After my last post about teeth issues I experienced whilst following a plant-based diet and how I healed my teeth after veganism, I wanted to explain in more detail how to eat for healthy teeth. This is not something that gets talked about enough in the nutrition world and dietary advice is usually simplified to “eat less sugar and acidic foods” which is absolutely not enough to maintain healthy teeth.
Tooth decay and de-mineralization
Modern dentistry usually puts the blame for tooth decay on bacteria in the mouth which feed on sugars in the diet and cause cavities. However, this is only part of the picture and a major component has been forgotten! That is that in order for bacteria to attack the teeth, a weakness needs to already be present. To understand this, we need to look at the structure of the teeth:
- The enamel layer on the outside of your tooth is what gives them a white colour and shiny, hard appearance. It is made up of minerals, primarily calcium-phosphate
- The dentin layer is less hard than enamel but also made up of calcified minerals. It usually has a yellow or grey colour. If the dentin is more exposed, you can experience tooth sensitivity and less white colour
- The pulp contains all the nerves and blood and is the most sensitive part of the tooth.
Strong enamel protects the dentin below from acid erosion and bacteria attacks. But enamel itself can also be worn down by acid, grinding the teeth or if minerals are leached from the teeth in a process called demineralization. Generally, minerals are constantly being lost and replaced via the blood supply to the tooth pulp and also the saliva. If the rates of mineralization and demineralization are equal, we have a stable tooth condition. In tooth decay, demineralization is generally occurring at a faster rate. Once enamel is worn down, it cannot be reformed but minerals can be deposited to strengthen the dentin and enamel layer. To heal the teeth we need to increase the rate of remineralization (more on that later).
Dietary causes of tooth de-mineralization and decay
In the 1930s, a dentist called Weston A Price discovered another theory for tooth decay. He studied indigenous people and found that many tribes living on traditional diets did not experience tooth decay, despite not having access to modern dental care and in some cases not even brushing their teeth! Once they switched to a more modern diet including refined carbohydrates and processed foods, they started to develop cavities and other dental issues. According to Price, there are three main dietary causes of tooth de-mineralization and decay:
- Inadequate amounts or imbalanced ratio of minerals (mainly calcium and phosphorous)
- A lack of fat-soluble vitamins (primarily vitamins A and D)
- Imbalanced blood sugar levels
As teeth and bones are made of similar material and go through the same process of building up and breaking down, these factors also play a major role in bone mineral density. Two key minerals for maintaining healthy bones and teeth are calcium and phosphorous. Calcium is a key component of enamel which gives the teeth strength and protects from decay. Phosphorous helps the body absorb calcium and also helps to release energy from food. The ratio of these nutrients in the blood is also important.
Fat soluble vitamins A, D, E and K are those that need fat to be present in order to absorb and store them in the body. They are also generally found in fat-containing foods such as dairy, meat or nuts and seeds. For healthy and strong teeth, vitamin A and D are particularly important. Vitamin A supports healthy saliva production which is important to maintain a neutral pH in the mouth and to kill harmful bacteria. It is also forms keratin in the tooth enamel layer and the gums. Vitamin D also helps with calcium absorption and plays a key role in remineralizing of teeth and bones.
Blood sugar stability is also important because high blood sugar levels trigger leaching of minerals such as calcium from the bones to neutralize the blood. Constant snacking or bingeing on sweet foods or processed carbohydrates as well a diet inadequate in protein and fat can lead to chronically high blood sugar or instability with peaks of high and low blood sugar several times throughout the day. This could be experienced as erratic energy levels, energy crashes throughout the day, constant or sudden hunger and cravings for sweet foods.
How a vegan diet can lead to tooth decay
Based on the above three factors, we can easily see how a vegan diet can lead to tooth demineralization and tooth decay. Let’s consider a typical, healthy vegan diet made up of primarily whole foods: fruits, vegetables, starchy carbohydrates, legumes and nuts/seeds. Plant-based sources of calcium could include fortified dairy-alternatives such as soy or almond milk, green leafy vegetables, beans, tofu and sesame seeds (tahini). With some attention, it is fairly easy to get enough calcium from consuming these foods as long as you are consistent day to day. The problem I see is in three areas: incomplete digestion, detoxification and the high carb low fat trend.
Firstly when it comes to digestion, you are not what you eat but what you digest and assimilate. By this I mean just because the foods you eat contain enough calcium, it doesn’t mean that your body is able to extract and use all of that calcium. Plants contain certain compounds which bind to minerals in particular making them more difficult to absorb. The bio-availability of nutrients in certain plants is therefore lower than in animal products meaning that you need to eat more to meet your nutritional needs. Many plant-based dieters are not aware of this and can unknowingly consume below their nutritional needs for a long period of time. Because we have a certain amount of nutrient stores in our body, it can take months or even years for deficiencies and symptoms to arise, at which point it becomes difficult to question the diet which has “worked” for so long.
Another common mistake with vegan and plant-based diets is the idea that we need to be detoxing or cleansing on a long-term basis. I am all for short-term cleanses to support the body e.g. on an annual or seasonal basis but I see many vegans attempting to live in a state of detox and this is a recipe for mineral deficiencies in particular. For anyone in the detox world, you may be familiar with the problems of tooth sensitivity, decay and even tooth loss than can occur with heavy detox. Rather than being just a part of the detox process, I see this as a major flag that the detox has been too prolonged and a period of rebuilding with mineral rich foods is essential to support the body.
Finally, there is also the risk of deficiencies in fat soluble vitamins that can occur with high carb low fat vegan diets. By nature, vegan diets are higher in carbohydrates and lower in fat compared to omnivorous diets and some plant-based doctors recommend as low as 5% fat in the diet for optimal health. Vegan diets particularly are low in saturated fats as all sources of meat and dairy are avoided and the only real source of saturated fat on a vegan diet would be from coconut. Without adequate fat in our diet, we cannot absorb fat soluble vitamins A, D, E and K. It is also not possible to obtain vitamin D from plants (other than a small amount in mushrooms) and therefore supplementation is necessary. Vitamins A and K are present in plant-based diets but they are again found in a different and less usable form compared to retinol and vitamin K2 found in animal products.
The best diet for healthy teeth and tooth healing
The UK national dietary guidelines suggest for adults aged 19-64 we should be consuming a minimum of 700mg of calcium and 550mg of phosphorous per day from either plant or animal sources. The recommended daily amount of vitamin A is 700mg (2300IU) for men and 600mg (2000IU) for women, for vitamin D it is 10mg (400IU). This can easily be achieved by following the Eat Well Plate and including a variety of foods in your daily diet. However, if you already are experiencing tooth demineralization or decay, these minimum intakes may not be adequate. In his book Cure Tooth Decay, which is based on the work of Weston A. Price, Ramiel Nigel proposes the nutrient intakes below to support tooth repair and remineralization which are significantly higher than our dietary guidelines recommend!
He recommends consuming foods from several categories on a regular basis for overall health, including for supporting healthy and strong teeth:
- Full or half fat dairy such as milk, cheese, yoghurt, butter
- Fish and sea food (especially small fish with bones such as sardines)
- Organ meats (including liver 1x per week)
- Bone marrow and broths or stews
- Variety of green vegetables (cooked or raw depending on tolerance)
- Moderate amount of cooked fruit and 1 glass orange juice per day
He also recommends to supplement with 1/2 tsp butter oil and 1/2 tsp cod liver oil daily.
You can use a food tracking app such as Chronometer to get a rough idea of your daily nutrient intakes and where you could be falling short. As an example, to consume approximately 1.5g of calcium you could include: 1c fortified cereal, 1c milk, 1c yoghurt, 1/2c ricotta cheese, 1c broccoli, 1c cooked greens, 1tbsp tahini, 1tbsp blackstrap molasses and 1 portion steamed salmon. You can see it’s quite a lot! You could try this as a vegan but you would need to ensure you are eating several portions of fortified dairy alternatives per day and exchange the salmon with 1/2c tofu or a whole cup of beans.
For blood sugar balancing, it is recommended to eat meals containing all three macro-nutrients as well as fibre. Fats, protein and fibre help to slow down the digestive process and rate of absorption of carbohydrates (glucose) into the blood stream. This prevents blood sugar spikes and crashes and maintains even energy levels as well as preventing mineral leaching from the teeth and bones. You can play around with the macro-nutrient ratios and see what supports your optimal mood and energy levels but try to incorporate at least some fat and protein at each meal or snack.
A note on fruit.. whilst fruit contains fibre and has a lesser effect on blood sugar levels compared to processed carbohydrates and sweets, it is still a high glucose food and can lead to blood sugar spikes if consumed alone or in too high quantities, especially dried fruits or juices. As there are so many health benefits from including fruit in your diet, I don’t recommend cutting it out completely unless your teeth are in a very serious condition. I usually recommend to my clients to consume fruit as part of a meal or if eaten as a snack to combine with raw vegetables or protein/fat source such as cheese or nuts for better blood sugar balancing. It is also helpful to neutralise your mouth after eating sweet or acidic foods such as fruit by rinsing with water or salt water.
Meal ideas for healing tooth decay
- Full fat yoghurt with stewed fruits and seeds
- Sardines on whole grain toast
- Porridge made with 2% milk and blackstrap molasses
- Smoothie with kefir, berries and 1 tbsp cocoa powder
- Meat and vegetable stew
- Green vegetable omelette cooked in butter
- Liver and onions with rice or potatoes
- Salad with olive oil dressing chickpeas
- Vegetable and tofu curry
- Roasted sweet potato with broccoli and tahini sauce
- 1 apple or 1c grapes with cheese
- 1c orange juice with 2 boiled eggs
- Fruit with 1c cucumber or celery
- 1c milk with 1tbsp blackstrap molasses
My experience shifting from a plant-based diet
For anyone like me in the past who is currently following a vegan or plant-based diet, reading this can come as a shock. I know, I was there. I was convinced that a vegan diet was the healthiest and most sustainable way to eat and that animal products were toxic and should be avoided. Honestly, it took me several years, including studying for a degree in Public Health Nutrition and doing my own research and experimentation to realize that yes we can survive on a vegan diet but not everyone can thrive.
I really wasn’t thriving on a vegan diet so in the end it was not difficult to reintroduce animal products, once I had made the mental shift. I was expecting to struggle with digestive issues after not eating meat and dairy for so long but honestly, it felt like my body absorbed them right away. The first few meals with fish and cheese tasted amazing and the craving that had been suppressed for so long (making me feel like I didn’t miss or need animal products) finally resurfaced. I started to have more energy and mental clarity and just feel more like myself which was not something I thought could be impacted by the diet.
If you are suffering from tooth decay or demineralization on a vegan diet, take it as a sign that you are not getting everything that you need from your food. It’s very common to experience black and white thinking and feel like it is either fully vegan or nothing when in reality there is a spectrum. It is possible to follow a mostly plant-based diet and add in some of the above foods and meals to give your body a healthy dose of concentrated nutrition. I did introduce things gradually over a period of two years and for a long time my diet was mostly plant-based. Even now I eat a lot of plant-based foods but I would consider myself a true omnivore and I make sure to eat at least dairy every single day!
Healing teeth on a vegan diet
I really didn’t start to see improvements in my teeth until I went all in and consumed dairy every day and ate meat and fish more regularly. But if after reading this you are still determined to remain vegan, here are a few tips on how to eat for healthy teeth as a vegan. Something which helped prevent further deterioration of my teeth was cutting back on some of the foods which I thought were contributing to my dental problems including oats, dried fruit and acidic fruits. Now I have added them back in without seeing any reversal of the progress with my teeth but in the beginning it was necessary to keep them to a minimum.
You can also make sure to include high calcium sources mentioned such as tofu, tahini, blackstrap molasses and green vegetables along with plenty of plant fats to help with absorption. Avoid restrictive diets or cleanses and really focus on eating balanced meals which support blood sugar stability. You can also consider taking a vegan calcium supplement but always consult with your doctor first as with any medication. The most important thing overall is to listen to your body rather than your mind when it comes to making food choices. Our bodies are extremely intelligent and know what they need to remain healthy and balanced, we just need to remember how to listen!
Over to you…
I really hope this post helps any of you who are struggling with teeth issues after veganism or any other restrictive diet. Please let me know if you found these tips and information useful or if you have any questions. Like this post and follow along with my blog for more posts about nutrition and yoga for holistic health and balanced hormones!
If you are looking for guidance, support and accountability on you health journey, please contact me or check out the nutrition and holistic health coaching packages I offer. I am a qualified Public Health Nutritionist and hatha yoga teacher and my specialty is helping women to balance their hormones and heal their body and metabolism after chronic or restrictive dieting. I would love to work together with you to move past any health blocks and get you feeling your best again!