A healthy body includes healthy teeth, and when it comes to preventing cavities and even building enamel back up in demineralized teeth, plant-based dairy alternatives don’t stack up to milk and real dairy, according to a new study published in the journal Nutrients.

Researchers from the Netherlands recently compiled existing data to explore how dairy products contribute to strong, healthy teeth and how plant-based alternatives compare. The foremost indication of tooth damage is dental cavities, which are largely related to consuming high levels of fermentable carbohydrates like the sugars found in food and drinks.

One of dairy’s best dental health attributes in relation to plant alternatives is the fact that milk’s natural sugar, lactose, is the least cariogenic (tooth-decaying) fermentable sugar. “Plant-based products contain sucrose, glucose, and maltose as the major types of carbohydrates, all of which are more cariogenic than lactose,” wrote the paper’s authors, Blerina Shkembi and Thom Huppertz.

The fermentation of these sugars allows organic acids to be produced, and when acids are produced in the mouth or acidic items are consumed, pH declines. This creates an environment where dentine, the main bony tissue of teeth, and enamel, its covering, can be demineralized, or broken down. Plant-based beverages not only contribute to this cascade by containing more fermentable sugars, but the authors also cited that they appear to be more acidic than real dairy.

Both dentine and enamel are mostly made of calcium phosphate, and the demineralization only occurs at reduced pH when the liquid in contact with the tooth is not “saturated” in calcium phosphate itself. Due to milk’s mineral content, the authors said this demineralization does not occur in the presence of dairy.

Natural cheese provides another avenue to prevent demineralization. In addition to its calcium and protein, it helps stimulate saliva flow, which buffers pH changes in the mouth and helps neutralize plaque acids.

The researchers also described that though the calcium content of plant alternatives may be fortified to be similar to milk, it is often in a form that is less soluble. The calcium in cheese and the calcium and phosphates in milk are available to help restore minerals that teeth may have may have lost due to other foods.

Finally, milk’s proteins provide valuable phosphopeptide sequences that are not found in plant-based alternatives, the authors said. One study in rats found that even when casein, which makes up about 80% of milk’s protein, was added to drinking water or chocolate, cavities were reduced. Additionally, lactoferrin and other milk components contribute to antibacterial efforts and can limit cavities. In fact, lactoferrin is often used in many oral commercial products, such as toothpaste. As an ingredient, it is largely sourced from bovine milk.

It is the combination and interaction of all of these components that make milk a smart choice for dental health, the authors conclude. Those same benefits are not found in plant alternatives and mark another way these products fall short of real dairy.