care of the new ones.” I tell him it’s best to get practicing!

“About once a week they’ll fall asleep and I’ll admit we take the easy route and let them rest, rather than have the tears when we wake them to brush their teeth – but after reading the Colgate Cavity Report that’s going to change!

“I completely relate to parents feeling guilty about their kids’ tooth cleaning habits and oral health. Although, it’s surprising that so many Brits (25%) don’t know that sugar is the main cause of decay. There’s so much hidden sugar in food, it’s hard to avoid it. My boys ask for fruit every night, and you think healthy snacks like bananas and raisins are a good choice, but they are actually jam packed with sugar, so you have to watch how much they have. Having too much sugar is the main reason we get cavities so we need to be careful, especially when a third of UK children aged 12 have visible tooth decay8. As long as my boys have their fruit an hour before bed and brush their teeth properly I am happy.

“Colgate® Maximum Cavity Protection plus Sugar Acid Neutraliser™ is a real innovation; it provides almost double the protection against early decay than a regular fluoride paste9, which is a big break-through. We all know about the importance of fluoride from school - but this technology is really going to have a big impact on improving oral health. The Sugar Acid Neutraliser™ technology helps de-activate sugar acids in plaque before they harm teeth, which is very reassuring.

Benefit of Colgate® Maximum Cavity Protection plus Sugar Acid Neutraliser™

• Clinically proven to deliver close to DOUBLE the protection against early decay vs regular fluoride toothpaste.9

The toothpaste is available in all major supermarkets across Britain, and is available in a range of products:

Product RRP

Colgate® Maximum Cavity Protection plus Sugar Acid Neutraliser™ Fresh Mint Toothpaste

£3.79

Colgate® Maximum Cavity Protection plus Sugar Acid Neutraliser™ Whitening Toothpaste

£3.79

Colgate® Maximum Cavity Protection plus Sugar Acid Neutraliser™ Kids Toothpaste (3+)

£2.00

Colgate® Cavity Protection Toothbrush £2.99

Colgate® Cavity Protection Mouthwash £4.49

“So I’m calling all UK mums to get informed about preventing cavities for themselves and their kids from the earliest age: everyone can now have the chance of a cavity- free family!”

THE HOPE FOR A CAVITY-FREE FUTUREColgate® is focused on educating Britons on how to prevent tooth decay in their families and has introduced a range of initiatives. One such initiative is the Bright Smiles, Bright Futures™ programme that helps educate school children about oral health and, since its launch, has helped over 700 million children in 80 countries worldwide. The Bright Smiles, Bright Futures™ initiative is due to launch in schools in the UK this September.

Colgate® is also developing new technologies to directly combat this health issue. In fact, it has taken eight years of clinical research and development, involving two milestone clinical studies and 14,000 people, to move one step closer to a world without cavities. The result is a breakthrough toothpaste that provides nearly double the protection against early decay compared to a regular toothpaste with fluoride alone9. New Colgate® Maximum Cavity Protection plus Sugar Acid Neutraliser™ is the first and only toothpaste with Sugar Acid Neutraliser™ technology which complements the protection of fluoride to directly target and neutralise sugar acids in plaque - the number one cause of cavities.

This toothpaste is clinically proven to fight cavities in two ways:

1. Its revolutionary Sugar Acid Neutraliser™ technology helps protect tooth enamel and neutralise sugar acids in plaque before they can start the tooth decay process

2. It strengthens and remineralises the tooth surface to help prevent cavity formation

Published by Colgate-Palmolive (UK) Ltd July 2014 ©Colgate-Palmolive (UK) Ltd 2014

Care is taken to ensure the accuracy of the information contained in this publication. Please contact Colgate-Palmolive (UK) Ltd if you have any concerns.

For more information go to:

colgate.co.uk

or contact Cohn & Wolfe on 0207 331 5445 or colgate.palmolive@cohnwolfe.com

References

1 UK Adult Dental Health Survey 2009, The Health and Social Care Information Centre

2 Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bulletin of the World Health Organization 2005;83:661-9. - See more at: http://www.actiononsalt.org.uk/actiononsugar/Press%20Release%20/133834.html#sthash.KzCBspgQ.dpuf

3 Based on a population of 46,851,042 adults (15+ years old) in the UK - Office of National Statistics. Mid-2013 Population Estimates: Pivot table Analysis Tool for the United Kingdom with 53% of adults not knowing the cause.

4 Credit Suisse, “Is Sugar Turning the Economy Sour?”, October 2013

5 Scientific Advisory Committee on Nutrition, “Draft Carbohydrates and Health report”: http://www.sacn.gov.uk/pdfs/draft_sacn_carbohydrates_and_health_report_consultation.pdf - 26 June 2014

6 Rugg-Gunn AJ et all. Public HealthNutr 2007; 10(4):354-63

7 OnePoll Colgate Survey. Data on file. Colgate-Palmolive Company

8 http://www.nhs.uk/conditions/Dental-decay/Pages/Introduction.aspx

9 Results from a 6 month study to assess improvement in enamel caries using the QLF™ (Quantitative Light induced Fluorescence) method vs a regular fluoride toothpaste, both with 1450 ppm fluoride. Toothpaste with fluoride alone reduced by 32%.”