Teeth Health of German Vegetarians

In May, a cross-sectional study from Germany was released, comparing the teeth and gum health of vegetarians (89 lacto-ovo, 11 vegans) to 100 non-vegetarians (1).

Among the exclusion criteria was “systemic diseases that negatively influence periodontal conditions (for example, diabetes mellitus…).” Because vegetarians have much lower rates of diabetes, that exclusion criteria could negate the capacity for this study to actually describe differences between vegetarians and non-vegetarians. There was also no information regarding from where they recruited the vegetarians and how anti-mainstream dental care they might be. They did find that the vegetarians in the study went to the dentist less.

The authors’ summary:

“A vegetarian diet or vegetarian lifestyle, respectively, has a positive effect on periodontal conditions. Vegetarians show less inflammation signs, less periodontal damage, less [missing teeth] and as a result of a better dental home care reveal better plaque scores. In addition, vegetarians have a higher level of education. However, regarding the dental conditions, vegetarians show more [decayed teeth] and more erosion.”

To put this in some perspective, the vegetarians averaged .98 teeth with erosion while the non-vegetarians averaged .40.

I would not take this study to mean anything for any given person’s dental health. As far as a vegan diet goes, make sure you get enough calcium and vitamin D. I personally get regular dental check-ups and use a toothpaste with fluoride. Be careful of eating too much dried fruit.

For more info on the German study, here is an article from the Dental Tribune (thanks, Dima):

Vegetarians have better periodontal health, worse dental status

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1. Staufenbiel I, Weinspach K, Förster G, Geurtsen W, Günay H. Periodontal conditions in vegetarians: a clinical study. Eur J Clin Nutr. 2013 Aug;67(8):836-40. doi: 10.1038/ejcn.2013.101. Epub 2013 May 29. | link

15 Responses to “Teeth Health of German Vegetarians”

  1. Michael Friesen Says:

    Funny. My fiancée, who is a vegan, recently went to the dentist who told her to get more calcium! Thanks for the update. : )

  2. Andreas Says:

    Contrary to popular belief, teeth are made mostly of magnesium and the reason why those vegetarians have more teeth erosion is because they brush with a cheap toothbrush for a longer duration which scrapes the enamel off. Sensodyne makes the best toothbrushes which don’t scrape the enamel off. A healthy hygiene habit turns sour when completed with the wrong tool.

  3. Arcadio Says:

    There is a misconception that healthy foods cannot do any damage because they are “good for you”. Many people think that a healthy and “natural” diet will protect their teeth.
    Apart from using a tooth paste with fluoride, and dental floss it might be good to rinse your mouth after eating citrus/berries, and NOT brush straight away but wait 1 hour at least.
    Berries can also realy stick to your teeth and also stain the teeth, like tea or coffee.
    This is text by Michael Greger is interesting http://nutritionfacts.org/2013/07/25/do-vegans-get-more-cavities/ “So should we avoid healthy foods like citrus? No! We just need to rinse.”
    Also using a soft tooth brush, using only light pressure when brushing, brushing vertically not horizontally and considering if one has bruxism could be useful.
    Why are they always so vague in studies? hahaha

  4. Dan Says:

    Hi Jack,
    Any findings particular to the n=11 vegans? I guess I’ll have to crack the study to find out!

  5. Daniel Says:

    Hi Jack.

    Michael Greger made a video about dental health of vegetarian and vegans: http://nutritionfacts.org/video/plant-based-diets-dental-health/

    Do you think there is a problem due to eat a lot of fruits? Is mouthwash a good advise after eating fruit?

  6. Alfredo Kuba Says:

    Hi Jack, thank you for this posting. I was surprised to see that you are advising to use fluoride? I do not think that fluoride prevents tooth decay as I have read the risks and benefits associated with it. There is in fact studies, some of which were conducted by the EPA in which high levels of toxicity, many times much higher than the EPA’s own guidelines of accepted levels (PPM). It suggests that fluoridation of water and fluoride are highly toxic and can cause caner of the liver, kidneys, increase levels of led in the blood stream and cause retardation in children. And as you know the way they test this is using animals.

    Jack I am sure you are aware of this but thought I wrote you abut it.

  7. Jack Norris RD Says:


    I looked into the fluoride issue a number of years ago and concluded that the potential good outweighed the potential harm.

  8. Annemarie Says:

    Hi Jack, I’m sorry for having a totally unrelated question but I hope you can answers it. As a new vegan I try to follow your guidelines as close as possible. My man usually eats along with me, but unfortunately he’s not too fond of taking supplements and fortified products are not so easy and cheap to come by over here. Is it possible to crush B12 and calcium pills and add them to our regular meals? If not, how about just through cold dishes such as salads? Thank you in advance.

  9. Jack Norris RD Says:


    > Is it possible to crush B12 and calcium pills and add them to our regular meals

    I wouldn’t cook the vitamin B12 but adding to hot or cold food would work. Calcium can probably be cooked, I’m guessing.

  10. Dan Says:

    Like Anne-Marie, I have another totally off-topic question for you, Jack. I just bought a product called “Green Superfood” which is a powderized blend of various fruits, vegetables, plants, fiber, probiotics, prebiotics, enzymes, etc. I bought it because they list “Vitamin A (as beta carotene) at 4945 IU, which they state is 100% of daily value based on a 2000 calorie diet. If the RDA for males is 900 RAE per day, which is equivalent to 3000 IU of beta-carotene supplementation, then the 4945 IU in this product should still be less than the recommended upper limit of 3000 RAE per day, right? I want to ensure I don’t overdose on vitamin A, but I am sick of buying carrots and eating one every day!

    Actually, I think my calculations are conservative, because Wiki states: “the Dietary Reference Intake is 900 RAE (900 μg or 3000 IU retinol). This is equivalent to 1800 μg of β-carotene supplement (3000 IU) or 10800 μg of β-carotene in food (18000 IU).” Since this is food and not a supplement form of beta carotene, the appropriate DRI here would be 18000 IU of beta-carotene (and this product has 4945 IU of beta-carotene). Or am I in error? Thanks for your help.

  11. Jack Norris RD Says:


    Check out:


    Scroll down to:

    Retinol activity equivalents (RAE)

    I don’t know if it’s the best policy to try to get the entire DRI of any nutrient at one sitting, though. I’d keep eating the carrots…

  12. Dan Says:

    Hi Jack,
    I was actually just on that website!
    From yahoo answers, I found out that 1 mg of beta carotene = 1,667 IU of vitamin A (as beta carotene). Thus 4945 IU in the product I bought is 2972 mcg (2.972 mg).

    Now, from the Linus Pauling website, 12 mcg of dietary beta carotene is bioconverted to 1 mcg of retinol. Thus, dividing the above number (2972 mcg) by 12, one gets 248 mcg of retinol. 1 mcg of retinol = 1 RAE of vitamin A. So, if my calculation is correct, this is 248 RAE of vitamin A. It is odd that they put 100% as the % daily value for this ingredient, unless my calculations are wrong (which is likely!).

    Point taken about getting all your DRI in one sitting. Perhaps I should return this product unopened, which was very expensive. And carrots are obviously very healthy as a whole food with lots of fiber and other carotenoids for retinal integrity.

  13. Tyler Says:

    The nice thing about eating a diet based on a variety of whole plant foods is that you don’t need to micro-managed your nutrient intake like this…..I take such micro-management to be a sign of bad dietary habits.

    Beta-carotene is found in a number of foods and any vegetable rich diet should supply plenty. For vegans, they should be consuming leafy greens for calcium anyways and most are rich sources of vitamin A as well. Personally, I always (when eating at home) include a leafy green with dinner. Tonight its brown rice, portobello mushrooms, tofu and steamed kale (Asian style).

  14. Zak Says:

    Jack –

    thanks for this article. I have been vegan for 30 years (I am in my 40’s) and have been told recently that I have a lot of erosion and multiple new cavities (in the past couple years). I am very concerned about this. I have osteoporosis and have been supplementing with Vitamin D for the past few years. I also take Calcium, Mag, and K2. I don’t eat any candy or “junk food” or soda. Just fruits, veggies, grains, beans, nuts, seaweed. I was putting lemon or lime juice on my salads, but have stopped that as it might be contributing to the erosion. I am now rinsing with water during and after meals and brushing with a special presription fluoride toothpaste.

    As this article is over a year old, do you have any new information or any suggestions for things I can do to help change what is going on with my teeth? I am discussing the matter with my dentist, but also would like any ideas you have. Thank you!

  15. Jack Norris RD Says:


    I’m sorry to hear about your dental problems. I have not seen anything new. One reader had dug up some info suggesting that a non-phytate form of phosphorus was needed to keep teeth healthy, but it was based on research from around 1930 and I could find no recent confirmation that this is true.

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