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Title: Distinguished Lecture Series: Tooth Decay and Liver Decay: The Nexus of Physicians and Dentists - Robert H. Lustig, University of California, San Francisco, Emeritus Professor of Pediatrics, Division of Endocrinology, Member, Institute for Health Policy Studies

This session will be recorded and available in the IADR/ADR Knowledge Community after the meeting. 

Tooth Decay and Liver Decay: The Nexus of Physicians and Dentists
Robert H. Lustig, University of California, San Francisco, Emeritus Professor of Pediatrics, Division of Endocrinology, Member, Institute for Health Policy Studies
Mountain Dew Mouth has been the scourge of dentists for decades. Dental caries are the greatest single cause of craniofacial pain. But there’s a new disease which affects even more people: Mountain Dew Liver. Non-alcoholic fatty liver disease (NAFLD). wasn’t even discovered until 1980; and now up to 1/3 of Americans suffer from it. Especially children - 13% of autopsies in children show NAFLD; and 38% of obese children. Both tooth decay and non-alcoholic fatty liver disease rates have been increasing. And excessive sugar consumption explains both. It's a popular misconception that glucose can cause cavities. Not true; glucose polymerizes on the teeth and forms a "biofilm" which actually protects the tooth from decay. This is why cavemen didn't get cavities. Glucose also doesn't cause NAFLD. Only 20% of the glucose consumed finds its way to the liver, and the overwhelming majority of that glucose is turned into glycogen (liver starch), which is not dangerous. It's the fructose moiety of the sugar molecule that causes both diseases. Fructose doesn't contribute to the mouth biofilm. It is metabolized by the mouth bacteria into lactic acid, which burns a whole right through the biofilm and through the tooth. And fructose in the liver gets turned into fat in the mitochondria, which drives NAFLD, which is the leading cause of liver transplantation now, surpassing alcohol. And yet who is most susceptible to both diseases? Children, because they are the biggest sugar consumers. Physicians and dentists must be united in supporting public health measures to reduce chronic disease.

Learning Objectives:

  • Understand how subcellular energy overload drives insulin resistance
  • Be familiar with the differences and similarities between hepatic glucose vs. ethanol vs. fructose metabolism
  • Be familiar with reactive oxygen species formation and cell damage, and the role of fructose in this process
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