The link between the vegan diet and oral health
“You can tell from a person’s teeth if they’re vegetarian! Eating raw vegetables wears out your teeth! Humans have omnivore teeth!”
…Sound familiar? You may have heard claims like these when discussing vegan diets and dental health.
There is very little research on the effects of a vegan diet on oral health. A healthy mouth is an integral part of general health, wellbeing and quality of life1. The goal of this article, which is based on a bachelor’s thesis, is to present information on the effects of the special characteristics of the vegan diet on oral health as well as to give advice on maintaining good oral health.
This article is based on the thesis “Does a Vegan Diet Effect on Oral Health?” carried out at Metropolia University of Applied Sciences. The article was commissioned by the Finnish Vegan Association.
Food that requires chewing increases secretion of saliva
Following a plant-based diet has benefits for oral health. Food that requires chewing, such as root vegetables, increases the secretion of saliva, thus decreasing the number of bacteria in the mouth2 and protecting the teeth from cavitation3. A balanced vegan diet has no significant effect on the oral microbiome or the formation of the bacterial flora of the mouth4.
The acidity of food affects dental health
Plant-based food may have an acidic pH-value and a hard consistency. Acidic food softens the surface of teeth, and intensive chewing contributes to the wearing out of enamel, causing dental erosion2. Studies have shown decreased pH-values in the saliva of those following a plant-based diet5. Decreased pH in saliva often goes hand in hand with dental erosion2.
A carefully planned vegan diet promotes good health
A vegan diet that is in line with nutritional recommendations promotes good health at all ages3. Planning the diet requires reading up on vegan nutrition, because a poorly put together diet may lead to deficiencies in certain nutrients. These critical nutrients include vitamins B12 and D, calcium, iodine, zinc, and iron6. This article provides a closer look at the changes to oral health caused by deficiencies in these nutrients, as well as dental erosion, dental cavitation, and self-care for good oral health.
B12 deficiency may cause pain in the tongue
A B12 deficiency may cause diverse symptoms. Typical symptoms of megaloblastic anemia caused by a deficiency include pain in the tongue, difficulty swallowing7, and even a tongue infection8 that presents as red coloration and fissures on the tongue. A B12 deficiency may also cause oral candidiasis, infections in the corners of the mouth, as well as aphthous ulcers10.
Vitamin D has beneficial effects on oral health
Vitamin D prevents infection and inflammation and decreases the number of bacteria in the mouth11. Its primary function is strengthening bones and teeth10. A vitamin D deficiency may cause developmental disorders in teeth enamel12, changes to jawbone strength or even loss of jawbone10.
Calcium deficiency weakens tooth attachment
Sufficient intake of calcium is essential for dental health12, because calcium and phosphate are the primary minerals in teeth3. Insufficient intake of calcium, combined with a low vitamin D level, weakens jawbone strength and the attachment of teeth to the jawbone9.
Iron deficiency anemia can be seen on the membranes of the mouth
Iron deficiency is the most common global cause of anemia13. Oral symptoms caused by it include pale and thinned-out membranes, decelerated healing of membranes, ulcers in the mouth, pain in the tongue, cracked corners of the mouth, difficulty swallowing, gingivitis7, and tongue infection13. Iron deficiency may also cause cavitation14.
Zinc improves sense of taste
Zinc plays an important role in both oral health and general health. Zinc deficiency can cause decelerated healing of wounds, changes to the tongue, or dry mouth. Zinc improves sense of taste and appetite, and a deficiency may lead to an impaired sense of taste14. Zinc can also prevent the growth and proliferation of bacteria that are linked to cavitation15.
Erosion is the wearing out of dental enamel
The only potential stumbling block in a balanced vegan diet is dental erosion, if the diet includes large amounts of acidic berries, fruits, or products containing vinegar16. Erosion is the wearing out of tooth enamel caused by acids in food17. Erosion shows up as dullness on the surface of the teeth as well as the loss of natural dental fissures17, most commonly on the incisors3. Its most common symptom is toothache17.
Avoid juices, eat fruits whole
A common cause of erosion is frequent exposure to acidic foods or drinks3. Fruit juices, fruits such as apple, pineapple, grapes, citrus and berries, as well as vinegar-based salad dressings, have an especially low, acidic pH-value16. If your diet includes large amounts of acidic foods, you can mitigate the adverse effects of fruits by eating them whole instead of drinking juice, as chewing increases the secretion of saliva2. For example, a carrot eaten whole has a pH of about six, but when made into juice, the pH drops almost down to four18.
Ways of avoiding erosion
The adverse effects of acidic foods can be balanced out by enjoying unflavored nuts after a meal. After eating acidic food, you should use xylitol products, preferably pastilles instead of chewing gum. Drinking enough water is important, as acidic food stays longer in a dry mouth2. To avoid damage, you should not brush your teeth immediately after eating acidic food2, as this wears out the surface of the teeth12. You should avoid abrasive toothpastes and choose a soft toothbrush. Dental immunity should be fortified with regular fluorine intake17.
Acid attack – a cause of cavitation
Caries – dental cavitation caused by acid attacks – is the most widespread infectious disease globally, and the most common mouth disease19. An acid attack is a reaction in which oral bacteria convert sugars and other carbohydrates into acids that dissolve tooth enamel, causing cavities. Almost every instance of eating or drinking causes an acid attack in the mouth1.
Regular mealtimes are important
In addition to a balanced diet, it is important to have regular mealtimes. Including snacks, you should have five to six mealtimes per day20. This way, your saliva has time to neutralize the mouth’s acidity between acid attacks1. If there aren’t enough rest periods (2-3 hours) in between, the caries damage advances3. When you are craving treats, foods high in sugar should be enjoyed as a dessert straight after a meal20. When you are thirsty, you should drink regular water21.
Using fluorine is the most effective way of preventing cavitation
At the population level, using fluorine has proven to be the most effective way of preventing cavitation22. Adults should brush their teeth twice a day with toothpaste that contains 1450 ppm of fluorine21. Fluorine’s cavitation-preventing effect is based on its ability to undermine bacterial activity23.
Xylitol increases secretion of saliva
Xylitol products should be used after eating. This shortens the duration of the acid attack19 and decreases the amount of dental plaque. A minimum of 5 grams of xylitol should be used daily to achieve the optimal anti-cavitation effect3.
Dental self-care – a way of improving oral health
Self-care is the key to improving oral health. Teeth must be brushed twice a day with fluorine toothpaste: in the morning as well as at night, last thing before bed. Using an electric toothbrush is recommended because of its superior cleaning power. You should also clean the spaces between your teeth at least once a day22. Dental plaque causes cavitation and gingivitis. The best way to remove plaque is brushing your teeth carefully24.
You should make dental self-care a priority, because with good self-care it is possible to halt the progress of incipient cavitation19.
Checklist for maintaining good oral health
- Brush your teeth carefully for at least two minutes twice a day. Use toothpaste containing fluorine.
- Use xylitol products after eating; after acidic food, preferably xylitol pastilles.
- Drink enough water.
- Do not brush your teeth immediately after eating.
- Avoid abrasive toothpastes and choose a soft toothbrush.
- Avoid excessive consumption of citrus fruits.
- Have a dental examination once a year.