 The effects of a vegetarian diet on systemic diseases like cancer, diabetes, and heart disease have been studied and revealed predominantly less systemic diseases in vegetarians. But there have only been a few studies on oral health, which I covered in previous videos. But what's the latest? In a study of 100 vegetarians compared to 100 non-vegetarians, the vegetarians had better periodontal conditions, less signs of inflammation like gum bleeding, less periodontal damage, and better dental home care, brushing and flossing 2.17 times a day compared to 2.02 times a day. Not much of a difference, so maybe it was something about their diet, though vegetarians may have a healthier lifestyle overall beyond just avoiding meat. They control for smoking, but other things like obesity can adversely affect oral health, so there may be confounding factors. What we need is an interventional study, where they take people eating the standard Western diet, improve their diets, and see what happens. But no such study existed until now. With professional support of nutritionists, the participants of the study with existing periodontal disease changed their dietary patterns to so-called wholesome nutrition. A diet emphasizing veggies, fruits, whole grains, potatoes, beans, peas, lentils, spices, with water as the preferred beverage. What a concept. To make sure any changes they witnessed were due to the diet, they made sure everyone maintained their same moral hygiene before and after the dietary change. What did they find? They found that eating healthier appeared to lead to a significant reduction of probing pocket depth, gingival inflammation, gum inflammation, and levels of inflammatory cytokines, which mediate the tissue destruction in periodontal disease. So maybe it concluded that wholesome nutrition may improve periodontal health. Why, though? Yes, plant-based diets have a number of nutritional benefits in terms of nutrient density, but it also may be about improving the balance between free radicals and our antioxidant defense system. Traditionally, dietary advice for oral health was just about avoiding sugar, which feed the bad bacteria on our teeth. But now we realize some foods and beverages like green tea possess antimicrobial properties to combat the plaque-producing bacteria directly. Streptococcus mutants has been identified as oral enemy number one. If plaque is caused by bacteria, though, why not just use antibiotics? Many such attempts have been made. However, undesirable side effects such as antibiotic resistance, vomiting, diarrhea, and teeth stains have precluded their use. In a Petri dish, green tea phytonutrients effectively inhibited the growth of these bacteria, but what about in our mouth? They found that rinsing with green tea strongly inhibited the growth of plaque bacteria on our teeth within minutes. Seven minutes after swishing with green tea, the number of these bacteria in the plaque scraped from people's teeth was cut nearly in half. So if you have people swish with sugar water in their mouths, within three minutes the pH on their teeth can drop into the cavity formation danger zone. But if 20 minutes before swishing with that sugar water, you swish with some green tea, you wipe out so many plaque bacteria that the same sugar water hardly has any effect at all. So they conclude using green tea as a mouthwash or adding it to toothpaste could be a cost-effective cavity prevention measure, especially in developing countries, because here in the civilized world we have antiseptic mouth washes with fancy chemicals like chlorhexidine, considered the gold-standard anti-plac agent. If only it didn't cause genetic damage. DNA damage has been detected in individuals who rinsed their mouths with chlorhexidine-containing mouth washes, and not just to cells in the mouth. Thirteen volunteers rinsed their mouth with this stuff for a few weeks, and there was not only an increase in DNA damage in the cells lining their cheeks, but also in their peripheral blood cells, suggesting it was absorbed into their bodies. Yes, it reduced plaque better than other antiseptic chemicals. However, it might be doubtful whether chlorhexidine can still be considered the gold standard when considering how toxic it is to human cells. So are we left with having to decide between effectiveness or safety? How about a head-to-head test between chlorhexidine and green tea? Green tea worked better than chlorhexidine at reducing plaque. So using green tea as a mouthwash may work cheaper, safer, and better. And if as a bonus you want to sprinkle some amla powder into it, dried Indian gooseberry powder, it evidently shows an outstanding cavity-stopping potential, not by killing off the bacteria like green tea, but just by suppressing the bacteria's plaque-forming abilities. Here's how much plaque is formed without amla. Here's how much is formed with.