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Don’t neglect oral health in dietary guidelines

I recently had the privilege of expressing my professional opinion on the development of the next nutritional guidebook for Americans in the press. The Dietary Guidelines for Americans (DGA) committee has begun the year long process of producing the most up-to-date guidelines and my concern is the glaring omission of oral health; having healthy teeth to chew healthy food. Historically oral health has been overlooked in both the US and the UK, yet diet and dental health are intrinsically linked.

In recent years, a growing body of evidence has emerged linking periodontal disease with a range of whole-body health issues, including diabetes, cardiovascular disease and even depression and anxiety. A strong correlation has been found between periodontal disease and obesity, indicating a common risk factor in many of these cases is poor dietary choices.

The mouth is a window and gateway to the body, since oral signs can be an early warning system highlighting poor dietary and lifestyle choices that impact the wider body. Dental decay is the most prevalent disease worldwide, bearing a huge global health burden, and is almost entirely preventable.

The new guideline review should be offering information on dietary patterns and choices that impact the mouth, as well as practical tips for how to safeguard against oral disease. For example, consumers should be educated about the benefits of choosing fresh, whole fruit like apples and bananas over sugar-laden smoothies and juices.

It is also worth offering clear oral health advice along these lines to help anchor the overall health message:

  • Individuals of all ages should follow a daily oral hygiene routine, which included brushing their teeth first thing in the morning and last thing at night with a fluoridated toothpaste and cleaning between their teeth.
  • Consider drinking fluoridated water, where available. Drink water or milk in preference to fizzy/flavoured drinks.
  • Limit frequent or constant use of dietary fermentable carbohydrates, particularly free sugars (present in processed fruit as well as natural sugars such as honey and maple syrup). Free sugars drop the pH of the mouth significantly, resulting in proliferation of dental decay-causing bacteria.
  • Consider chewing sugar-free gum after meals or snacks, to help stimulate saliva flow, buffering against oral acidity and helping to remineralise teeth.
  • Choose healthy snacks for teeth too, especially for children at school, including fresh fruit and vegetables, cheese, oatcakes and crackers, breadsticks, savoury muffins, olives, nuts, plain yoghurt and kefir.
  • Be mindful of snack bars labelled as ‘healthy’ as they are still loaded with free sugar.

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