Natural Dental Care

July 7, 2009 Written by JP    [Font too small?]

A heartfelt smile doesn’t just convey contentment and warmth, it’s also an external sign of health. Like most other measures of wellness, genetics do play a roll in the shape, size and the whiteness of our teeth. We’re all aware of the commonly prescribed oral care basics. But there are also some emerging trends that are sprouting up in medical literature that I think you should know about. Besides regular brushing and flossing, there are a few additional steps that you can take to improve the status of your breath, gums and smile.

In the past, I’ve written about a natural sugar alcohol called xylitol that may help reduce the incidence of cavities and generally promote a positive oral environment. A new study published in the Archives of Pediatrics & Adolescent Medicine is the most recent piece of evidence to support such claims. This particular trial was conducted on a group of 94 boys and girls with ages ranging from 9-15 months. The group was divided into three segments: 1) received xylitol syrup twice daily; 2) received the syrup three times a day; 3) the final group received a much smaller amount of xylitol only once a day – this group was used as the control/placebo in the study.

After a 10 month period, it was determined that 24% of the twice daily group experienced some degree of tooth decay. 41% of the three times daily group demonstrated decayed teeth. The worst results were found in the low dose/placebo group (52% exhibited tooth decay). The average number of decayed teeth was .6 in those receiving the twice daily xylitol, 1 tooth in the 3 times daily users and 2 teeth in the control group.

The authors of the research concluded that, “Our results suggest that exposure to xylitol (8 grams per day) in a twice daily topical oral syrup during primary tooth eruption could prevent up to 70 percent of decayed teeth.” (1) Another trial, also from July 2009, found that xylitol lozenges can also help to maintain good oral health in young children (18 months to 5 years of age). (2)

While doing my periodic review of what’s new and interesting in the natural health marketplace, I’ve noticed that there are now some probiotic lozenges that are being marketed to support oral health. Some of these products contain xylitol, in part because of its dental benefits, but also because of its naturally sweet taste. The research behind the probiotic lozenges has been around for several years. (3,4,5,6,7,8) The most recent study was presented in the June 2009 issue of the Journal of Clinical Periodontology. In that trial, 66 patients with advanced gum disease were assigned to use either a probiotic/xylitol lozenge or a placebo for 8 weeks. At the 4 and 8 week mark, oral samples were studied for select bacteria that are known to contribute to periodontal disease. The researchers discovered that several types of “periodontopathic bacteria” were significantly reduced in the probiotic/xylitol lozenge users. These changes could very well contribute to an improvement in gum health. The specific strain of healthy bacteria used in this trial goes by the name of Lactobacillus salivarius. (9)

The use of strategically applied probiotics and xylitol appears to be an effective, natural and safe approach to improving an assortment of dental and gingival issues. But if we leave out the role that diet can play, we’re missing a big part of the picture. Here’s a brief review of several new studies that offer clues about what foods to eat if we want to maintain a healthy smile.

  • The most recent issue of the Journal of Periodontology features a fascinating study about the effects of a “Stone Age diet” on oral hygiene. This type of diet focuses primarily on animal sourced protein, some fruits and vegetables, nuts and seeds. In this experiment, 10 participants lived in a controlled environment and were provided with Stone Age meals for a 4 week period. Tests were conducted on their gum integrity (“bleeding on probing” and “probing depth”), plaque levels and oral bacterial counts. The health of volunteers’ gums improved significantly after the 4 week dietary shift. There was, however, an increase in plaque and oral bacterial levels that were not linked to gum disease. The bacterial population of the tongue decreased. It’s important to note that these volunteers did not practice modern oral hygiene. They really did live like our ancestors and still managed to improve their oral environment. (10)
  • A recent 6 year population study examined the effect of diet on “dental caries and periodontal disease” in a group of 600 Japanese seniors. The consumption of dark green and yellow vegetables provided a protective effect to both gums and teeth. (11) Alcohol consumption and sugar intake were positively associated with a greater rate of oral complications. The negative effects of sugar probably come as no surprise. But frequent alcohol drinkers should be aware of the potential for an increased risk of dental problems. (12,13,14)
  • Diet may also play a role in the natural management of inflammatory gum disease. A recent experiment in monkeys discovered that a low calorie diet/caloric restriction could dramatically reduce inflammation and the progression of gum destruction typically associated with periodontal disease. The anti-inflammatory effects demonstrated here may also be applicable to other conditions that are characterized by chronic inflammation. (15)

Even if you’re blessed with good oral health, you may want to consider incorporating xylitol based gums and mints into your daily routine as a preventive measure. Including foods rich in antioxidants such as green and yellow vegetables, probiotics in foods such as kefir and yogurt, and focusing on whole, unprocessed menu selections can support many aspects of health. By incorporating these strategies, you’ll likely have more reasons to smile and a healthier looking smile to present to the world.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

Be well!


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Posted in Alternative Therapies, Dental Health, Nutrition

8 Comments & Updates to “Natural Dental Care”

  1. JP Says:


    I can relate to your frustration. That’s part of the reason why I add footnotes to each column I write. That way, anyone who reads it can find the source material which I base my content on.

    Be well!


  2. jonathan Says:

    “careful with the food you eat” for your dental health

  3. JP Says:

    Update 05/18/15:

    Ann Epidemiol. 2015 Apr 18.

    Higher vitamin D intake during pregnancy is associated with reduced risk of dental caries in young Japanese children.

    PURPOSE: The intrauterine environment, including maternal nutrition status, may affect the development, formation, and mineralization of children’s teeth. We assessed the relationship between self-reported maternal dietary vitamin D intake during pregnancy and the risk of dental caries among young Japanese children.

    METHODS: This study is based on a prospective analysis of 1210 Japanese mother-child pairs. Information on maternal intake during pregnancy was collected using a validated diet history questionnaire. Data on oral examination at 36-46 months of age were obtained from the mothers, who transcribed the information from their maternal and child health handbooks to our self-administered questionnaire. Children were classified as having dental caries if one or more primary teeth had decayed or had been filled.

    RESULTS: Compared with the lowest quartile of maternal vitamin D intake during pregnancy, adjusted odds ratios (95% confidence intervals) for quartiles 2, 3, and 4 were 1.06 (0.72-1.56), 0.53 (0.34-0.81), and 0.67 (0.44-1.02), respectively (P for trend = .01). When maternal vitamin D intake was treated as a continuous variable, the adjusted odds ratio (95% confidence interval) was 0.94 (0.89-0.995).

    CONCLUSIONS: Higher maternal vitamin D intake during pregnancy may be associated with a lower risk of dental caries in children.

    Be well!


  4. JP Says:

    Updated 11/10/15:

    J Clin Periodontol. 2015 Nov 9.

    Java project on periodontal diseases: effect of vitamin C/calcium threonate/citrus flavonoids supplementation on periodontal pathogens, CRP and HbA1c.

    OBJECTIVE: To assess in a periodontally diseased rural population deprived from regular dental care and having poor dietary conditions, the effect of vitamin C/calcium threonate/citrus flavonoids (VitC/Ca/Fl) supplementation on subgingival microbiota and plasma levels of vitamin C, HbA1c and hsCRP.

    MATERIAL & METHODS: The study population consisted of 98 subjects who previously participated in a prospective study on the natural history of periodontitis. Participants were instructed to consume one tablet/day containing 200mg Ester C® calcium ascorbate, 25mg calcium threonate and 100mg citrus flavonoids for 90 days. Following parameters were evaluated: prevalence/amount of seven traditional periodontal pathogens, cytomegalovirus, Epstein Barr virus (EBV); and plasma levels of vitamin C, HbA1c and hsCRP.

    RESULTS: After VitC/Ca/Fl supplementation, 100% of subjects showed normal plasma vitamin C values compared to 55% before. At baseline, 48% of subjects harbored A. actinomycetemcomitans, >97% the other periodontal pathogens and 73% EBV. Supplementation with VitC/Ca/F reduced the subgingival load of all studied bacteria (p-values: 0.014-0.0001) and EBV (p<0.0001) substantially in all initially positive subjects. Plasma levels of HbA1c and hsCRP dropped in all subjects (p<0.0001).

    CONCLUSION: This uncontrolled study suggested that supplemental VitC/Ca/Fl may be helpful in reducing subgingival numbers of periodontal pathogens and EBV, and promoting systemic health.

    Be well!


  5. JP Says:

    Updated 12/16/15:

    Int J Clin Pediatr Dent. 2015 May-Aug;8(2):114-8.

    Comparative Evaluation of the Effects of Fluoride Mouthrinse, Herbal Mouthrinse and Oil Pulling on the Caries Activity and Streptococcus mutans Count using Oratest and Dentocult SM Strip Mutans Kit.

    BACKGROUND: As the technological level of healthcare increases, it is important not to lose sight of the basics of patient care. No matter how sophisticated dental techniques have become, preventive dentistry still remains the foundation for oral health. Therefore, antimicrobial mouthrinses are developed to provide an effective means of preventing colonization by micro-organisms.

    AIM: The aim of this study was to evaluate and compare the antimicrobial activity of oil pulling, herbal mouthrinses and fluoride mouthwash on the caries activity and S. mutans counts in the saliva of children, using Oratest and Dentocult SM kit.

    DESIGN: Fifty-two healthy children between the age group of 6 to 12 years were selected for the study and divided into four groups based on the mouthrinse used as group 1: fluoride, group 2: herbal, group 3: oil pulling and group 4: control. The estimation of caries activity and S. mutans was done prior to and after the subjects were instructed to use the mouthrinse twice daily for a period of 2 weeks.

    STATISTICAL ANALYSIS: The comparisons were made by applying paired ‘t’ test with the level of significance set at p < 0.05. Difference between more than two mean values was done by using ANOVA and Post hoc Bonferroni test was used for multiple comparisons. RESULTS AND CONCLUSION: The efficacy of fluoride and herbal mouthrinses was found to be comparable while oil pulling did not provide any additional benefit to be used as an effective antimicrobial agent in reducing the bacterial colonization of an individual. Be well! JP

  6. JP Says:

    Updated 1/18/16:

    J Dent Res. 2016 Jan 8.

    Probiotic Compared with Standard Milk for High-caries Children: A Cluster Randomized Trial.

    The aim of this study was to compare milk supplemented with probiotic lactobacilli with standard milk for the increment of caries in preschool children after 10 mo of intervention. The study was a triple-blind, placebo-controlled randomized trial. Participants were children aged 2 and 3 y (n = 261) attending 16 nursery schools in a metropolitan region in Chile. Nursery schools were randomly assigned to 2 parallel groups: children in the intervention group were given 150 mL of milk supplemented with Lactobacillus rhamnosus SP1 (107 CFU/mL), while children in the control group were given standard milk. Interventions took place on weekdays for 10 mo. Data were collected through a clinical examination of participants. The primary outcome measure was the increment of caries in preschool children. This was assessed using the International Caries Detection and Assessment System (ICDAS). The dropout rate was 21%. No differences in caries prevalence were detected between the groups at baseline (P = 0.68). After 10 mo of probiotic intake, the caries prevalence was 54.4% in the probiotic group and 65.8% in the control group. The percentage of new individuals who developed cavitated lesions (ICDAS 5-6) in the control group (24.3%) was significantly higher than that in the probiotic group (9.7%). The increment of dental caries showed an odds ratio of 0.35 (P < 0.05) in favor of the probiotic group. At the cavitated lesion level, the increment of new caries lesions within the groups showed 1.13 new lesions per child in the probiotic group compared with 1.75 lesions in the control group (P < 0.05). The probiotic group showed an increment of 0.58 ± 1.17 new lesions compared with 1.08 ± 1.70 new lesions observed in the control group. The difference in caries increment was significant at the cavitated lesion level (P < 0.01). In conclusion, the regular long-term intake of probiotic-supplemented milk may reduce caries development in high-caries preschool children ( NCT01648075). Be well! JP

  7. JP Says:

    Updated 06/28/16:

    BMC Complement Altern Med. 2016 Jun 7;16(1):171.

    Adjunctive use of essential oils following scaling and root planing -a randomized clinical trial.

    BACKGROUND: Hitherto no study has been published on the effect of the adjunctive administration of essential oils following scaling and root planing (SRP). This study describes the effect of a mouthrinse consisting of essential oils (Cymbopogon flexuosus, Thymus zygis and Rosmarinus officinalis) following SRP by clinical and microbiological variables in patients with generalized moderate chronic periodontitis.

    METHODS: Forty-six patients (aged 40-65 years) with moderate chronic periodontitis were randomized in a double-blind study and rinsed their oral cavity following SRP with an essential oil mouthrinse (n  =  23) or placebo (n  =  23) for 14 days. Probing depth (PD), attachment level (AL), bleeding on probing (BOP) and modified sulcus bleeding index (SBI) were recorded at baseline and after 3 and 6 months. Subgingival plaque was taken for assessment of major bacteria associated with periodontitis.

    RESULTS: AL, PD, BOP and SBI were significantly improved in both groups after three (p   <   0.001) and 6 months (p   ≤   0.015). AL improved significantly better in the test than in the control group after 3 and 6 months (p < 0.001), so did PD after three months in the tendency (p  =  0.1). BOP improved better in the test group after 3 months (p  =  0.065). Numbers of Treponema denticola (p  =  0.044) and Fusobacterium nucleatum (p  =  0.029) decreased more in the test than in the control group after 3 months, those of Tannerella forsythia after 6 months (p  =  0.039). Prevotella micra (p  <  0.001, p  =  0.035) and Campylobacter rectus (p  =  0.002 , p  =  0.012) decreased significantly in both groups after 3 months. CONCLUSIONS: The adjunctive use of a mouthrinse containing essential oils following SRP has a positive effect on clinical variables and on bacterial levels in the subgingival biofilm. Be well! JP

  8. JP Says:

    Updated 03/27/19:

    Oral Dis. 2019 Mar 26.

    The Influence of Vitamin D Supplementation on Local and Systemic Inflammatory Markers in Periodontitis Patients: A Pilot Study.

    OBJECTIVES: Vitamin D deficiency/insufficiency is a worldwide public health issue that has been linked to numerous inflammatory disorders, including periodontitis. There is increasing support for a role for adequate vitamin D levels in overall health. Populations with darker skin color have a higher prevalence of vitamin D deficiency/insufficiency and periodontitis. The purpose of this small pilot study was to investigate the influence of 12 weeks of 25(OH)D vitamin D supplementation on mediators of systemic inflammation in dark-skinned, periodontitis patients.

    MATERIALS AND METHODS: A total of 23 patients with moderate to severe periodontitis were randomly assigned to the vitamin D group or Placebo group and received intensive single visit scaling and root planing to elicit a systemic inflammatory response.

    RESULTS: Vitamin D supplementation (VDS) increased serum 25(OH)D levels approximately 2-fold over baseline levels; moreover, VDS group had reduced peripheral blood CD3 and CD3+CD8+ cytotoxic T lymphocyte (CTLs) counts and reduced pro-inflammatory salivary cytokines. In contrast, VDS group had higher levels of the autophagy-related proteins and other proteins crucial for anti-microbial autophagy in whole blood PBMCs.

    CONCLUSION: In conclusion, vitamin D supplementation has multiple benefits for reducing systemic inflammation and promoting induction of autophagy related proteins related to anti-microbial functions.

    Be well!


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