How to Treat Periodontitis with Diet

How to Treat Periodontitis with Diet

“How to Treat Periodontitis with Diet” What’s the effect of nutrition
on periodontal disease? Periodontal disease is a
bacterial infection that results in inflammatory destruction of
the connective tissue and bone that supports the teeth, and is therefore one of the leading
causes of our teeth falling out. Like most infections though, how our
body responds may play a critical role. Yes, the presence of bacteria
is the primary cause, but a susceptible host is also
necessary for disease initiation. The standard explanation of periodontal
disease is the plaque theory: the buildup of plaque leads to
gingivitis, gum inflammation, which leads to periodontitis,
inflammation lower down beneath the gums.
But in some forms of periodontal disease plaque
doesn’t appear to play a critical role. Therefore, in the last few years,
there’s been more interest in the importance of systemic
health, our body’s response. In this respect, nutrition may
be of great importance since it’s been implicated in a number
of other inflammatory diseases, all of which carry elevated
periodontal disease risk. Traditionally, when we think of the
effects of nutrition on dental diseases, we’re only thinking about cavities. However, there’s been less research on
the role of diet in periodontal diseases. Well, if it’s about inflammation, one
would expect saturated fat-rich diets to make things worse,
increasing oxidative stress as well inflammation,
so we may want to cut down on saturated fat.
But, look, let’s not just speculate. I mean is there an association between
cholesterol levels and periodontitis? If not, it would be hard
to implicate saturated fat. But no, there does
appear to be a link. Those with high cholesterol do
appear to have up to double the risk. What about periodontal
conditions in vegetarians? A 100 vegetarians versus
non-vegetarians were studied, and those eating vegetarian did
have better periodontal conditions (less inflammation signs,
less periodontal damage, and better dental home care). However, it should be
considered that vegetarians may not just be avoiding meat, but are healthier in other ways,
like better dental home care. But do people who eat more
saturated fat get more periodontitis? Yes, about double the risk at
the highest levels of intake, and this study was in Japan
where they eat less than half the meat and dairy
compared to the US. The only way to know for sure, though,
is to do an interventional trial where you change people’s
diets and see what happens. In other words, you
have to put it to the test. And bone loss was indeed
magnified by a diet high in saturated fat
and cholesterol. But if you’re thinking, hmm…
that’s a weird-looking jaw, that’s because it was
a study done on rats. This is what I was looking for, though
the title kind of ruins the suspense. “A high-fiber, low-fat diet improves
periodontal disease markers” in terms of probing depth,
clinical attachment loss, and bleeding on probing—
all the standard measures. And, of course, eating a healthier diet,
body weight, blood sugar control, and systemic inflammation
improved as well. Ah, but that complicates things. Maybe their mouths got better just
because they lost so much weight? You can improve
periodontal disease with just bariatric surgery,
like stomach stapling. Well, after eight weeks on the diet,
they went back on their regular diet and so gained most
of that weight back, but the periodontal disease
improvements persisted, suggesting that it was more than just the weight
loss that lead to the improvements. They’re thinking maybe the high-fiber
diet altered their good gut flora, or maybe their oral flora?
What exactly was going on? Well, German researchers
took 20 women with mild to moderate chronic periodontitis, and for a year tried
to transition their diets towards more wholesome nutrition,
meaning more plant foods, more whole foods, more fresh foods,
trying to center their diets around vegetables and fruit,
whole grains, potatoes, and legumes—beans, split
peas, chickpeas and lentils. And after 12 months, the patients
showed a significant reduction of probing pocket depth,
gingival inflammation, and measured for the first time
decreased concentrations of inflammatory chemicals inside the
crevice between the tooth and gums, which are thought responsible
for the tissue destruction in periodontal disease, a
decrease by as much as 75%. And all the while, their oral
hygiene status didn’t change, suggesting it was
the diet that did it. But what was missing here?
A control group. But there’s never been any randomized,
double-blind, placebo-controlled trials of diet for periodontal disease
until now, which we’ll cover next.

30 thoughts on “How to Treat Periodontitis with Diet

  1. Are there any studies on the affects of eating a lot of fruit in the diet? I am developing very sensitive teeth, and my dentist keeps telling me it's from an acidic diet (eating fruit). I don't eat refined sugar in my daily diet. I eat about 2-3 serving of whole fruit per day (no smoothies).
    I do rinse my mouth out with water directly after eating fruit, but this doesn't seem to be helping much.

  2. im 66 had this problem a long time, i have been vegan for 2yrs, 8mths ago i had an attack of this disease, i awoke one morning with loose skin in my mouth, during research i discovered ,s,l,s [sodium laurel sulfate ] which is used for creating froth in tooth paste, i found a tooth paste which is s,l,s free, and ;bingo; my mouth is not totally cured , but there is a marked difference, my disappointment is not ever being told by a dentist that s,l,s can have a detrimental reaction on my gums,

  3. Dentistry is the next profession to just get blown to smithereens. Let's scrape all this stuff off and have you put toxins down into this portal constantly to keep badies away. Wow, that is so dumb, yet it's still SOP everywhere. Learning about the microbiome has not metastasized yet.

  4. Uuhhhh. Ehhhhhh. Uhhhhhhhhh. Ehhhhhhh. Uhhhhhhh ehhhhhhhh. Uuhhhhhhhhh. Ehhhhhhhhh.
    You know what I’m talking about uhhhhhhhh. Ehhhhhhhh.

  5. I know this is anecdotal…I started a 12 daily dozen style, whole-food, planet-based diet 3 years ago. It has done wonders for my weight & energy. I make sure to supplement B12, Omega 3, D, Zinc & Magnesium. I'm almost 40 and I'm now in the best shape of my entire life. However, 1.5 years after starting my new diet I developed periodontal disease…basically I'm suffering from bone loss and gum recession. I have great oral hygiene habits and have never had a problem in the past. I believe the diet is causing this. I won't stop my diet however, because so far the other benefits have been great for me. I've done some reading online and it appears other planet based dieters have had similar issues. What I don't get is that I'm very careful with my diet…I follow the daily dozen religiously. Any advice anyone?

  6. I have periodontal disease so it's going to be interesting to see what part 2 is like. I have noticed since going vegan, I've had much less issues with it though.

  7. I had gingivitis for 20 years Dentist couldn’t improve it – went vegan and became more alkaline my sweat didn’t sting my eyes anymore and no more bleeding gums!!! Others I have converted to vegan have had the same result

  8. Many indigenous tribes found around the world never used or had toothbrush/floss/paste ect.. yet perfect set of teeth. Explain? Those who say you need to brush/floss are full of it.

  9. Please make a video on what kinds of breads to eat. Also, huge thank you for making these videos Dr. Greger. I'm honestly really grateful.

  10. I have been on a WFPB diet for just over a year and had a dentist visit this month. I was shocked at the lowering in measurements from hearing 7s and 8s to mostly 0s.
    I had been told by my dentist that it is incurable and that I could only slow it down but eventually would lose my teeth. Dentists are so unaware of diet benefits.

  11. awesome video, I hope we can have more on tooth health from dr greger, if you want to help your teeth for a good oral hygiene regiment then using a range of tools is important, a decent tooth powder is great and a all natural toothpaste also E.O.s can be good, salt water rinse after eating, you can get some awesome products for your oral health

  12. When i took on a vegan diet a year ago, i had shocking problems with inflamation abcesses pockets, my dentist said i was to just live with it and visit him every 3 months,well after 3 months of eating vegan every problem went away!! And lots of other things did too!! I see him once a year for a clean now, I never expected that to happen, its wonderfull!!!😊

  13. Dr Greger – you should change your title. It is misleading. It should say how to "help prevent" instead of treat. I'm a dentist and we see patients with periodontal disease- lots of calculus stuck to the roots of their teeth and bone loss. The treatment, which every dentist and hygienist in the world knows, is to scale the calculus off. So you can't "treat" by saying follow this video, the calculus will come off. This video talks about treatment. Misleading. You should title it something else. I'm disappointed in you Dr. Greger. Don't help uneducated people misunderstand the basics of dentistry.

  14. While you are trying to give dental advice to people, you should mention that people should floss to clean the sides of the teeth where the toothbrush cannot reach. Either give complete dental advice and real advice on actual treatment of perio, or stay in your lane. I don't want my patients to believe they can treat perio themselves with diet. Diet won't be physically removing hardened calculus stuck to the teeth below the gums. The title of this video is truly misleading and disappointing

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