Say almond cheez!

NOTE: Before reading the rest of this, please check out my more recent article at Frugivore magazine, which talks about the role of fat-soluble vitamins in dental health—particularly in the context of vegan diets. Although I still think the information below is important, I’m now convinced that an insufficiency of vitamins D, K2, and A are the main reason so many vegans and raw vegans experience declining dental health.

Ah, teeth. Everyone’s favorite subject. In the land of the raw, no topic springs up quite as often as dental woes do—everything from cavities to sensitivity to receding gums to eroding enamel. It’s a little scary. And considering raw foodists probably do more chewing than any other humans on the planet, keeping our chompers in good shape is vital.

Before raw, my own teeth were in tip-top condition: only one tiny cavity when I was 12, perfect dental checkups, never needed braces. Dentists loved me, and I loved them. All was well.

Alas, after my first year as a raw foodist, reality bit me (with its own perfectly-whittled incisors): 14 cavities in one dental visit. That’s not a typo, although I kind of wish it was. I’m still dealing with the aftermath, and will probably never have a bite that fits together perfectly due to the grinding and drilling all that dental work required.

And my experience is an unfortunately common one. Amidst a laundry list of health improvements, many raw foodists find a startling decline in their oral health when they amp up the fruits and veggies and nuts—a paradox, considering that good nutrition and avoidance of refined sugar should improve the state of your mouth, not degrade it.

So what’s going on here?

It’s not just detox

There’s an odd belief floating around that cavities (and other dental damage) are signs your body is detoxing through your teeth, and are therefore normal when you first go raw. I’m not sure how many people believe this, but I’ve seen the cavities-as-detox theory proposed more than once—and it never fails to make me cringe. I like to keep an open mind, I really do. But if your teeth are decaying, it’s not a good thing—ever. If a tooth falls out, it’s probably not because your body is going to sprout a new, pretty, better one; it’s because something is very, very wrong.

After my own dental health crisis, I started researching like mad. Why do so many otherwise vibrant raw folks suffer from dental drama? Indeed, one of the few studies conducted on raw foodists shows a definite correlation between eating a 95 percent (or more) raw diet and acquiring dental caries—you can check out the abstract here: Dental erosions in subjects living on a raw food diet (1999)—so this is really more than anecdotal observation.

It seems tooth damage can be divided into two main categories: external factors and internal ones. In this post, let’s look at the former.

External factors

1. Eating frequency.

Many raw foodists—especially in the beginning of a dietary switch from cooked fare—ditch the three-square-meals-a-day mantra and become chronic grazers. Much of the time, this is the only conceivable way to consume enough calories; it’s either snack or starve, at least until you get used to eating a lot of bulk in one sitting.

Unfortunately, frequent eating spells trouble for teeth. The more often you put food in your mouth, the more often your teeth are exposed to sugars and acids from foods—and the less of a chance your saliva has to remineralize your enamel. (Saliva is a natural tooth-builder, rich in key minerals like calcium and phosphorus.) Even if no other eating habits change, turning into a grazer—or even an all-day juice and smoothie sipper—can contribute to enamel damage and decay.

The solution? Consolidate your eating schedule. Leave plenty of time between meals. If you must munch frequently, rinse your mouth out with water after eating, finish each meal with a mineral-rich food like greens, and floss, floss, floss until you can floss no more. Ideally, your day should be full of some large chunks of no-eating time so your saliva can work its remineralizing magic.

2. Nuts, dried fruit, and dehydrated foods.

Sticky, hard-to-scrape-off foods play a major role in dental damage. The longer food debris stays stuck on or between your teeth, the easier it is for bacteria to launch the process of decay. Nuts, dried fruit, and dehydrated foods—which fill the menus of many raw foodists, especially transitioning ones—tend to cling to tooth surfaces, providing a convenient meal for bacteria.

The solution? Eat these things sparingly, and when you do consume them, floss the debris out of your teeth immediately afterward.

3. Changes in dental health practices.

There seems to be some kind of rumor that wild animals—especially our higher primate relatives—live free from any sort of dental distress. As a result, going raw often comes with a shift in dental hygiene. If the chimps don’t brush on their natural diet, why should we?

Actually, animals do suffer from tooth decay and cavities, albeit not at the rate most humans do. Skeletons of dead chimpanzees in the wild, as well as examinations of live ones, frequently reveal cavities, broken or chipped teeth, decay, and other signs severe wear. Not to mention some pretty gnarly staining. Eating raw does not make you immune to dental problems. Not to mention, many of us are coming to raw with compromised health and not-so-perfect genes, so we’re already at a disadvantage to other creatures who’ve had a lifetime of good nutrition.

The solution? Keep flossing, keep brushing. If you had a successful dental health regimen on cooked food, don’t ditch it just because you go raw. If you’re concerned about chemicals and certain ingredients in oral health products, absolutely look into less toxic alternatives—but don’t stop brushing altogether. It won’t help. I promise.

4. Physical pH of raw foods.

You’ve probably heard of foods being “alkaline” or “acidic”—that is, some leave an alkaline residue after digestion, while others leave an acidic one. But when it comes to dental health, you’ve also got to consider the actual pH of food when it first enters your mouth and hits the surface of your teeth. Regardless of what happens to food after metabolization, the initial contact is what can cause the most damage.

Here’s a list of the pH of some raw foods taken from FDA measurements. The lower the number, the more acidic the food; 7 is considered neutral, although anything with a pH of 5 or greater is less likely to damage your teeth. Citrus often gets a bad rap, but notice that some other fruits—especially berries, plums, and grapes—have an even lower pH than oranges. And bear in mind that unripe fruit will typically have values lower than the ones listed.

For your viewing pleasure, I’ve highlighted the items under 5.0 pH in red.

Raw plant foods:

Aloe juice: 6.0 – 6.8
Apple, Red Delicious: 3.9
Apple, Golden Delicious: 3.6
Apple, Jonathan: 3.3
Apple, McIntosh: 3.3
Apricots: 3.3 – 4.8
Asparagus: 6 – 6.7
Avocado: 6.3 – 6.6
Bananas, red: 4.6 – 4.8
Bananas, yellow: 5.0 – 5.3
Beets: 5.3 – 6.6
Blackberries: 3.9 – 4.5
Blueberries: 3.1 – 3.3
Broccoli: 6.3 – 6.5
Cantaloupe: 6.1 – 6.6
Carrots: 5.9 – 6.4
Cauliflower: 5.6
Celery: 5.7 – 5.9
Cherries, Royal Ann: 3.8
Chives: 5.2 – 6.3
Coconut meat: 5.5 – 7.8
Corn: 5.9 – 7.3
Cucumbers: 5.1 – 5.8
Dates: 4.1 – 4.9
Eggplant: 5.5 – 6.5
Fennel: 5.5 – 5.9
Figs, Calamyrna: 5.2 – 6.0
Garlic: 5.8
Ginger: 5.6 – 5.9
Gooseberries: 2.8 – 3.1
Grapes, Concord: 2.8 – 3.0
Grapes, Lady Finger: 3.5 – 3.6
Grapes, Malaga: 3.7 – 3.8
Grapes, Muscadine: 3.2 – 3.4
Grapes, seedless: 2.9 – 3.8
Grapefruit: 3.0 – 3.8
Honey: 3.7 – 4.2
Jackfruit: 4.8 – 6.8
Jujube: 5.2
Kale: 6.4 – 6.8
Kelp: 6.3
Kumquat: 3.6 – 4.2
Leeks: 5.5 – 6.2
Lemon juice: 2.0 – 2.6
Lettuce, Boston: 5.9 – 6.1
Lettuce, iceberg: 5.7 – 6.1
Lettuce, romaine: 5.8 – 6.1
Lime juice: 2.0 – 2.4
Loganberries: 2.7 – 3.5
Lychee: 4.7 – 5.0
Mangos: 3.4 – 4.8
Mangosteen: 4.5 – 5.0
Melon, Casaba: 5.8 – 6.0
Melon, honeydew: 6.0 – 6.7
Melon, Persian: 5.9 – 6.4
Mushrooms: 6.0 – 6.7
Nectarines: 3.9 – 4.2
Onions, red: 5.3 – 5.8
Onions, white: 5.4 – 5.9
Onions, yellow: 5.3 – 5.6
Oranges, Florida: 3.7 – 4.3
Oranges, “color added”: 3.6 – 3.9
Papaya: 5.2 – 6.0
Parsley: 5.7 – 6.0
Peaches: 3.3 – 4.0
Pears, Bartlett: 3.5 – 4.6
Peppers, green: 5.2 – 5.9
Persimmons: 4.4 – 4.7
Pineapple: 3.2 – 4.0
Plums, blue: 2.8 – 3.4
Plums, red: 3.6 – 4.3
Plums, yellow: 3.9 – 4.5
Pomegranate: 2.9 – 3.2
Radishes: 5.8 – 6.0
Rambutan: 4.9
Raspberries: 3.2 – 3.9
Sauerkraut: 3.3 – 3.6
Scallion: 6.2
Spinach: 5.5 – 6.8
Strawberries: 3.0 – 3.9
Sweet potatoes: 5.3 – 5.6
Swiss chard: 6.2 – 6.8
Tangerine: 3.3 – 4.5
Tomatillo: 3.8
Tomatoes: 4.3 – 4.9
Vinegar:  2.4 – 3.4
Walnuts: 5.4
Watercress: 5.9 – 6.2
Watermelon: 5.2 – 5.6
Zucchini (Courgette): 5.7 – 6.1

Non-vegan, potentially raw foods:

Cheese, Camembert: 7.44
Cheese, cheddar: 5.9
Cheese, cottage: 4.75 – 5.0
Cheese, Roquefort: 5.1 – 6.0
Cheese, parmesan: 5.2 – 5.3
Egg white: 7.9
Egg yolk: 6.1
Honey: 3.7 – 4.2
Mackerel: 6.3 – 6.5
Milk, cow: 6.4 – 6.8
Milk, goat: 6.5
Salmon: 5.9 – 6.5
Tuna: 5.9 – 6.2

In addition, many raw foods—especially fruits—are water-rich, so whatever acidity they carry turns into a literal mouthwash when you chew. Bite into a not-quite-ripe orange, for example, and your teeth will receive a complete acid bath, with low-pH juice hitting all surfaces of your teeth before you swallow (and lingering there for a while afterwards). If you eat a diet full of low-pH foods, you’re bound to experience that dreaded tooth sensitivity, and you may eventually notice the tips of your teeth becoming transparent from enamel loss.

The solution? Avoid super-acidic items, go easy on lemon juice and vinegar, and eat your fruit as ripe as possible. Sugar is less damaging to enamel than acid is, so even a minimal-sugar diet with some highly acidic items can cause damage. The worst combination is likely sugar and acidity, which gives bacteria a head-start on enamel erosion (acid) along with supplying it with food (sugar). That makes unripe citrus, grapes, apples, plums, and berries the most damaging of the bunch.

To quickly raise the pH of your mouth after eating (and thus avoid enamel damage), swish your mouth out with a mixture of water and baking soda, which has an alkaline pH of about 8.2. This works wonders.