Enamel remineralization guide
If you search for a in-depth how-to-guide, jump to the article on the practical applications here: How to Remineralize your Teeth as a Vegan without Fluoride
Vegans and tooth decay – a biased perception
Generally, raw vegans have been shown to have better oral hygiene than cooked-food eaters and equal levels of cavities and tooth decay. But, regarding teeth health, the food chemistry of raw foods can wear off enamel – like acids in fruits and simple sugars feeding cariogenic bacteria. However, eventual dental problems arising from a high-fruit diet can effectively be prevented and (to some degree) reversed.
Eating a raw alkaline-forming diet, in the long run, will ultimately help mineralize your teeth because the body will not be forced to mobilize calcium from teeth (and bones) to buffer the acid overload in the body. Also, eating a healthy diet will improve your saliva composition, which is crucial to teeth health. Initially, though, during detoxification, saliva can get acidic: accumulated acids in the interstitium (space between cells) and lymph can exit through saliva, and can contribute to demineralization and sensitive teeth. Those symptoms disappear over time, and teeth then start to strengthen, but it can take a long time. During this transition it’s essential to know how to protect our teeth from demineralization with a proper mineralization approach! Learn in-depth how remineralization works:
Can teeth be remineralized?
Yes, there are ways to mineralize teeth effectively, even naturally and as a vegan.
Enamel can be remineralized but not restored AND as long as the breakdown has not progressed too much and hasn’t reached the dentin layer. “What is gone is gone,” as I quote my dentist, stressing that once the enamel structure has broken down, it cannot be built up again. However, the remaining structure can be hardened (the hardening halts the decay); thus, not every cavity has to be drilled and filled. Demineralized white spot lesions can be mineralized and hardened (before the enamel structure breaks down) with effective methods, and thus the decay can be reversed at this stage. Enamel decay due to frequent acid and sugar exposure or fruits and lack of remineralization (i.e., due to dry mouth) can be preventable.
“Remineralization of minor enamel defects is a normal physiological process that is well known to clinicians and researchers in dentistry and oral biology. This process can be facilitated by various dietary and oral hygiene procedures and may also concern dentin caries lesions. Dental caries is reversible if detected and treated sufficiently early.”Mäkkinen et al. (2010)
Teeth and enamel health on a vegan and raw-vegan diet
Many people live years and decades on raw foods or even a fruitarian lifestyle and have perfectly healthy and strong teeth. Therefore, it wouldn’t be reasonable to blame diet alone. Fortunately, the raw community has many positive teeth health outcomes with improved gum and teeth health over time. There must be more to the story than diet alone: only if several factors come together do demineralization and cavities arise.
The leading cause of fast demineralization is an excessively acidic oral environment. When demineralization of enamel progresses faster than remineralization (see mineralization balance below), the enamel gets worn off over time and can break down. So, while it is not true that a raw or vegan diet inevitably leads to weak teeth, dental problems can emerge or worsen. There are three main factors that intensifies enamel loss on a raw vegan diet:
- Frequent consumption of fruits (acids and fruit sugar): Enamel erosion and other dental problems are not limited to the vegan or raw-vegan community. However, there are certain particularities and factors to consider for teeth health on a raw or high-fruit diet. Enamel is worn down faster by prolongated and frequent exposure to acid in fruits (especially unripe fruits or fruits high in acids) or the simple sugars in fruits, which feed acid-producing bacteria. This can lead to white spot lesions and smooth surface cavities. This type of enamel damage resembles the demineralization and caries seen in heavy soda pop drinkers (sugary acid drinks), resulting in decay in front teeth. To avoid the impact of this, there are many precautions that we can take on a daily basis and adopt a routine by minding our enamel integrity. Replacing acidic fruits with ripe tropical fruits is a huge factor here!
- Nutrient deficiency during transition: The body has a higher requirement for nutrients during the transition from a conventional diet to a more healthy diet. This can affect teeth and oral health, too. Therefore taking supplements to support remineralization can be beneficial.
- Oral detoxification crisis: Transitioning to our biological species-appropriate diet most often leads to an extended or intense period of detox crisis, affecting teeth health. It is common to experience sensitive teeth in this period, which is usually only temporary. During this period, it is critical to give your teeth extra attention: saliva tends to be more acidic during detoxification. Thus regularly neutralizing the oral acid environment, providing additional nutrients, and avoiding enamel erosion mistakes (see list below) are critical in the first months (or years) of adapting to a healthy diet. Once health is improved and the enamel is stronger, raw foods and fruits will likely not pose a problem to the enamel.
Enamel erosion typical for frequent sugar and acid exposure (i.e. due to soda or energydrink consumption).
Does tooth decay occur in nature?
YES, tooth decay is also found among our closest relatives, the chimpanzees in the wild. Chimpanzees are frugivores: their diet in the wild consists mostly of ripe tropical fruits (depending on food availability). A feeding behavior called “wadging” in chimps can cause cavities and tooth decay in front teeth, as the animals “clamp” the fruit with their front teeth to suck out fruits’ juice. Wadging exposes the enamel to fruit acids and sugars over an extended period of time during the day.
So enamel erosion could be considered a natural problem on a high fruit (acid and sugary) raw vegan diet since human teeth have to last longer than chimp teeth due to a longer life span.
I was impressed when my new dentist noticed that my enamel problems looked like a case of a fruitarian diet or at least consuming fruits often. This indicated that a diet healthy for us, unfortunately, is not necessarily enamel-friendly: chemistry dictates that acids break down tooth enamel.
Thus a fruit-based diet can be tricky in terms of teeth. However, these issues are preventable in many cases – and keep in mind that meat-eaters and omnivores have dental problems too.
Understanding teeth (re)mineralization
Natural remineralization is the deposition of calcium and phosphate within the enamel structure. Calcium and phosphate form the main component of enamel as calcium hydroxyapatite crystals. If fluoride is used as a mineralization agent, fluorapatite is produced instead, which has slightly different chemical properties than hydroxyapatite. Low pH (acid) dissolves the hydroxyapatite crystals. 95% of enamel is an inorganic material, mainly calcium hydroxyapatite plus small amounts of trace elements (iron, magnesium, potassium, sulfur etc.). Around 2% is organic material, including proteins, which are involved in enamel building (read a more in-depth article by Dogan, 2017).
Effective and fast remineralization is the key to strong teeth resistant to decay: mineralization is a dynamic process that is constantly in flux. To avoid enamel weakening, we need to mineralize faster than demineralization occurs. Meaning the rate of enamel mineral build-up has to be faster than the erosion and micro-decay.
Teeth mineralization balance
Knowing the mineralization balance is the basis for understanding how to mineralize effectively and how fluoride and natural compounds and remedies act to mineralize. This teeth decay balance is described in-depth by this article of Pocket Dentistry:
- Demineralization due to acids: Acid-producing biofilm (bacterias), dry mouth (not enough saliva), sub-optimal and acid saliva composition (not enough minerals, high pH), frequent drinking and eating of fermentable carbs (feeding the acid-producing bacterias), poor oral hygiene (not removing acids or the acid-producing bacteria)
- Remineralization due to alkalinity and enamel building blocks: Saliva flow and components (minerals, alkalinity), Remineralizing components that we can add (calcium, phosphates, and others), antibacterial agents (reduce acid-producing bacterias), good oral hygiene
How to remineralize teeth naturally
For practical instructions on how to remineralize enamel without fluoride, visit this article on vegan-friendly remineralization:
Go To Vegan-Friendly Remineralization Guide
Does sugar cause demineralization of teeth?
No, sugar alone does not stripe minerals from teeth. But can sugary foods lead to decay? Yes, indirectly, it can: while sugar itself does not hurt the enamel, it feeds the cavity-causing bacterias, that produce the acids. When there is an accumulation of bacteria (a biofilm) on top of the tooth surface, the enamel is exposed to the bacterial acids over time. To prevent this cariogenic environment, removing the biofilm is an important factor when it comes to decay.
Regrowing whole teeth? maybe…
Some out-of-the-box stories and pictures of whole teeth regrowing appear at times. We all really want this to be true, yet most have never witnessed it for themselves. Is regrowing teeth possible? It seems, at least in the lab, it is… there are reports since 2004 that teeth have been regrown in rats using stem cells.
I do not have a conclusive opinion on this, but science has shown that teeth have their own stem cells, which are currently used in promising tooth engineering research. Read more about stem cells and teeth in the last section of this guide. Unfortunately, experimental dentistry seems far away from providing a stem cell solution, so we need to stick to natural remineralization for now.
DIY stem cell therapy for teeth health
Dental stem cells for tooth regeneration have been known in science for a while and are investigated in dental engineering. However, we don’t find the practical application at the dentist. We can’t speed up science, but we can always use nature’s treasures and resources! We have stem cells in many parts of our body, such as fat tissue and blood. But we also have easily accessible sources such as urine and menstrual blood. Thus, as crazy and impossible as it may sound – there are DIY stem cell home remedies:
Stem cells in urine: This is no joke, but rather stunning! Urine stem cells have already been used to regrow teeth in science, and in yogic religion morning, urine drinking is a common practice. In Ayurveda healing art, the method of oral urine swishing in the morning is known for dental health improvement. Modern science explains some of the mechanisms, i.e., that one of the “miracle ingredients” in urine is stem cells.
Stem cells in menstrual blood: no joke. Menstrual blood can be rubbed on receding gingival gums, which can regrow within weeks and even days if the damage is not too extended. Yes, regrow gums. Just place drops of menstrual blood on affected areas and leave them for as long as possible. Menstrual blood has been discovered as an easy-to-access (non-invasive) source of stem cells in regenerative medicine, i.e., epidermal tissue.