The rule of healthy food choices in Sustaining a Healthy Mouth 

“If I eat healthily do I still have to brush my teeth two or three times a day?” The answer is an emphatic Yes! Of course, some foods, particularly raw fruits and vegetables, are terrific adjuncts to good oral care. These foods act like toothbrushes (or more specifically, chew sticks) helping to scour the teeth and gums.

Furthermore, eating raw fruits and vegetables, while providing a variety of delicious nutrients, also supports the oxygenation of tissues in the oral cavity, gently massages the gums, and helps to remove debris from the mouth.

The mouth reaps the benefits of a daily care regimen when we choose to support our oral health with real food choices. In this way we let the body support the mouth, and the mouth support our overall health. Let’s take a closer look at what’s healthy (and what’s not), and where we can safely and easily reach for snacks and the types of food and drink that we’d like to predominate in our diets. Here, as throughout our work, the focus is on supporting and sustaining our oral health.

Eating from a balanced array of real foods not only sup- ports our oral health but also aids in the prevention and management of disease throughout the body. Real foods (including everyday snacks) include:

Raw and cooked fruits and vegetables (raised without pesticides and other chemicals)
Wild caught fish with edible bones
Milk and milk products (organic, preferably raw milk/ milk products if available)
Proteins (grass-fed and wild meats, wild-caught fish, and organic produce)
Carbohydrates and cereals (such as those found in the kinds of whole, unprocessed, organic grains and cereals that our ancestors used)

Raw and Cooked Fruits and Vegetables 

These lead the pack in terms of healthy food choices. Often these plants are underappreciated and overlooked—and overcooked, thus limiting their full nutritional impact. Many of us tend to give more space on a plate to proteins and less to these plant allies. These fibrous foods are excellent sources of vitamin K and vitamins A, B, and C; they host an array of nutrients, including calcium, magnesium, and phosphorous, as well as being good sources of bioflavonoids, which strengthen connective tissue and enhance the effects of vitamin C.

Paint a colorful palette with sound choices of fruits and vegetables.  When choosing fruits and vegetables, it behooves us to strive for multiple colors at each meal, or as one client recently remarked, “Eat a rainbow of fruits and vegetables.” For dark leafy greens, broccoli and kale, as well as salad greens such as arugula, spinach, and mizuna, make excellent choices. Kale is particularly high in calcium and vitamins A and C. Broccoli is a veritable powerhouse of nutrients—high in beta-carotene, it is a remarkable every- day food and for these reasons an important part of any anticancer protocol.

For bioflavonoids look to brightly colored berries, namely, raspberries, strawberries, blueberries, blackberries, and other edibles specific to various bioregions.  The nutritional value of our fruits and vegetables is a re- flection of the health of the soil in which they are grown. It’s often worthwhile knowing where, and how, our foods are grown—another sound reason to buy locally grown foods. Ask a farmer, she or he will tell you all about it.  Our consumption of fruits and vegetables is supported by a balance of both cooked and raw items.

For the majority of us, when we talk about “balance” we are referring to an overall balance, associated with a day or a week, for example, and not individual meals. It’s worth remembering that raw foods often require us to chew more than cooked foods. For the mouth this is  beneficial, as chewing produces saliva. As a buffer, saliva helps to neutralize acids. The more we chew, the greater the production of saliva and the more we benefit. Raw foods are also more fibrous than cooked foods, and their nutritional quality is often richer.

Raw foods have a beneficial physical effect, too, gently scouring the teeth and gums. Scouring—it sounds abrasive, and it is. Another way to look at raw foods is to imagine them massaging our gums with every bite. Massage increases blood flow and oxygen flow to the tissues. Ah, that invisible toothbrush . . . Additionally, when we talk about a low-fat diet, we are referring to eating fewer fats overall on a day-to-day basis and not, as many think, on a “food-to-food” basis. Indeed, processed “low-fat” (i.e., “diet”) foods can be avoided entirely and still total fat intake can be described as being “low fat.”

Milk and Milk Products 

These are sound choices that promote healthy teeth. Rich in calcium, lactose, and phosphorus, milk products help to strengthen enamel and inhibit caries. Wholefat, live yogurt contains beneficial live bacteria that are worth incorporating regularly into our diets along with other fermented foods, such as pickles, kombucha, miso, and so forth. These beneficial microorganisms, called probiotics, support a healthy digestive tract.

Remember, digestion begins in the mouth. 

Cheeses, especially hard cheeses, are a good addition to the diet. Snacking on hard cheeses in moderation or ending a meal with a small piece of a hard-aged cheese is thought to reduce the likelihood of caries. Many milk products sold in the United States contain antibiotics and growth hormones. Neither growth hormones nor antibiotics, when delivered in this way, benefit the health of the mouth. Hard cheeses made from small cheeseries usually do not contain these products, nor (at the time of writing) do cheeses from many European countries.

Proteins A balance of healthy proteins is essential to our diet. Too much protein can result in an acidic mouth, while too little can inhibit immune function. With animal proteins—as others often highlight—wild, organic, and grass-fed are key descriptors. These products can be consumed freely. Conversely, highly processed meats; commercially raised grain-fed meats, which have almost certainly been fed with genetically modified (GMO) corn; and farm-raised fish should be avoided entirely, as their contribution to our well-being is highly suspect.

In addition to meat, poultry, fish, eggs, and other protein-rich foods that help to build bones and teeth, nuts provide a beneficial source of fat as well as protein. Consider enjoying these as snacks or as additions to salads. Good examples are macadamia nuts, hazelnuts, pistachios, almonds, pecans, and cashews. Peanuts, which are actually legumes, as well as other members of the bean family, and seeds, such as pumpkin seeds, sesame seeds, chia seeds, and so forth offer additional sources of protein.

Carbohydrates and Cereals 

Most of these are comprised of starches, fiber, and sugar. Carbohydrates are generally foods we think of as energy foods and are often high in calories. Complex carbohydrates are not broken down in the mouth—that doesn’t mean that we can’t chew them sufficiently. Rather, it

means that these nutrient-dense foods, such as whole- grain breads, starchy vegetables, and beans, deliver fiber, as well as valuable amounts of vitamins and minerals that are extracted after foods leave the mouth. Insoluble fibers, such as wheat bran, wheat products, and brown rice, are not easily dissolved in water. Largely derived from whole grains and other plants, they help to decrease intestinal transit time and cleanse the digestive system. Conversely, soluble fibers help to slow absorption and include such foods as apples, bananas, oranges, car- rots, barley, oats, and kidney beans. Note that carbohydrates can vary.

Fermentable carbohydrates such as crackers, potato chips, pretzels, cereals, white breads, fruits, sugars, sweet treats, and desserts are best avoided or consumed in moderation. Why? Because they turn into simple sugars in the mouth. As their digestion begins in the mouth with an enzyme in our saliva called salivary amylase, they lower the pH of the mouth. Sugar is perhaps the most notorious fermentable carbo- hydrate. Are sugars a healthy choice if we’re interested in a maintaining the health of our teeth, gums, and other tissues of the mouth? The short answer is no, although sugar comes in many shapes and guises.

The Truth About Sugar

 It’s a startling fact that the average American consumes around 100 pounds of sugar annually. That’s a lot of sugar! Notably, much of it isn’t consumed by consciously dipping a teaspoon into the sugar bowl. It’s sometimes difficult to identify sugars in our foods and beverages. Those sugars most commonly consumed include sucrose (table sugar); fructose, a natural sugar found in fruits and vegetables and concentrated fruit sugars (e.g., high-fructose corn syrup); maltose, found in the grains used to make both breads and beers; lactose (or milk sugar), found in dairy products; and glucose, our main source of energy and the sugar utilized by our bodies. Each form of sugar contributes to shifting the pH of the mouth, causing a disruption in the delicate balance of healthy and unhealthy microorganisms that compose our biofilms. Indeed, sugar goes by still more names. When reading ingredient labels, it’s common to find not just one or even two, but three or more different names for natural and artificial sugars.

Natural Sugars vs. Free Sugars

 Sugars that are naturally present in certain foods and beverages are far less likely to be associated with caries than free sugars. Natural sugars also occur in smaller quantities. Free sugars—distinct from those naturally present in vegetables, grains, fruits, and milk

products—are those that are added to foods and drinks, and they include the sugar found in honey, fruit juice, and syrups, as well as sucrose, glucose, fructose, and dextrose. The most pervasive free sugar today, the one that gives rise to the greatest concern, is the ubiquitous high- fructose corn syrup, which is manufactured almost exclusively from genetically modified corn. High-fructose corn syrup is less expensive to manufacture than many commercial sweeteners. It is a processed, calorie-dense substitute for glucose and sucrose. Not only is it sweeter than sucrose, it is now believed to be much more harmful to our health than regular fructose. It is higher in calories for certain. Some also think that compared to sucrose or table sugar it is metabolized differently by our bodies. When we feed sugar to the bacteria in the mouth, they produce acid as a by-product. Certain microbes really like an acidic environment, and they thrive. Limiting sugars helps mediate microbes in the mouth by curbing their acid production.

Stevia, a Healthy Herbal Sugar Alternative

 It’s quite probable that a few sweet leaf plants would pro- vide enough sweetener for an entire village. Stevia—also commonly called sweetleaf—is reputed to be somewhere between 300 and 600 times sweeter than sugar. Some studies have indicated that it inhibits tooth decay and may improve mental well-being, fight fatigue, aid digestion, and guard against hypoglycemia. Stevia adds zero calories to food and is therefore a fitting addition to any weight- control regimen. It can be used fresh or dried, in hot and iced teas and other beverages, and because it does not break down with cooking it can be added to cookies, muffins, and cakes in place of honey or sugar.

As with other sugar substitutes and foods in general, moderation is key to well-being. A small plant grown (depending on region) as a perennial or an annual, stevia is native to Paraguay. There, the Guarana natives have used it for centuries to sweeten their drinks. Its botanical name is Stevia rebaudiana, and any- one with even a limited amount of gardening experience and access to a window ledge, if not a garden, can cultivate stevia.

Hyadration 

Being well hydrated translates into fewer infections. Additionally, our joints will bend more smoothly because they are more cushioned; constipation is less likely to be an issue, and bowel movements are likely to be easier, more regular, and well formed—not like little rabbit pellets. Urination will occur more frequently—perhaps about every two hours—and urine will be light colored. Drinking more water means feeling fuller (and thus we are less likely to snack), and we will sweat when we exert ourselves. Being well hydrated improves the tone of the mucous mem- branes and tissues throughout the body; it inflates the veins and arteries and helps to tone, cleanse, and clear the skin. Just as with herbs and other plants, we can clearly see the effects of being underwatered in our own bodies and the loss of vitality that results. Perhaps one of the most common signs of being well hydrated—and there are many—is that we will get thirsty and notice it!

We must water ourselves and not just our plants

It is important to remember that not all beverages are equal. Water is often an ideal choice; it can have an approximately neutral pH and is hydrating. While we have included some popular beverages in table 13.1, we include a more detailed list in table 13.2 because each gulp affects the pH of the mouth. As can be seen, some drinks are more acidic than others. Some contain sugar, some alcohol, some both. Alcohol dries the tissues in the mouth.  It’s helpful to balance drinks with foods.

So when in doubt, drink water or choose a beverage that has a near neutral pH. It’s worth noting that some beverages, such as black and green teas, have naturally higher concentrations of fluoride. This can confer some natural protection against caries. While these plants contain naturally higher levels of fluoride and are therefore desirable, fluoridated waters, toothpastes, mouth rinses, and various foods that have been watered with fluoridated water all contribute to our overall fluoride load, which we need to consider carefully.

How Much Water? 

Water is integral to our health and well-being. We are largely composed of water. Often, dehydration is associated with aging. Generally, it is recommended that we drink half our body weight in ounces of water per day. Confusing? Not really. If someone weighs 100 pounds (45 kilograms), then it’s suggested that they drink 50 ounces (1.5 L) of water each day. Does coffee, black tea, alcohol, or juice count to- ward a daily goal? No. And what about soft drinks or even “energy” drinks? The short answer? No. Of course, that’s not to say avoid other liquids. Simply, in addition to other liquids, drink water. And it’s important to remember that while developing one’s awareness about being well hydrated, certain beverages such as coffee, many non herbal teas, and certainly alcohol are dehydrating, so it behoves us to further increase our water intake to compensate for the dehydrating effects of these beverages if we imbibe them.

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