Can Cavities Be Healed with Diet?
Can cutting out grains help prevent or even reverse tooth decay? Nutrition Diva explores the science and lore of remineralization.
Monica Reinagel, MS, LD/N, CNS
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Can Cavities Be Healed with Diet?
Emily writes:
“I’ve heard claims that you can remineralize your teeth and even heal cavities through certain diet and lifestyle choices. These claims usually involve cutting out grains and other foods high in phytic acid. Most of the arguments I’ve encountered so far have been anecdotal. Is there any scientific documentation of this process?”
I’ve been hearing a lot about this, too, Emily! And when I researched the topic, I was a little surprised (and pretty excited!) to learn that remineralization of tooth enamel—and even reversal of small cavities—is possible! But you don’t need to cut out grains, nuts, and beans in order to remineralize your teeth.
That idea dates back to some research done in the 20s and 30s, long before the era of modern dentistry. This was before we knew exactly how cavities (or even teeth!) were formed. Back then, one hypothesis was that cavities were caused by mineral deficiencies and that grains were largely responsible for those deficiencies, perhaps by blocking the absorption of certain nutrients. We now know pretty conclusively that this is not the case—at least, not in industrialized countries.
Those early studies were conducted in Britain, a nation not exactly renowned for its dental superiority. This was long before fluoride treatment and kids’ teeth were basically rotting in their heads. To test the theory that grains were to blame, a dentist named May Mellanby divided a bunch of school kids into groups, and put one group on a grain-free diet. That group got fewer cavities…and confidence in that hypothesis grew.
In the intervening 80 or so years, we’ve developed a much better understanding of how teeth (and cavities) form. New and better hypotheses were formed and tested, and the profession moved on–which is why you’ll be hard-pressed to find much research on cereal grains and dental caries published since about 1950.
How are teeth mineralized
You might be tempted to think of demineralization as a one way process: You start out with a certain amount of enamel on each tooth. Over time, that enamel gradually erodes and when a hole—or cavity—develops, you have to have it filled. But that’s not always how it goes.
The truth is your teeth get “demineralized” and “remineralized” several times a day. It’s a natural process that’s not quite as dramatic as it might sound. It just means that calcium and phosphate move in and out of the tooth matrix, in response to changes in the environment of your mouth.
Eating, especially foods containing sugar, tends to promote the demineralization process by lowering the pH in your mouth. But after you eat, the remineralization process begins. Saliva helps raise the pH of your mouth and bathes the teeth in calcium and phosphate ions, which re-enter the tooth matrix and reharden the enamel.
In a perfect world, the two processes are balanced and the tooth remains whole. But if your teeth are demineralizing faster than they can be remineralized, you will begin to develop cavities. So the key is to try to avoid things that speed the destructive process and do what you can to support the rebuilding process.
How to preserve (and repair) tooth enamel
1. Avoid sugar. Bacteria that reside on your mouth feed on sugar. Their metabolic by-products are acidic, which creates the perfect conditions for deminerilization and decay. And here’s something to think about: The more often you consume sugar, the more times a day your teeth are demineralizing.
2. Protect your teeth from acids. Soft drinks, fruit juice, lemonade or lemon water, coffee, tea, and wine are all acidic beverages that can speed demineralization and enamel loss. Use a straw to protect the teeth and/or rinse your mouth with fresh water immediately after drinking them (and before brushing).
3. Brush or rinse soon after eating. This reduces the amount of time your teeth are in contact with sugar and/or acid and restores the pH. Alternatively you can:
4. Chew sugarless gum. Perhaps the lowest tech but most effective tactic is to chew sugarless gum after or between meals. Gum made with sugar alcohols like xylitol are very effective in preventing and even repairing minor enamel lesions. Chewing gum increases the flow of saliva (which itself has an enamel hardening effect). But sugar alcohols also have direct chemical and enzymatic activity that promotes remineraliation or hardening of teeth.
5. Use a fluoride toothpaste and/or mouth rinse. This is especially important if you live in an area where the water is not fluoridated.Fluoride does two things: it makes the tooth enamel more acid resistant and it aids in the remineralization and repair of tooth enamel.
See also: Pros and Cons of Water Fluoridation
6. Eat a nutritious, balanced diet. Building strong teeth requires a broad range of vitamins and minerals, but a varied diet of whole foods should provide all the nutrients you need. In the context of even a moderately nutritious diet, there’s little evidence that taking extra mineral supplements will enhance remineralization.
The good news is that the optimal diet for dental health looks a lot like the optimal diet for overall health. In particular, be sure to include leafy greens, nuts, and healthy fats. Dairy products and fish are both particularly rich in in smile-building nutrients. If you don’t eat animal products, be sure you’re getting enough calcium and vitamin D from plant-based sources. If you eat grains, focus on whole grains and eat even those in moderation.
If you are concerned about phytates, (which I doubt you need to be) I have an entire episode on how to reduce them as well as an episode on some of the surprising benefits of phytates.
And, of course, limit your intake of sugar.
The bottom line on remineralization of teeth
So, is it possible to remineralize your teeth? Absolutely! You already do it every day—but the tips I’ve just given can promote the process. Is it possible to heal cavities without having them filled? In some cases, yes. But bear in mind that it’s much easier to repair a very small cavity than a large one—and even easier to prevent them from happening in the first place.
So, by all means, put these tips into action but don’t fire the dentist just yet. If you (or your kids) have the beginnings of small cavity, ask your dentist if she’d be comfortable giving you 3-6 months to work on it before deciding whether to fill it. Your dentist may even have topical products that can help with remineralization. But if she feels that it’s progressed beyond the point of no return, I think you’re probably better off with a filling. Advanced, untreated tooth decay can lead to some much larger problems down the road!
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References
Academy of Nutrition And Dietetics Position Paper: Oral Health and Nutrition. J Acad Nutr Diet. 2013 May; 113 ( 5): 693-701.
Lingström P, van Houte J, Kashket S. Food starches and dental caries. Crit Rev Oral Biol Med. 2000;11(3):366-80.
Mäkinen KK. Sugar alcohols, caries incidence, and remineralization of caries lesions: a literature review. Int J Dent. 2010; 2010:981072.
Mellanby M, Pattison CL. Remarks on THE INFLUENCE OF A CEREAL-FREE DIET RICH IN VITAMIN D AND CALCIUM ON DENTAL CARIES IN CHILDREN. Br Med J. 1932 Mar 19;1(3715):507-10.
Moynahan, PJ. Dietary Advice in Dental Practice. British Dental Journal 2002; 193, 563 – 568.
Image courtesy of Shutterstock.
About the Author
Monica Reinagel is a board-certified licensed nutritionist, author, and the creator of one of iTunes’ most highly ranked health and fitness podcasts. Her advice is regularly featured on the TODAY show, Dr. Oz, NPR, and in the nation’s leading newspapers, magazines, and websites. Do you have a nutrition question? Call the Nutrition Diva listener line at 443-961-6206. Your question could be featured on the show.