dental issues related to vegetarianism

[ButterflyBreath]

Question about dental care:

I have always had good teeth. I've had a few cavities, but nothing major. Last year I had 4 cavities all at once! I was shocked. One of them necessitated a root canal in March. I still have not had the crown put on because of the pain (it's almost July). Also, I am having horrible bad breath even though I floss every day, brush 2x a day, and use mouthwash every time I brush.

I read recently that vegetarians develop more tooth decay than the SAD as a result of their diet. Is this really true?! I have been veg all my life so if so, this could be the reason.

Anyone else have this experience? What should I do?! It's really worrying me because although I have dental insurance right now, I don't always have it and this would be EXPENSIVE without it.

[catherine]

I've read mixed things about this, too. Not sure what the "right" answer is. I'm 90% vegetarian (I do eat fish, and I very occasionally eat a bit of poultry (maybe once a month). I just returned from the dentist: no cavities at all--haven't had any in the past 5 years. Also, he told me that my gums are absolutely fine, with no sign of periodontal disease or gingivitis... I'm 60, so that was good to hear. Genetics probably has something to do with it.

[Kestra]

I don't believe it. My whole family is vegetarian and growing up my two brothers had cavities all the time. I've never had a cavity once and I'm 35 now. Some minor gum recession but that's it. I suspect if the diet was a main factor then vegetarian families would be similarly affected, since their genetics are similar as well. I think the dental thing only holds true when you take almost pure carnivore individuals such as Canadian Inuit, and force them onto a more omnivore diet with white sugar and flour - sure they'll get tooth decay then since their bodies aren't accustomed to sugar. As well as the certain segment of vegetarians who hate vegetables and subsist solely on unhealthy carbs. Otherwise, I don't buy it.

[Rosemary]

If you are having any acid reflux, this can contribute to both tooth decay and bad breath. Perhaps it's not the type of diet you're eating, but the specific foods?

[bunnys]

I have never heard anything along those lines. Nothing. This is the first hint. I've been veg*n for nearly 10 years and have not had a cavity. I have had a a root canal and 3 crowns but I'm 48 and all that dental work I got when I was 10-20 is flat out getting old and falling apart. (I had some pretty big and deep cavities filled during my non-brushing, non-flossing childhood.)

There is a lot of cultural legend out there that demonizes vegetarianism for some reason. You've heard it. Veg*n's are anemic and wasting away from lack of protein, Hitler was a vegetarian. All that crap. I don't know what so many non veg*ns are so worried about people being veg*n. But I do not believe the bad teeth thing on an anecdotal level (never experienced it) or scientifically (never seen evidence of it.)

[CathyA]

Besides genetics, maybe it has something to do with a vitamin/mineral deficiency? Are you covering all your bases, since you don't eat meat? Also, how old are you? My teeth seemed to have alot of problems during perimenopause.
My DD is a VEGAN. I noticed that her consumption of sweets went up after she began to be VEGAN. Also, I just wonder what all those grains are doing, since now they are implicated in diabetes and obesity.
Did you happen to have a different dentist when you discovered the cavities?

[Suzanne]

There's a fair amount of information available on tooth issues related to vegetarianism/veganism; many people report tooth issues ranging from mild to severe after quitting omnivory and especially after switching to a diet high in raw veggies, fruits, and nuts, and there are some studies showing higher rates of dental problems ranging from tooth erosion to tooth loss amongst vegetarians and vegans. Denise Minger has some excellent information both on the causes and the cures for these problems: http://rawfoodsos.com/category/teeth/. Her experience and reading lead her to suspect that deficiencies in vitamins D, K2, and A are involved - problematic for vegans unless they supplement seeing they're fat-soluble vitamins of animal origin. Minger became a raw food vegan and within a year developed multiple cavities! Chris Masterjohn reported a similar experience, with 15 cavities and 2 dead teeth 2 years after he became vegan. http://www.cholesterol-and-health.com/Vegetarianism.html. Vitamin D deficiency is linked with softening of tooth enamel: http://www.knowyourteeth.com/infobites/abc/article/?abc=n&iid=315&aid=1273. While vitamin D can be made in-house from sunlight, many people don't get enough sun to make decent amounts; or they wash off their skin oils daily, thereby short-circuiting the process (it takes, as I remember it, about 36 hours for the cholesterol on the skin surface to be converted and absorbed, or they have thyroid or kidney malfunctions that derail it. This page has a lot of information on vitamin D - the video lecture is particularly interesting because of the sunlight aspect. http://www.mercola.com/article/vitamin-d-resources.htm. The Wikipedia page shows just how complex the process is! http://en.wikipedia.org/wiki/Vitamin_d

I think that vegetarian/veganism is like any other dietary choice - you can be healthy and happy on it provided your biochemistry supports the diet, you're aware of your individual requirements for nutrients (may be much higher than the RDA!), and you avoid processed and packaged foods - especially refined carbohydrates, and industrial seed oils.

[ApatheticNoMore]

I think most of it has to do with whether you are eating carbohydrates that remain on your teeth, even sweets themselves are not necessarily the problem but what remains on the teeth. Eat dried fruit like dates or raisins or trailmix? Constantly sip sweet liquids (soda, sweetened coffee/tea, juice)? What about foods like rice (this food makes me teeth literally hurt), so I just intuitively know it remains on the teeth unless you brush. I honestly don't think most fruits and vegetables in their plain state are that much of a problem.

[bunnys]

Thanks for the info Suzanne. I have been vegan 7+ years and I don't take a supplement and haven't had one problem. I also know different people have different mouth chemical conditions and so some are more prone to decay?

I do agree that food that sticks to the teeth (esp. sticky carbs) increases likelihood of cavities. And veg*ns do eat more carbs.

[heydude]

i have been vegetarian for 12 years. perfect teeth so far!

[Suzanne]

You're welcome! Yes, different people have different mouth pHs, and this definitely affects plaque formation and tooth health. A coworker (a medical writer) told me about this, and I put it to the test. I stopped using ordinary toothpaste and started brushing with a 50/50 mix of baking soda and salt. Bingo! Required cleanings fell from 4 per year to 1, and my oral health improved dramatically. There's a lot of talk about the alkaline effect of fruit, for instance, but the reaction of sugar (including sweet fruit) in the mouth is to form acid, which makes a sticky film on the teeth, part of which is actually dissolved from the teeth, and is much beloved by harmful bacteria. Refined starch converts to sugar in the mouth and that adds to the problem.
http://www.livestrong.com/article/531740-does-the-consumption-of-sugar-increase-the-acidity-of-saliva/

Apparently the first sign of trouble for anybody, vegan or omnivore, is transparency of tooth tips, which indicates demineralization of the enamel. This is the time to take action! Calcium alone isn't enough; one needs the right amount of phosphorus - tooth enamel is a form of calcium phosphate. Without sufficient vitamin D, calcium isn't absorbed properly, and I've recently read that vitamin D isn't efficiently absorbed without good amounts of vitamin C! And then magnesium is also needed...

Speaking of mouth bacteria, it wouldn't be surprising to find that each person has his/her own distinctive colony, seeing that there are definitely distinct groups of gut bacteria that strongly influence what foods are digested and assimilated.

It sounds like you know your body and have gotten the mix right!



Thanks for the info Suzanne. I have been vegan 7+ years and I don't take a supplement and haven't had one problem. I also know different people have different mouth chemical conditions and so some are more prone to decay?

I do agree that food that sticks to the teeth (esp. sticky carbs) increases likelihood of cavities. And veg*ns do eat more carbs.

[ButterflyBreath]

CathyA, I'm 37 today (June 28)! I take Vit D supplement, and I take a general multi which has 50% of my Vit A, 250% more Vit D, 75% of Vit E, and 31% of Vit K. Maybe I should talk to my doc to see if I need to have bloodwork for these fat soluble vits. When I was told I had 4 cavities I asked the assistant if I'm eating too much sugar and she said that it's not the refined sugar necessarily, but carbs in general and that we really can't help it. She suggested using mouthwash because it can get into the cracks and crevasses that tooth brushing can't so I've been a religious mouthwash-er since.

I recently a week ago started raw foods again. I need to find a nutritionist because although I think it's an awesome "diet" and way to eat, very healthy, it takes more awareness and knowledge to know if you are getting what you need. Protein is the concern. Veg & fruits are pretty much carbs, as well as grains, and I get the fat in coconut oil (so yum), sesame oil, olive oil so that's not a problem. That leaves protein. It's hard to track protein because I might make nut or rice milk, but then use the pulp in a cracker or bread recipe. Or, I might sprout a bean. Does THAT change the protein content? See, so many protein questions. A lot for me to learn.

So anyways back to the carbs, I'm concerned about making my tooth issues worse.

[ButterflyBreath]

Maybe I'll start brushing 3 x a day or at least using mouthwash after I eat.

[Tussiemussies]

Been vegetarian for 21 years now and only ever had one cavity until about five years ago when I started to eat chocolate. I have deep crevices in my molars and I think this is why I got cavities, not due to a vegetarian diet.

[awakenedsoul]

I use this system and it's really helped me. I had a lot of dental problems. Dr. Ellie wrote a book called Kiss Your Dentist Goodbye. It's excellent. She prescribes a program of zylotol, using Closys, Crest regular toothpaste, Listerine, and then ACT flouride rinse. It's done wonders for me. She has 30 years of experience in dentisty, and makes some excellent points about the enamel. Her website is www.zellies.com (http://www.zellies.com)

[ButterflyBreath]

I might have figured it out. I take a medication that causes horrible dry mouth. I just read that your saliva is supposed to wash down bacteria and if you have dry mouth it doesn't happen. Just one more reason to get off meds!

[bunnys]

Apparently the first sign of trouble for anybody, vegan or omnivore, is transparency of tooth tips, which indicates demineralization of the enamel. This is the time to take action! Calcium alone isn't enough; one needs the right amount of phosphorus - tooth enamel is a form of calcium phosphate. Without sufficient vitamin D, calcium isn't absorbed properly, and I've recently read that vitamin D isn't efficiently absorbed without good amounts of vitamin C! And then magnesium is also needed...
It sounds like you know your body and have gotten the mix right!

NO! I don't think I have the mix right. My hygienist has been on me as a GRINDER. She said that my transparent teeth at the bottom indicate that I grind my teeth (I do, but maybe it's more.) She doesn't know I'm a vegan.
She got me to start wearing a night guard. But you're saying I need to start taking calcium phosphate and also vitamin d supplement as well. Will this build up my teeth at all or am I just at the point that I keep from losing more?

Thanks.

[kenh]

Also, remember that Suzanne pointed out the importance of Vit K, by which she probably means K2, which should be named a whole new vitamin because of it's newly found functions. It helps to direct calcium to the bones instead of the arteries. The lack of K2, for many of the reasons mentioned in the above diets and lifestyles, may explain the recent study that showed calcium supplementation being somewhat detrimental.

[Suzanne]

Hi Bunny, the good news is that teeth can be remineralized - they go through demineralization and remineralization every day; the trick is to ensure that the processes stay in balance, without a net loss. My own preference is to eat food rather than take supplements, but there are times (like with vitamin B12) that supplements are necessary, and sometimes they come in handy as a booster. There's a fairly good body of evidence to show that supplements are less effective than food, and can even produce negative effects. I think this is because our bodies can't handle a big flush all at once, and also because a pill probably passes through the system without major mixing with the intestine contents. Foods, on the other hand, do a slow-release process, and can even start being processed in the mouth provided one chews well. A bit off topic, but fascinating: I've just watched a video called "The Diets That Time Forgot", which pits Victorian, Edwardian, and 1920s slimming diets against each other, and the Edwardian diet (eat anything you want, but chew each bite 32 times) came out tops! Back to the mouth: when we chew our food really well, the minerals and vitamins in it get well mixed with saliva and brought into contact with the teeth, where a soft spot can readily absorb, from contact, the required nutrient.

Back to supplements: I'm toying with the idea that it might be good to crush up the tablet and mix it with the meal, or pop the capsule and mix the oil with the meal. I don't know yet how this might affect the taste!

Kenh is right - the form of vitamin K that shunts calcium to teeth and bones is vitamin K2, which should really have another name given its importance. For people who have the right biochemistry, vitamin K2 can apparently be synthesized from vitamin K1, which is found in leafy green vegetables. For those who can't make the conversion - don't produce the necessary enzyme - there are sauerkraut and natto if you're vegan, where bacteria have done the conversion for us. K2 is most abundant in animal source foods; as usual, grassfed and pastured animal products are richest. I am NOT trying to convert you into omnivory - can't resist doing a whole picture thing!

From what I've been reading, fat-soluble vitamins seem to be really important in tooth health, so adding coconut oil (medium-chain saturated fat) to veggies might be very helpful. Then too, it seems that one should NOT brush one's teeth directly after a meal, but wait 30 minutes for the saliva to revert to alkaline and recoat the teeth so brushing doesn't erode the temporarily softened enamel. Denise Minger suggests speeding up the process by rinsing with baking soda and water after a meal.


NO! I don't think I have the mix right. My hygienist has been on me as a GRINDER. She said that my transparent teeth at the bottom indicate that I grind my teeth (I do, but maybe it's more.) She doesn't know I'm a vegan.
She got me to start wearing a night guard. But you're saying I need to start taking calcium phosphate and also vitamin d supplement as well. Will this build up my teeth at all or am I just at the point that I keep from losing more?

Thanks.

[bunnys]

What's natto?

I don't think you're trying to convert me.

I do drink soy milk and it is pretty heavily fortified with B12 and I'm just going to buy a bottle of flax seed oil and start adding a tablespoon of that to all recipes to replace 1T of olive oil I currently use.

I don't brush after meals anyway but not too worried about it. I had my teeth cleaned yesterday and hardly had any tartar and gums were great. Asked the dentist and he said they look like I've lost some but it isn't that bad. And now I'm just trying to figure the best way to get enough calcium back in.

I think I'll have to look at getting a K2 supplement to take. I seriously don't think I can eat sauerkraut on a daily basis (I like it--but it doesn't go with that much.) And I really want to build my teeth back up.

Thanks for taking the time to share the info both of you!

[Suzanne]

You're welcome, Bunnys! Natto is a fermented soy paste. Some people swear by it, others find the smell (I've never tried it myself, but have read that it smells like rotting socks) and slimy texture unbearable! Flax seed oil is good (cold pressed), but there does seem to be a need for medium and longer chain saturated fats as well to support our lymph nodes in their task of protection against infection. The healthiest vegan I know (she's obviously blooming, a rock climber and distance runner) uses 1-2 tablespoons of coconut oil per day. A few months ago she went on a get-all-saturated-fat-out-of-my-diet streak because she'd put on a couple of pounds, and found that her cuts and scrapes didn't heal and went all nasty. Three days after digging back into the coconut oil jar, all was well again. I know it's anecdotal evidence, but it seems likely to me given that our lymph system strains out and takes first pick of the fats in our bloodstreams. I find this stuff fascinating!

[bunnys]

Thanks Suzanne! Honestly, I can't even stand Miso. And your explanation of Natto isn't exactly tantalizing. I'll probably have to get a K2 supplement. I'm not worried about the b12 and the flax seed oil will be for my Omega 3's and I'm going to supplement with the calcium for a year and then just make damn sure I drink at least 2 glasses of soy milk daily and eat some almonds each day and I should be ok there. Hopefully, otherwise I'll be able to stay away from the supplements.

I do eat really, really well--generally. And I exercise a lot. And of course I "don't" everything that's bad.

But I haven't been concerned about supplementing with the exception of b12 and I've never even given that much thought. Soy milk is so fortified now that it gets a lot of nutrients in that I couldn't naturally get anywhere.

I'm sure your vegan friend feels great. I do. I'm 48 and have NO AILMENTS. Nothing. So I can't complain.

[Spartana]

I'm a long term vegan who has had no dental issues what so ever. The term "vegeterian diet" can mean a healthy, natural, plant based, whole food diet or one that is nothing but white bread, sugar, chocolate and orange soda. So when they say vegetarians have dental issues, you need to look at what they are eating rather than just take the data as carte blanche. Same when you see overweight vegans or vegetarians - just because it doesn't use animal products doesn't mean it's healthy or low calorie!

[Suzanne]

That's very true, Spartana, that vegetarians can eat well or badly just as omnivores can; the term "omnivore" should not be equated with standard western diet based on packaged and processed food. However, the studies I've read have matched omnivores and vegetarians as far as possible so that diet is the strongest variable, and these have found more dental erosion, more crown wear, and more enamel thinning in vegetarians. This is true even with subjects who eat no junk food and who pay attention to brushing and flossing. One study focused on Indian vegans who were punctilious about diet and hygiene practices, but who still had more dental problems than a matched group of omnivores. Dental woes seem to come up quite often on vegetarian/vegan sites. This may be due to a high intake of fruit, which is acidic in the mouth and is not recognized as problematic because fruit is regarded as the great alkalinizer of the body; eating more carbs, which tend to pack down into tooth crevices; then too plants, especially fibrous ones, legumes, and whole grains, contain phytoliths (plant stones) of silica, which are hard enough to scratch and grind enamel; and another factor could be a shortage of fat-soluble vitamins. While many, if not most, people can convert betacarotenes to vitamin A, some of us can't do this clever trick and need our retinol ready-made, for instance. Vitamin D production can be derailed in a number of ways, one of which is through eating a lot of unfermented soy without balancing it with sufficient iodine - a low-functioning thyroid can wreak quite a lot of havoc on vitamin D formation and absorption, and soy binds to iodine, thus making it unavailable to the thyroid. Okinawans tend to eat their tofu with fish broth or other seafood, like seaweed. There's no reason why vegetarians and vegans who pay careful attention to their diets and their personal biochemistries shouldn't have healthy teeth; I think that both vegetarians and omnivores sometimes run into trouble through complacency, assuming that just because their diet falls into the vegetarian or omnivore category it must be healthy and no attention is required to detail!


I'm a long term vegan who has had no dental issues what so ever. The term "vegeterian diet" can mean a healthy, natural, plant based, whole food diet or one that is nothing but white bread, sugar, chocolate and orange soda. So when they say vegetarians have dental issues, you need to look at what they are eating rather than just take the data as carte blanche. Same when you see overweight vegans or vegetarians - just because it doesn't use animal products doesn't mean it's healthy or low calorie!