Maria Papavergos
Two leading American health agencies have a chance to correct a decade’s worth of incomplete nutrition guidelines by reestablishing oral health as an essential part of overall dietary wellness.
Every five years, the Health and Human Services and Agriculture departments commission the Dietary Guidelines for Americans (DGA) Advisory Committee to review the latest science and recommend the best nutrition advice for Americans.
The resulting guidelines are used to inform school lunches and breakfasts by state and federal policymakers and in the Daily Value nutrition labels you’re debating when holding two jars of peanut butter at the grocery store.
But for these recommendations to be helpful, they also must be complete. And yet there is a glaring deficiency: the last set had just two mentions of oral health despite the introduction to the standards asking “health professionals and policymakers” to “make every bite count” — and the fact that decades of research show that bodily health starts in the mouth.
As Caswell A. Evans Jr. wrote for a 2009 Institute of Medicine workshop, “The connection between oral health and overall health and well-being cannot be ignored.”
Oral symptoms can also be an early warning system highlighting poor dietary and lifestyle choices affecting other body parts.
Joel Strom, a former member of the California State Dental Board and a former National Institutes of Health dental adviser, has cited an instructive patient anecdote. During a “routine dental hygiene appointment,” he noticed bad bleeding in his patient’s gums. His referral led to the diagnosis of a rare, potentially deadly cardio-vascular condition — which might have killed the patient if he hadn’t visited the dentist. Instead, he got a successful experimental treatment and lived for an additional 12 years.
This call for greater inclusion of oral health care in the nutrition standards is not new. The American Academy of Nutrition and Dietetics has previously raised this issue in its comments to the DGA, to no avail.
The last time the guidance came close to properly addressing oral health was in 2010 — a disservice not just to the public health leaders who use the standards to make policies and regulations but, most important, to the end consumers who make critical buying decisions based upon how these standards are spread across nutrition labels, schools, and elsewhere.
The 2025 DGA cannot continue to leave this gaping hole.
At a bare minimum, the guidelines published next year should start by including and expanding on the following on their 2010 predecessor: “A combined approach of reducing the amount of time sugars and starches are in the mouth, drinking fluoridated water, and brushing and flossing teeth is the most effective way to reduce dental caries.”
The committee can — and should — quickly go further on oral health matters.
People can avoid damaging their teeth by choosing fresh fruit over processed, sugar-packed “health” food like smoothies and snack bars. Likewise, water should be a priority over soda and acidic, high-sugar fruit juices.
Simple proactive measures like chewing sugar-free gum help to stimulate the production of saliva to buffer against oral acidity and to remineralize teeth. (Sugary gum also stimulates saliva, but the impact of sugar is unacceptable. The sweeteners used in sugar-free gum are non-fermentable, meaning they cannot be used as food by cavity-causing bacteria.)
A study from Frontier Economics suggests that a simple practice like chewing sugar-free gum three times per day could prevent 180,000 fillings yearly in Great Britain.
“Making every bite count” means starting with the body parts doing the biting.
An emphasis from the DGA on simple, achievable oral health recommendations means better food for Americans in every state and station of life, in public schools, grocery stores, hospitals and more. That leads to healthier mouths, healthier bodies, and longer lives.
Maria Papavergos is a dentist and yoga instructor. She founded The Lifestyle Dentist, which promotes a lifestyle-centered approach to oral health.
