"Best Food for Periodontal Disease and Gingivitis"
Experimentally, if you have people stop brushing their teeth,
plaque starts to build up and within
a few days the gums start to get inflamed.
You can’t see anything yet,
but if you take a biopsy at the gum line
you can see the inflammation starting to spread,
and within a few weeks overt gingivitis
becomes apparent, where your gums can get
red, swollen, and bleed easily.
And if you don’t do anything about it,
you can develop periodontal disease,
where the inflammation creeps down into
the supporting structures of the tooth—
the bone and ligaments-- setting you up for tooth loss.
OK, but how did we get along
for millions of years without brushing?
Yeah, dental disease is almost universal these days,
but thousands of years before the invention
of the toothbrush there are skulls with perfect teeth.
Now, you can say: “yeah, but that was also
thousands of years before the invention of candy bars,”
but you don’t know until...
you put it to the test.
OK, yeah, but where are you going to find
people to not only stop brushing
but also to forgo eating processed junk?
Security guards.
That‘s how you do it.
It was one of these survivor-type TV shows
where people were forced to live under stone-age conditions;
so no toothbrushes, toothpaste, dental floss,
toothpicks, or other oral hygiene products for a month.
Now they could use a twig or something
but they were pretty much on their own.
But, no candy bars either.
They were going for about 4,000 BC;
so lots of whole grains, with supplemental salt,
herbs, honey, milk, and meat,
and then they could go out and pick berries
or see what they could catch.
So, what happened?
With no oral hygiene their plaque built up,
but their gums got healthier.
This is measuring BOP, bleeding on probing
(whether or not your gums bled when poked with a dental tool),
a measure of gingivitis;
and in almost every case they got better.
Here are before and after pictures.
Yeah, lots of plaque buildup but actually healthier gums.
How is that possible?
Well, many of the more disease-causing bacteria
seemed to have disappeared from their mouths.
They suggest this could be from the lack of refined sugars,
but they were eating honey;
so it wasn’t a a sugar-free diet.
Ah, but what they were eating was lots
of whole grains and berries rich in antioxidant phytonutrients
with anti-inflammatory properties.
So, maybe it was a combination:
sugar intake restriction combined with
the intake of really healthy foods.
Thus, all those experimental studies where people stop brushing
and their gums inevitably get inflamed
may only be applicable for people eating
lots of processed foods rich in sugar
and low in anti-inflammatory whole plant foods.
What about the role of nutrition in periodontal health?
Gingivitis can lead to periodontitis,
an inflammatory disease of the supporting tissues
of the teeth, which if untreated,
can lead to the progressive loss of the bone
that holds the teeth in place.
Now, part of the development of periodontal disease
may involve oxidative stress;
so, not only do we need to reduce our intake
of pro-inflammatory foods like refined carbs and saturated fats,
maybe it would help if we sought out foods
that are antioxidant rich.
So, is there an association between dietary vitamin C intake,
for example, with periodontitis?
Apparently so, with increasing risk of periodontitis
associated with lower levels of vitamin C intake,
but you don’t know until...
you put it to the test to figure out
what effect vitamin C depletion and supplementation
would have on periodontal health.
They basically locked everyone up for three months
so they can provide controlled amounts
of vitamin C and measures of gum inflammation
were directly related to their vitamin C status.
On about one orange worth of vitamin C
their gums improved,
but then down to 5 mg a day they got worse,
but then on 10 oranges worth a day they got better,
and then worse again when back down to 5.
Pretty convincing, though 5 mg a day is like scurvy level.
I mean we know that your gums start bleeding,
your teeth could fall out when you have scurvy
but that doesn’t mean taking extra helps.
And indeed, 1,500 mg of vitamin C a day
did not seem to help prevent gingivitis.
And even 2,000 a day failed to help periodontitis sufferers.
Maybe vitamin C is just too weak of an antioxidant?
OK, what about lycopene, the powerful antioxidant pigment
that makes tomatoes red?
It worked!
But that was from injecting the stuff directly
into the gum pocket with a syringe.
Does it work if you just eat it?
Let’s find out.
A randomized, placebo- controlled clinical trial
on the efficacy of lycopene in the treatment of gingivitis.
Two weeks of less than a single tomato-a-day’s worth
of lycopene versus placebo for two weeks
both along with the standard dental treatment,
which helped—a 10 to 20% reduction in gingivitis
in the placebo group, but nearly 30% improvement
within just one week in the lycopene group.
And this was just like the amount of lycopene
found in a teaspoon and a half of tomato paste a day.
Totally doable.
OK, so tomatoes may help with gingivitis.
What about periodontitis?
Another randomized, double-blind, placebo-controlled trial
again treated with usual dental cleaning
plus either that one tomato-a-day’s worth
of lycopene or a placebo for two months and…
significant improvements in plaque gingivitis and bleeding,
though not probe pocket depth and clinical attachment.
You can see the difference.
See how much better their gums look.
They conclude that supplementation with lycopene
seems to have augmented the healing sequence
of inflamed gingival tissues.
OK, but that was with a whole tomato’s worth a day.
How about half-a-tomato’s worth,
or just three-quarters of a teaspoon
of tomato paste worth of lycopene a day?
it didn’t work, no difference,
so looks like you have to go the whole tomato.