With the popularity of Veganuary booming, Dr Maria Papavergos explores this choice from an oral health perspective.
A vegan diet is often thought of as a nod towards leading a healthier lifestyle. That a completely plant-based diet is full of positives for oral health.
Nutrition is vital to oral health. Its influence extends to our inflammatory and immune status and is directly linked with the periodontal status.
Oral health has a well established association with overall health. For example periodontal disease pushes up the risk of cardiovascular disease, Alzheimer’s and diabetes. Additionally there is emerging evidence in the role of the oral microbiome in both pregnancy outcomes and gut health.
The vegan lifestyle
But is also has huge effects on our teeth and gums. And when it comes to oral hygiene, evidence does suggest that vegans are doing it better.
An interest in living a healthy life comes an interest in oral health practices. Brushing and flossing are likely to feature meticulously. The question we need to ask is: ‘Does the patient use a fluoride toothpaste?’.
Vegans are more likely to choose natural toothpastes, which are often fluoride free. Fluoride is still vital for caries prevention, so this could be a potential downfall in achieving good oral health.
When it comes to lifestyle, again vegans score quite highly.
Vegans are less likely to to smoke, drink alcohol or consume highly-sugared beverages. This bodes well for their oral health.
It is the apparent 'healthy' choices that may cause a well-meaning vegan to stumble.
An increased consumption of masked sugars can easily take place. For example these are present in fruit juices and smoothies.
Lemon in hot water – often packaged as a ‘detox’ drink – can appeal to vegans or those adopting healthy choices. Often, this is regularly consumed without any consideration to the erosive effects.
This potential increase in risk of caries and tooth surface loss falls on the responsibility of our profession to educate and inform patients, from both a mindful and mitigating perspective.
We can encourage practices like rinsing with a fluoride mouth rinse or chewing with xylitol chewing gym after mealtimes.
Nutrition – the pros and cons
It is known that a nurtured oral microbiome requires good macro and micro-nutrition.
A plant-rich diet will be rich in antioxidants and phytochemicals, both of which support oral and periodontal health.
Equally, foods rich in refined carbohydrates are also major cause of chronic inflammation, having a direct negative impact on periodontal health.
This ties in well for those choosing a vegan diet. But the key messages of plant variety and choosing whole grain carbohydrates need to be harnessed.
Unless guided, there are certain nutrients that vegans will easily miss out on. It is important to educate the consumer to check the label on plant-based milks, for example, and be wary of options other than those ‘unsweetened’.
Other plant-based sources of calcium include green, leafy vegetables and pulses. Sources of iodine include whole grains and green beans. A vegan diet often overlooks Omega-3 fatty acids too – evidence suggests that plant sources, such as walnuts and chia seeds, may not have the same benefits. As a result, supplementation is often appropriate.
Iron-deficiency anaemia may also occur in those following a vegan solicitor. Especially those trying Veganuary, who may usually eat red meat; a major source of iron.
Oral manifestations could include burning mouth, glossitis, increased prevalence of candidal infections or angular cheilitis.
Vegan sources of iron include pulses, nuts and dark green, leafy vegetables. Plant-based iron (non-haem) has reduced bioavailability but it can be enhanced through concurrent vitamin C consumption. This could be simply drizzling vegetables with a squeeze of lemon.
Veganuary is a great chance to experiment with more plant-based foods. But remember that an educated approach is the key to a healthy mouth and body.