Why You Shouldn't Neglect Your Gums

Dietitians, dental professionals, and Vivian in Pretty Woman agree: “You shouldn’t neglect your gums!” 

Proactively caring for your gums is key for anyone with gastrointestinal issues such as acid reflux or a history of vitamin and mineral deficiencies or undernutrition--all of which increase the risk of gum disease.

Your gums, also known as gingivae, are the pink tissue surrounding and protecting the teeth. They are more complex than meets the eye; they have blood, nerve, and immune cell access, and collagen proteins as crucial structural components. 

Gum disease is a two-way street: a systemic disease often shows up in your mouth, and poor gum health can worsen the systemic disease.

Gum disease, also known as gingivitis or periodontitis, is brought on by microbial dysbiosis subverting the immune system to allow chronic inflammation in the gums. In other words, when there is a rowdy crowd of oral microbes coming a little too close, it can make your immune system get curmudgeonly and constantly on edge in the background. Making matters worse, the rude little microbes might become inflammaphilic, meaning they relish it when the immune system reacts with inflammation

If that doesn’t sound great-- it isn’t. Those cantankerous immune cells and impudent oral microbes do not necessarily stay put, so periodontitis not only leads to tooth loss, but also gastrointestinal inflammation, inflammation, and increased risk for chronic diseases elsewhere.

But there is good news. Successful local treatment of gum disease may help decrease inflammatory factors on blood tests, promote a healthy metabolic and lipid profile, and decrease systemic inflammation. You have only to gain by paying attention to your gums--it could prevent future problems, and might just help in the short term.

Oral hygiene--dental visits, correct brushing and flossing technique, and fluoride treatment as appropriate--fight oral dysbiosis and gum inflammation. But what you eat and drink matters, too. 

Malnutrition and almost every micronutrient deficiency will be the enemy of a healthy mouth. You would be surprised how much a mouth can say without a word: vitamin C and B vitamins, especially thiamine, riboflavin, niacin, B6, and B12 deficiencies can all show up in or around the mouth and gums during a nutrition-focused physical exam.

Beyond oral hygiene, the WHO also recommends preventing oral diseases, such as periodontal disease by
  • Eating a well-balanced diet
  • Decreasing added sugar intake
  • Increasing intake of fruits and vegetables
  • Choosing water instead of other beverages 
  • Avoiding Tobacco
  • Reducing or avoiding alcohol 
What specifically does a periodontal disease prevention diet include? 

According to a 2021 review, a periodontal disease prevention diet should be low in sugar and saturated fat, and rich in polyols, fibers, polyunsaturated fats, and vitamins A, B vitamins, and vitamin C, as well as calcium, zinc, and polyphenols. Certain traditional diets rich in these nutrients and a variety of minimally processed and unprocessed foods such as the Mediterranean diet appear to improve periodontal disease risk factors and gum health in a small clinical trial

But what if you are following a Low FODMAP diet?

This should be a reminder to follow it correctly: include a variety of foods at every stage, work with a dietitian to make sure you are reaching your nutrition needs, and never skip the reintroduction phase so that you can include as many foods that will promote gum health as possible in your long term diet. 

 

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  4. Kitamoto, S., Nagao-Kitamoto, H., Jiao, Y., Gillilland, M. G., 3rd, Hayashi, A., Imai, J., Sugihara, K., Miyoshi, M., Brazil, J. C., Kuffa, P., Hill, B. D., Rizvi, S. M., Wen, F., Bishu, S., Inohara, N., Eaton, K. A., Nusrat, A., Lei, Y. L., Giannobile, W. V., & Kamada, N. (2020). The Intermucosal Connection between the Mouth and Gut in Commensal Pathobiont-Driven Colitis. Cell, 182(2), 447–462.e14. https://doi.org/10.1016/j.cell.2020.05.048
  5. Martinon, P., Fraticelli, L., Giboreau, A., Dussart, C., Bourgeois, D., & Carrouel, F. (2021). Nutrition as a Key Modifiable Factor for Periodontitis and Main Chronic Diseases. Journal of clinical medicine, 10(2), 197. doi:10.3390/jcm10020197
  6. Hajishengallis, G., & Chavakis, T. (2021). Local and systemic mechanisms linking periodontal disease and inflammatory comorbidities. Nature reviews. Immunology, 21(7), 426–440. doi:10.1038/s41577-020-00488-6
  7. Laiola, M., De Filippis, F., Vitaglione, P., & Ercolini, D. (2020). A Mediterranean Diet Intervention Reduces the Levels of Salivary Periodontopathogenic Bacteria in Overweight and Obese Subjects. Applied and environmental microbiology, 86(12), e00777-20.  doi:10.1128/AEM.00777-20
  8. Sheetal, A., Hiremath, V. K., Patil, A. G., Sajjansetty, S., & Kumar, S. R. (2013). Malnutrition and its oral outcome - a review. Journal of clinical and diagnostic research : JCDR, 7(1), 178–180. doi:10.7860/JCDR/2012/5104.2702 

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