STEVIA IS ANTI-CARIOGENIC. SO IS VITAMIN D, BUT THE LATTER HARDENS ENAMEL

One of the things that we all struggle with is getting the right information.  In the old days, if we didn't know something we'd rely on professionals--doctors, lawyers, dentists, teachers, and so forth.  Today, the internet has become a kind of equalizer, leveling the playing field of information, which puts an even greater premium on specialized information.  We'd like to think that this specialized information is more targeted as well to our individual circumstances.  But with greater information comes more competitors into a field.  And this can cause problems with getting the right, accurate, and actionable information.  Take dentistry, for instance.  For decades we were told that fluoride prevents cavities, and the science on this was so conclusive that municipal authorities began putting fluoride into the water supply of different cities around the country to the point that it is in almost every municipal water supply.  Then we learned that fluoride was bad for our health, that it was a neuro-toxin.  That can't be good.  Then companies and marketers began jumping on the non-fluoride bandwagon, convinced by the science and hopped up on propaganda, and to nearly ban fluoridate toothpaste and mouthwash from the marketplace.  The naysayers had won a victory.  But at what price?  Though we may not like having municipal committee members deciding for its citizens what we want in our water, the amount of fluoride in water is not enough to prevent cavities.  A lot of natural product supporters will cite this fact as proof for fluoride's poor performance in protecting teeth and gums.  But fluoride does have its place.   

I only wished I'd done my homework on dentistry when I was a kid.  Had I done so, I would have understood some of the terms that dentists threw around while my body was prone, my mouth agape, and twin female assistants took turns to warble flattering non-sense.  This image and these terms are a good start. 

So based on this picture, it looks like anything that threatens to unsocket your tooth is what you want to address immediately.  The gum tissue is what you want to nourish and clean.  Nutritionally speaking, vitamin C nourishes healthy gums.  But what about unhealthy gums, bleeding, or receding gums?  This is where the information gets overwhelming, and each person recommending this or that introduces an elaborate system for cleaning.  I hope that gum maintenance would be simple and elegant.  

GOAL #1: PRESERVE YOUR TEETH
We acquire 32 permanent, adult teeth.  KidsHealth explains that

By about age 12 or 13, most kids have lost all of their baby teeth and have a full set of permanent teeth. There are 32 permanent teeth in all — 12 more than the original set of baby teeth. Most people have four teeth (called wisdom teeth) grow in at the back of the mouth when they're between 17 and 25 years old.

How many teeth do you have today?  Following teenage cavities, braces, busted teeth from sports or rough play, we may only be left with 26 or 28 teeth at an early age.  And parents themselves don't know how many or what to do about lost teeth.  Can anything be done?  Since we don't know what is possible, it is better to adopt early a diet and hygiene that will keep as many of your permanent teeth as possible.  Remember that when you talk and when you smile, you show your teeth.  Make sure that that smile and that moving mouth during a speech or presentation is something to admire; least that it's not to frighten your audience. 

Periodontal Disease refers to the teeth and tooth structures inside and outside the tooth--gums, bone structure, and pulp inside the tooth.  One particular periodontal disease is gingivitis or swelling of the gums.  Swelling of the gums, or gingivitis, is different from a gingival recession, or receding gums.  So know your terms.  That doesn't answer for everything, but at least it will put you on a level footing with the dentist and keep him or her honest.  They don't really like their patients talking because questions and discussion eat into their scheduled list of patients for the day.  Better if you can put questions to them in advance.  
NUTRITIONAL SUPPORT FOR HEALTHY TEETH & GUMS Turns out that vitamin D is the main ingredient to help prevent cavities.  Oh, your dentist didn't tell you that?  Huh.  

from the Vitamin D Council, September 23, 2014.  Health Conditions: Dental Caries.  

DENTAL CARIES

WHAT ARE THEY?
Cavities.  

Dental caries, also known as tooth decay, is a tooth infection caused by bacteria that leads to a loss of the hard tissues of your teeth. It is one of the most common diseases in the world.  

THEIR CAUSE?
In a word, bacteria.  

Bacteria on the surface of teeth that can turn certain sugars into acids, which in turn can demineralize the hard tissues of your teeth. The bacteria form a sticky layer, which helps protect the bacteria from being removed by your immune system.

What produces corrosive bacteria?  Frequent snacking, sugary foods, and not enough saliva all increase your risk of developing dental caries.

PROVEN WAYS TO REDUCE BACTERIA
A few things.  Do all three.

1)  Vitamin D3. 

Research shows that vitamin D may help reduce the risk of dental caries in infants and younger children. Studies have shown that children with dental caries have lower levels of vitamin D.

More experiments are needed to know for sure if vitamin D can help to treat dental caries. Doctors and scientists don’t know yet whether taking a vitamin D supplement or getting more sun exposure, can help to prevent or treat dental caries.

Vitamin D will keep the enamel of your teeth hard.  The hardened enamel makes it more difficult for bacteria to corrode your teeth.  Vitamin D also keeps your immunity strong.  Saliva is part of your immunity that keeps bacteria in check.  

If you have cavities and want to take vitamin D, it is unlikely to make your cavities worse or cause you any harm, as long as you take less than 10,000 IU per day. However, it’s not proven that taking vitamin D will help treat dental caries or reduce your risk of developing dental caries.  What is proven is that vitamin D hardens enamel; the harder your enamel, the more difficult it is for bacteria to eat the surface of your teeth.  

2)  You'll need to use a fluoride toothpaste.  Fluoride-free toothpastes no added benefits to your health.  It's not the amount of fluoride in the toothpaste that you should worry about, for it is very little, but it is the accumulation of fluoride on your teeth that is protective.  You need protection from bacteria directly on the teeth themselves.  By hardening the enamel, fluoride protects from acid-forming bacteria.  

3)  Stop feeding yourself and your children sugar and sugary foods, like donuts, cookies, cereals, candy.  These produce acid-forming bacteria on the teeth.  If a sweetener is required, consume Stevia.  

Look, you've got to have a long-term outlook on your children's well-being.  Vitamin D, by the way, is extremely important, particularly during the winter months when more of our activities are indoors, cooking, watching TV, on the computer, or whatever.  Vitamin D isn't just beneficial for your children's teeth as important as that is for their confidence and social life, but vitamin D also is important for the bones in your mouth.  Vitamin D

has a critical role in enamel, dentin, and oral bone formation as ameloblasts and odontoblasts are target cells for 1,25-dihydroxyvitamin D, the active form of vitamin D. 

Vitamin D should be taken by the mother in a prenatal regimen, perinatal regimen (yes, babies can be given small amounts of vitamin D supplements), and post-natal.  Your efforts in your child's teeth will pay off years down the road.  He'll be happier, more confident.  

PERIODONTITIS
Here's a definition for Periodontitis.

Periodontitis, also referred to as gum disease, is a gum infection that damages the soft tissue and bone that surrounds the teeth. It can often result in gum recession and loosening of the teeth. It is the most common cause of tooth loss in the elderly.

Gingivitis is one form of periodontitis.  Know what gingivitis is.  It's inflammation of your gums.  Gingival recession means receding gums.  

For further explanation, check this out: 

Periodontitis is usually a painless, slowly progressing infectious disease in tooth-supporting tissues. Persistent bacterial colonization on the tooth surfaces leads to chronic inflammation in periodontal tissues. Periodontal inflammation results in gingival bleeding, pocket formation, destruction of alveolar bone, and eventually loss of teeth (33). Severe forms of periodontitis are relatively common, affecting up to 20% of the population worldwide (34).  

It's vitamin D to the rescue again, thanks to its anti-bacterial and anti-inflammatory properties

The pathogenesis of periodontitis is based on bacterial driven inflammation. Therefore, vitamin D has been hypothesized to decrease the risk of periodontitis by maintaining oral health by exerting its anti-inflammatory effects and reducing pathogenic bacteria.

Not only is periodontitis associated with low vitamin D, but so is low vitamin C.   10,000IUs of D and 500mgs of C should treat this condition.  The federal government of the United States collected dental data between 1988 and 1994 and found this: 

The study found a clear linear trend – the higher the vitamin D level, the lower the prevalence of gingivitis. There was no vitamin D level at which the relationship leveled off; the 10% of individuals with the highest levels of vitamin D (the group median was 45 ng/mL) had the lowest levels of gingivitis. 

A definition may not be enough to understand the seriousness of periodontitis disease.  It's serious.  Unfortunately, it's played down by dentists who either don't know how serious the disease is in connection with other vital organs or who are only interested in providing dental services--a tooth cleaning or filling--to remedy the disease in your mouth.  But it is serious stuff. 

Association of periodontal infection with organ systems like cardiovascular system, endocrine system, reproductive system and respiratory system makes periodontal infection a complex multiphase disease.

OIL PULLING REDUCES PLAQUE ACCUMULATION ON YOUR TEETH and, thus, ELIMINATES GINGIVITIS AND GUM RECESSION

Oil pulling with Sunflower oil, sesame seed oil, and coconut oil each reduce the amount of plaque on your teeth.  These reduce plaque accumulation on your teeth.  That, to me, seems like the number one benefit to oil pulling.  And because of its lauric acid, it seems that coconut oil could be the most effective of the three: sunflower oil, sesame seed oil, and coconut oil.  Odd that the study did not include olive oil.  How does it work?  

The oil film thus formed on the surface of the teeth and the gingiva can reduce plaque adhesion and bacterial co aggregation.⁵

TREATING GINGIVITIS with MOUTHWASH
Apparently, the best mouthwash to use is one that contains Chlorhexidine.

A 2017 study Trusted Source suggests chlorhexidine is the most effective antiseptic mouthwash to date. Dentists primarily prescribe it to treat the inflammation, swelling, and bleeding that comes with gingivitis.

Chlorhexidine is available in the United States under the brand names:

Paroex (GUM) [or PerioShield]

Peridex (3M)

PerioGard (Colgate)

There are a few unwanted side effects to using Chlorhexidine, so please read the link above where I obtained the information.

This video recommends a product called Gum Recession Rescue Tooth Powder, which sounds like a toothpaste.

WHAT ABOUT GUM SURGERY?  IS THAT THE WAY TO CURE GUM DISEASE? 
Hardly.  Gum surgery will only make gum disease worse.  Most surgeries in and around the body only compromise the tissue that is being cut.  David Kennedy, DDS, makes a good point.

So if you had an infected finger and went to the doctor and he/she got out a chopping knife to “fix” your problem you would likely run. If you go to a dentist and they recommend surgery I suggest you run as well. Cutting on gums merely accelerates the disease because it allows the bad guys to burrow deeper into tissue and bone and dose little to remove the offending bad guys. 

For gum recession and gingivitis, Andrew Saul recommends comfrey.  

DAVID KENNEDY, DDS, AMONG OTHERS, SUGGESTS USING A WATER PICK

HOW CAVITIES (or CARIES) DEVELOP
There are bacteria that live inside of your mouth that help break down foods and sugars that you eat. When dental caries develop, certain bacteria turn sugars into acids, which demineralize and destroy the hard tissues of the teeth. This demineralization and destruction of tooth tissue is tooth decay.

In children, dental caries are called early childhood caries (ECC). ECC, also known as bottle rot, is the presence of one or more decayed, missing, or filled tooth surfaces in any primary tooth in a child under three years of age¹.  

VITAMIN D TO THE RESCUE, LITERALLY 
Lacking Vitamin D has shown to be the main culprit in Early Childhood Caries.  Vitamin D keeps tooth enamel hard.  The way that works is that if you have adequate Vitamin D in your blood, the vitamin D makes the calcium in your blood more absorbent.  The result is that you get more calcium into the bone.  Know, too, that the cells that make up your teeth, the dentin and enamel and pulp, all have vitamin D receptors on the cells.  

You can give your child up to 1,000IUs of vitamin D per day.  Children playing outside in the front or backyard or up at the local elementary school with short sleeve shirts and shorts can get some vitamin D.  They get more vitamin D at the beach where more of their skin is exposed to sunlight.  Same for adults.  But the point of this is to make sure that you provide your child with adequate vitamin D for strong teeth that can better resist tooth decay.  And as your child becomes a teenager and a young adult, they'll feel better about themselves and their smile if their teeth are strong and healthy.  

Also, for mothers, you should be supplementing with vitamin D during pregnancy.  Don't be so arrogant about your physical powers to think, "Nah, I don't need no supplementation."  You do.  You need it for you AND for your baby's well-being.  Supplementing with vitamin D during pregnancy will prevent several unfortunate occurrences with your baby.  Truly. 

Low maternal vitamin D levels during pregnancy have been associated with a plethora of adverse neonatal outcomes, including small for gestational age and preterm births, detrimental effect on offspring bone and teeth development, and risk of infectious diseases. 

Without vitamin D, your child will be looking forward to regrettable and expensive procedures at the dentist's office as well.  Read for yourself:

Usually, treatment of caries involves removing the decay and then filling the space with restorative materials, such as porcelain or gold. In extreme cases, what is known as a “root canal” is needed if the pulp in your tooth dies from infection by bacteria.

MAINTENANCE

A professional cleaning every six months, brushing at least twice a day, and flossing daily can help you to prevent developing dental caries². Brushing your teeth removes plaque, which is a group of bacteria hidden under a protective surface on the teeth. As the amount of plaque increases, the tooth is more vulnerable to dental caries.

Nothing new here.  Except you might not know that using fluoride toothpaste is an added layer of protection for your enamel, dentin, and pulp.  There has been such a brouhaha over the hazards or toxicity of fluoride.  And yes it is an industrial solvent.  Yeah, so if you drink a gallon of the stuff, you're right, it is bad for you.  As to the fluoride in your municipal water supply, right again.  It's not nice that local governments put that in without your permission and then refuse to remove it after you're aware of it.  The government will always provide some rationale, usually false so that it serves some other purpose.  But the government's promise is that the fluoride is in the water supply to protect children's teeth.  Hardly.  The amount of fluoride in the water supply does not provide enough fluoride to protect your teeth.  Bill Sardi states it best

Fluoride helps harden dental enamel and thus makes teeth resistant to acid-forming bacteria that induce cavities.

Eating healthy can help reduce the risk of decay, such as reducing both the amount of and how often you consume sugars that are fermented by bacteria in the mouth. Increasing your intake of calcium is also often recommended to protect against dental caries because this can strengthen your teeth.

HOW CAN I AVOID ACID-PRODUCING FOODS?
Stop feeding yourself and your kids sugar.  

Start by reading this from Bill Sardi.  

Another major assault against dental decay would be for food processors and home cooking mothers to cease use of added sugars to foods that feed the growth of acid-forming bacteria in the mouth that are primarily responsible for dental decay.  In that regard, stevia leaf non-caloric sweeteners are considered to be “non-cariogenic” and would be a preferred form of sweetener for children whose taste buds are drawn to sweetened foods.  A stevia-based mouth rinse may even be superior to fluoride mouth rinses.

WHAT CAUSES DENTAL CARIES? 
Dental caries are caused by bacteria on the surface of teeth that can turn certain sugars into acids, which can demineralize the hard tissues of your teeth. The bacteria form a sticky layer, which helps protect the bacteria from being removed by your immune system.

Caries develop when your tooth enamel starts to demineralize by acids secreted by bacteria. Enamel is the thin, highly mineralized coating that makes up the visible part of teeth. The damage caused by the acids then spreads into the dentin, which is the softer tissue underneath the enamel. At this point, the tooth develops a cavity.

Before the cavity forms in the dentin, the process is reversible, but after it spreads to the dentin, it is not. The decay then spreads through the dentin to the layer below, called the pulp. The pulp is the part of the tooth that is made up of living connective tissue and its main purpose is to form dentin.

WHAT ARE THE SYMPTOMS OF DENTAL CARIES?
When caries begin to develop in your mouth, you may not be aware that you have the disease. As your tooth decays more and more, the most apparent symptom is pain in your tooth. This pain can be caused by sensitivity to heat and cold or consumption of sweet foods and drinks.

When your tooth is severely decayed, a toothache can develop which means the pain will become constant.

HOW COMMON ARE DENTAL CARIES? 
About 92% of adults aged 20 to 64 years old have had dental caries in their permanent teeth. In this same group, there is an average of about 3 decayed or missing permanent teeth caused by dental caries³.

About 92% of adults age 20 to 64 years old have had dental caries in their permanent teeth.

Medical conditions that reduce the amount of saliva in your mouth, such as Sjögren’s syndrome, diabetes, and sarcoidosis, can increase your risk of developing caries. Certain medications such as antihistamines and antidepressants can also reduce the amount of saliva in your mouth and increase your risk of caries. Saliva contains antimicrobial compounds, as well as minerals that neutralize the acids created by bacteria and help to protect and restore the teeth.

There are certain things that can increase your risk for dental caries, such as⁴:

Tooth location and surface. Caries are most commonly found on incisors, canines, premolars, and fissure sites in molars.
Foods that cling to the teeth, such as candy or chocolate.
Frequent snacking and sipping on sugary drinks.
Bedtime infant feeding.
Inadequate brushing of teeth.
Dry mouth.
Heartburn.

WHAT IS THE LINK BETWEEN VITAMIN D AND DENTAL CARIES? 
Enamel is the most mineralized substance in the human body. It is made up of mostly calcium and phosphate. Vitamin D is important for increasing the absorption of calcium and phosphate from the food you eat.

Increasing the absorption of calcium and phosphate can improve the strength of your teeth and their ability to fight demineralization from bacteria.

Vitamin D receptors are found on cells in your immune system and in your teeth. Vitamin D can bind to these receptors and increase the amount of good antimicrobial proteins in your body which help to fight the bacteria that cause dental caries⁵.

In addition, the cells in the teeth that form dentin and enamel contain vitamin D receptors, meaning that vitamin D may play a role in their functioning.

WHAT DOES THE RESEARCH SAY, IN GENERAL, ABOUT DENTAL CARIES?
Some studies show that dental caries are most common in late winter and early spring, when vitamin D levels are likely to be at their lowest⁶.

Many studies have found that geographic location and sun exposure are related to dental caries. People living closer to the equator with greater amounts of sun exposure are less likely to develop dental caries⁷.

Mothers of children have lower vitamin D levels during pregnancy than mothers whose children don't have caries.

Most of the research on vitamin D and dental caries has looked at ECC and severe ECC.

Children with ECC tend to have lower vitamin D levels than healthy children^8,9. Mothers of children with ECC have lower vitamin D levels during pregnancy than mothers whose children don’t have caries¹⁰.

Some experiments have found that giving a mother vitamin D supplements while she is pregnant can reduce the rate of dental enamel defects in their children. Defects in dental enamel increase the risk of a child developing dental caries¹¹.

Studies that give people vitamin D supplements to prevent caries have found that vitamin D is effective at preventing the development of caries¹².

WHAT DOES RECENT RESEARCH SAY ABOUT DENTAL CARIES?
A study published in 2014¹⁰ looked at the vitamin D levels of pregnant Canadian women and whether or not their children developed ECC in their first year of life. They found that:

Mothers of children who developed ECC had lower vitamin D levels compared to mothers of children who did not develop ECC.

Children with ECC had more dental caries if their mothers had low vitamin D levels during pregnancy.

The researchers conclude that the vitamin D levels of a mother during pregnancy may relate to their children’s risk of developing ECC.

A Canadian study from 2013⁹ looked at preschool children with severe ECC and children of the same age without dental caries. The researchers measured the children’s vitamin D levels and the parents answered questions on their child’s nutritional habits, oral health, and family information. They found that:

Children with severe ECC had lower vitamin D levels than healthy children.

Winter season was also related to low vitamin D levels in children with severe ECC.

A 2013 review from the United States¹² looked at many studies that measured the effects of UV therapy and vitamin D supplementation in preventing dental caries. The main findings were:

Taking vitamin D supplements resulted in a 47% reduced rate of dental caries.

Taking vitamin D supplements had no effect on caries in those older than 13 years old, especially in girls.

The researchers concluded that taking vitamin D supplements may help protect against developing dental caries in children younger than 13 years old.

KEY POINTS FROM THE RESEARCH
Dental caries are more common in late winter and early spring, which is when vitamin D levels tend to be lower.

Children with severe ECC have lower vitamin D levels compared to children without caries.

Mothers with low vitamin D levels are more likely to give birth to children who develop dental caries.

Vitamin D supplementation may help reduce the risk of developing dental caries.

WHAT DOES THIS MEAN FOR ME?
Research has shown that there is a link between vitamin D and dental caries.

Vitamin D can help strengthen your teeth's resistance to bacteria by helping to absorb calcium and phosphate.  

Vitamin D can help strengthen your teeth’s resistance to bacteria by helping to absorb calcium and phosphate. Vitamin D also increases the amount of good antimicrobial proteins which can destroy the bacteria that cause caries.

Research shows that higher vitamin D levels in pregnancy and early life can help to reduce the risk of dental caries.

However, more experiments are needed to know for sure if vitamin D is effective in treating dental caries. Doctors and scientists don’t know yet for sure whether or not taking a vitamin D supplement or getting more sun exposure, can help to prevent or treat dental caries.

If you have dental caries and want to take vitamin D, it is unlikely to make your dental caries worse or cause you any harm, as long as you take less than 10,000 IU per day. However, it’s not proven that taking vitamin D will help you prevent or treat dental caries.

You shouldn’t take vitamin D in place of the treatment medications for your dental caries. Talk to your doctor for more advice about taking supplements.  

HALITOSIS
Is bad breath.  But there are multiple sources for his.  NCBI describes one kind of halitosis: 

Physiological halitosis (foul morning breath, morning halitosis) is caused by stagnation of saliva and putrefaction of entrapped food particles and desquamated epithelial cells by the accumulation of bacteria on the dorsum of the tongue, recognized clinically as coated tongue and decrease in frequent liquid intake. 

Tongue scrapers are one way to remove 75% of the bacteria that causes halitosis.  So that's good.

Tongue scrapers are shaped according to the anatomy of the tongue and reduces 75% VSCs compared to only 45% using a toothbrush. 

Failure to floss leads to halitosis.  

REFERENCES

1. "Statement on Early Childhood Caries.” Statement on Early Childhood Caries. American Dental Association, 22 Sept. 2014. Web. 22 Sept. 2014.

2.  "Dental Cavities: MedlinePlus Medical Encyclopedia.” U.S National Library of Medicine. U.S. National Library of Medicine, 8 Sept. 2014. Web. 22 Sept. 2014. 

3.  "Dental Caries (Tooth Decay) in Adults (Age 20 to 64).” Dental Caries (Tooth Decay) in Adults (Age 20 to 64). National Institute of Dental and Craniofacial Research, 22 Sept. 2014. Web. 22 Sept. 2014.

4.  "Cavities/Tooth Decay.” Risk Factors. Mayo Clinic, 22 Sept. 2014. Web. 22 Sept. 2014. 

5.  Youssef, D., C. Miller, A. El-Abbassi, D. Cutchins, C. Cutchins, W. Grant, and A. Peiris. “Antimicrobial Implications of Vitamin D.” Dermatoendocrinology 3.4 (2011): 220-29.

6.  McBeath, E., and T. Zucker. “The Role of Vitamin D in the Control of Dental Caries in Children.” Journal of Nutrition 15.6 (2937): 547-64.

7.  Grant, W.B. “A Review of the Role of Solar Ultraviolet-B Irradiance and Vitamin D in Reducing Risk of Dental Caries”. Dermatoendocrinology 3.3 (2011): 193-98.

8.  Schroth, R., N. Jean, E. Kliewer, and E. Sellers. “The Relationship between Vitamin D and Severe Early Childhood Caries: A Pilot Study.” International Journal for Vitamin and Nutrition Research 82.1 (2012): 53-62.

9.  Schroth, R. et al. “Vitamin D Status of Children with Severe Early Childhood Caries: A Case-control Study.” BMC Pediatrics 13 (2013): 174.

10.  Schroth, R. et al. “Prenatal Vitamin D and Dental Caries in Infants.” Pediatrics 133.5 (2014): 1277-284.

11.  Cockburn, F. et al. “Maternal vitamin D intake and mineral metabolism in mothers and their newborn infants.” British Medical Journal 281.6332 (1980): 11-14.

12.  Hujoel, P. “Vitamin D and dental caries in controlled clinical trials: systematic review and meta-analysis.” Nutrition Reviews 71.2 (2013): 88-97.

This page was last updated in September 2014.

Stevia leaf non-caloric sweeteners are considered to be non-cariogenic.  Meaning that this sweetener, unlike sugar or high-corn fructose syrup, does not produce cavities.