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Plant-Based Diets: Oral Health

Plant-based diets may help protect against oral cancer and periodontal (gum) disease, a leading cause of tooth loss.

February 4, 2013 |
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Plant-Based Diets: Oral Health, 5.0 out of 5 based on 2 ratings

Sources Cited

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A. Lussi, B. Megert, R. P. Shellis, X. Wang. Analysis of the erosive effect of different dietary substances and medications. Br. J. Nutr. 2012 107(2):252 - 262

A. Arora, R. W. Evans. Is the consumption of fruit cariogenic? J Investig Clin Dent 2012 3(1):17 - 22

T. Attin, S. Siegel, W. Buchalla, A. M. Lennon, C. Hannig, K. Becker. Brushing abrasion of softened and remineralised dentin: An in situ study. Caries Res. 2004 38(1):62 - 66

M. Iwasaki, M. C. Manz, P. Moynihan, A. Yoshihara, K. Muramatsu, R. Watanabe, H. Miyazaki. Relationship between saturated fatty acids and periodontal disease. J. Dent. Res. 2011 90(7):861 - 867

N. Schwartz, E. K. Kaye, M. E. Nunn, A. Spiro III, R. I. Garcia. High-fiber foods reduce periodontal disease progression in men aged 65 and older: The Veterans Affairs normative aging study/Dental Longitudinal Study. J Am Geriatr Soc 2012 60(4):676 - 683

E. Lucenteforte, W. Garavello, C. Bosetti, C. La Vecchia. Dietary factors and oral and pharyngeal cancer risk. Oral Oncol. 2009 45(6):461 - 467

S. Amar, N. Gokce, S. Morgan, M. Loukideli, T. E. Van Dyke, J. A. Vita. Periodontal disease is associated with brachial artery endothelial dysfunction and systemic inflammation. Arterioscler. Thromb. Vasc. Biol. 2003 23(7):1245 - 1249

A. Sharma, A. R. Pradeep, A. R. P. Association between chronic periodontitis and vasculogenic erectile dysfunction. J. Periodontol. 2011 82(12):1665 - 1669

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K. Herman, A. Czajczy'nska-Waszkiewicz, M. Kowalczyk-Zając, M. Dobrzy'nski. Assessment of the influence of vegetarian diet on the occurrence of erosive and abrasive cavities in hard tooth tissues. Postepy Hig Med Dosw (Online) 2011 65(NA):764 - 769

P. Moynihan, P. E. Petersen. Diet, nutrition and the prevention of dental diseases. Public Health Nutr 2004 7(1A):201 - 226

C. Drinkard, D. C. Dilley. Rampant caries as a result of a bizarre food habit: A case report. Pediatr Dent 1982 4(2):131 - 134

R. S. Levine. Fruit juice erosion--an increasing danger? J Dent 1973 2(2):85 - 88

P. J. Moynihan. Dietary advice in dental practice. BRITISH DENTAL JOURNAL 2002 193(10):563-568

CH Chu, Karie Pang, Edward Lo. Dietary behavior and knowledge of dental erosion among Chinese adults. BMC Oral Health 2010 10(13):1-7

Acknowledgements

Transcript

Two studies were recently published on plant-based diets and oral health. What do you think they found? Well for periodontal disease, the health of tissues surrounding the teeth, like gingivitis, gum disease, one of the leading causes of tooth loss, plant-based diets should be protective.  Inflammation is now recognized as one of the key underlying causal factors in periodontal disease, and we know saturated fats produce an inflammatory response, and so no surprise this recent study found that "High dietary saturated fat intake was significantly associated with a greater number of periodontal disease events," which in this country comes mostly from cheese and chicken. The same diet that leads to high cholesterol may also contribute to periodontitis as they both appear correlated. People with periodontal disease also suffer from arterial dysfunction. Inflammation, high cholesterol and arterial dysfunction, is it any wonder there may even be an Association Between Chronic Periodontitis and Erectile Dysfunction?  By looking in your mouth your dentist may find out more about you than you may have realized. We know we can reverse impotence with a plant-based diet, what about periodontal disease? A new study found that higher intake of high-fiber foods, especially fruits, may at least slowing periodontal disease progression.  For oral cancer it's a no-brainer. According to the latest review in the Journal of the American dental Association, " Evidence supports a recommendation of a diet rich in fresh fruits and vegetables as part of a whole-foods, plant-based diet."

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by Jonathan Hodgson.

To help out on the site please email volunteer@nutritionfacts.org

Dr. Michael Greger

Doctor's Note

Cholesterol buildup, oxidation, and inflammation are the three harbingers of Arterial Acne, the leading cause of the death in the United States. In celebration of National Heart Health Month, watch my video series starting with Blocking the First Step of Heart Disease.

So what is a safe intake for cholesterol and saturated fat? See Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero. Why is saturated fat intake associated with inflammation? See my three-parter:

  1. The Leaky Gut Theory of Why Animal Products Cause Inflammation
  2. The Exogenous Endotoxin Theory
  3. Dead Meat Bacteria Endotoxemia

For more on the relationship between our diet and sexual function, see:

For more on oral health, see:

But wait—what did those two recent studies on plant-based diets have to say? Find out in the next video Plant-Based Diets: Dental Health.

If you haven't yet, you can subscribe to my videos for free by clicking here.

  • Oliver Lucas

    That’s interesting. My dentist recently said that I’ve got almost no dental calculus. I went vegan two years ago.

  • HemoDynamic, M.D.

    That makes me smile!

  • r h

    Dr. Gregor, are you referring to only animal based sources of saturated fat as causes of the inflammation (amongst lots of other diseases) or are you also including in this causation group the vegan based/plant sources of saturated fat? (such as avocados, nuts, seeds.) Many vegans eat heaps of saturated fat on a daily basis. Could excessive vegan saturated fat intake cause these same ailments you mention in the video(s)?

    • Massimo

      Avocados, nuts and seeds contain small percentages of saturated fats, the bulk being mono- and poly-unsaturated. The only plant source of saturated fats in high amount are tropical fats (palm, palm kernel, coconut), which are too often hidden in industrial products under the label “vegetable fat” or “vegetable oil”.

      • r h

        i know lots of vegans (some that frequent this website) that consume, on average, 2 avocados a day, a handful of walnuts, a cup of pumpkin seeds, macadamia nuts, pecans, ., ….yes, all on a daily basis, often exceeding well over 100 percent of the RDA for saturated fat. If one does the fat analysis using an online app, one will see that just the foods i mentioned above, eaten in liberal amounts that many vegans consume (not all vegans, but a lot), exceeds the 100 percent. When we have vegans out there eating these plant-based -saturated fats, in such liberal quantities, i think it is important for Dr. Gregor to address whether or not the detrimental effects of saturated fats talked about in this video, as well as other videos, applies to plant based saturated fats as well.

        • r h

          …..and what about the vegans amongst us ingesting a couple tablespoons of coconut oil a day? It is easy to over-eat coconut oil, especially when one drops a tablespoon of it intio their salad, bean dish……one ounce of coconut oil, apparently, blows the the 100 percent RDA for saturated fat.

          • Massimo

            Coconut oil (actually fat) is extremely high in saturated fatty acids, especially lauric – which is as bad as palmitic. Don’t use tropical fats, whatever the advertisments of the industy say.

          • http://www.DonForresterMD.com/ Don Forrester MD

            I agree with the ratio issue as both the omega 3 and omega 6 go through the same enzymes that produce the anti inflammatory/anti-clotting and inflammatory/clotting substances our body needs. The target is about 2/1 omega 6 to omega 3 but can be as high as 40/1 in some plant based diets especially with the ingestion of corn oil. I agree that on a whole food plant based diet you should be okay especially if you add in some ground flax or some walnuts. However the amount is also important and depending on one’s goals nuts should be limited to around 1 serving per day unless you are very active and can go to 2 servings per day… as general rules which… can vary from individual to individual. Dr. Esselstyn, who has had the most success with patients with clinically apparent heart disease, allows no nuts in his diet due to the saturated fats.

        • Massimo

          I’m afraid your reasoning is faulty from the beginning. With such a “liberal” intake, one exceeds first of all the RDA for calories – unless he does a lot of physical activity – and then the reasonable percentage of fat – unless he eats a lot more of grains and pulses, in which case the total calories consumed must be very high – back to the same problem thus. The issue with saturated fats is the proportion. Our body synthesizes saturated fats (actually, fatty acids), because it needs them too, in the right proportions, to build membranes with the right structure and permeability. And it also has enzymes (desaturases), which transform saturated fatty acids to unsaturated (especially stearic to oleic). Also, all foods contain saturated fatty acids, none excluded. The real problem is when the proportion of saturated fatty acids (and actually not all of them; the three atherogenic ones, lauric, myristic and palmitic) are too abundant. Which is never the case by consuming unrefined plant foods with the exception of the tropical fats (pal, palm kernel, coconut).

          • r h

            Interesting. I hadn’t thought of it that way. It seems like what your are saying is that the ratio of saturated fats, to other fats, if maintained in a proper way, is what determines whether the saturated fat dose is healthy or not. Even so, though, Dr. Gregor does seem to be concerned about the amount of saturated fat one’s diet, and once again many vegans out there blow through the 100 percent RDA, many well past 200 percent. Are you saying that this amount, if balanced with other fats, would not be of concern (in regards to the detrimental effects of saturated fats as stated in the video above? Are these excess plant based saturated fats exempt from causing the ailments that the meat, egg, dairy based saturated fats cause, according to Dr. Gregor?

          • Massimo

            What I’m saying is that one cannot get an excess of saturated fats if he eats a whole-food plant based diet and avoids tropical fats. If his diet contains – say – 10% of fats as saturated fat (thus 90% is unsaturated), that proportion remains the same whether he eats 2000 or 4000 calories. If he is closer to 4000 than 2000, then he’s probably eating a too high proportion of fats; which however are still 10% saturated vs. 90% unsaturated. I am NOT saying that a high-fat diet is healthy, of course. I am just saying that until you stick to unrefined, non-tropical fats, the relative amount of saturated fat can hardly be problematic. In such a diet, you have to be careful to the proportions of omega-6 (pro-inflammatory vs omega-3 (anti-inflammatory), which in the Western diet, and especially in the SDA, is far definitely unbalanced toward the former.

          • r h

            correct me if i’m wrong, but following your logic (in regards to fat ratios and omega types of fat, salmon is no worse off in its fat ratio and content than many healthful plant based fats. And the same could then me said for some types of meat. Look at the ratio of saturated fat to other types of fat in salmon. Doesn’t seem to bad to me. Same goes for lots of other non-vegan foods.

          • Massimo

            Sure. But the problem of animal products is far from being limited to their fat content. We are not made to eat animal proteins – Dr. Greger has a nice video about the IGF-1 raising effect of animal proteins; also, they are generally more acidifying than plant proteins and also require a more acidic environment in the stomach to be digested. And you do not eat fish or meat raw, just hunted, do you? Cooking produces heterocylic amines. Also, cholesterol is partly oxidized and when you eat stored and cooked meat or fish you get cholesterol oxides, which are highly atherogenic. You cannot reduce the health effect of a food, whether it is plant or animal, to one component, unless you are speaking of separated fats (oils, margarines, solid fats) which are practically 100% fat.

          • r h

            yes, but i brought all this up in reference to the video Dr. Greger put out on saturated fats and their detrimental effects. I am sticking to the thread of this, and think, as a vegan, it is important to address if excess saturated fats, (when eaten in excess) from plant-based sources can/do cause the same/similar negative consequences that meat dairy egg based sources cause as Dr. Greger states in the video above, as well as other videos. I think you are bringing something else into this (and what you are saying has merit, believe me), but i think it is mutually exclusive from the video’s premise.

          • Veganrunner

            And let’s not forget the FDA recommends limiting fish servings to 3 times per week due to its’ polluted meat. As far as I am concerned, 1 serving of mercury and such is too much. Definitely isn’t appetizing.

          • r h

            yes, you are right on limiting fish due to…….
            but keep in mind, let us stick to the premise of the video, as to what i have suggested as a reason for concern, and hope that someone on this website with knowledge and wisdom on this matter will contribute their expertise: do high saturated fats from plant based sources, when ingested in large amounts that exceed the 100% RDA for saturated fat (sometimes doubling and tripling the RDA) cause the same detrimental effects that meat dairy egg based sources do in the the above video? i have deep concern for many vegans i know, in this regard, as many are ingesting well over 200 percent of the RDA for saturated fat, maybe 350 days a year. are they prone to the same ailments suggested by the video, or are plant-based saturated fats, when eaten in excess, exempt from causing this harm, as it pertains specifically to the video’s premise?

    • http://www.DonForresterMD.com/ Don Forrester MD

      I believe that you should avoid regular consumption of the tropical oils which are high in saturated fat. Of course the animal sources come with other substances both natural (e.g. cholesterol) and man made (e.g. persistent organic pollutants, mercury, arsenic) that contribute to inflammation and chronic conditions. If you have not already seen it view…. http://nutritionfacts.org/video/does-coconut-oil-clog-arteries/.

  • B

    I used to have to have my teeth cleaned 3x per year due to massive plaque buildup, especially around the lower front teeth. I would use a paperclip to easily dislodge chunks of plaque down there! Since going vegan 5 years ago I have had virtually no plaque buildup at all. Due to lack of insurance and money, I went almost 3 years without a cleaning and when I finally went, no plaque! I’ve often wondered if there is a relationship between that plaque buildup and the plaque in our arteries. My dentist said no, but when this came up in conversation with a dental technician recently, she noted having seen an article in one of the dental journals suggesting there is.

  • GYMR

    Been Vegan for over three years now. I went to the dentist and she said “I don’t know how you keep your mouth so clean, but keep it up!” Awesome video.

  • Beth Genly

    Some other studies in support of this discussion: Inflammation – http://www.ncbi.nlm.nih.gov/pubmed/20425759. Artierial dysfunction: http://media2.newsnet5.com/uploads/WEWS_EffectsOfSupplementalPhytonutrients.pdf. Periodontitis: onlinelibrary.wiley.com/doi/10.1111/j.1600-051X.2011.01793.x/pdf

  • http://www.facebook.com/eogrey Eric O’Grey

    Hi Dr. Gregor: Could you please do a video on testosterone in vegans vs. non-vegans. In my case, my testosterone rose slowly over 2 years from 269 ng/dl as an omnivore (285 lbs, Type 2 diabetes, hypertension, statins) to where it is now at 1111 ng/dl after being on a 100% whole plant vegan diet for the past two years (now zero meds, 180 lbs, 114 cholesterol, normal glucose). My main point here is that med literature (what I can find on the Internet) seems to suggest that testosterone declines with age. I do not believe that, I believe testosterone declines with declining health, which declines faster on the SAD but not on a vegan diet as we age. I am 53, and my testosterone appears to be at the high end of the range for an 18 year old according to the charts I see. Any info on point about this, or a video, would be very much appreciated. Thank you!

    • http://www.facebook.com/eogrey Eric O’Grey

      I’m very sorry I misspelled your name, which I know is Dr. Greger. :)

    • http://nutritionfacts.org/ Michael Greger M.D.

      Your wish = my command: How Plant-Based to Lower IGF-1?

      • http://www.facebook.com/eogrey Eric O’Grey

        Dr. Greger, as always you are awesome. Thank you. :)

    • http://www.DonForresterMD.com/ Don Forrester MD

      You have to be careful when talking about numbers and aging. Most studies are done on patients who are on the standard American diet. The ingestion of meats often brings with them male hormones used mainly in the beef industry. I think it is clear that going on a plant based diet doesn’t feminize men or interfere with their fertility. It is somewhat complex as low fat plant based diets also increase the binding protein in the blood so you may not have as much free testosterone. Since higher testosterone is associated with prostate cancer I’m not sure I want higher levels. The increase in your testosterone is higher then the literature and my clinical experience. I think it is more important to look at how well you are functioning as opposed to absolute values. I believe the best science at this point supports a whole food plant based diets with avoidance of GMO foods plus adequate Vitamin B12. Congratulations on your success and as always if you experience any clinical symptoms you need to discuss with your physician. Together you and s/he are the best ones to interpret the significance of specific lab values .

  • Steve E.

    Thanks for the great videos and info, Dr. Gregor!

    To what extent are these effects a result of actually chewing the food versus simply ingesting the food? I ask because a somewhat considerable proportion of my typical daily veggie and fruit intake is in blended form via my Vitamix. Am I reaping all the benefits these studies cite, or am I missing out due to not chewing all my food?

    • Thea

      Steve E.: Excellent question! I don’t have the full answer, but I do remember a series of videos that Dr. Greger did that showed that chewing certain foods and getting the saliva going had an effect. I think it was about broccoli and energy/work outs? I don’t remember enough to look it up. I remember Dr. Essyelstyn saying something like: you shouldn’t drink smoothies to get the best effect of your food for a healthy heart. He talked about the importance of chewing. Again, sorry I don’t have the details.

      Also, I remember the series Dr. Greger did on nuts. Check out the videos on reasons why nuts (may) not contribute to weight gain despite their high calorie and high fat content. One of those reasons had to do with the body simply not digesting all of the nuts, some chunks pass through. At least that is what I remember. So, here’s my personal thought as it relates to your post: If you make a smoothy with nuts or seeds, then you are getting chunks of nuts that can pass through undigested.

      All of which makes me think that chewing really is important – whether it applies to this question of oral disease or not.

      That said, if you are consuming a whole plant-food based diet which happens to include some vegan smoothies, you are miles and miles above what so many other people are eating. I’m sure your diet consists of more than *just* smoothies and that you also get some fruits and veggies threw chewing. So my thought is: If you love smoothies a lot, maybe the question is not worth fretting over.

      Good luck. I hope someone can give you a better answer.

    • http://www.DonForresterMD.com/ Don Forrester MD

      The Vitamix does function much like your teeth in help breaking up the food. However we are designed as hind gut fermenting herbivores which have evolved from great apes to have more amylase genes and increased volume in our small intestine to absorb digested starches. Amylase is the enzyme that digests starches. Our salivary glands are one source of amylase so by chewing food in your mouth you release amylase to help digest starches. By swallowing smoothies I would imagine you add alot less amylase to aid in digestion. Now downstream in the intestine your pancreas adds more amylase to the mix but the upstream amylase gives you a head start in digesting your starches. There are other functions that are important in the mouth such as the nitrate to nitrite cycle… see videos..http://nutritionfacts.org/video/priming-the-proton-pump/ and http://nutritionfacts.org/video/dont-use-antiseptic-mouthwash/ . Smoothies are a good way to get your greens but there is value to chewing your food to aid the digestion of starches. I’m sure as science progresses we will find other benefits to chewing such as getting the benefits from crushing broccoli see… http://nutritionfacts.org/video/the-best-detox/. What works for each individual varies for instance if you lack teeth blending would be helpful. You need to keep tuned to Nutrition.Facts.org as the science keeps coming…

      • Steve E.

        Thanks for the info, Dr. Forrester!

        Interesting that the nitrate to nitrite videos involved drinking beet juice, rather than chewing the beets. Seems they got the benefits of the beets just from the beet juice passing through the mouth in that case.

        I’ve seen the broccoli video before. I thought about this question when I watched that, too, but then I thought, what crushes and mixes broccoli better than a Vitamix? Seems like you just need to bust it open to get the beneficial reaction, and I’d assume either teeth or high speed steel blades would get the job done.

        Nevertheless, I had a big salad for lunch, including broccoli, and ate it the “old-school” way. I chewed it ;-)

        You can bet I’ll stay tuned to the site. Great stuff, Dr. Greger (my apologies for the name misspelling in my original post!). Would love to see any research analysis on this topic specifically…all the pros and cons of blending vs. chewing. I’m pretty sure Dr. Greger uses a Vitamix himself on occasion (I recall that from his interview on Rich Roll’s podcast), so I imagine it’s something he’s put some thought into.

        -Steve

  • Melanie

    This is a really fascinating topic. I was wondering about the impact this diet might have on my dentition. We must not be complacent and stop brushing/flossing, however. Eating plant-based helps, but we have to do other things too. Just like exercising, for our cardiovascular health. There is no one panacea.

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