Diet and Oral Health

Diet and Oral Health

Summary

Diet has a significant impact on a person’s oral health. Eating certain foods can cause tooth decay or gum disease. A poor diet can also lead to poor nutrition, which can cause oral health problems such as premature tooth loss and bad breath (halitosis).

The mouth naturally contains bacteria that rest on a person’s teeth in a sticky film called dental plaque. These bacteria feed on food particles and release acids that eat away at the enamel of a person’s teeth for 20 minutes or more after each meal or snack. This erosion is the major cause of dental problems such as tooth decay and gum disease. Certain types of sugary or starchy junk foods (e.g., candy, cookies, cakes and sodas) or healthier foods (e.g., certain fruits, milk, bread, cereal, processed food) can produce more of the acid and thus cause more dental decay.

Frequent snacking is particularly bad for oral health, because the cycle of acid creation and destruction of enamel repeats with each snacking session. In addition, foods that are especially sticky (e.g., candies) stay in the mouth longer and cause more damage.

A person’s diet can also affect other aspects of overall health such as poor nutrition. In fact, people who lack proper nutrition may experience the symptoms in their mouths first before the effects are felt in the rest of the body.

Certain populations face their own special challenges in regard to diet and oral health. For example, children are often attracted to sugary foods that are less healthy. Some elderly people eat inadequately or consume large amounts of soft foods, which may be high in the carbohydrates and sugars that can lead to tooth decay.

Vegans (vegetarians who do not eat any animal products) are at risk for oral health problems unless they find alternative sources of some vitamins and minerals, such as protein and calcium. People with eating disorders may have poor oral health due to a lack of nutrition and repeated vomiting of stomach acid, which damages tooth enamel.

Good oral health is essential to maintaining healthy teeth, gums and overall health of the body. Several tips related to diet can help improve the odds of maintaining good oral health. They include eating a well-balanced diet, limiting snacking and choosing healthy snacks, and brushing and flossing regularly.

About diet & oral health

People’s diets can have a profound effect on their oral health. Eating certain types of sugary or starchy foods contributes to oral health problems such as tooth decay and gum disease. In addition, poor nutrition has negative effects on oral health, including premature tooth loss and bad breath (halitosis).

For most people, tooth decay and gum disease are the chief oral health dangers associated with a poor diet. Normally, the mouth contains bacteria that rest on a person’s teeth in a sticky film called dental plaque. Plaque constantly forms on the teeth. Bacteria in plaque feed on the food particles, creating an acid that eats away at the enamel of a person’s teeth for 20 minutes or more after eating. This erosion is the major cause of dental problems such as tooth decay and gum disease. The only way to stop this process is to brush and floss the teeth regularly, preferably as soon after eating as possible.

The bacteria in plaque especially thrive on sugary and starchy foods known as fermentable carbohydrates. Some carbohydrates break down into simple sugars (glucose, fructose, maltose and lactose) in the digestive tract. However, fermentable carbohydrates break down into simple sugars in the mouth. When bacteria feed on these sugars, they dissolve the minerals inside the tooth enamel (demineralization). Saliva, fluoride and foods such as vegetables and milk can help replenish these minerals (remineralization). However, in some cases minerals are lost faster than they are regained. The result is tooth decay.

Today, Americans appear to be eating record amounts of sugary sodas, processed foods, fruit drinks and snacks. The average American eats about 147 pounds (67 kilograms) of sugar every year, according to the National Institutes of Health (NIH). People who consume such foods regularly put themselves at much higher risk for developing tooth decay and gum disease.

Frequent snacking is particularly bad for oral health, because the cycle of acid creation and destruction of enamel repeats with each snacking session. The more often a person eats – and the longer the food remains in the mouth – the greater the risk of destruction of the enamel.

In addition, foods that are especially sticky (e.g., candies) stay in the mouth longer and create more damage. Foods that pack tightly into tooth crevices – such as potato chips – also can wreak havoc with dental health. The molars are particularly likely to be affected by these foods. Soft drinks, sweetened coffee and other sugary liquids that are sipped during the day provide an almost constant source of food for oral bacteria, leaving the teeth under attack for long periods at a time. In addition, soft drinks are acidic and usually contain phosphorus, both of which erode the tooth enamel and contribute to the development of more tooth decay than sugars.

Although sugary foods like candies, cookies and sodas are especially bad for the teeth, healthier foods also contain sugars and starches that can promote dental problems. Certain fruits, bread and cereal all contain these substances. This does not mean these foods should be avoided. However, it is best to try to eat these foods during meals, limit snacking and to brush soon after meals when possible.

On the other hand, some foods actually decrease the risk of tooth decay. Fats alter the surface properties of tooth enamel, hamper the ability of sugar to dissolve and are toxic to oral bacteria. Proteins affect the ability of plaque to metabolize and increase salivary urea levels. Foods such as aged cheese help buffer acid when eaten soon after sugary or starchy foods.

A person’s diet can also affect other aspects of oral health. For example, poor nutrition can lead to severe periodontal disease and dental pain. In fact, people who lack the proper nutrition may experience the symptoms in their mouths before the effects are felt in the rest of the body.

Diet & oral health in special populations

Certain populations face special challenges in regard to diet and oral health. It is essential that children eat nutritious foods that allow their teeth to develop properly and that keep their gums healthy. However, children often are attracted to foods that are less healthy, especially sugary candies and sodas. Eating such foods can establish lifelong dietary habits that lead to long-term tooth decay or gum disease and the complications that result.

Parents are urged to encourage children to eat healthier snacks, limit overall snacking, and brush and floss daily. Keeping only healthy foods and snacks inside the house may help promote good habits.

It is often difficult for children to pass up the temptation to snack on foods that promote poor oral health. Parents are urged to explain to children that such snacking is a major source of cavities and encourage them to delay eating sweets until desserts after meals. After children finish dessert, they should be urged to brush their teeth immediately.

Elderly people may not eat properly if they are in poor health or if they have oral problems such as extensive tooth loss. Some elderly people eat inadequately, which can lead to poor nutrition and associated oral health problems. Others who experience pain or discomfort while eating may consume increasing amounts of soft foods, which may be high in the carbohydrates that can lead to tooth decay. People who wear dentures also may eat these types of foods frequently.

People who have trouble chewing can chop, grind or puree their meats, fruits and vegetables. Eating foods such as canned sugar-free fruits and vegetables or instant breakfast drinks are other options. People who do not eat because of other physical symptoms can take other approaches. For example, an older person who fails to eat because of dry mouth can consult a dentist about saliva supplements, while those who have an altered sense of taste can add spices and other flavorings to their foods.

Vegetarians who do not consume any animal products (vegans) also may be at risk for certain oral health problems unless they find alternative sources of protein, some vitamins and minerals, such as vitamin D and calcium. For this reason, people who plan to eat a vegan diet are urged to consult with a dentist or dietician about planning a diet that has adequate levels of nutrients. 

Women who are pregnant may also need to increase their consumption of certain vitamins and minerals, such as calcium. These minerals are vital to the developing fetus. If a pregnant woman does not consume adequate amounts of these nutrients, there may not be enough available for both the woman and the developing fetus.  As a result, the woman may develop tooth decay or other oral health problems.

Patients with eating disorders such as bulimia nervosa and anorexia nervosa are at higher risk of oral health problems for two reasons. First, their bodies do not receive the minerals, vitamins, proteins and other nutrients necessary to ensure good oral health. Secondly, patients with bulimia nervosa repeatedly vomit the food they consume to avoid weight gain. This vomit contains stomach acids that can severely erode enamel causing teeth to appear worn and translucent. A swollen mouth, throat and salivary glands and bad breath also may result.

Tips for good oral health

Good oral health is essential to maintaining healthy teeth and gums and overall body health. Some infections and other disorders that begin in the mouth eventually spread to other parts of the body, causing more widespread illness.

Several tips related to diet can help improve the odds of maintaining good oral health. They include:

  • Maintain a healthy diet based on foods from the five major food groups:
    • Whole-grain breads, cereals and other grains
    • Fruits, especially hard- and high-water-content fruits like apples, pears and melons
    • Vegetables
    • Meat, poultry, fish, dry beans, eggs and nuts
    • Milk, cheese and yogurt
  • Avoid processed foods. Foods that are purchased processed contain more sugar than unprocessed foods. Seemingly healthy foods such as commercial peanut butter and pizza contain added sugars. Homemade pizza and fresh ground peanut butter are better choices for oral health.
  • Try to eat foods during meals. More saliva is released during meals than during snacking. This helps to wash foods from the mouth, reducing the harmful effect of acids. Studies show that people who eat sweets during meals have less tooth decay than people who snack on similar sweets outside of meal times.
  • Snack appropriately and in moderation. Limit overall eating and drinking between meals. Foods such as cheese, nuts, milk and meats protect tooth enamel by either reducing acidity or providing calcium and phosphorus needed for remineralization. Hard fruits like apples and pears have a high water content that compensates for natural sugars, while vegetables have too few carbohydrates to pose a significant danger to teeth. Avoid foods such as candies, cookies, cakes, french fries, gooey foods (e.g., dried fruit snacks, caramel), muffins, potato chips and pretzels. Seemingly healthy snack foods such as breads, bananas, raisins and other dried fruits, and citrus fruits also can be bad for teeth because of concentrated sugars, stickiness and acidity. However, some studies suggest that raisins may contain compounds that fight cavity-causing bacteria, offsetting the detrimental effects of their stickiness and sugar content.
  • Avoid sodas and other sweetened drinks. Drinks that are high in sugar are especially hazardous to teeth when they are sipped over long periods of time. In addition to sodas, such drinks include coffee or tea with sugar, cocoa, lemonade and fruit juices. It is best to limit exposure to such drinks. If these beverages must be consumed, the use of a straw positioned beyong the front teeth (rather than between the lips and the teeth) will help to reduce the potential damage. Unsweetened tea, milk (which has sugar, but also helps remineralize teeth) and water are better alternatives.
  • Drink water often. This helps to cleanse the mouth of food debris, which reduces the amount of acid on the teeth.
  • Avoid mints and hard candies. Sucking on these sweets for long periods of time is especially bad for the teeth due to the constant presence of sugars. Sugarless varieties are preferable.
  • Chew specific types of sugarless gum. A natural sweetener found in certain plants and fruits (e.g., strawberries, plums, lettuce, cauliflower) called xylitol is added to many sugarless gums. It reduces the amount of bacteria in the mouth and helps protect teeth against the effect of acid. Sugarless gums and candies also promote production of saliva, which cleans the mouth and has antibacterial properties.
  • Brush at least twice a day and floss at least once daily. When possible, brush and floss after all meals and after eating snacks. This helps remove the plaque that damages the teeth and gums.
  • Visit the dentist regularly. In addition to professional cleaning of the teeth, a visit to the dentist helps to catch problems early, when they are most treatable.

Questions for your doctor on diet & oral health

Preparing questions in advance can help patients to have more meaningful discussions regarding their conditions. Patients may wish to ask their doctor the following questions related to diet and oral health:

  1. Where can I find information about what kinds of foods might promote dental help?
  2. Which foods promote remineralization of my teeth?
  3. Should I schedule a visit with a dietician who can help plan my meals?
  4. If I can’t brush my teeth right away, what steps can I take to reduce potential damage to my teeth?
  5. How often can I safely eat sweets and other foods I enjoy that nonetheless promote decay?
  6. Where can I find out about alternative foods that might safely satisfy my sweet tooth?
  7. How can I encourage my children to eat healthier snacks?
  8. I’m older and have trouble chewing. What steps can I take to make it easier to eat foods that will give me a well-balanced diet?
  9. I’m a vegetarian – what foods do I need to include in my diet to ensure oral health?
  10. Should I chew sugarless gum?
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