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Can healthy habits promote dental health?

Long in the Tooth

Can healthy habits promote dental health? More specifically, can a combination of regular exercise, weight control and a healthy diet prevent periodontitis?

Researchers at Case Western Reserve University (CWRU) posed that question in a recent study and came up with some surprising results.

Risk: Low, lower, lowest

Periodontitis is a form of periodontal disease in which the gums and bone that support teeth become infected and inflamed. About three out of 10 people suffer from periodontitis.

Researchers at CWRU collected data on more than 12,000 subjects who participated in the third National Health and Nutrition Examination Survey. For each subject, three “health-enhancing” behaviors were assessed:

  1. getting regular exercise
  2. maintaining a normal body weight; and
  3. maintaining a “high quality” diet.

When this data was compared to the incidence of periodontitis, the researchers produced these results:

  1. Periodontitis risk was reduced by 16 percent in subjects who engaged in at least one of the health-enhancing behaviors
  2. Risk was reduced by 29 percent in those who engaged in two of the behaviors
  3. Risk was reduced by 40 percent in those who engaged in all three behaviors

Sum of the parts

When I first looked over this study I noticed something missing. There was no mention of the obvious fact that an individual who makes the everyday efforts required to pursue a healthy, balanced diet and regular exercise is almost certainly inclined to also make a special effort to maintain dental health with regular visits to the dentist and daily brushing and flossing. After all, most cases of periodontitis are attributed to poor oral hygiene (although, for some, genetics is also believed to play a role). Nevertheless, some healthy habits do have a direct effect on dental health.

For instance, a 2000 study in the Journal of Periodontology confirmed earlier studies showing that people who have an inadequate intake of vitamin C tend to have higher rates of periodontal disease. Vitamin C is believed to help repair and maintain healthy connective tissue.

Vitamin C intake, regular exercise and the maintenance of proper body weight have all been shown to reduce C-reactive protein (CRP), the inflammation marker that’s been associated with periodontitis. As I’ve mentioned in many e-Alerts, CRP is also an aggravating factor in creating blood clots that commonly lead to stroke, heart attack and other cardiovascular events.

High quality diet

The last word today goes to William Campbell Douglass II, M.D., who offered these dietary guidelines for dental health in his Daily Dose e-letter:

“I have always said, and still maintain, that you can brush your teeth after every meal, water-pick them, floss them, and go to the dental hygienist every month and you will still get cavities and gum disease if your diet is loaded with sugar and other carbohydrates and is deficient in animal protein and fat.”

High glycemic carbohydrates in particular may increase periodontitis risk. The glycemic index (GI) is a measurement system developed to help diabetic patients manage their blood glucose levels. In a nutshell:

  • Low GI foods (such as most fruits and vegetables) prompt a slow increase in blood sugar levels, while high GI foods (such as processed baked goods and starchy foods) produce a quick spike in blood sugar levels.
  • A steady intake of high GI foods promotes a gradual insensitivity to insulin – the precursor of type 2 diabetes. And diabetes happens to increase the risk of periodontal diseases.

You can estimate the GI rating of various foods by searching a free database on a web site called

“Periodontitis and Three Heath-Enhancing Behaviors: Maintaining Normal Weight, Engaging in Recommended Level of Exercise, and Consuming a High-Quality Diet” Journal of Periodontology, Vol. 76, No. 8, August 2005,
“Case Researchers Find Exercise, Eating Right and Maintaining Weight Benefit Oral Health” Case Western Reserve University Press Release, 8/22/05,
“Giving Strokes the Brush” William Campbell Douglass II, M.D., The Daily Dose, 6/25/02,