Health professionals often refer to diet and nutrition when discussing various patient issues and their management of these concerns. However, the effect of these factors on dental health is still largely obscured and garners emphasis. There is no doubt that nutrients are our source of energy and essentially make the building blocks inside us, which our body needs to work with on a daily basis; but what exactly does the mouth have to do with all of this?

The oral cavity, also known as the mouth, is the first to be exposed to food and its constituents. What an improper diet and nutrition could do here directly or indirectly has proven to be of greater importance than once believed. The choice between ‘good’ food and ‘bad’ food has taken on more serious consequences as our knowledge increases.

To improve oral care and general health we must understand a few aspects of the relationship between the two:

• Diet, nutrition and dental health exist in a bidirectional relationship
• Good dental health reflects in good general health and well-being
• An improper diet can directly cause dental issues
• Improper nutrition can exacerbate pre-existing systemic oral health conditions or be the cause for them
  

As is the gold standard with all medical and dental conditions - prevention is better than cure. Quitting bad habits, changing unhealthy routines, and taking a few steps in the right direction towards healthier options is the way to go for long-term and consistent good health.

The impact of problems in our mouths to functionality or appearance affects us in many ways, including physically, emotionally, mentally and socially. Continue reading to learn the fundamentals of this dynamic between food and dental health, and how to use simple and easy fixes to protect yourself from many unwanted health problems and their expenses.

The Root Cause of Cavities

Ever noticed a black spot on your teeth that can’t be brushed off? Wondering how it got there in the first place? It’s more than likely that a combination of improper oral care and poor diet habits has led to a cavity. 

Cavities are areas on teeth that are being dissolved and damaged by bacteria. You may be asking what diet has got to do with it. Well, the answer is simple: bacteria need food to replicate and continue their destruction; when we ingest food and drinks with high carbohydrates and sugar, we’re helping the bacteria thrive.

In short, higher sugar levels mean more bacteria, which in turn means more cavities. Fortunately, there a few ways to save your teeth from this ordeal:

•  Swap out high sugar foods for low sugar foods
• Try to decrease the frequency of how often you eat your sugary food items
• Try to decrease the frequency of how often you eat your sugary food items
• Include coarse foods (such as carrots) into your diet to help neutralize the pH in your mouth
• Avoid sticky and sugary, carbonated drinks
• Keep up to date with regular dental check-ups
• Ensure proper oral hygiene habits such as brushing twice a day and flossing
• Look into prophylactic treatments with your dentist - these may include fluoride treatments, varnishes, gels, and mouthwashes
  

The combination of all these factors, combined with a modified diet, will more than likely reduce the possibility of cavities. The same principles should be applied to children, so they are safe from early childhood caries.

Cavities in younger children can lead to early tooth loss, malocclusion and other changes. It is important to be wary of sugar content in formula milk, biscuits, snacks, chocolates and juices, which are known to have high sugar levels. Be sure to check with your dentist on how to take care of children’s teeth appropriately if you suspect they may be prone to cavities or have them already.

Development of Teeth

We’ve heard it before - food is fuel for the body. We need the vitamins, various complexes, and macro and micronutrients even before being born, to aid  proper growth and the development of the entire body and its different parts.

Teeth are no exception: depending on the time period of a nutritional deficiency in an individual’s lifetime, the outcomes will differ.  For example, early life nutritional imbalance can cause teeth malformations, making their appearance abnormal. In the womb, the fetus requires vitamins and minerals to form the skeletal structures - including the jaws and tooth buds that later become  teeth.

A lack of appropriate protein can lead to changes in  tongue surface and abnormal teeth structure, whilst a lack of lipids can cause decreased saliva and inflammatory conditions visible in the mouth. This is why it isn’t just important for us to have a good healthy diet in our 40’s or 50’s, but in fact, vigilance should start as early as getting the right supply of nutrients from the mother to the fetus.

If you notice that one or a few of your teeth don’t look like ‘normal teeth,’ there are numerous treatment options just a dental consultation away, that can provide you with a pleasing aesthetic smile..

Teeth Erosion

If you’ve never heard of the term ‘erosion’ before, here is a simplified definition: acids from food and beverages cause an irreversible loss of teeth surfaces without the use of bacteria.

The key difference between erosion and cavities involves bacteria and their presence. Acid may seem like a harsh word, and you may be asking yourself - how exactly do our teeth get in contact with it? 

 Acids such as citric acid, phosphoric acid, ascorbic acid, malic acid, carbonic acids and some others are commonly derived from fruit, vinegar, fruit juices, and many types of drinks we daily consume. Some acids come from our own stomachs - this happens particularly with people who have acid reflux issues. Acid from the stomach comes back into the mouth and damages teeth. 

The presence of acid in the mouth brings the pH to a lower level that causes the hard layers of teeth to demineralize and dissolve. If our intake of these highly acidic beverages and food is frequent, we expose our teeth to harsh conditions repeatedly - a dangerous pattern that will eventually lead to parts of our teeth structure dissolving. 

Seeing a dentist is absolutely necessary to look into options to replace tooth structure, manage sensitivity and improve the appearance of your teeth. For acid reflux issues, it is advised to consult a medical practitioner so that the condition can be managed.

Gum Disease and Conditions

Although the most important risk factor contributing to gum and periodontal disease is inadequate oral hygiene, the progress of these diseases is faster in populations that are malnourished. Some data suggests that a low level of folic acid can be related to periodontal disease and that folate levels in serum should be investigated in management of these conditions. 

The term periodontal tissues refers to gum, the tissues around the teeth holding it in its place (known as the periodontal ligament), and the bone it is in contact with. Naturally, diseases affecting these important structures can cause a wide array of painful issues and discomfort, leading even to tooth loss, gum pockets, bleeding gums, bad breath, and stomach issues due to improper chewing of food.

Painful inflammatory mouth conditions such as Necrotizing Ulcerative Gingivitis have two crucial risk factors: malnutrition and poor oral hygiene. With proper nutrition and diet, the body’s fighting system is well-supported to combat pathogens and help the repair of tissues. Vitamin C, for example, has antioxidant properties that are necessary for repair. The intake of dietary calcium strengthens bones and teeth, making them more resistant to physical and chemical damage. It is important to visit your dentist for emergency dental care if you suspect an untreated or progressing periodontal health condition, as it may have underlying causes requiring immediate attention.

The Link to Oral Cancer

It comes as no surprise that the incidence of oral cancer has been linked to alcohol consumption. Nevertheless, the same seriousness applies to people who indulge in smoking and tobacco users.

A combination of more than one of these habits warrants even more concern, as a synergic effect then takes place. What may seem harmless on the surface is actually directly causing damage as it is being used: tobacco alters the reach of nutrients, including antioxidants that disable tissue protection.

Smoking also poses a difference in the distribution of carotenoids and Vitamin E that does not resemble the norm; meanwhile, the inside of cheeks might reveal modifications connected to precancerous and cancerous lesions. The inclusion of Vitamins A, E, C, and Beta Carotene ensures that the body has antioxidant abilities to resist oral carcinogenesis; their presence can potentially halt the progression of malignant oral cancers. 

The American Cancer Society and The National Cancer Institute have listed recommendations for dietary intake when it comes to food, some of them including:

• Eating a varied diet
• Include a new variety of vegetables and fruits in your daily diet
• Eating a greater quantity of fiber-rich foods
• Limiting intake of alcohol
• Maintaining a desirable body weight
• Decreasing total intake of fats
• Limiting consumption of salted food and those preserved with nitrates

Mucosal Disorders and Changes

Nutritional deficiencies can be the cause of many oral mucosal conditions worsening. This affects a wide area in the mouth and can be a hindrance to eating, drinking and overall may be painful and extremely uncomfortable.

 Aphthous ulcers have been reported to arise from suspected and likely food triggers including acidic, rough and hard food, as well as alcohol and fizzy drinks. Some early findings suggest that these ulcers are linked to deficiencies in Zinc2. The same food substances can worsen Xerostomia, also known as ‘dry mouth’, causing more drying out, burning, tingling and difficulty speaking and swallowing.

 A fungal infection known as Oral Candidosis also has been related to an iron deficiency, low levels of folic acid, vitamins and zinc. Various other effects of improper nutrition include tongue swelling, surface ulceration, and tongue surface changes.

Since the oral cavity is a bio-environment with a complex system where many factors depend on each other to sustain a healthy oral environment, one risk factor can start a chain reaction for numerous other problems. It is crucial that regular health check-ups take place, to stay ahead of these medical concerns, and to take note of any changes in the oral cavity as soon as possible.

Help Is Closer Than You Think

If by the end of reading this article, you are now worried of possible diet-related dental problems, or resonate with some you’ve already experienced, let me mention again that help is very much available, and what may seem like a tough feat has many simple solutions.

With our abundance of processed food and food with hidden sugar content, regardless of any present issues, it is necessary for us to instill healthy eating habits, exercise for our health and intraday use of oral products to prevent further damage. 

The same belief should be passed on to the younger generation who are more used to junk food than the older generation. The reward of health and movement is one that gives back in older age! Treatment and management plans are in place for all the dental issues listed above, assuring you that an expert in the field will be able to help you.

If you are someone who likes to be cautious with their health, or has been admittedly avoiding seeing your dentist for a concern you have, there’s no better time than now. With preventive measures and awareness, you slim your chances of these dental problems! This is your reminder to take care of yourself now for a better tomorrow.

 Footnote:

1 Data supplied by the National Health and Nutrition Examination Survey 2001/02

2  Preliminary data suggest that zinc deficiency is more common in those with RAS than healthy individuals without them66

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3272860/

https://www.ada.org/en/member-center/oral-health-topics/nutrition-and-oral-health

Author bio:

Dr. Hanaa Nasir is a dental professional who has worked for a well-recognized dental hospital in Pakistan, and is in the process of attaining her further education from Australia. Having graduated with honors, she is currently pursuing her Masters in Oral Surgery. Still in the early process of research based on Psychology and Dentistry, she aims to broaden dental care, and advocate for it to be integrated with mental health. Dr. Nasir dedicates most of her time to science and medicine, balancing it with her love of poetry and art. She is a regular contributor to the Rockwest Dental Clinic.