Expert calls for sugar control, fluoride use to tackle Nigeria’s tooth decay crisis

“If you must take sugar, take it with meals—not in between,” she said, explaining that constant exposure of teeth to sugar fuels harmful bacterial activity that leads to decay.

However, she clarified that not all sugars are harmful. According to her, xylitol—a naturally occurring sugar substitute found in certain gums—has protective benefits. Chewing xylitol-containing gum stimulates saliva production, which she described as “the unsung hero” in oral health due to its role in neutralizing acids and repairing early tooth damage.

Drawing from over three decades of research, including international laboratory studies, Okoye revealed a critical gap in Nigeria’s natural fluoride levels. 

She noted that water sources in parts of the country, including Enugu, contain fluoride levels far below the internationally recommended minimum of 0.7 milligrams per litre required to protect teeth.

“In Enugu, we have about 0.3 milligrams per litre. That is not enough. Therefore, our most reliable source of fluoride is fluoridated toothpaste,” she said, urging Nigerians to brush their teeth at least twice daily with fluoride-based products.

The professor also disclosed findings from research conducted in collaboration with international laboratories, which showed that some toothpastes sold in Nigeria do not contain adequate fluoride despite being marketed for dental protection. She called for stricter regulatory oversight to ensure product integrity and consumer safety.

Beyond individual responsibility, Okoye tasked government at all levels to take decisive policy actions. She described the current allocation to oral healthcare—less than 0.5 percent of the national health budget—as grossly inadequate.

“Oral health must be integrated into general healthcare. What happens in the mouth affects the entire body,” she stressed.

Among her key recommendations, she urged authorities to mandate clear labeling of sugar content in food and beverages, regulate sugar exposure among schoolchildren, and consider water fluoridation programmes, especially for growing children.

“People should know what they are consuming. Many soft drinks contain high levels of refined sugar that are not obvious to consumers,” she warned.

Okoye also addressed common misconceptions surrounding traditional oral hygiene practices. While acknowledging that substances like charcoal and chewing sticks can aid mechanical cleaning, she stressed that they lack fluoride, which is essential for strengthening tooth enamel and preventing decay.

She cautioned against reliance on unverified alternatives such as “Agnes Nwamma,” citing clinical evidence of severe dental deterioration among users who avoid fluoride-based products.

“You need fluoride to protect your enamel. Without it, you are only cleaning the surface without preventing decay,” she said, recounting a recent case of advanced dental disease linked to such practices.

The lecture further highlighted ongoing research into alternative remineralization technologies aimed at supporting communities with fluoride-related challenges, signaling hope for future innovations in oral care.