How Does What I Eat Affect My Oral Health?

You may be able to prevent two of the most common diseases of modern civilization, tooth decay (caries) and periodontal (gum) disease, simply by improving your diet. Decay results when the teeth and other hard tissues of the mouth are destroyed by acid products from oral bacteria. Certain foods and food combinations are linked to higher levels of cavity-causing bacteria. Although poor nutrition does not directly cause periodontal disease, many researchers believe that the disease progresses faster and is more severe in patients whose diet does not supply the necessary nutrients.

Poor nutrition affects the entire immune system, thereby increasing susceptibility to many disorders. People with lowered immune systems have been shown to be at higher risk for periodontal disease. Additionally, research shows a link between oral health and systemic conditions, such as diabetes and cardiovascular disease. So eating a variety of foods as part of a well-balanced diet may not only improve your dental health, but increasing fiber and vitamin intake may also reduce the risk of other diseases.

How can I plan my meals and snacks to promote better oral health?

Eat a well-balanced diet characterized by moderation and variety. Develop eating habits that follow the recommendations from reputable health organizations such as the American Dietetic Association and the National Institutes of Health. Choose foods from the five major food groups: fruits, vegetables, breads and cereals, milk and dairy products and meat, chicken, fish or beans. Avoid fad diets that limit or eliminate entire food groups, which usually result in vitamin or mineral deficiencies.

Always keep your mouth moist by drinking lots of water. Saliva protects both hard and soft oral tissues. If you have a dry mouth, supplement your diet with sugarless candy or gum to stimulate saliva.

Foods that cling to your teeth promote tooth decay. So when you snack, avoid soft, sweet, sticky foods such as cakes, candy and dried fruits. Instead, choose dentally healthy foods such as nuts, raw vegetables, plain yogurt, cheese and sugarless gum or candy.

When you eat fermentable carbohydrates, such as crackers, cookies and chips, eat them as part of your meal, instead of by themselves. Combinations of foods neutralize acids in the mouth and inhibit tooth decay. For example, enjoy cheese with your crackers. Your snack will be just as satisfying and better for your dental health. One caution: malnutrition (bad nutrition) can result from too much nourishment as easily as too little. Each time you eat, you create an environment for oral bacteria to develop. Additionally, studies are showing that dental disease is just as related to overeating as heart disease, obesity, diabetes and hypertension. So making a habit of eating too much of just about anything, too frequently, should be avoided.

When should I consult my dentist about my nutritional status?

Always ask your dentist if you're not sure how your nutrition (diet) may affect your oral health. Conditions such as tooth loss, pain or joint dysfunction can impair chewing and are often found in elderly people, those on restrictive diets and those who are undergoing medical treatment. People experiencing these problems may be too isolated or weakened to eat nutritionally balanced meals at a time when it is particularly critical. Talk to your dental health professional about what you can do for yourself or someone you know in these circumstances.

Updated: January 2007

Nutrition and Dental Health

by J. Anderson and L. Brown ¹

Quick Facts... See your dentist regularly. Brush and floss teeth at least once a day -- after each meal or snack is best. In areas with low fluoride in the water, use a toothpaste or mouthwash containing fluoride. Limit foods high in simple carbohydrates or very sticky; snack wisely. Good dental health begins early in life. To prevent "nursing bottle syndrome," never allow a child to fall asleep with a bottle. Good nutrition is essential for good physical health. Nutrition also plays a key role in the development and maintenance of a healthy mouth, especially the teeth and gums. The food we eat affects our teeth. At the same time, the health or lack of health of our teeth and gums affects what we can eat. Good dental health begins early in life and must be practiced throughout life. Tooth development begins shortly after conception, usually between the sixth and eighth weeks of gestation and continues throughout pregnancy. It seems to take severe nutritional deficiencies in the mother to cause obvious changes in tooth formation in the child. However, slight deficiencies may cause changes in tooth structure that will leave a tooth at greater risk for decay later in life. A good diet during pregnancy is always important. However, nutrient excesses as well as nutrient deficiencies, may play a role in congenital anomalies of the mouth. Therefore, take supplements during pregnancy only on the advice of a doctor or dietitian. Fluoride Intake Good nutrition is equally important during infancy, childhood and adolescence. During these growth periods, primary and permanent teeth are being mineralized. This occurs before they erupt into the mouth. Fluoride intake from birth has been shown to reduce dental caries (tooth decay) by as much as 60 percent. During tooth development, fluoride is incorporated into the tooth structure making the tooth strong and decay resistant. Many community water supplies are fluoridated at the rate of 1 ppm (1 part per million). This rate has proven safe and effective at reducing dental caries. The normal daily intake from fluoridated water is about 1 milligram per day. When teeth are forming, an intake of more than 2 parts per million may cause fluorosis, a condition in which tooth enamel becomes toughened, mottled and discolored. However, teeth remain strong and resistant to decay. If you live in an area where drinking water has little or no fluoride, prescription fluoride drops or tablets may be prescribed by your doctor. An alternative to supplements is the daily use of fluoridated toothpaste and mouthwash. If you don't know the fluoride level of your water, contact your local water department. The Decay Process Brushing after meals and snacks is one of the best ways to remove sugars and food particles from tooth surfaces. The decay process begins when the bacteria that are always present in the mouth break down components of saliva. These components adhere to tooth enamel. This is the start of dental plaque. Dental plaque is a clear, gelatinous material that allows bacteria to remain on the teeth. If dental plaque is not removed frequently (at least once a day) by proper brushing and flossing, the plaque becomes tightly attached to the tooth and only mechanical cleaning can remove it. This is why frequent visits to a dentist and regular, thorough cleaning by a dental hygienist is very important. Inside this dental plaque, the bacteria ferment dietary carbohydrates for a food source. This fermentation produces lactic and other acids. These acids demineralize the tooth enamel. As the tooth demineralizes, bacteria move into the tooth, decay begins and a cavity is formed. Untreated dental caries are painful and can result in tooth loss. Pain or loss of teeth may cause malnutrition. These conditions often prevent a person from chewing and eating adequate amounts, as well as eating some hard, high-fiber foods. Bacteria need carbohydrates for food. By cutting back on simple carbohydrates, the rate of dental caries can be reduced. Sucrose (table sugar) is the carbohydrate bacteria prefer. However, other simple carbohydrates, such as fructose, lactose and glucose, are easy to ferment and also support bacteria growth. Simple sugars are found in many foods and have many names. Some of these are table sugar, corn syrup, honey, molasses and dextrose. By reading labels on food products, you can limit foods high in simple sugars and thus reduce the chance of dental caries. Bacteria also can ferment complex carbohydrates (starches), but the process takes longer. However, many complex carbohydrates are sticky and become lodged between teeth and gums. This allows the bacteria time to ferment the carbohydrate. Meats and foods high in fiber, such as fresh fruits and vegetables, help clean the teeth of food particles and sugars during the chewing process. These foods promote saliva flow, which helps rinse the teeth of food particles. Saliva also neutralizes the acid. Although fresh fruits and vegetables do contain carbohydrates that can be fermented by bacteria, the fiber content counteracts the effect and helps clean the teeth, therefore protecting against dental caries. When we eat, we provide food for mouth bacteria. Eating three meals a day is important for adequate energy and nutrient intake, but snacking between meals presents special dental health problems. The snacks most people enjoy tend to be high in simple sugars (examples might be dried fruits such as raisins, sweet rolls, candy bars, pop or caramel corn). Snacking does not need to be completely omitted. In many situations, snacking is important for good physical health. This is especially true for young and growing children who need the calories and nutrients from snacks for proper growth. Choose snacks that do not harm teeth. Such snacks also tend to be more nutritious. Good snacks include cheese, yogurt, meats, plain nuts (not recommended for children younger than school age), peanut butter, fresh fruits and vegetables, unsweetened breads or cereals, and popcorn. Nursing Bottle Syndrome One preventable dental problem that affects young children is "nursing bottle syndrome." It is characterized by rapid decay of the primary upper teeth and some of the lower back molars. The lower front teeth are seldom affected. This condition develops when a child is given a bottle that contains a carbohydrate liquid or a sweet pacifier at bed or nap time. While the child is awake and sucking, saliva flow helps wash sugars away from teeth. As the child falls asleep sucking and saliva flow decreases, the sugars in the liquid pool around the teeth and provide an excellent feeding ground for bacteria. Painful decay results from this practice. If left untreated, infections and abscesses are possible. Premature loss of upper teeth may lead to the child developing poor "tongue-thrust." This could cause poor alignment of permanent teeth and future orthodontic and speech problems. All of these problems can be avoided by never allowing a child to fall asleep with a bottle. References Nutrition: Principles and Application in Health Promotion. Carol West Suitor and Merrily Forbes Hunter, J.B. Lippincott Co., 1980. Nutrition: Concepts and Controversies. Eva May Nunnelley Hamilton and Eleanor Noss Whitney, West Publishing Co., 1979. Diet, Nutrition and Dentistry. Patricia M. Randolph and Carol I. Dennison, C.V. Mosby Co., 1981.

1 J. Anderson, Colorado State University Extension foods and nutrition specialist and professor; and L. Brown, former graduate student; food science and human nutrition. 12/92. Reviewed 2/05.