The following article was written by Danielle Oexman, RDH, in completion of requirements to become an IABDM Certified Biological Hygienist. Congratulations, Danielle!
“The hygienist discussed nutrition with me at my cleaning!”
Yup, you read correctly. Dental hygienists are trained to discuss nutrition with patients, especially in a biological office.
Nutrition is often thought of as something that can affect a person’s overall look, but did you know it highly affects your mouth as well? It is not often thought that the mouth is connected to the rest of the body, but think about it: It is! When a patient is seen in a biological office, the clinical team is looking at how the patient’s mouth is affecting their whole body, and a big part of what is affecting the patient’s mouth is their nutrition.
One of the largest ways nutrition affects the mouth is by changing the pH of the saliva. A normal, healthy oral pH range is 6.8 – 7.0. Anytime something is put into the mouth, the saliva will then become alkaline, acidic, or stay neutral based on the pH of the food/beverage and the body’s reaction to it. In Clinical Nutrition for Biological Dentistry, Dr. Rehme discusses how the diet should be made up of around 60 – 70% alkaline foods and 30 – 40% acidic foods. However, this is not normally the case as the American diet has become much more of an acid food diet than an alkaline one.1
What happens when the saliva becomes more acidic or alkaline? Research has shown the risk for dental caries and periodontal disease greatly increase. A healthy pH of 7.0 has been shown to have a very low caries risk and little to no calculus present. A pH of below 7.0, or acidic pH, has been shown to cause a much greater risk for dental caries, chronic periodontal disease, and even halitosis. A pH above 7, or alkaline pH, has been found to cause significant plaque accumulation which can cause chronic gingivitis.2
One of the best ways a hygienist can help their patients achieve a more neutral pH by changing their nutrition is by making small recommendations the patient can accomplish. Since almost no foods have a neutral pH, one of the highest priorities to focus on when discussing nutrition is to decrease the frequency of acidic foods/beverages. When anything is put into the mouth, the body generally takes 20 – 30 minutes to compensate for the new pH and adjust it back to its normal. Let’s take soda for instance. Soda has an average pH that is 5.5 or below, which means it’s highly acidic. If a patient is sipping on a soda all day long, or increasing the frequency, their saliva is going to get into the very acidic range and not be able to regulate itself back into a normal range. As discussed before, if the saliva consistently is staying acidic, the caries risk and risk for periodontal disease drastically increases. For this, a recommendation can be made to limit soda exposure to only with meals.
What happens when a patient has great nutrition but their saliva is still acidic? One of the most basic treatment options would be baking soda rinses. Research has shown that rinsing with a half-tablespoon of baking soda per 50 ml of water daily can help raise the pH to healthy levels.3 Baking soda rinses can also have an anti-inflammatory effect on the mouth. By making a recommendation to use baking soda rinses daily, the patient’s risk of caries and periodontal disease can be decreased. These recommendations might seem small but they can have great benefits for the overall health of the mouth.
- Rehme, M., DDS. (n.d.). Clinical Nutrition for Biological Dentistry.
- Baliga, S., Muglikar, S., & Kale, R. (2013, July). Salivary pH: A diagnostic biomarker. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3800408/
- Chandel, S., Khan, M., Singh, N., Agrawal, A., & Khare, V. (2017). The effect of sodium bicarbonate oral rinse on salivary pH and oral microflora: A prospective cohort study. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5773983/