Hostname: page-component-758b78586c-qvhcc Total loading time: 0 Render date: 2023-11-28T15:31:09.542Z Has data issue: false Feature Flags: { "corePageComponentGetUserInfoFromSharedSession": true, "coreDisableEcommerce": false, "useRatesEcommerce": true } hasContentIssue false

The interrelationship between diet and oral health

Published online by Cambridge University Press:  07 March 2007

Paula Moynihan
School of Dental Sciences, University of Newcastle, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK
Rights & Permissions [Opens in a new window]


Core share and HTML view are not possible as this article does not have html content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Diet and nutrition impact on many oral diseases, in particular dental caries. Consumption of fluoridated water coupled with a reduction in non-milk extrinsic sugar intake is an effective means of caries prevention. However, studies on the fluoride concentration of bottled waters suggest increased consumption of these waters, in preference to fluoridated tap water, would lead to a marked decrease in caries protection. Concerns have been raised about the bioavailability of fluoride from artificially-fluoridated water compared with naturally-fluoridated water. This issue has been addressed in a human experimental study that has indicated that any differences in fluoride bioavailability are small compared with the naturally-occurring variability in fluoride absorption. Research has unequivocally shown sugars to be the main aetiological factor for dental caries, and information on intakes guides health promotion. Repeat dietary surveys of English children over three decades indicate that levels of sugars intake have remained stable, while sources of sugars have changed considerably, with the contribution from soft drinks more than doubling since 1980. Dental caries eventually leads to tooth loss, which in turn impairs chewing ability causing avoidance of hard and fibrous foods including fruits, vegetables and whole grains. A very low intake (<12 g/d) of NSP and fruit and vegetables has been found in edentulous subjects. Provision of prostheses alone fails to improve diet. However, initial studies indicate that customised dietary advice at the time of denture provision results in increased consumption of fruits and vegetables, and positive movement through the stages of change. Feasible means of integrating dietary counselling into the dental setting warrants further investigation.

Nutrition Society Medal Lecture
Copyright © The Nutrition Society 2005


Alexy, U, Sichert-Hellert, W & Kersting, M (2002) Fifteen-year time trends in energy and macronutrient intake in German children and adolescents: results of the DONALD study. British Journal of Nutrition 87, 595604 Google Scholar
Barton, K, Anderson, A, Pine, C, Paterson, M & Burnside, G (2001) Dietary interventions in general dental practice: an unexplored opportunity for promoting dietary change in low income communities. Proceedings of the Nutrition Society 60, 5A.Google Scholar
Berry, WTC (1972) Mastication, food and nutrition. Dental Practice 22, 249253 Google Scholar
Bradbury, J (2002) Dietary intervention in edentulous patients. PhD Thesis – University of NewcastleGoogle Scholar
Bradbury, J, Thomason, JM, Jepson, NJA, Walls, AWG, Allen, PF & Moynihan, PJ (2003) A nutrition education intervention to increase the fruit and vegetable intake of denture wearers. Proceedings of the Nutrition Society 62 86AGoogle Scholar
British Nutrition Foundation. 2002. Beverages and health. Google Scholar
Buttner, (1971) Zuckeraufnahme und Karies (Sugar and Caries) Basel: Karger.Google Scholar
Carmichael, CL, Rugg-Gunn, AJ & Ferrell, RS (1989) The relationship between fluoridation, social class and caries experience in 5-year-old children in Newcastle and Northumberland in 1987. British Dental Journal 167, 5761 Google Scholar
Crawley, HF (1993) The energy, nutrient and food intakes of teenagers aged 16–17 years in Britain. British Journal of Nutrition 70, 1526 Google Scholar
Department of HealthDepartment of Health (1991) Dietary Reference Values for Food Energy and Nutrients in the UK. Report on Health and Social Subjects, no. 41 London: H. M. Stationery Office.Google Scholar
Department of HealthDepartment of Health 1994. Nutritional Aspects of Cardiovascular Disease. Report on Health and Social Subjects no. 46. London: H. M. Stationery Office.Google Scholar
Dhaliwal, J, Steele, GJ, Sheiham, A, Walls, AWG, Marcenes, W & Moynihan, PJ (2002) Does tooth loss affect fruit and vegetable intake in older people. Journal of Dental Research 82, 267 Google Scholar
Ettinger, R (1973) Diet, nutrition and masticatory ability in a group of elderly edentulous patients. Australian Dental Journal 18, 1219 Google Scholar
Fletcher, ES, Rugg-Gunn, AJ, Matthews, JNS, Hackett, AF, Moynihan, PJ, Mathers, JC & Adamson, AJ (2004) Changes over 20 years in macronutrient intake and BMI of 11 and 12 year olds. British Journal of Nutrition 92, 321333 Google Scholar
George, JH, Brinstone, SC, Paulin, JM & Aitkin, EG (1993) What do young adolescent New Zealanders eat? Nutrient intake of a nationwide sample of form 1 children. New Zealand Medical Journal 106, 4751 Google Scholar
Gregory, JR & Lowe, S (2000) National Diet and Nutrition Survey: Young People Aged 4–18 Years. Vol. 1: Report of the Diet and Nutrition Survey. London: The Stationery Office.Google Scholar
Gunn, H-S, Wall, A-K (1985) The effect of new complete dentures on mastication and dietary intake. Acta Odontologica Scandinavica 43, 257268 Google Scholar
Guthrie, JF & Morton, JF (2000) Food sources of added sweeteners in the diets of Americans. Journal of the American Dietetic Association 100, 4348 Google Scholar
Heath, MR (1972) Dietary selection by elderly persons, related to dental state. British Dental Journal 132, 145148 Google Scholar
Hildebrandt, GH, Dominguez, BL, Schork, M & Loesche, WJ (1997) Functional units, chewing, swallowing and food avoidance among the elderly. Journal of Prosthetic Dentistry 77, 588595 Google Scholar
Hinds, K & Gregory, J (1995) National Diet and Nutrition Survey: Children Aged 1.5–4.5 Years. Vol. 2: Report of the Dental Survey. London: H. M. Stationery Office.Google Scholar
Hopkin, SM & & Ellis, JC (1980) Drinking Water Consumption in Great Britain; A Survey of Drinking Habits with Special Reference to Tap-water-based Beverages. Technical Report TR 137. Marlow, Bucks.: Water Research Centre.Google Scholar
Joshipura, K, Willett, W & Douglass, C (1996) The impact of edentulousness on food and nutrient intake. Journal of the American Dental Association 127, 459467 Google Scholar
Kelly, M, Steele, J, Nuttall, N, Bradnock, G, Morris, J, Nunn, J, Pine, C, Pitts, N, Treasure, E & White, D (2000) Adult Dental Health Survey. Oral Health in the United Kingdom 1998, London: The Stationery Office.Google Scholar
Kersting, M, Sichert-Hellert, W, Alexy, U, Manz, F & Schoch, G (1998) Macronutrient intake of 1 to 18 year old German children and adolescents. Zeitschrift für Ernahrungswissenschaft 37, 252259 Google Scholar
Krall, E, Hayes, C & Garcia, P (1998) How dentition status and masticatory function affect nutrient intake. Journal of the American Dental Association 129, 12611269 Google Scholar
Laurin, D, Brodeur, J-M, Bourdages, J, Vallee, R & Lachapelle, D (1994) Fibre intake in elderly individuals with poor masticatory performance. Journal of the Canadian Dietetic Association 60, 443449 Google Scholar
Levine, R, Stillman-Lowe, C (2004) The Scientific Basis of Oral Health Education London British Dental AssociationGoogle Scholar
Lyhne, N & Ovesen, L (1999) Added sugars and nutrient density in the diet of Danish children. Scandinavian Journal of Nutrition 43, 47 Google Scholar
McDonagh, M, Whiting, P, Bradley, M, Cooper, J, Sutton, A, Chestnutt, I, Misso, K, Wilson, P, Treasure, E & Kleijnen, J (2002) A Systematic Review of Public Water Fluoridation York NHS Centre for Reviews and Dissemination, University of YorkGoogle Scholar
Maguire, A, Zohouri, FV, Steen, IN, Hindmarch, PN, Bruce, A, Mathers, JC & Moynihan, PJ (2005) Fluoride bioavailability in naturally and artificially fluoridated drinking water Journal of Dental Research Google Scholar
Marthaler, T (1996) The prevalence of dental caries in Europe 1990–1995. Caries Research 30, 237255 Google Scholar
Medical, Research Council (2002) MRC Working Group Report on Water Fluoridation and Health. London: Medical Research Council.Google Scholar
Michael, CG, Javid, NS, Collaizzi, FA & Gibbs, CH (1990) Biting strength and chewing forces in complete denture wearers. Journal of Prosthetic Dentistry 63, 549553 Google Scholar
Miyazaki, H & Morimoto, M (1996) Changes in caries prevalence in Japan. European Journal of Oral Sciences 104, 452458 Google Scholar
Mobley, C, Hattaway, K & Wicks, RA (1994) The oral health-nutrition connection: edentulous adult issues. Journal of the Texas State Nutrition Council 4, 24 Google Scholar
Moynihan, P, Butler, TJ, Thomason, JM & Jepson, NJA (2000a) Nutrient intake in partially dentate patients: the effect of prosthetic rehabilitation. Journal of Dentistry 28, 557563 Google Scholar
Moynihan, P, Greaves, R, Walls, AWG, Steen, N, Sheiham, A, Marcenes, W & Steele, J (2000b) The relationship between dental status and intake of fruits and vegetables by older adults. Proceedings of the Nutrition Society 60 68AGoogle Scholar
Moynihan, P, Snow, S, Jepson, N & Butler, TJ (1994) Intake of non-starch polysaccharide (dietary fibre) in edentulous and dentate persons: an observational study. British Dental Journal 177, 243247 Google Scholar
Moynihan, PJ & Petersen, PE (2004) Diet, nutrition and the prevention of dental diseases. Public Health Nutrition 7, 201226 Google Scholar
Munoz, KA, Krebs-Smith, SM, Ballard-Barbish, R & Cleveland, LE (1997) Food intake of US children and adolescents compared with recommendations. Pediatrics 100, 323329 Google Scholar
Murray, JJ (2003) Fluoride and dental caries. In Prevention of Oral Disease, pp. 3760 [Murray, JJ, Nunn, JN, Steele, JG, editors]. Oxford: Oxford University Press.Google Scholar
Murray, JJ, Rugg-Gunn, AJ & Jenkins, GN (1991) Fluorides in Caries Prevention, 3rd ed. Oxford: Butterworth-Heinemann.Google Scholar
O'Brien, M (1994) Children's Dental Health in the United Kingdom 1993, London: H. M. Stationery Office.Google Scholar
O'Mullane, D & Whelton, H (1994) Caries prevalence in the Republic of Ireland 44, 387–391Google Scholar
Osterberg, T & Steen, B (1982) Relationship between dental state and dietary intake in 70-year old males and females in Goteborg Sweden: a population study. Journal of Oral Rehabilitation 9, 509512 Google Scholar
Petersen, PE (2003) The World Oral Health Report 2003. Geneva:WHO.Google Scholar
Pitts, NB, Boyle, sJ, Nugent, ZJ, Thomas, N & Pine, CM (2004a) The dental caries experience of 14-year-old children in England and Wales: BASCD Survey Report – Google Scholar
Pitts, NB, Boyles, J, Nugent, ZJ, Thomas, N & & Pine, CM (2004b) The dental caries experience of 5-year-old children in England and Wales: BASCD Survey Report. Google Scholar
Renaud, M, Mercier, P & Vinet, A (1982) Does the rehabilitation of masticatory function influence the nutritive value of the diet?. St Mary's Hospital Bulletin 24, 186195 Google Scholar
Rugg-Gunn, AJ, Fletcher, ES, Matthews, JNS, Hackett, AF, Moynihan, PJ, Kelly, SAM, Mathers, JC & Adamson, AJ (2005) Changes in consumption of sugars by English adolescents over 20 years Public Health Nutrition Google Scholar
Rugg-Gunn, AJ, Hackett, AF, Appleton, DR, Eastoe, JE, Dowthwaite, L & Wright, WG (1987) The water intake of 405 Northumbrian adolescents aged 12–14 years. British Dental Journal 162, 335340 Google Scholar
Rusen, J, Krondl, M & Csima, A (1993) Perceived chewing satisfaction and food use of older adults. Journal of the Canadian Dietetic Association 54, 8892 Google Scholar
Ruxton, CHS, Garceau, FJS & Cottrell, RC (1999) Guidelines for sugar consumption in Europe. Is a qualitative approach justified. European Journal of Clinical Nutrition 53, 503513 Google Scholar
Sandstrom, B & Lindquist, L (1987) The effect of different prosthetic restorations on the dietary selection in edentulous patients. Acta Odontologica Scandinavica 45, 423428 Google Scholar
Scheinin, A, Makinen, KK & Ylitalo, K (1976) Turku sugar studies. V. Final report on the effect of sucrose, frutose and xylitol diets on the caries incidence in man. Acta Odontologica Scandinavica 34, 179198 Google Scholar
Schulerud, A (1950) Dental Caries and Nutrition during Wartime in Norway Oslo, Norway Fabritius and Sonners TrykkeriGoogle Scholar
Sebring, N, Guckes, A, Li, S-H & McCarthy, G (1995) Nutritional adequacy of reported intake of edentuylous subjects treated with new conventional or implant-supported mandibular dentures. Journal of Prosthetic Dentistry 74, 358363 Google Scholar
Sheiham, A (1983) Sugars and dental caries. Lancet i, 282284 Google Scholar
Sheiham, A (2001) Dietary effects on dental diseases. Public Health Nutrition 4, 569591 Google Scholar
Sreebny, LM (1982) Sugar availability, sugar consumption and dental caries. Community Dentistry and Oral Epidemiology 10, 17 Google Scholar
Steele, JG, Sheiham, A, Marcenes, W & & Walls, AWG (1998) National Diet and Nutrition Survey: People Aged 65 years and Over. Vol. 2: Report of the Oral Health Survey. London: The Stationery Office.Google Scholar
Strain, JJ, Robson, PJ, Livingstone, MBE, Primrose, ED, Savage, JM, Cran, GW & Boreham, CAG (1994) Estimates of food and micronutrient intake in a random sample of Northern Ireland adolescents. British Journal of Nutrition 72, 343352 Google Scholar
Takeuchi, M (1962) On the epidemiological principles in dental caries attack. Bulletin of the Tokyo Dental College 3, 96111 Google Scholar
Tate and, Lyle Speciality Sweeteners (2001) Sucralose Soft Drinks Report. Reading, Berks.: Tate and Lyle.Google Scholar
Wayner, H & Chauncey, HH (1983) Impact of complete dentures and impaired natural dentition on masticatory performance and food choice in healthy aging men. Journal of Prosthetic Dentistry 49, 427433 Google Scholar
Weaver, R (1950) Fluorine and war-time diet. British Dental Journal 88, 231239 Google Scholar
Whelton, H, Crowley, E, O'Mullane, D, Cronin, M & Kelleher, V (2003) Children's Oral Health in Ireland 2002. A North-South Survey Coordinated by the Oral Health Services Research Centre University College Cork Dublin, Republic of Ireland Department of Health and Children.Google Scholar
Woodward, M & Walker, ARP (1994) Sugar and dental caries: The evidence from 90 countries. British Dental Journal 176, 297302 Google Scholar
World Health OrganizationWorld Health Organization (1996) Monitoring Caries in Adults Aged 35–44Years Geneva:WHO.Google Scholar
World Health OrganizationWorld Health Organization (2003) Diet, Nutrition and the Prevention of Chronic Disease. Geneva:WHO.Google Scholar
Yukstas, A & Emerson, W (1964) Decreased masticatory function in denture patients. Journal of Prosthetic Dentistry 14, 931934 Google Scholar
Zohouri, FV, Maguire, A & Moynihan, PJ (2003) Fluoride content of still bottled waters available in the North-East of England. British Dental Journal 195, 515518 Google Scholar