How to Reduce Your Decayed, Missing, and Filled Teeth (DMFT) Index
Restricting free sugars intake to less than 5% of total energy intake is the most effective dietary strategy to reduce your DMFT index and improve oral health throughout life. 1
Understanding DMFT and Sugar's Impact
The DMFT index is a standardized measure used to assess oral health status by counting:
- Decayed teeth (D)
- Missing teeth due to caries (M)
- Filled teeth due to caries (F)
The Sugar-Caries Relationship
- Strong evidence shows a direct relationship between sugar consumption and dental caries development across all age groups 1
- Dental caries is a progressive disease - being cavity-free at age 12 does not guarantee lifelong oral health 1
- Even with good fluoride exposure, high sugar intake continues to cause significant caries progression throughout life 1
Evidence-Based Strategies to Reduce DMFT
1. Sugar Restriction
- Primary recommendation: Limit free sugars to <5% of total energy intake (approximately 25g or 6 teaspoons daily for adults) 1
- Evidence shows significantly lower caries rates when sugar intake is below 5% of energy compared to higher intakes 1
- Japanese population studies demonstrated a log-linear relationship between sugar consumption and caries incidence, with significant reductions when sugar intake was <10 kg/person/year (~5% energy) 1
2. Oral Hygiene Practices
- Regular brushing significantly reduces DMFT scores - higher frequency of brushing correlates with lower DMFT 2
- Use of dental floss shows the strongest association with reduced DMFT scores among all oral hygiene practices 2
- Regular use of mouthwash provides additional protection against caries development 2
3. Regular Dental Visits
- Routine dental check-ups allow early detection and intervention of caries before they progress 3
- Professional cleanings remove plaque and tartar that cannot be eliminated through regular brushing 3
Special Considerations
- Dental caries is not just a childhood disease - most dental caries now occurs in adults 1
- Even small reductions in caries risk during childhood significantly impact oral health in later life 1
- First permanent molars are particularly vulnerable and strongly correlate with overall DMFT scores - special attention should be given to these teeth 4
Common Pitfalls to Avoid
Misconception: Low caries at age 12 indicates good lifelong dental health
- Reality: Studies show children with low DMFT can develop significant caries by adulthood 1
Misconception: Limiting sugar to 10% of energy intake is sufficient
- Reality: While better than higher intake, evidence shows further benefits when limiting to <5% 1
Misconception: Fluoride exposure alone prevents caries
- Reality: Even with fluoride exposure, high sugar intake still leads to caries progression (annual increment of 1 carious surface/person reported in older adults) 1
By implementing these evidence-based strategies, particularly focusing on sugar restriction to less than 5% of total energy intake, you can significantly reduce your DMFT index and improve your long-term oral health 1.