Nutrition and oral health go hand in hand—what you eat, how often, and even the way you eat affect the health of your oral cavity (mouth), but oral health also impacts your ability to consume enough food and nutrients.¹

Some of the main nutrients needed to sustain good oral health include calcium, vitamin D, vitamin K, and protein. As you might recognize, many of these nutrients are also required to maintain bone health.²

While good dental hygiene and regular, semi-annual dental cleanings are key to healthy teeth and gums, a mindful use of nutrition alongside these practices can supplement and maintain good oral health and reduce the risk of dental caries (cavities), enamel decay, and inflammation in the gums.

In this article, we’ll review the links between nutrition and oral health, who is most affected by oral health issues, nutrition recommendations for oral health, and basic oral hygiene strategies.

The link between nutrition and oral health

There are many specific ways that nutrition can impact oral health. The most common include: 

• Your diet
• How often you eat
• Your saliva levels
• Hydration

Your diet has a significant impact on all aspects of your health, and oral health is no different. Certain foods like grains, fruits, starches, simple sugars, and acidic foods can all deteriorate the enamel of your teeth, promote the development of cavities and bacterial growth in the mouth. This doesn’t mean you have to eliminate all of these foods from your diet, but you should be mindful of how often you’re consuming them and what foods you’re pairing them with to promote oral health.³

Spacing out your meals instead of constantly snacking throughout the day is also important for oral health. The more often your teeth and gums come into contact with food, the higher chance food will get stuck in or between your teeth, feeding the bacteria that promote the breakdown of your enamel.

Your saliva contains enzymes that begin the process of digestion as you chew and proteins and ions that confer antimicrobial properties. If you don’t produce enough saliva, which is caused by aging, lack of sleep, and some medications, you run a higher risk of tooth decay and oral infection. Your saliva can also vary in pH level; a more alkaline saliva promotes healthy teeth and gums, while more acidic saliva promotes enamel decay and bacterial growth.^{4, 5} 

Finally, hydration or a lack thereof impacts saliva levels. In fact, hydration affects nearly every process in the body and is essential for health and well-being, including helping to clear the mouth of food that may promote dental caries.⁶

Most affected populations

There are some key populations that are more susceptible to oral health issues, who would especially benefit from a focus on nutrition to support oral and dental health. These populations include:

• Infants and children: Tooth decay is one of the most prevalent chronic diseases of childhood in the U.S. As much as 20% of children between the ages of five and 11 have at least one cavity. Furthermore, children and teens from low-income households are twice as likely to have untreated tooth decay compared to children from higher-income households.⁷
• Older adults age 65 and above: One-third of older adults are estimated to have dental caries, and 40% have periodontal disease.^{1, 2}
• Pregnant women

Research has also shown that socio-economic status, the state of other chronic health conditions, and trauma have an impact on oral health in the overall population.²

The oral microbiome

You’ve probably heard plenty about the gut microbiome by now, but your mouth has its own microbiome too, with a diverse array of beneficial and sometimes not-so-beneficial bacteria. These bacteria can be acid-producing or alkali-producing; acid-producing bacteria associated with dental decay and gum inflammation and alkali-producing bacteria aiding in pH homeostasis and potentially providing protection from demineralization. (Teeth are mineral-rich!) That said, we are still learning about how the oral microbiome works.⁶

Nutrition recommendations for supporting oral health

Now that you know how nutrition and oral health are linked and dependent on each other, let’s take a look at some of the strategies you can incorporate to support oral and dental health through nutrition.

Diet for oral health

Good oral hygiene, and then your diet, is going to be your first line of defense against oral health issues, like cavities and periodontal disease. 

What foods are good for oral health, and what foods aren’t so good? Some foods in your diet can be cariogenic—promoting cavities—and some can be cariostatic—reducing the risk of cavities. You don’t have to completely avoid cariogenic foods, many of which are still part of a healthy diet. But there are ways you can plan your meals so that you combine cariogenic and cariostatic food choices, and in general be more mindful about what you consume. 

Some cariogenic foods (cavity-promoting) include: 

• Fermentable carbohydrates (food for bacteria), such as bananas, potatoes, rice, wheat flour, and corn. Again, these foods are a part of a healthy dietary pattern. 
• Highly acidic foods and beverages, like coffee, sports drinks, soda, even lemon water
• Processed foods with fermentable carbohydrates like cookies, pastries, etc. 

Some cariostatic foods (cavity-preventing) include: 

• High fiber foods, like raw vegetables, nuts and seeds, etc.
• Dairy: including cheese, yogurt, milk, etc.
• Animal proteins such as shellfish, meats, and eggs.

For example, if you want to have whole-grain cereal with banana for breakfast, which is a more cariogenic choice due to the banana, you could pair it with milk, a more cariostatic food since it provides calcium. Liquids are also considered to be less cariogenic in general, since they don’t stick to the teeth as much as solid food can. 

Other factors: meal spacing, hydration, saliva

Paying attention to meal spacing can also affect oral health. When you’re snacking throughout the day, your oral environment is more often in contact with foods and beverages that can cause build up on the teeth and wear down enamel. 

Try to space your meals with at least two hours between each. If you are going to eat a fermentable carbohydrate-rich snack, it’s better to do so once during the day (having multiple cookies at one time) rather than splitting it up into multiple small snacks (one cookie after lunch, one for an afternoon snack, and one after dinner). If you get hungry between meals, balancing a fermentable carbohydrate with a cariostatic food is a good strategy for snacking.

Our next factor is hydration. Hydration is not only essential for your body’s cells, but also for your oral health. If you struggle to drink enough water, you can try adding cucumber or mint for extra flavor. Hydrating between meals helps wash away food particles and supports saliva production. 

Lastly, healthy saliva composition and production begin the process of digestion and act as a buffer for the surfaces of your teeth and gums. Liquids and chewy solid foods stimulate saliva production, though the latter can also get stuck in your teeth. The most important factor for saliva is to maintain adequate hydration, but if you have a dry mouth, you can try chewing some sugarless gum to promote salivation.⁵

Fluoridation

The CDC recommends community water fluoridation, citing that fluoridated water reduces cavities by 25% in both children and adults.⁸ Fluoridated water is considered to be one of the most critical public health developments of the 20th century and has supported oral health for generations of Americans.⁹

The American Dental Association recommends fluoridated toothpastes and mouth rinses to support oral health¹⁰, and topical fluoride in the mouth has been shown to prevent dental caries in children.⁴ But ingesting too much fluoride can be hazardous. Make sure to use fluoridated products as directed and monitor children when using them to prevent ingestion.⁸

Basic oral hygiene strategies

Along with paying attention to your diet, meal spacing, and hydration, don’t forget about maintaining good oral hygiene. Just as a reminder: 

• Brush your teeth at least twice a day, morning and night, or after each meal if you have dental health concerns
• Floss twice per day
• Use fluoridated toothpaste, and mouthwash if needed
• Rinse mouth after meals or chew sugarless gum to stimulate saliva flow
• See your dental care provider for a routine cleaning twice yearly, and consult with your provider if you notice any dental pain, sensitivity, or inflammation in the gums. 

Key takeaways

The good news is that nutrition recommendations for maintaining oral health are many of the same recommendations for maintaining overall well-being. Strategies like— 

• Eating a healthy and balanced diet with adequate protein, fibrous vegetables, fruits, and complex carbs
• Spacing your meals appropriately throughout the day
• Hydrating well
• Supporting healthy saliva production
• Maintaining basic oral hygiene

—can help you feel confident that you’re doing your best to support your oral and dental health. As always, consult with your oral healthcare professional if you have specific oral or dental health concerns.