Hidden sugar is the sugar in foods you wouldn’t think of as sweet: pasta sauce, ketchup, bread, salad dressing, granola, flavored yogurt, protein bars and many “healthy” drinks. Your teeth don’t care whether sugar is obvious or hidden. Plaque bacteria feed on it either way and make acid that attacks enamel. The way to find it is the food label: check the sugar lines on the Nutrition Facts panel, look for sugar’s many other names in the ingredient list, and remember that four grams of sugar is about one teaspoon.
This guide from the Timonium office of Dr. Steven W. Haywood, DDS shows where hidden sugar tends to turn up, how to read a label in a few seconds, and what helps protect your teeth when some sugar is unavoidable.
Why sugar you can’t taste still matters for your teeth
Every time you eat or drink something with sugar, the bacteria in plaque use it as fuel and release acid. That acid softens enamel for a while after you finish, until saliva neutralizes it and helps minerals return to the tooth. Frequent small doses keep that cycle going all day, which is why sugar spread across sauces, snacks and drinks can add up to more acid attacks than a single dessert.
Savory foods with hidden sugar are often starchy too, like crackers, bread and chips. Starch breaks down into sugars in the mouth and tends to stick in the grooves of back teeth. Read are all carbs created equal for your teeth?
Where hidden sugar shows up
Sauces, dressings and condiments
Ketchup, barbecue sauce, jarred pasta sauce, teriyaki and many salad dressings are sweetened. “Low-fat” versions of dressings and snacks can be sweeter still, because sugar is often used to replace the flavor that fat provided.
Foods sold as healthy
Granola, cereal bars, protein bars, flavored yogurt, dried fruit and trail mix with candy pieces can carry a surprising amount of sugar. Dried fruit is also sticky, so it lingers on teeth.
Bread, crackers and cereal
Many breads, buns, crackers and breakfast cereals include added sugar, and even unsweetened versions are starchy.
Drinks
Fruit juice, smoothies, sweetened coffee drinks, flavored milk, iced tea, sports drinks and energy drinks can deliver a lot of sugar in a form that is easy to sip slowly. Many are acidic as well. Read soda spells double trouble for teeth and gums.
Soups, peanut butter and ready meals
Canned soups, some peanut butters and many packaged and fast food meals include added sugar you wouldn’t expect.
Cough drops and medicines
Cough drops, throat lozenges and some liquid or chewable medicines are sweetened. If you use them often, ask your pharmacist whether a sugar-free version is available, and don’t stop any medication without talking to your physician.
Sugar’s other names on an ingredient list
Ingredients are listed by weight, so a food can include several kinds of sugar that each look minor but add up. Watch for:
- Cane sugar, raw sugar, brown sugar, caster sugar and confectioner’s sugar
- Evaporated cane juice and crystallized cane juice
- Corn syrup, high-fructose corn syrup, rice syrup and malt syrup
- Glucose, fructose, dextrose, sucrose, maltose and lactose
- Maltodextrin and dextrin
- Honey, agave, maple syrup, molasses and sorghum
- Fruit juice concentrate
- Invert sugar
Words ending in “-ose” and anything called a syrup or a juice concentrate are good clues.
Four grams of sugar: doing the label math
The Nutrition Facts panel lists sugar in grams, which is hard to picture. A simple conversion helps: four grams of sugar is about one teaspoon. Divide the grams by four and you have a rough number of teaspoons.
- Check the serving size first. A bottle, bar or bag may hold more than one serving, and the sugar line applies to one serving only.
- Look at total sugars and added sugars. Total sugars includes sugar that occurs naturally, as in milk and fruit. Added sugars shows what the manufacturer put in.
- Divide by four. That tells you roughly how many teaspoons you are getting.
- Compare brands. Sugar content varies widely between versions of the same food, so a quick comparison in the aisle is often the easiest win.
For your teeth, remember that the label only tells you how much. How often you eat sugar, and how long it stays on your teeth, matter just as much.
Is raw or unrefined sugar better for your teeth?
Not really. Raw sugar, caster sugar, honey, coconut sugar and maple syrup may differ in flavor, texture and how they are processed, and whether sugar is raw or cooked into a recipe makes no difference to the bacteria in your mouth. Plaque bacteria use all of them to make acid. A “natural” or “unrefined” label does not make a sweetener safer for teeth.
Sugar-free is not always tooth-safe
Swapping to sugar-free products can help, but check what else is in them. Diet sodas and many sugar-free drinks are still acidic. Some sugar-free sweets use sweeteners that bacteria can’t easily feed on, and xylitol in particular is associated with lower decay risk. The practice offers xylitol mints and lollipops, which help reduce decay risk.
A practical plan for cutting hidden sugar
- Pick one swap at a time, such as an unsweetened yogurt with fruit or a dressing with no added sugar.
- Make water your everyday drink, and keep juice and sweet coffee drinks for meals.
- Eat sweet things with meals instead of as snacks through the day. Read have your dessert: a dentist’s guide to sweets.
- Rinse with water after a sugary snack when you can’t brush.
- Brush twice a day and clean between your teeth once a day, so plaque has less to work with.
Shopping for children? Read how to limit sugar for kids without the battle.
How the practice helps protect your teeth
If you seem to get new cavities at every visit despite a careful diet, hidden sugar is one place to look, but it isn’t the only one. Dr. Haywood reviews your health history and medications, because dry mouth and certain medications raise decay risk. Read does your dentist keep finding cavities?
- Early detection. Digital X-rays appear on screen right away, and DIAGNOdent laser detection can find decay at its earliest stages, sometimes before it shows on an X-ray.
- Super sealants. Sealing the pits and fissures of the chewing surfaces keeps bacterial byproducts and simple sugars from being harbored there. The practice offers a lifetime warranty.
- Calcium rebuilding instead of fluoride. For anyone who prefers to avoid fluoride, the practice offers calcium rebuilding treatments to help strengthen enamel for patients of all ages.
- Hour-long cleanings. A professional cleaning every six months is recommended, and appointments last a full 60 minutes.
See general dentistry in Timonium and dental cleanings and preventive care.
Paying for your visit
The practice is out of network with all dental insurance providers. You pay at the time of your visit, and the office files the claim on your behalf so your plan can reimburse you for whatever it covers. Health savings and flex plans are welcome, and financing is available through CareCredit, with no-interest options for up to 12 months, and Cherry, with plans from 3 to 24 months. See financing options.
Frequently asked questions
How much is four grams of sugar?
About one teaspoon. Divide the grams of sugar on a label by four to estimate teaspoons per serving.
Is natural sugar in fruit bad for teeth?
Whole fruit is a healthy food, and its fiber and water make it a better choice than juice or dried fruit. Bacteria can still use its sugar, so enjoying fruit with meals and rinsing with water afterward helps.
Is caster sugar or raw sugar better for your teeth?
No. Raw, caster, brown and white sugar all feed plaque bacteria, whether they are eaten raw or cooked.
Are sugar-free foods good for teeth?
They can help, but many sugar-free drinks are still acidic. Xylitol-sweetened mints and lollipops are a better choice, and the practice offers them.
Keep hidden sugar from costing you a filling
A checkup can show whether sugar is already taking a toll and what protection suits your teeth. Request an appointment or call (410) 453-9399. The office of Dr. Steven W. Haywood, DDS is at 108 W Timonium Rd, Ste 200, Timonium, MD 21093, serving Timonium, Lutherville, Cockeysville, Towson and Hunt Valley. New patients are always welcome.
Ready to see your future smile?
Still getting cavities despite a careful diet? Book a checkup in Timonium.
