World Oral Health Day (WOHD) is celebrated globally every year on 20 March. It is organised by FDI World Dental Federation and is the largest global awareness campaign on oral health.
WOHD is promoting the fact that:
- Oral health is much more than a nice smile
- Oral diseases can impact every aspect of life, from personal relationships and self-confidence to school, work, and even to enjoying food
- Oral health and general health have a two-way relationship
- The mouth is the mirror to the body and offers clues about the status of general health, revealing nutritional deficiencies and signs of other diseases
Your body is complex. The foods you choose and how often you eat them can affect your general health and the health of your teeth and gums too and this will be discussed in the article below.
Diet and nutrition impact on many oral diseases, in particular dental caries. A balanced diet is correlated to oral health (periodontal tissue, quality, and quantity of saliva).(1,2) Conversely, an incorrect nutritional intake correlates to oral disease.(3,4)
Dental caries is the scientific term for tooth decay or cavities. It is caused by specific types of bacteria. They produce acid that destroys the tooth’s enamel and the layer under it (dentin). The development of caries requires the presence of sugars and bacteria but is influenced by the susceptibility of the teeth, the type of bacteria, and by the quantity and quality of the salivary secretion. Dental caries may eventually lead to tooth loss, which in turn impairs chewing ability causing avoidance of hard and fibrous foods including fruits and vegetables. Dental status such as tooth deterioration should be considered a serious risk factor for malnutrition.
It is interesting to note that very low levels of dental caries are found in isolated communities with a traditional lifestyle and low consumption of sugars. As soon as economic conditions improve or they begin eating a ‘Western diet’ and the quantity of sugars and other fermentable carbohydrates increases in the diet, an increase in rates of dental caries is noticed.(5,6)
Frequency of consumption of food and drink is an important factor to consider, especially when fizzy drinks are consumed throughout the day. Sipping sugar-containing beverages provides repeated hits of sugar on the teeth. Most sugary beverages are highly acidic and thus promote demineralisation. Whether frequency or amount of sugar intake is key, one thing is certain: a diet built around refined and processed carbohydrate foods can lead to tooth decay and gingival inflammation.
Gingivitis is inflammation due to bacterial infection of the gums, often referred to as gum disease. Increased colonisation of Streptococcus mutans is linked with gingivitis and also known to be associated with bacteraemia and infective endocarditis.(7,8)
Additionally, Prevotella, a gram-negative, anaerobic pathogenic bacterium is involved in periodontal infections, including gingivitis and periodontitis, and has been shown to have a potential role in the pathogenesis of autoimmune disease.(9,10)
Gingivitis is an early stage dental problem and if left untreated, it can become a more serious infection known as periodontitis. The most common cause of gingivitis is poor oral hygiene. Eventually the inflammation will lead to “pockets” (small spaces between the teeth and gums). Bacteria love to colonise these pockets, which can lead to periodontitis: the permanent destruction of the tissues that connect teeth to bone in the mouth.
Symptoms of gingivitis include:
- red, swollen or tender gums
- bleeding when brushing or flossing, or after you have eaten hard food
- receding gums, so that the tooth appears abnormally long
- change in tooth sensation when eating
- loose teeth
- mouth sores
- tooth loss
- persistent bad breath
- pus between gums and teeth
What causes gingivitis?
Effectively, gingivitis is caused by poor plaque removal from the teeth. The gums attach to the teeth at a lower point than the gum edges. This forms a small space called a sulcus. Plaque is a thin film of bacteria constantly forming on the surface of the teeth. Food and plaque can get trapped in the sulcus and cause a gum infection or gingivitis. As plaque advances, it hardens and becomes tartar. An infection can occur when plaque extends below the gum line and oral hygiene is not effective at removing it.
Risk factors for gingivitis
The following are risk factors for gingivitis:
- poor diet
- smoking or chewing tobacco
- diabetes (when blood sugar levels are consistently high, saliva will have higher levels of glucose. This encourages bacteria to grow and increases the risk of the gums becoming damaged)
- broken fillings
- genetic factors
- compromised immunity
Left unchecked, gingivitis can cause the gums to separate from the teeth, encouraging bacteria to colonise these pockets. This can cause injury to the soft tissue and bone supporting the teeth. The teeth may become loose and unstable. Gingivitis is reversible with good oral hygiene, however, without treatment, gingivitis can progress to periodontal disease in which the inflammation of the gums results in tissue destruction and bone resorption around the teeth.
Periodontitis (or periodontal disease) is a bacterial infection of the specialised tissues, ligaments and bones that surround and support the teeth, collectively known as the periodontium. When gums are inflamed and broken, harmful bacteria can enter the bloodstream more easily, leading to other chronic health problems.
Diabetes (Type l & Type ll)
There is emerging evidence to support the existence of a two-way relationship between diabetes and periodontitis, with diabetes increasing the risk for periodontitis, and periodontal inflammation negatively affecting glycaemic control. Epidemiological data confirm that diabetes is a major risk factor for periodontitis; and susceptibility to periodontitis is increased by approximately threefold in people with diabetes.(11) Subjects with type 2 diabetes also had greater gingival inflammation than did control subjects without diabetes; the highest level of gingivitis was found in subjects with poor glycaemic control.(12)
An overall assessment of the available data strongly suggests that diabetes is a risk factor for gingivitis and periodontitis.
Gingivitis may increase your risk of other health complications, including stroke and heart disease and has even been linked with problems in pregnancy and dementia.(13)
Chief Executive of the British Dental Health Foundation, Dr Nigel Carter, explains: “The link between oral health and overall body health is well documented and backed by robust scientific evidence. Despite this, only one in six people realises that people with gum disease may have an increased risk of stroke or diabetes. And only one in three is aware of the heart disease link.”
Calcium/Vitamin D/Vitamin K2/Magnesium
Most people think that vitamin D is a vitamin, but in reality, the active form of Vitamin D is one of the most potent hormones in your body and is essential for health. It is produced as a pro-hormone in your skin after sunlight exposure and is then converted to the potent hormone form. Vitamin D is famous for its role in helping the body absorb the calcium needed for strong bones, teeth and in maintaining an adequate level of calcium in the blood. Decreased uptake of calcium and vitamin D has been associated with periodontal disease.(14-16) Research suggests that patients in periodontal maintenance programmes, taking vitamin D and calcium supplementation, have a trend for better periodontal health compared to patients not taking supplementation. One such study found a positive influence of vitamin D and calcium supplementation in the management of periodontitis.(17)
Magnesium is essential for healthy bones and teeth as it plays a role in absorption and metabolism of calcium.
Vitamin K2 is important for vascular and bone health and the correct use of Vitamin D and calcium in the body.
Coenzyme Q10 (CoQ10)
Periodontal disease is associated with reduced salivary antioxidant status as well as decreased glutathione levels, and increased oxidative damage within the oral cavity.(18) Coenzyme Q10 (CoQ10) is an essential element for many daily functions and is required by every single cell in the body. These include:
- works as a strong antioxidant
- cell membrane stabilising properties
- enables the mitochondria to produce energy
Ubiquinol serves as an endogenous antioxidant which increases the concentration of CoQ10 in the diseased gingiva and effectively suppresses advanced periodontal inflammation.(19)
A recent study revealed a connection between vitamin B12 and periodontitis.(20) In particular, an inverse association between serum vitamin B12 and the progression of gum disease and tooth loss risk. It established that the lower a person’s B12 levels, the higher the risk of tooth loss and advancement of periodontitis.
Folic Acid (Folate)
Studies have demonstrated folic acid’s ability to improve gingivitis symptoms, reducing the inflammatory response in gum tissue, and ensuring that gum tissue is more resilient to irritants such as bacteria and plaque.(21-23)
Some of these friendly bacteria have “antibiotic” action against specific strains of pathogenic bacteria, particularly those which are anaerobic (survive without oxygen) and are prevalent in the mouth. A 2016 systematic review and meta-analysis found that probiotic therapy can be used for managing periodontal diseases.(24) A consensus report in 2017 concluded that probiotics could be helpful in caries prevention and periodontal disease management.(25)
Vitamin C’s role in maintaining the health of teeth and gingivae remains undisputed. Currently, clinical evidence indicates that vitamin C functions in improving host defence mechanisms and is thereby implicated in preserving periodontal health.(26-27)
Periodontal disease is associated with reduced salivary antioxidant status as well as decreased glutathione levels, and increased oxidative damage within the oral cavity.(28-29) Studies suggest that glutathione is considered to be the master antioxidant that controls inflammatory processes, and thus damage to the periodontium.(30,31)
Good Dental Nutrition
In brief, a dental friendly diet includes eating wholefoods with adequate lean protein, healthy fats and plenty of fresh vegetables. Here’s a breakdown:
Protein – chicken, lean beef, turkey, nuts, sunflower and pumpkin seeds
Vitamin D – fatty fish (see omega-3 fats), mushrooms and grass-fed dairy products (but sunshine is the best source). For most people living at our latitude it is not possible to obtain sufficient vitamin D from diet and sunshine, therefore a supplemental source is recommended for everyone
Omega-3 fats – wild-caught fish – salmon, mackerel, sardines and herring
Vitamin K2 – soft cheeses, eggs, butter, liver
Calcium – kale, broccoli, kelp, spinach, fortified non-dairy milks (e.g. coconut, almond), yoghurt, cheese
Vitamin B12 – salmon, beef, liver, chicken, fish, yogurt, spinach
Magnesium – green leafy vegetables e.g. spinach, almonds, pumpkin / sesame seeds, dark chocolate (70%), tofu, sardines, beans
- Diet and nutrition impact on many oral diseases, in particular dental caries.
- A balanced diet is correlated to oral health, conversely, an incorrect nutritional intake correlates to oral disease.
- Dental caries is the scientific term for tooth decay or cavities. It is caused by specific types of bacteria. They produce acid that destroys the tooth’s enamel and the layer under it (dentin).
- Dental caries may eventually lead to tooth loss.
- Frequency of consumption of food and drink is an important factor to consider. Most sugary beverages are highly acidic and thus promote demineralisation.
- A diet built around refined and processed carbohydrate foods can lead to tooth decay and gingival inflammation.
- Gingivitis is inflammation due to bacterial infection of the gums, often referred to as gum disease.
- Gingivitis is an early stage dental problem and if left untreated, can become a more serious infection known as periodontitis. The most common cause of gingivitis is poor oral hygiene.
- Left unchecked, gingivitis can cause the gums to separate from the teeth, encouraging bacteria to colonise these pockets.
- Periodontitis (or periodontal disease) is a bacterial infection of tissues, ligaments and bones that surround and support the teeth. When gums are inflamed and broken, harmful bacteria can enter the bloodstream more easily, leading to other chronic health problems.
- There is emerging evidence to support the existence of a two-way relationship between diabetes and periodontitis, with diabetes increasing the risk for periodontitis, and periodontal inflammation negatively affecting glycaemic control.
- Gingivitis may increase your risk of other health complications, including stroke and heart disease and has even been linked with problems in pregnancy and dementia.
- Research suggests that patients in periodontal maintenance programmes, taking vitamin D and calcium supplementation, have a trend for better periodontal health compared to patients not taking supplementation.
- Coenzyme Q10 (CoQ10) is considered a master antioxidant and an essential element for many daily functions. Periodontal disease is associated with reduced salivary antioxidant status as well as decreased glutathione levels.
- It has been established that the lower a person’s B12 levels, the higher the risk of tooth loss and advancement of periodontitis.
- Studies have demonstrated folic acid’s ability to improve gingivitis symptoms, reducing the inflammatory response in gum tissue, and ensuring that gum tissue is more resilient to irritants such as bacteria and plaque.
- Certain probiotic strains have “antibiotic” action against specific strains of pathogenic bacteria which are prevalent in the mouth.
- Clinical evidence indicates that vitamin C functions in improving host defence mechanisms and is thereby implicated in preserving periodontal health.
If you have any questions regarding the topics that have been raised, or any other health matters, please do contact me (Jackie) by email at any time ([email protected])
Jackie and the Cytoplan Editorial Team
Related Cytoplan Products
Dentavital CoQ10 Multi – A comprehensive wholefood multivitamin and mineral formula incorporating antioxidant CoQ10, beta glucan for immune support, and good all-round vitamin and mineral levels including optimal levels of vitamin D3 & vitamin B12.
Dentavital Cell-Active Glutathione – Glutathione is a tripeptide molecule that prevents damage to important cellular components from peroxides, free radicals and other reactive oxygen species. It is produced naturally by our body and all of the other antioxidants that we consume, such as vitamin E and vitamin C, depend on it to function.
Cherry C – Our capsules are rich in vitamin C and carotenoids, with the cherry-like fruits being one of the richest-known natural sources of vitamin C.
Dentavital Bone Complex – Bone Complex is a multi-nutrient formulation specifically tailored for those who are concerned about bone health and bone mineral density, providing calcium alone with other nutrients that are important for bones – magnesium, boron, vitamin D3 and K2.
Vitamin D3 and K2 – This product contains 100ug (4,000 i.u.) Vitamin D3 and 100ug Vitamin K2 (Mk-7) and is designed to elevate levels of K2/D3 and is ideally used in conjunction with any of our multi formula.
Vitamin B12 sublingual (as methylcobalamin & adenosylcobalamin) – A high potency active B12 supplement containing 1mg of methylcobalamin and adenosylcobalamin, both of with provide great benefit to the body.
Methylfolate (Folic Acid) – Our Methyfolate supplement contains 400ug of Methylfolate per capsule in a base of alfalfa. Methylfolate (5MTHF) is the most stable, safe and bio-effective form of folate. An adequate intake of folate is essential for the prevention of many disorders such as anaemia neural tube defects, various forms of heart disease, Alzheimer’s, colon cancer and depression.
High potency fish oil – Cytoplan high potency fish oil capsules give you 500mg of the essential fatty acids EPA/DHA per 1000mg. Our fish oils are guaranteed to be clean, stable and free from pollutants. Fatty acids are recognised in having an essential role in normal brain function.
Dentavital Bifidophilus – Dentavital Bifidophilus contains 6 strains of native bacteria. Native bacteria are natural (friendly) inhabitants of our digestive system where they serve as powerful immune system stimulators and regulators.
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- Cutler CW, Machen RL, Jotwani R, Iacopino AM. Heightened gingival inflammation and attachment loss in type 2 diabetics with hyperlipidemia. J Periodontol 1999;70(11):1313-21
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