Fad Diets and Their Implications on Oral Health

ABSTRACT

As professional health-care providers, dentists are primarily concerned with promoting good oral health. This does not only include oral hygiene practices but also good nutrition to promote good oral health. As more people try restrictive diets to lose weight, even diets that many consider healthy — liquid cleanses, low-carb diets like Atkins or Paleo, vegan or raw diets — may not always be so healthy for the teeth and gums. Followers of fad diets may lose unwanted pounds — but they might also lose some tooth enamel in the bargain, or experience other side effects in their teeth and mouth.

INTRODUCTION

By definition, a fad diet is a diet that is popular for a time, similar to a fashion trend, without being a standard dietary recommendation and often promising unreasonably fast weight loss or nonsensical health improvements.

RISK FACTORS

There are a number of factors that can put individuals at risk for poor oral and overall health such as an unhealthy diet, age, medication, allergies, restrictive diets, chronic disease, lack of vitamins (supplements), as well as socioeconomic conditions.

Children and teens

Children need a balanced nutritious diet so that their teeth develop properly and are strong and decay-resistant. Eating patterns and food choices are important factors that affect how quickly tooth decay develops and could put them at risk for serious ailments, such as diabetes and osteoporosis, later in life.

The elderly

Often the elderly are at high risk for poor nutrition. Those on restrictive diets or undergoing medical treatment may be too isolated, weak or lack the appetite, time, resources or money to eat nutritionally balanced meals. This could result in tooth loss, gum disease, pain or a joint dysfunction such as temporomandibular joint (TMJ) disorder, which can impair an individual’s ability to taste, bite, chew and swallow food.

Medication

Some medications can cause dry mouth, making it difficult to chew and swallow food. This can result in a poor nutritional state that could have a negative impact on oral health.

Restrictive diets/allergies

Those with food allergies or on restrictive diets, e.g., gluten free, as well as vegetarians, particularly vegans (consuming no food or drink of animal origin) may experience vitamin and protein deficiencies. This could put them at greater risk for tooth decay and gum disease. Choosing the right food and quantities can supply the nutrients they need. Taking a multi vitamin daily is also recommended.

DIET PRACTICES TO WATCH OUT FOR

Juicing / Liquid Diets

A diet which is gaining popularity with the current detox culture is the juice cleanse. Many swear by the benefits of a juice cleanse, a three- to seven-day regimen of consuming only fruit and vegetable juices (or other concoctions with ingredients such as lemon juice and cayenne pepper), forgoing solid foods.
An all juice diet seem to make sense to the lay man, after all, fruits and vegetables are vital to a healthy diet and juice diets revolve around consuming them in a liquid form.
From an oral health standpoint, this diet presents two major problems. One, it takes all the sugar from the fruit and concentrates it into liquid form and two, it removes one of the most healthy parts of eating, chewing.
If one is not eating solid food, then one is not chewing, and chewing performs more functions than just breaking down our food. Chewing stimulates saliva production. If we are just drinking all of our calories, then there is a decrease in the amount of salivary production and as we know, saliva has a protective aspect in its functions. We need saliva to counteract the bacterial action that can lead to cavities in our mouth and to maintain a healthy pH.
Moreover, juices lack fiber and nutrients, which may even lead to stability loss as collagen fibres hold our teeth in place.
Tooth friendly solution: Advise patients to choose whole pieces of fruit and vegetables, rather than consuming them in liquid form. Crunchy fruits and vegetables can help cleanse the teeth.
Juices can be a good way to supplement a nutritious diet but should not be the majority basis of it. When consumed one must wait 30 mins till brushing their teeth, as the sugars and acids soften the enamel and if you brush straight after then brushing softened enamel can damage it.

Lemon Water / Apple Cider Vinegar

Another popular trend is of consuming Lemon Juice or Apple Cider Vinegar, both considered as ‘superfoods’ for weight loss and overall health.
If we look at our teeth, drinking an excess amount of lemon water or lemon juice can put our teeth at risk. The ph of lemon juice is about pH 2, compared to coke pH 2.5. The lower the pH of foods/ drinks the more likely they are to cause dental erosion, the thinning of enamel which exposes the dentine underneath which can contribute to dental decay, or sensitivity. The highly acidic nature of these drinks can easily lead to enamel erosion and makes teeth more prone to chipping, breaking, sensitivity, pain and cavities. The effect worsens if one chooses to brush their teeth immediately after.
Lemons no doubt have valuable antioxidants, certain headlines have claimed to help with weight loss, improved digestion, “alkalising” effect on the body, better skin & detoxification. However the research, especially human studies is minimal. If one likes the taste of lemons, then it’s a good and simple way to amp up our hydration but drinking lemons for detoxifying is unnecessary as our liver does that for us.
Tooth friendly solution: If patients choose to indulge in this regimen, then dilution of these liquids in water must be advised prior to their consumption.
Patients should be suggested to drink such concoctions with a straw. This sends it to the back of your mouth and away from your teeth.
Remind them to swish afterward with sone plain water as well.
A tip for patients to manage the acidity in their mouth is to snack on cheese, almonds or cashews that neutralise the acidity with alkalinity.
We can also prescribe such patients a fluoride mouth rinse or remineralising toothpastes for the same.

Low carbohydrate diets / High Protein Diets

Diets that cause a severe carb restriction such as Atkins, Paleo or the keto do eliminate sugars and carbohydrates which as we know are the main culprit of dental caries. These diets however can lead to dry mouth and bad breath.
Dry mouth can lead to increased plaque and risk of cavities.
High protein foods fuel the sulphur and phosphorous acid in the mouth which leads to bad breath and damage to the teeth. “Keto breath” is a common phenomenon due to the release of ketones making the breath have a peculiar acetone like odour.
Tooth friendly solution: Such diets should be advised against, unless certain medical conditions demand for them, as eliminating a total food group can never be sustainable in the long run.
For patients following low-carb diets, drinking plenty of water, using a mouthwash (without alcohol), and chewing gum or mint containing xylitol should be advised.

Vegan or Raw Food diet

Vegan and raw food diets, though inherently healthy, as they allow us to avoid unhealthy preservatives and chemicals, may also have a negative effect on oral health if not followed under correct guidance with nutrition in check.
The potential for damage from these diets comes from the high amounts of fruits, nuts and seeds. The sugar in fruit, if consumed in excessive amounts, can lead to tooth decay, as previously mentioned. Similarly, nuts and seeds can be stuck to the teeth for long periods of time, if patients are not maintaining good oral hygiene practices.
Vegan diets and “raw food only” diets typically mean that the person eats no animal products — meat, fish, cheese, milk or eggs. In that case, it’s important to find ways to get enough vitamin B-12, vitamin D, calcium and zinc, which are important for the teeth, bones, gums and tissue health. If someone develops a nutritional vitamin or mineral deficiency, it can manifest itself in the oral cavity, with symptoms like cracking and fissuring of the lips or burning tongue.
Tooth friendly solution: Patients following such diets must include foods like chia seeds, flax seeds, spinach, amaranth and fortified nuts and seeds in their diets. These foods are great for the teeth and help to keep the waistline in moderation as well.
To combat damage from nuts and seeds, sugar free gum or flossing must be made mandatory for the patient.

CONCLUSION

A healthy diet is a balanced diet. In most cases, patients start an extreme diet with the best of intentions but unfortunately, good intentions do not protect the teeth. If patients give history of indulging in any such regimes then it is our duty to counsel them against the ill effects these diets bring not only to their overall health but also to the oral cavity in particular.

REFERENCES