Optimizing patient care through nutrition

By Jennifer L. Rankin, DDS

We are at such an exciting time in dentistry!

Every day new materials and technologies emerge to better serve our patients.Though it is old news that nutrition and oral health are connected, we are learning more and more just how important nutritional status is to dental health and systemic health, that there is not any part of the body that operates in isolation, and that we can significantly impact our patients lives in this area. The role of food in oral health has 2 purposes. The first is that food contributes to the health of the mouth as well as overall health. A balanced diet is the foundation of a healthy body. Secondly, eating habits have a direct effect on decay. Many of the same foods that are highly cariogenic are also pro-inflammatory. Complex carbohydrates found in fruits, vegetables and whole grains should be encouraged over highly processed, sugary foods and beverages to reduce cariogenic potential and improve overall health. Periodontitis is a chronic, inflammatory infection. Chronic inflammation is the common underlying factor in most other diseases including, but not limited to, heart disease, rheumatoid arthritis, and autoimmune diseases. Periodontitis is associated with cardiovascular disease, diabetes, stroke and low birth weight children, and chronic inflammation can put patients at risk for subsequent bacterial or viral infections. It is reasonable to suggest that if we can help our patients reduce their systemic inflammation, we would see an improvement in their periodontal status. Importance of fruits and vegetables
Fruits and vegetables contain essential vitamins, minerals, antioxidants and fiber that help protect our bodies from chronic disease. People who eat more fruits and vegetables as part of a healthful diet are likely to have reduced risk of chronic diseases, including, but not limited to, stroke, other cardiovascular diseases, diabetes, and cancer.Phytonutrients found in fruits, vegetables, and spices help fight harmful inflammation and reduce oxidative stress. Molecular Biologist Daniel Hwang’s studies indicate that some phytochemicals in fruits and vegetables protect us by disrupting established inflammatory pathways. When they do that, they block the activation of pro-inflammatory genes. Research in this area continues, but one message is certainly clear: chronic inflammation and subsequent risk of chronic disease, which includes periodontal disease, can be altered by what we eat. Based on the facts that oral and systemic health are related and that good nutrition has a positive impact on all facets of health and disease, it is reasonable to suggest that if we educate our patients on the significant role of nutrition and recommend antioxidant-rich fruits and vegetables in their diet, we can improve the outcomes of treatment for all of our patients. A study published in the Journal of Clinical Periodontology illustrates just that. Initial findings showed that patients taking adjunctive fruit and vegetable juice powder concentrate (Juice Plus+) compared to placebo had a higher reduction in initial pocket depth, diminished gingival crevicular fluid volumes, and lower % BOP and cumulative plaque scores.Juice Plus+
Juice Plus+ is concentrated whole food. Dr. Humbart Santillo was treating cancer patients in New Mexico and noticed that those patients who had better nutritional status had a significantly better response to treatment than those with poorer nutrition. He began giving his patients fruit and vegetable powders. These later developed into the product known today as Juice Plus+. After 17 years, there are 22 studies (and more underway) proving what Dr. Santillo saw clinically. Nineteen of the 22 studies are gold standard studies done at universities throughout the world. The studies are all human clinical trials. In summary, Juice Plus+ has been proven to:1. Deliver key antioxidants and other phytonutrients that are absorbed by the body2. Reduce oxidative stress3. Reduce key biomarkers of systemic inflammation4. Support a healthy immune system5. Help protect DNA from damage6. Support cardiovascular wellness7. Support healthy skin8. Enhance periodontal health Juice Plus+ is one of the only products we can offer our patients that benefits them systemically. Even better, there are no side effects, and we can see the results orally. Prevention has always been the focus of our amazing profession. Juice Plus+ is an outstanding adjunct to continue that mission. There is one product out there called Fruit and Veggie Support that claims to be comparable to Juice Plus+. The primary benefit that sets Juice Plus+ apart from the former product is research. Fruit and Veggie Support has several testimonials, but no research. Ultimately, don’t you, as dental professionals, want to know that what you are recommending is backed by research? It is your reputation on the line. References
1. adha.org/CE_courses/course7/table4.htm.2. The Role of Food in Oral Health. www.mchoralhealth.org/PediatricOH/mod4_3.htm.3. Rose, Gianna. List of Pro-inflammatory Foods. www.livestrong.com/article/332010-list-of-pro-inflammatory-foods.4. Wood, Marcia. Inflammation and You: How Foods from Plants Protect Us From Disease. www.ars.usda.gov/is/ar/archive/apr09/plants0409.htm.5. Oral Health Topics: Oral-Systemic Health. www.ada.org/4081.aspx.6. Demmer, Ryan T., Desvarieux, Moise. Periodontal Infections and Cardiovascular Disease: The Heart of the Matter. JADA, Vol 137. jada.ada.org.7. Zoellner, H. Dental Infection and Vascular Disease. www.ncbi.nih.gov/pubmed/21455852.8. Clem, Donald S, DDS. The Link Between Periodontal Disease and Upper Respiratory Infection. Inside Dentistry. Oct. 2011, www.dentalaegis.com.9. Wong, DMD, DMSc, David T. M. Biomarkers in Saliva Help Detect Early Stage Pancreatic Cancer, Inside Dentistry, Oct. 2011; www.dentalaegis.com/id.10. Jin, Yu, et al. Systemic inflammatory load in humans is suppressed by consumption of two formulations of dried, encapsulated juice concentrate. Molecular Nutrition and Food Research 2010; 54:1506-1514. www.mnf-journal.com.11. Chapple, I, Milward, Michael R, et.al. Adjunctive daily suplementation with encapsulated fruit, vegetable, and berry juice powder concentrates and clinical periodontal outcomes: a double-blind RCT. Journal of Clinical Periodontology 2012;39:62-72.12. www.fruitsandveggiesmatter.gov/benefits/.13. www.juiceplus.com/nsa/content/Science.soa.

Jennifer L. Rankin, DDS, is in general practice in Aurora, Colo. US Navy 1993-1996 Graduate University of Iowa 1993. For additional information, contact her at [email protected] or visit www.livinhealthywithjp.com.