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Factors in Development, continued
Sugar
The metabolism of carbohydrates by oral bacteria creates acid that demineralizes enamel. All types of fermentable sugars (sucrose especially, but also lactose, fructose, and glucose) can be metabolized by bacteria, so the risk of demineralization and caries development is directly related to the frequency with which the teeth are exposed to sugar.

Caries formation is promoted through the following activities:
 
Frequent or prolonged contact of the teeth with sugary substances from frequent bottle or sippy cup use, nocturnal feedings (breast or bottle) once teeth erupt, and frequent snacking between meals.
 
Consumption of “sticky” foods, such as candy, fruit roll-ups, raisins/dried fruit, and peanut butter.
 
Dipping a pacifier in sweeteners like honey or corn syrup.
 
Regular use of medications that contain sucrose, including some multi-vitamins. For this reason, physicians should be mindful when prescribing medications that contain sugar.

Caries risk is diminished when the following steps are taken:
 
Teeth are immediately brushed after eating to remove sticky foods.
 
Fresh fruit, vegetables, and whole grain snacks are chosen.
 
 
The risk of demineralization and caries development is in direct relationship to the frequency in which the teeth are exposed to sugar.
 
All fermentable sugars can be metabolized by bacteria.
 
Because certain medications contain sugar, physicians should be mindful when prescribing them.
 
Brushing teeth immediately after eating sticky foods and choosing fresh fruit, vegetables, and whole grain snacks helps to decrease caries risk.
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