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Eating leafy greens could be better for oral health than using mouthwash

More than half of the adult population in the UK and the US suffer from gum disease. Typical remedies include mouthwash and, in severe cases, antibiotics. These treatments come with side effects such as dry mouth, the development of antimicrobial resistance, and elevated blood pressure.



However, research has suggested that a compound known as nitrate, present in leafy green vegetables, presents fewer adverse effects and offers greater advantages for oral health. It could potentially serve as a natural alternative for treating oral diseases.


Inadequate brushing and flossing lead to the accumulation of dental plaque, a sticky layer of bacteria on the surface of teeth and gums, causing tooth decay and gum disease.


Additionally, sugary and acidic foods, dry mouth, and smoking can contribute to bad breath, tooth decay, and gum infections.


Gum disease primarily falls into two categories: gingivitis and periodontitis. Gingivitis manifests as redness, swelling, and bleeding of the gums, while periodontitis is a more advanced form of gum disease that damages the soft tissues and bones supporting the teeth.


Periodontal disease can, therefore, lead to tooth loss, and when oral bacteria enter the bloodstream, it can contribute to the development of systemic disorders such as cardiovascular disease, dementia, diabetes, and rheumatoid arthritis.


Leafy greens and root vegetables are packed with vitamins, minerals, and antioxidants. It's widely known that a diet rich in these vegetables is vital for maintaining a healthy weight, bolstering the immune system, and preventing heart disease, cancer, and diabetes.


The numerous health benefits of leafy greens can be attributed in part to their high nitrate content, which can be converted to nitric oxide by nitrate-reducing bacteria in the mouth.


Nitric oxide is known to lower blood pressure and enhance exercise performance. However, in the mouth, it helps prevent the overgrowth of harmful bacteria and reduces oral acidity, both of which can cause gum disease and tooth decay.


In our research on nitrate and oral health, we focused on competitive athletes, who are susceptible to gum disease due to factors like a high carbohydrate intake, stress, and dry mouth from strenuous training. Our study demonstrated that beetroot juice, containing approximately 12 millimoles of nitrate, protected their teeth from the acidic effects of sports drinks and carbohydrate gels during exercise. This suggests that nitrate could be used as a prebiotic by athletes to lower the risk of tooth decay.


Nitrate holds great promise as an oral health prebiotic. Combining good oral hygiene with a nitrate-rich diet could be the key to a healthier body, a radiant smile, and gum disease prevention. This is particularly encouraging news for those at higher risk of oral health issues, such as pregnant women and the elderly.



In the UK, antiseptic mouthwashes containing chlorhexidine are commonly used to address dental plaque and gum disease. Regrettably, these mouthwashes have a broad impact on oral health, indiscriminately eliminating both beneficial and harmful bacteria while increasing oral acidity, which can lead to disease.


Concerningly, early research suggests that chlorhexidine may contribute to antimicrobial resistance. Resistance occurs when bacteria and fungi withstand the effects of one or more antimicrobial drugs due to repeated exposure, posing a global health concern projected to cause 10 million deaths annually by 2050.


In contrast, dietary nitrate exhibits more precise targeting. It eliminates disease-associated bacteria, lowers oral acidity, and promotes a balanced oral microbiome, encompassing all microorganisms in the mouth. Nitrate offers exciting potential as an oral health prebiotic, capable of preventing disease onset or slowing disease progression.


The question arises: how much leafy greens should one consume daily? As a general guideline, a substantial serving of spinach, kale, or beetroot during meals typically contains about 6-10 millimoles of nitrate, delivering immediate health benefits.


Collaborative research we've conducted indicates that treating plaque samples from patients with periodontal disease with 6.5 millimoles of nitrate increases the levels of beneficial bacteria and reduces acidity.


For instance, a two-week regimen of consuming lettuce juice reduced gum inflammation and boosted healthy bacteria levels in patients with gum disease.


An increasing body of evidence suggests that nitrate is fundamental to oral health.


Incorporating a portion of vegetables into your meals can help prevent or treat oral diseases, leaving your mouth feeling fresh and healthy.


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