Foods for Teeth – Introduction

The subject of food for oral health is enormous, so I have picked just a few topics to consider. First it’s important to have goals and know that teeth do not naturally deteriorate, even with age. The subjects I selected were to illustrate the intricate relationship between body chemistry, bacteria, and diet – in an effort to endorse the message that our mouth and body work in harmony with each other. A healthy diet supports us in a myriad of ways and helps protect us from infection and harm.

Time for change?
If you follow someone’s advice, yet continue to need dental treatments – consider a change in your diet and think carefully about how you care for your teeth. Sometimes it is hard to know if advice is working, but oral health offers an easy way to evaluate dietary patterns and oral care– just experiment for a few months - then go to your dentist for an evaluation!

One of my favorite teachers is Pastor David Jeremiah and I listen to many of his lessons. In one he describes a Windmill Syndrome to illustrate how we age. Each windmill paddle is a problem and, as we sidestep one, we are hit by the next. The paddle speed increases as we age and Dr Jeremiah believes five things are guaranteed: baldness, bifocals, bridges, bulges, and bunions. I’m not sure about baldness, but I know pre-emptive actions can help avoid bridges, bulges, and even bunions. It’s interesting that the earlier we begin preventive efforts, the easier it is to avoid damage from these chronic, progressive problems.

Ageless Teeth
My belief is that teeth do not naturally deteriorate with age. Reviewing hundreds of success stories with patients using my Complete Mouth Care System, I have seen gum disease reverse and cavities stop and teeth look brighter with every passing year, no matter the patient’s age. The speed and completeness of this appears however, to be dependent on the general body health of the patient. It is always easier to help people on a good diet than patients who do not understand the value of nutrients, exercise, stress-reduction and a healthy, whole food diet.

The importance of diet
We are warned that the majority of adults do not get adequate nutrients from diet either because of declining food quality, dietary choices, or poor digestive health. A nutrient deficit may not have visible consequences for years – so some people find it hard to believe that what they eat and drink matters.

Poorly made vitamins give vitamins a bad name, and xylitol products with tiny amounts of xylitol combined with antagonistic ingredients (like sorbitol) do not improve oral health. Probiotics must be evaluated for effectiveness, avoiding ingredients that may be antagonistic or detrimental (for example, some dental probiotics are sweetened with sucralose /Splenda – which can upset digestive bacteria and gut pH).

Monitoring nutrition in the mouth
The effect of diet on the mouth may be the perfect way to demonstrate the importance of nutrition and show how small dietary changes and good oral care can stop and reverse tooth and gum damage, often in a surprisingly short time. It’s easy to evaluate teeth, unlike the effort to evaluate general health. One check of your mouth by a dentist can confirm whether your effort to eat well and care for your teeth is working. This may be the motivation you need!

Whole Food
I suggest vitamins be food-derived from a trusted source. I believe all supplements should be consumed alongside a healthy diet, and I agree that in a perfect world supplementation would not be necessary because we could derive sufficient nutrients from food. Unfortunately modern systems of agriculture have stripped most food of its nutrients and vitamins and today it’s nearly impossible to get nutrition for vibrant health from a Western diet alone. Most people know the general meat, poultry, and dairy supplies have been pumped full of hormones and antibiotics, and that the majority of animals no longer roam free to enjoy mineral-rich feed.

Researchers at Colorado State University found pasture-raised cows have 400% more vitamin E in their meat than grain fed cows. Researchers at the University of Texas compared U.S. Department of Agriculture nutritional data from 1950 and 1999 for 43 different vegetables and fruits. They found a decline in the amount of protein, calcium, phosphorus, iron, riboflavin (vitamin B2) and vitamin C over this half-century. Genetically modifying foods is another problem, turning food into something that has never existed before in the history of humanity. Without good nutrition how can we expect to enjoy either a healthy body or a healthy mouth?

Gender differences
When you read studies about oral health be concerned if biofilm is removed. This change may reduce disease in an infected mouth, but it does not translate into promoting oral health. We need healthy biofilm and without it, teeth may experience sensitivity and serious enamel damage and erosion. Teeth devoid of biofilm can be sensitive, weak, and experience recession and cavities. A good example of this is seen with green tea studies.

Many of the green tea studies involved groups of men who saw benefits from drinking green tea. It would be interesting to know if women would experience the same results, or do they develop sensitivity and recession? My hunch is there are differences in saliva quality and we need to give more gender-specific recommendations. (This was a 2009 a study in the Journal of Periodontology examined 940 males, aged 49-59 and found less gum disease in men who drank green tea, and the benefits increased with the amount of tea consumed.

Magical Foods
Beware any media articles that suggest one food is the magical answer to medical or dental problems. The concern with this information is that there is often more to the story. Below are just two examples:

  1. Cranberry juice is said to reduce plaque (and it does) BUT this juice is extremely acidic, often highly sweetened, and drinking it can ruin - not protect - your tooth enamel, especially if you swish it around your mouth.
  2. Apples have dental benefits and may fight plaque and limit gum disease. Apples contain quercetin, a compound with antimicrobial properties, and polyphenols, said to offer protection against gum destruction by the periodontal bacteria Porphyromonas gingivalis. Apples are a great food, and it may be useful to include them in your diet if you have periodontal disease. On the other hand, eating bushels of apples will not reverse pocketing or periodontal disease. Apples do not work in this way. Apples are a food and, along with a host of other great foods, can provide nourishment and detoxification – two essential functions for anyone looking to prevent gum disease and promote periodontal healing.

Food Combinations
Science shows eating one food exclusively, alone on a plate, does not give you the same benefits as when the food is part of a collection, or in the combination we call meals. When foods look and taste good in a complimentary way, they appear to offer more nutrition for our bodies. A great example of this is adding a little butter to broccoli, which can aid the transportation of minerals into the body. Research also shows that blueberries, kale, and spinach are more nutritious when combined with healthy fats, because these foods are rich in lutein, a carotenoid that is fat-soluble.

Food Preparation
Food preparation affects the properties of food -sometimes to enhance flavor while preserving and adding to its benefits, but other times processing can remove a food’s benefits and create a potentially health-damaging product. Apples are a good demonstration as apples (described above) contain nutrients that are excellent for oral health. One could assume because apples are so good, we can extract the nutrients from an apple that has been dried, juiced, or bottled, and the more we consume, the healthier. As a pediatric dentist, I have seen the devastation apple juice causes to erupting baby teeth, especially when children sip the juice from a bottle or sippy cup. The acidity, along with the high sugar content, feeds colonies of harmful plaque bacteria that erode through the enamel of teeth. These children have cavities, damaged teeth, and bad breath, and often grow into adults with candida infections and periodontal gum disease.

Digestive health and mouth health
I rarely suggest oral probiotics because I believe it’s important to improve body health - particularly digestive health - to solve problems in the mouth. Without a healthy digestion, the immune system will be compromised and unable to fight disease. For digestive health I suggest fermented foods and digestive probiotics, gender tailored for men/women. As we learn about bacteria from the Human Microbiome project, we will learn about strains that are useful. The subject is complicated because we need colonies and mixtures of bacteria, rather than one strain, and each of us has a “microbial fingerprint” affected by many factors. Here is a video from the University of Michigan on this subject:

Foods to Improve Digestive Health
You may be eating a good diet, but if you are not absorbing the nutrients from the food, you may not be providing your body with the vitamins and minerals it needs to keep your mouth healthy. Digestive enzymes aid digestion – and I recommend a small amount of fresh pineapple or papaya in the diet, since they can provide assistance in the way that enzymes do. Healthy gut bacteria synthesize vitamins to aid digestion and help prevent disease – specifically B-12 and K. There are several fermented foods that provide good bacteria for digestive health and I encourage everyone to try and incorporate some into their daily menu.

Fermented foods to help rebalance digestive health:

  • Brine pickles (kosher dill) – fermented sources
  • Korean kimchi
  • German sauerkraut
  • Miso, Tempeh and Natto
  • Yogurt and Kefir
  • Raw-Milk Cheese – particularly aged cheddar, Gouda, blue cheese (Roquefort), soft cheese (Brie) and cave-aged cheeses (Camembert etc.)
  • Salami and Fermented Dry Charcuterie
  • Kvass and Kombucha

Nitric Oxide
Media celebrity Dr. Oz said on one of his shows that mouthwash could cause a heart attack. The real message was that we should not destroy healthy mouth bacteria and Dr. Oz described how some mouth bacteria produce a special gas that dilates blood vessels in the heart. He was wrong about the mouthwash targeted, but he is correct that nitrates and nitrites exist in the mouth and certain bacteria turn them into a gas called nitric oxide (NO). Nitric Oxide is neither a mineral nor a vitamin, yet it has been shown to assist in improving the quality of sleep, reduce obesity, control diabetes and benefit other health problems.

In the mouth, nitric oxide appears to be generated in a special area on the back of the tongue, where specific bacteria collect on the surface. Although this gas has been shown to benefit the heart, it is more likely that nitric oxide offers us protection from ingested bacteria and is a defense against viruses and oral yeast infections like thrush or lichen planus. Nitric oxide has the ability to be a messenger between cells, behave as a neurotransmitter, and also function as a hormone to give signals for blood vessels to relax (which makes blood flow more freely) to make breathing easier. Nitric oxide is formed from nitrates, and there are ten times more nitrates in the mouth than anywhere else in the body.

Vegetables and Nitric Oxide
The main source of nitrates is green leafy vegetables. The nitrogen content of vegetables depends on the soil in which they are grown, so buying organic will usually yield more nitrogen. Foods rich in nitrates include spinach, lettuce, kale, beets, and beet greens. Ingested nitrates are absorbed through the walls of a healthy intestine and then they travel around the body until they are secreted into the mouth as a component of saliva. The salivary glands concentrate nitrates 10 to 20 fold compared with their concentrations in blood. Nutritional studies show that increasing nitrate consumption enhances oral nitric oxide production in a healthy mouth, and some argue that the cardiovascular benefit from a vegetarian or Mediterranean diet may be related to this.

Sometimes these nitrates interact with saliva to form an even more reactive compound called peroxynitrite. When nitrite-rich saliva is swallowed it reacts with acidic gastric juices to form nitrous acid, which is exceptionally active as an antibacterial, and decomposes to release nitric oxide, which increases blood flow in the stomach to protect its lining. Peroxynitrite also reacts with enzymes in saliva, turning into nitrogen dioxide at a neutral mouth pH, but not in a plaque-infected or acidic mouth, where the reaction may result in by-products that cause injury to the skin of the mouth or gums. Antioxidants C and E help prevent this breakdown, and interestingly greens and beets naturally have these vitamins alongside the nitrates they provide. This explains why it is difficult to use supplements or take a nitric oxide pill and achieve the same results as from a well-balanced diet of healthy food.

Spinach – be careful!
Spinach is a confusing vegetable and although it contains a number of great vitamins and healthy minerals, it is difficult to gain maximum nutrition from spinach unless you understand its chemistry and the way it interacts with other foods. Spinach contains fat-soluble vitamins A, E and K, as well as the eight water-soluble B vitamins and vitamin C - but in excess, or incorrectly prepared, spinach may not be as good as you imagine.

Spinach provides nonheme iron, which is good for circulation. The problem, however, is that nonheme iron is more difficult to absorb than heme iron from meat. Eating spinach with vitamin C is said to improve its iron absorption – so it’s good to serve spinach with citrus juice or vinegar. Two cups of raw spinach can supply more than a day's recommended intake of A and K for men and women, but these are fat-soluble vitamins and will only be absorbed if there is sufficient fat alongside spinach in the diet. As spinach travels through the digestive tract it breaks down to release these vitamins, but only when they are dissolved in fat droplets will the body be able to absorb them. Without fat in the diet, vitamin A and K cannot be absorbed. Nutritional experts suggest coating spinach with a little olive oil or add butter after steaming. (Steaming is an ideal cooking method since it helps spinach retain its water-soluble vitamins).

Another problem is that spinach contains oxalate, which can pull calcium from teeth and can cause acid erosion. Oxalate can also interfere with the body’s ability to absorb calcium, since it binds with calcium, leaving only 10% free for absorption. Oxalate is present in rhubarb and other dark leafy greens such as chard, beet greens and kale. Oxalate binds with calcium in the digestive tract to form an insoluble salt that cannot be absorbed. This is why it takes more than 15 cups of raw spinach to match the amount of calcium absorbed from a cup of milk. Lightly cooking spinach will help break down oxalic acid without losing too many nutrients. Vitamin C in citrus juices can also help block oxalate from binding to calcium and encourage absorption. Finally be aware that spinach is a food with potential for high pesticide residue, so be sure to buy organic.

Sugars – Good and Bad
Today anything with a label sugar has a well-deserved negative connotation. No one can deny the obsession with sucrose and how it has contributed to many serious health problems, ranging from obesity to diabetes. Along with others I consider refined white sugar to be one of the worst public health enemies, so suggesting there are therapeutic sugars to prevent and cure disease is a difficult idea.

For those familiar with ancient herbal remedies, we have known for generations that many plants are rich in special sugars. In fact, there are a rising number of people who link illnesses to an imbalance of certain sugar molecules, and saccharides (another name for plant sugars) are being studied and harvested for their use as weapons against infection. It appears these health sugars may correct chemical imbalances in our immune system and by correcting saccharide deficiencies we may be able to reverse genetic code malfunctions that predispose us to disease. Saccharides may be vital sugars for health, and they combine with proteins and fats to create glycomolecules that coat the surface of virtually all cells. This sugarcoating allows cell membranes to transfer messages to other cells and if this layer is missing, the immune system will be weakened and cellular messages may be full of errors.

When proteins are covered by a saccharide the molecule is called a glycoprotein, and when a fat molecule is covered by a saccharide it is called a glycolipid. Sugarcoated molecules in our immune system bind to invading microbes and fight off the invaders to reduce the extent and duration of an infection, without the potentially dangerous side effects of a drug. These saccaride plant sugars perform a variety of complicated chemical actions in the body to help sustain life and health. Sugarcoated proteins help keep hormones in balance, enable blood to clot, and even provide structural support to cells.

Aloe Vera, Echinacea, Shiitake mushrooms and breast milk
The healing properties of xylose and Aloe Vera, the ability of Echinacea to fight infection, the way shiitake and reishi mushrooms affect cancer, all reflect the actions of glyconutrients ( described above). There are other examples of glyconutrients, including the immunoprotective action of breast milk and the protection of glucosamine to cartilage. Specific plant sugars can exert extraordinary actions on the body to promote health. Healthy glyconutrients, unlike the sugar most people know, do not raise insulin levels or add useless calories that translate to weight gain.

The problem is that unless you eat a wide array of plants, nuts, fruits, seeds, certain algae and other whole foods, you may easily lack the glyconutrients necessary to support your immune system. The irony is that most people have never heard of these desirable sugars or the science called glycobiology that surrounds them, yet everyone is familiar with white, refined, bleached and weight-gaining sucrose that harms health. In the US some people consume the equivalent of 40 teaspoons of refined sugar at each meal, unaware that a small soda contains 9 teaspoons of sugar and sugar lies buried in packaged foods, soups, sauces, cereals, ketchup, and salad dressings, to name just a few.

Carbohydrates also eventually convert into glucose, so they appear to mouth bacteria and your body as the sweet identical twin of sucrose. Carbohydrates cause just as many problems for teeth as sugar, along with upsetting the digestive system and depleting the body of B vitamins and minerals (since significant amounts of vitamins and minerals are needed to detoxify ingested sugars).

Confusion and Green tea
With so much confusion about the benefits and dangers of “healthy” drinks and foods, my suggestion is to confidently eat a varied diet of foods that are as natural as possible. Spend time to educate yourself about nutrition from trusted sources and limit eating and drinking to mealtimes as much as possible. This way you can enjoy the benefits of healthy citrus juice, vinegar, and foods containing oxalic acid, but still protect your teeth from damage by ending every meal and drink with Zellie’s mints and gum.

Another confusing subject is about the health benefits from drinking green tea. I am not sufficiently knowledgeable to comment - but here are some facts about green tea:

  • Contains natural chemicals believed to offer health benefits, and has the highest concentration of catechins found in any natural food. However, green tea should not be brewed with boiling water, since high temperatures disable catechins, and 160-degree water is suggested. Also most of the studies have been on animals, which is why reports state its benefits are unproven.
  • Provides a source of antioxidants (including epigallocatechin 3 gallate- known as EGCG), which may help fight inflammation, especially the kind produced by cigarette smoking.
  • Green tea has a number of useful enzymes, amino acids, lipids, sterols, and minerals, but its quality varies dramatically with growing conditions and beneficial phyto-chemicals are affected by these factors. Adding lemon may make the health compounds of green tea easier to absorb, and although you may be told dairy should not be added, it appears protein-catechin complexes are re-activated during digestion, so this is disproven.
  • Green tea differs from black teas because its leaves are minimally oxidized. Green teas (particularly powdered green tea) can be a source of considerable fluoride. Here are three links to explore this subject:
  • A 2008 study in the journal of the Academy of General Dentistry suggests to avoid tooth erosion people should drink brewed tea. However this study compared green tea with juice and soda, and concluded there was less enamel loss with tea. Ha! Interesting. If you read the study you will see that green tea appears to remove biofilm – but remember that this may not be helpful in mouths where there is difficulty reforming healthy biofilm (those with dry mouth and women in particular).


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