SUGAR is often blamed for tooth decay but the evidence shows that simply cutting out sugar is not the best advice, at least not for people in developed countries with access to fluoride.

The most important factors are when and how often sugar is consumed, rather than the amount of sugar itself.

Studies of English, American and Canadian children have been unable to show a clear link between either the amount or frequency of sugar consumption and tooth decay.

Indeed, in the early to mid 1980s, in Sweden, Norway and New Zealand, levels of tooth decay fell whilst sugar consumption increased. This is because the caries process is influenced by many factors, and good oral hygiene with fluoride can outweigh any impact of specific dietary constituents.

Other studies have shown that the sugars in fruits produce acid in the mouth as well.

These include apples, dried dates, dried raisins, and bananas. For example, a study of fruit pickers in South Africa found that they ate fruit frequently and had higher levels of tooth decay than the control group.

Although evidence of a link between fruit consumption and tooth decay in practice is limited, the above study indicates that fruit clearly has the potential to cause caries if eaten frequently.

Starches are broken down by digestion into simple sugars. This process starts in the mouth and again studies have demonstrated that foods such as white bread, cooked spaghetti and cooked rice can cause acid attacks.'

Again there is limited evidence within populations, of tooth decay actually being caused by eating starchy foods, but it has been concluded that complex carbohydrates such as starches do have this potential.

Many of these foods are essential for a healthy and balanced diet. So how do you keep your teeth healthy? Here are some tips that will work more effectively than trying to eliminate any particular item from the diet.

* Brush regularly - Remove plaque and reduce the bacteria responsible for producing acid at the surface of the teeth.

Regular brushing and flossing carefully between the teeth will do this, although it is important not to brush too hard as this could damage teeth and gums.

Brushing before meals can help to dislodge plaque before food arrives. Brushing last thing at night is particularly important as saliva flow reduces during sleep and leaves teeth unprotected.

* Use fluoride toothpaste - It is now widely accepted that fluoride has a vital role to play in the protection from acid attacks, and repair, of the teeth.

In children, fluoride is incorporated into the structure of developing teeth, strengthening them against plaque attack. The use of fluoride has greatly reduced dental caries over the past 15-20 years

* Reduce the frequency of sugary snacks - The British Nutrition Foundation recommends a maximum of five sugar-rich snacks, meals or drinks each day. Snacks and drinks can be varied by including foods such as cheese and raw vegetables, and drinks such as milk or water.

Meals should not always end with sweet foods - nuts or cheese should be considered as alternatives on some occasions

* Visit your dentist regularly - Don't wait until you have problems to visit you dentist or oral hygienist. Schedule in regular check-ups at least once a year.

Your dentist or dental hygienist will advise you on whether you are cleaning your teeth properly