The impact of modern diet on oral health
Is it enough to brush your teeth and use floss to have a healthy mouth and strengthen your teeth?
Currently, our lifestyle and, at its core, our diet, have undergone a tremendous shift with globalization, the need to always be 'on', or else you are 'off' and 'out'. We have lost our connection to the essentials and learned the protocols and recipes that bring us what we need to survive, quickly and preferably in a way that doesn’t waste our time, which is hours to get back to work!
Food is no longer what it used to be. Fruits and vegetables no longer come from the local village, but from all corners of the world, and when they arrive, they are not fresh; they lack the nutrients we attribute to them. The lack of these essential nutrients is causing the general population to increasingly show nutritional deficiencies and an increase in inflammatory diseases, of autoimmune origin, as well as various types of cancer. These deficiencies also reflect on oral health, making it essential to seek ways to strengthen the teeth through proper nutrition and supplementation.
Supplementation to strengthen teeth: when and why
Supplementation to strengthen teeth is the act of ingesting vitamins, minerals, and other bioactive substances that will address possible deficiencies or enhance the levels of these substances already present in the body. Supplementation should occur with specific goals, such as boosting the immune system during periods of biological stress (healing processes or exposure to extreme environments), or prevention, in situations of predisposition to developing certain types of diseases or for management of chronic conditions.
They present themselves as a necessity in this era with such demanding lifestyles, and it is extremely important to have an individual evaluation: the fundamental basis of a healthy life is individual behaviours, such as sleep routines and physical exercise, associated with a healthy diet and good stress management. Based on this, the need or not for supplementation and/or prescription of traditional medications can be concluded. This is the correct evaluation cascade, and the rational sequence we must always keep in mind.
A new vision of integrative health
There is a trend among the general population towards natural products and an integrative and functional approach to health that covers all aspects influencing the onset of disease, including genetic factors, environmental factors, lifestyle, diet or even emotional well-being. This is transforming health professionals and their practices, who see the patient as a whole, in contrast to merely treating the disease and its symptoms. People are dynamic and complex organisms and not just a state of health. Health status is the culmination of a vast array of experiences, life situations, and behaviors that resulted in a particular diagnosis.
This global perspective is also essential in Dentistry, where strengthening teeth involves understanding the balance between body, mind, and nutrition.
On the other hand, there is a growing demand for reducing the number of chemicals to which we expose our bodies (whether through medications, hygiene products, personal care, nutrition, etc.). However, their use should be evidence-based, and it is within this context that we aim to frame the use of certain natural products in Dentistry to strengthen teeth.
The role of nutrition and supplementation in Dentistry
In Dentistry, as in any area of Medicine, various health states and a myriad of clinical circumstances dictate the need for certain therapies. Nutrition plays a central role here, as the adequate intake of vitamins and minerals is fundamental to strengthening teeth and preventing oral diseases.
We can say that a patient’s journey in Dentistry is divided into three crucial moments that require specific approaches and where supplementation can prove to be a fundamental tool: Diagnosis, Treatment, and Maintenance.
1. Diagnosis
In assessing a patient’s overall health in Dentistry, there are certain pathologies and medications that are of greater relevance as they may interfere with the treatments to be performed, with recovery, and with the long-term success and maintenance of the treatments provided.
Uncontrolled diabetes mellitus promotes slower healing, greater susceptibility to infections, and a higher risk of periodontitis; autoimmune diseases (Sjögren's syndrome, rheumatoid arthritis, lupus) may manifest with dry mouth and increase the risk of cavities and infections; oncological diseases and their treatment through radiotherapy and chemotherapy may increase the risk of infection, osteoradionecrosis, and mucositis.
Therefore, there are steps to take in the diagnostic process and in preparation for necessary oral procedures, which already allow us to assess whether there is any imbalance in a broader picture.
Examples of this include clinical analyses such as a complete blood count with coagulation study, vitamin D, vitamin B12, and folate; iron and ferritin; thyroid hormones; renal function; HbA1c and fasting glucose. The interpretation of these results within the context of the symptoms manifested and the examinations and clinical history of the patient will allow us to infer about the need to request additional tests, refer to other areas of Medicine, and assist in managing the patient in treatment, contributing to the strengthening of the teeth and the body as a whole.
2. Treatment and Maintenance
In the treatment phase and the subsequent maintenance process, it is important to know the substances that can contribute to the success of treatments. We must also understand how vitamin deficiencies impact oral health and the ability to effectively strengthen the teeth .
What follows is a description of the main nutrients and compounds recognized for their role in oral health and the success of dental treatments, helping to strengthen the teeth at all stages of life.
Vitamin A
Vitamin A is essential for oral health as it helps maintain the mucous membranes of the mouth, tongue, and gums, keeping them healthy and protected, as well as supporting the immune system to fight infections and ensuring proper saliva flow, which helps break down food and eliminate bacteria. A deficiency of vitamin A has been associated with a decrease in the development of oral epithelium, changes in tooth formation, enamel hypoplasia, and periodontitis. Therefore, adequate levels of this vitamin directly contribute to strengthening teeth and keeping gums resilient.
Vitamin B Complex
The vitamin B complex includes water-soluble vitamins that play a role in crucial processes such as energy production, enzymatic function, and neurological health. Its deficiency can influence healing, intensify alveolar bone resorption, and decrease the body's response to infections. Scientific evidence increasingly points to a relationship with periodontal disease. Its lack has been associated with recurrent aphthous stomatitis, enamel hypomineralization, cheilitis, halitosis, gingivitis, glossitis, atrophy of taste buds, stomatitis, dysphagia, and pale complexion.
On the other hand, they are crucial for the maintenance and regeneration of nerves, and their deficiency can lead to neurological changes resulting in symptoms of paresthesia (numbness) in the mouth. B complex supplements can help strengthen teeth and support healing.
Vitamin C
Vitamin C (ascorbic acid) is involved in tissue repair and plays an important role in several biomechanical processes, including collagen synthesis, immune protection, and the regeneration of other antioxidants. In a situation of vitamin C deficiency, for example, there is the production of defective collagen molecules, resulting in weak connective tissues (which are the tissues responsible for connecting, linking, nourishing, and supporting other tissues in the body), such as the connective tissue present in the periodontal ligament around the teeth. Studies indicate that vitamin C plays a fundamental role in healing after extractions and dental implants. Local and systemic administration has significantly improved the healing of bone and gums, also helping to strengthen teeth.
Vitamin D
Vitamin D is related to bone health and in one way or another is in the mouth of the world as the levels of most of the population, including the Portuguese, despite being a sunny country, are below reference values. It is estimated that around 200 million people worldwide suffer from osteoporosis, with this number increasing, making it a public health problem. We know that an adequate diet, with intake of foods rich in vitamin D (fatty fish) and daily sun exposure (15-20 minutes) are crucial factors for stabilizing vitamin D levels, and that supplementation with calcium and protein, along with physical exercise will contribute to better bone metabolism.
However, when these measures are not sufficient, a lack of vitamin D has been associated with various inflammatory diseases, including periodontitis, as demonstrated by clinical studies.
Vitamin K
Vitamin K plays an important role in coagulation and bone and cardiovascular health and has long been recognized as a therapeutic agent in the treatment of osteoporosis, primarily in its K2 form. However, it is difficult to obtain it through diet, as it is present in few foods, particularly fermented ones, such as fermented cabbage (sauerkraut). Moreover, most of the vitamin K ingested is used by the liver for the production of coagulation factors, leaving it deficient in bones. There is a growing body of evidence regarding the role of the combination of vitamins D and K in optimizing the regulation of calcium metabolism, ensuring that calcium is deposited in bones and teeth, rather than accumulating in soft tissues and blood vessels.
This could allow for greater safety in dental implant treatments acting preventively against bone loss, and generally in the healing of tissues. This combination has also been studied in the treatment of chronic periodontitis with promising results, influencing the effectiveness of treatment and the severity of the disease.
Ashwagandha
It is a fact that interest in plant-based treatments has increased due to their safety and efficacy, as it is estimated that around 44% of flowering plants contain medicinal compounds with antioxidant and anti-inflammatory properties. Ashwagandha is a highly reputed medicinal plant used for centuries in traditional Indian medicine. Several studies corroborate the beneficial effects of Ashwagandha, as a potent anticancer agent, with antioxidant, anti-inflammatory, and calming effects, also used as an adjunct in the management of stress and oral infections. The use of this plant helps to strengthen teeth, maintaining more resilient oral tissues.
Quercetin
Quercetin is a natural flavonoid with antioxidant, anti-inflammatory, and anti-aging properties, playing an important role in cardiovascular and neurodegenerative protection. It is present in various fruits, such as grapes and apples, and in vegetables like onions and capers. In Dentistry, Quercetin has significant benefits due to its antioxidant and anti-inflammatory action, as well as its ability to act as an antibacterial agent, preventing its adhesion and the formation of biofilm, the main culprit in the onset of dental caries and periodontal disease. Studies show that Quercetin has an efficacy similar to that of chlorhexidine in reducing biofilm.
Coenzyme Q10
Coenzyme Q10 is an antioxidant that reduces oxidative stress and inflammation, showing special efficacy in periodontal disease, where levels of this substance are often decreased. Supplementation with CoQ10 may act as an adjunct in periodontal treatment, helping to reduce inflammation and improve clinical parameters.
Additionally, its potential benefits in treating the Burning Mouth Syndrome are being studied. Its use also contributes to strengthening teeth, promoting healthier gums.
Turmeric
Curcumin, the main active component of Curcuma longa, is a potent antioxidant, anti-inflammatory, antimicrobial, and bone resorption inhibitor, highly relevant in Dentistry. It has demonstrated efficacy as an adjunct in the treatment of periodontal disease, promoting a significant reduction in clinical parameters when associated with root planing treatment, with results similar to chlorhexidine.
Additionally, topical use of curcumin has shown benefits in alleviating oral lesions. Due to its broad spectrum of action and safety, curcumin has been studied for decades for its therapeutic potential in various inflammatory and degenerative conditions, including periodontal diseases, oral mucosal lesions, and oral cancer.
The growing scientific evidence regarding the effect of certain nutrients and compounds has reinforced the importance of supplementation as a therapeutic complement in contemporary Dentistry. These natural agents demonstrate potential not only in the prevention and control of oral diseases but also in improving clinical outcomes and promoting overall health. It is essential that oral health professionals understand the role of these substances, recognizing signs of deficiency and integrating evidence-based supplementation strategies, in order to provide more comprehensive, personalized, and preventive care aligned with the current concept of integrated health.
