Does the Paleo Diet Affect Teeth and Gums?

That's more like it

Nice set of choppers

I got a little excited when I ran across this scientific article.  My hopes were quickly deflated and I’ll tell you why shortly.

In 2007, 10 study subjects did a Stone Age reenactment over the course of four weeks. It was covered extensively by Swiss TV.

Background First

Dental plaque is a complex biofilm that accumulates on teeth and oral tissue.  It’s influenced by diet and genetics.  Plaque can lead to gingivitis (gum inflammation and disease).  If untreated, gingivitis can lead to the more serious periodontitis with tooth loss.  A couple human studies in the 1980s showed that a high-carbohydrate diet leads to gingivitis, compared to a low-carb diet.  Dietary sucrose (table sugar) is linked to increased plaque and gingivitis.

The Experiment: Swiss Stone Age Lifestyle

The ten subjects included two families of four plus two young men.  Four were children or adolescents.  Anthropologists created an environment replicating living conditions close to the Rhine River between 4000 and 3500 BC.  “Living quarters, clothing , tools, and types of food stock were provided as known from archeological findings in the region.  Therefore, the diet was restricted to included a basic supply of whole grains of barley, wheat, spelt (“einkorn,” “emmer” = local ancient agricultural wheat), some salt, herbs, honey, milk, and meat from domestic animals (goats and hens).  A hunter would shoot one of the goats at the participants request….(T)hey were forced to seek supplemental food from nature, including berries, edible plants, and fish without nets.”  Subjects had no access to toothbrushes, toothpaste, tooth picks, or floss.  Oral hygiene was assessed before and after the four weeks in this environment.  We don’t have a nutritional analysis of individuals’ dietary habits during the experiment.  “Cereals and berries were primary food sources for the subjects.”

Some of you have already noted the source of my disappointment. The paleo diet most of us talk about today in the U.S. provides no wheat or milk, or at least very little.  The anthropologists considered this set-up early Stone age, but wasn’t it more late Stone Age or Neolithic?

What Did They Find?

Gum bleeding-on-probing and probing depth decreased (potentially healthy trends).  Plaque index increased (more plaque, but they had no increase in severity of gingival inflammation).  Gingival index (not defined in the paper) didn’t change.  Bacteria growing on the teeth and gums changed, but I won’t bore you with the details.

The investigators surmise that subjects avoided an increase in gingival inflammation due to table sugar restriction and intake of foods rich in anti-inflammatory and antibacterial components.

The researchers conclusions:

The experimental gingivitis protocol is not applicable if the diet (e.g., Stone Age) does not include refined sugars.  Although plaque levels increased, bleeding-on-probing and plaque index decreased.  Subgingival bacterial counts increased for several species not linked to periodontitis whereas tongue bacterial samples decreased during the study period.

Bottom Line for Me

I’m not aware of other paleo bloggers covering this study, and I can see why.  It’s a small short-term experiment.  The inclusion of grains and milk in the experimental protocol limits its applicability to the currently trendy paleo diet.

While I mostly wasted a couple hours on this, I hope I saved you the effort.  You’re welcome.

In the comment section, feel free to share your dental effects when you switched to a paleo diet.

Steve Parker, M.D.

Reference: Baumgartner, Stefan, et al.  The impact of the Stone Age diet on gingival conditions in the absence of oral hygiene.  Journal of Periodontology, 2009 (80): 759-768.

15 responses to “Does the Paleo Diet Affect Teeth and Gums?

  1. It may have been a different story if before starting the trial Vitamin D3 levels were raised to those naturally attained/maintained by peoples living as human DNA evolved
    pubmed/22264449 “Traditionally living populations in East Africa have a mean serum 25-hydroxyvitamin D concentration of 115 nmol/l.” =46ng/ml
    Vitamin D is most effective at dealing with inflammation when 25(OH)D levels around 50ng/ml.

    Both Gingivitis and periodontal disease found at higher rates in those with lower 25(OH)D levels.

    pubmed/16155270 “Vitamin D may reduce susceptibility to gingival inflammation through its antiinflammatory effects.”

    pubmed/21547146 “Are Hill’s criteria for causality satisfied for vitamin D and periodontal disease?”

  2. Philip Thackray

    Stupid study!

    I have noticed much less tartar build since going very low carb about eight years ago. Both of my dogs are low carb as well and they have no tartar build up at all. When I go to the vet they check their teeth and I think they are hoping to see a build up so they can charge me $xx.xx to clean them. I think they are disappointed to see that their teeth are so clean.



  3. I was raised pretty close to paleo with the bulk of my diet as a child being wild meats and organic vegetables. We did eat homemade bread and a small amount of dairy. My father was a dentist who was a fan of Weston Price. Although I strayed from the path of dietary righteousness (LOL) in my 20s and early 30s, my dental health has always been very good, I think because the foods I ate in childhood were very nutrient-dense and established a happy balance of oral bacteria. I currently get my teeth cleaned only every couple of years, which typically appalls the hygienist until it only takes her 10 minutes. I’ve never had a cavity. My diet isn’t strictly paleo but it’s closer to it than it is to a standard north american diet. My two sisters are the same (both in history, dental health and current dietary practices). Neither of our parents even HAD all their natural teeth when we were born so I’m pretty sure it’s not a case of “oh, well, genetics…” although I should point out also that our water was fluoridated when we were growing up.

  4. I have found that brushing my teeth with corn starch/baking soda/coconut oil helps prevent plaque build up and the coconut oil is supposed to help build enamel.

  5. Cutting out grains and sugar has definitely saved my remaining teeth.

    Neanderthals did in fact eat some (probably whole, roasted) grains. They seem to have been a food of opportunity that added variety of flavour to their diet, but wild-harvested grains are unlikely to have ever been a significant calorie source for such people, who hunted and collected many more nutritious foods.

  6. Lean proteins support strong muscles, healthy bones and optimal immune function. Protein also makes you feel satisfied between meals.

    • No kidding, TPH!
      A researcher needs to do at least a pilot study of the paleo diet as a periodontal treatment, to see if J Stanton’s results are typical or not. Perhaps you’ve seen that in your own practice.

      • ThePaleoHygienist

        I wish, Steve! Unfortunately, I only have two patients following a Paleo template diet. One patient just started eating Paleo the last few months, but her periodontal status was already very good. However, I have seen reduction in periodontal probe depths and stabilization in my other patient. I obviously need more than one patient to observe to be able to make any conclusions, but I definitely think eating a nutrient dense diet that eliminates processed foods would have a positive impact on oral health.