 Yeah, saturated fats produce an inflammatory response. Yeah, inflammation is recognized as one of the key underlying causal factors in periodontal disease. And so that could explain why moderating people's intake of meat and dairy could promote periodontal health. But plant-based diets don't just offer lower levels of saturated fat, cholesterol, and animal protein, but also higher levels of complex carbohydrates and dietary fiber, vitamins, minerals, antioxidants, phytochemicals. So we don't necessarily know what the mechanism is. Yes, saturated fat is associated with the progression of periodontal disease, but at the same time dietary fiber intake may be protective, but you don't know either way until you put it to the test. The effect of dietary intervention in a randomized controlled trial at seven months of age, more than 1,000 infants were randomized, about half of whom to a low saturated fat and cholesterol intake, to see if they get less heart disease when they grow up. They're still just in their 20s, but as children and adolescents, those randomized to the healthier diets ended up with better saliva production. They had them chewing like wax cubes, and those randomized since infancy to the better diet produced more saliva. And saliva is essential for the maintenance of oral health, for example, clearing out sugar and acid faster off the teeth. But they think happened is that the greater increase of salivary flow was due to the greater intake of fiber-rich foods— whole grains, vegetables, fruit, and berries— they required more chewing, which in turn is known to boost saliva production. So maybe their bodies were just used to putting out more. In other words, in addition to general health benefits, dietary fiber may have benefits on oral health as well, but not necessarily the fiber itself, but just the act of chewing itself. That reminds me of this study, in which a single high fiber meal was able to reduce bad breath for hours. Bad breath is caused by these gaseous sulfur compounds produced by a certain type of bacteria that are concentrated in the back of your tongue. And so when we eat, the reason that bad breath gets better may be due to kind of a self-cleaning of the mouth while chewing food. And so it makes sense that foods that need to be chewed more intensively have a stronger self-cleaning effect on the back of your tongue than foods that require less chewing, but you don't know until you put it to the test. Two very similar meals, but one had a whole grain roll. More fiber, more chewing, and a raw apple and jam, whereas the other was just white bread with jelly and cooked apples, less chewing. Then they just measured the halitosis compounds in people's breath at two hours after the meal, then eight hours. And even after the low fiber meal, bad breath levels dropped. But in the higher fiber meal, they dropped significantly more and stayed down even eight hours later. So the reason a high fiber diet may improve parodontal disease may be from the fiber, the lower saturated fat intake, or just the chewing, but there's another possibility. Maybe it's the nitrate-containing vegetables. You know, we know the ingestion of dietary nitrate in the form of greens and beets has been proven to exert many beneficial clinically relevant effects on general health, including maintaining good blood flow and reducing inflammation in general. So hey, my improved circulation to the gums in anti-inflammatory effects benefit parodontal patients. Let's find out a randomized, double-blind, placebo-controlled clinical trial of repeated consumption of lettuce juice? Why lettuce juice? That sounds so disgusting. Not to worry though, to improve patient acceptance, the lettuce juice was seasoned by a chamomile honey flavor and sweetened with Splenda. That just sounds worse. But it worked. The clinical intervention trial demonstrated an attenuating effect of dietary nitrate on gingival inflammation. Check it out. In the placebo group, most of their teeth had no gingivitis, about 60%, but 40% did have mild gingivitis with almost no moderate gingivitis. And after drinking two weeks of placebo lettuce juice, I don't know if that sounds better or worse, no real change, as you would expect. Okay, but in the lettuce group, they started out a bit worse, actually. About half their teeth had mild or moderate gum disease, but then after two weeks of actual lettuce juice, significant improvements. No more moderate disease. The mild disease rates were cut in half, and three quarters of their teeth had no gingivitis at all. In conclusion, our findings suggest that the ingestion of greens and beets may be a clinically useful adjunct in the control of chronic gingivitis and all sorts of chronic disease. What's good for the mouth, not smoking, and healthier diet is good for the rest of our body. So many dental professionals who may see people more frequently than their doctors should be counseling patients on living more healthily. And indeed, nearly all dental hygienists surveyed, said that they thought they have a role in helping patients improve their diets, yet that's not what happens at all. Asked the patients, and less than one in ten said they got dietary advice from their dental professionals. Why? Thus, although dentists were motivated to include nutrition in their clinical care, most felt unqualified to provide dietary guidance. That never stopped doctors, but it's true, nutrition is neglected in dental school, just like in medical school. And in most cases, all people got were like the biochemistry of vitamins, the Krebs cycle all over again, as opposed to applied clinical nutrition. I mean, it's really not rocket science, or is it? Why, dietary nitrate is hard to beat.