Healthy Diet, Healthy Smile – Richmond magazine

Midlothian dentist Alex Hawkins wants to educate his patients about good nutrition and dental health rather than constantly preaching that too much sugar causes cavities.

“We’ve all heard that talk before,” he says. “While true, this is too simplistic and doesn’t really provide alternatives.” So he recently added formal nutrition consultations at his practice, Hawkins Family Dentistry. “We are early on the bell curve, but I see it gaining traction as patients recognize the importance of being treated in light of whole-body health, rather than as just another mouth.”

Hawkins has enlisted the help of his wife, Amy, who has a psychology degree and a master’s in nutrition; she’s also a certified health coach through the Institute for Integrative Nutrition. The dental patients may receive a free one-hour consultation with Amy Hawkins, who also has a separate health coaching practice. “She will find out your story, discuss numerous nutrition/health topics and give you some action steps to begin to effect change,” he says.

Nutrition and Healthy Smiles

Proper nutrition is important at all stages of life, and dental professionals play a “key role in the education of patients on proper nutrition to ensure a healthy mouth,” says Ellen Byrne, senior associate dean and professor of endodontics at the Virginia Commonwealth University School of Dentistry. “Guidance regarding diet and dietary habits can play a major role in the prevention of [dental decay and cavities].”

Poor nutrition can lead to poor oral health and affect the ability to “taste, eat, chew and swallow,” says Shillpa Naavaal, assistant professor of oral health promotion and community outreach at the dental school.

Nutrition should be discussed with patients, especially if a person “has evidence of acid erosion on the enamel or a high risk of developing cavities,” says Richmond dentist Sarah Dowdy.

Everyone has oral microbiome (organisms) that affect not only oral health but also your overall health. Disease can start when there is a harmful imbalance in the types of oral bacteria.

“That may be as minimal as a cavity,” Hawkins says. “When enough of the bacteria that cause periodontal disease take hold, you lose foundational support for the teeth, and your gums bleed, but it doesn’t stop there. Those same bacteria that cause periodontal disease are now shown to be a cause of heart disease, as well as contributing to Alzheimer’s, diabetes and a host of other inflammatory processes.”  

People with a healthy, balanced diet usually have cleaner teeth and healthier gums than those who eat a diet high in refined carbohydrates. Such a diet, especially when it’s packed with simple carbohydrates such as sugar, causes more plaque buildup on the teeth. “This makes the teeth more susceptible to cavities,” Dowdy says. “If there is more plaque, it can cause the gums to become more inflamed, which can lead to gingivitis. Gingivitis then can progress to gum disease.”

Refined vegetable oils such as canola, safflower, corn and palm in your diet can also contribute to systemic inflammation, which can worsen inflammation in oral tissues. But it’s difficult to break away from simple carbs and vegetable oils.

“They are so prevalent in the American way of life that even limiting these is quite a paradigm shift, often requiring careful planning,” Alex Hawkins says. “Pick up any prepackaged item at the grocery store, and it likely contains a simple carbohydrate, refined oil or both.”

Replacing simple carbohydrates and refined oils with whole, unprocessed foods and healthy fats is the healthiest route to take. “Whole foods are not broken down as quickly in the mouth and therefore ‘starve’ the bad bacteria, while supporting the good,” Alex Hawkins says. 

During routine cleanings, Dowdy often takes the time to talk with her patients about nutrition and the impact food and refined carbohydrates, especially sports drinks, energy drinks, sodas and juice have on teeth, especially if there’s acid erosion on the enamel or the patient is at high risk of developing cavities.

“Nutritional information will be a large piece of this puzzle.” —Alex Hawkins

“Drinking them in one sitting with a meal is not as harmful to the enamel,” she says. “It is most harmful when you sip on beverages throughout the day. Basically, if the liquid has more in it than 100 percent water, it may contain acid or sugars. Acid and sugar break down enamel. Once enamel has been lost, you cannot build it back.”  

Not surprisingly, tobacco use and vaping are harmful to gum health as well, she adds.

Eating a variety of nutrient-rich foods from all food groups promotes healthy teeth and gums. A balanced diet of fruits, vegetables, proteins, calcium-rich foods and whole grains provides essential nutrients for optimum oral health, as well as overall well-being.

Calcium-rich foods, such as low-fat or fat-free milk, yogurt and cheese, fortified soy drinks and tofu, canned salmon, almonds, and dark green leafy vegetables promote strong teeth and bones, Naavaal says. Phosphorus, which is in eggs, fish, lean meat, dairy, nuts and beans, is good for your teeth, while vitamin C, which is bountiful in citrus fruits, tomatoes, peppers, broccoli, potatoes and spinach, promotes gum health.

Water is also important for healthy teeth and gums because it helps to clean the mouth and keep it moist without exposing it to any sugars, Naavaal says. She notes that foods such as crunchy vegetables and fruits, and sugarless gum stimulate saliva production, which is a great way to neutralize acids produced by oral bacteria.

Teaching Future Generations

Nutritional training has always been incorporated into the dental and dental hygiene curriculum at the VCU School of Dentistry. Naavaal notes that the school is using a federal grant to develop new programs and curriculum to enhance students’ training in nutrition counseling and obesity prevention.

Hawkins says he expects that nutritional counseling will become a common part of a dental practice. “I definitely think that discriminating patients will seek out providers that treat them as a whole person rather than simply a mouth,” he says. “Nutritional information will be a large piece of this puzzle.” 


Hawkins Family Dentistry suggests these do’s and don’ts when it comes to nutrition and your dental health.

Do: 

  • Educate yourself on this topic and ask your dentist for information.
  • Strive to cut processed foods and sugars and replace them wherever possible with whole foods.
  • Embrace good fats rather than following the low-fat trend.

Don’t: 

  • Stick with a diet of convenience that isn’t supporting a healthy mouth or body.
  • Be a teetotaler who never allows an occasional treat or refuses to eat out (that isn’t sustainable for most).
  • Neglect traditional advice such as proper brushing and flossing (hygiene and nutrition work together).