Vegan Nutrition with Dina Aronson, M.S. R.D.

Dina AronsonDina Aronson, MS, RD is a vegan dietitian whose specialties include chronic disease prevention, vegetarian/vegan nutrition, and lifestyle management. She is the founder and director of, a nutrition consulting company. Active in many vegetarian nutrition organizations, Dina was the recipient of the American Dietetic Association's Recognized Young Dietitian of the Year Award in 2002.

See full index of questions

Can a poor vegetarian diet cause dental problems like receding gums or tender gums? -Delia

Dear Delia,

Absolutely, a poor vegetarian diet (a poor ANY type of diet) can lead to dental problems.

Throughout the lifecycle, a healthy diet, paired with good oral health care habits, are our best defense against problems with gums and teeth. Most people don't think much about oral health care in the early years, but it turns out that pregnancy and early life present golden opportunities to instill good dental and eating habits that promote the future health of the teeth and gums. For example, although infants should have their first dental visit by the age of 1 year, most parents wait until after most of the primary teeth erupt, usually around the age of 2 or 3 years. By then, cavities and other oral health problems, such as thumb sucking, can be well underway. Lack of early oral care also increases the risk of cavities later on, especially if the child has developed habits like snacking on sweets.

Children over two and adults should go to the dentist twice a year for a professional cleaning. Some children might need fluoride treatments or be prescribed a fluoride supplement; this depends on the fluoride content of your drinking water and of the current oral health. Your pediatrician or dentist is the best person to ask about fluoride. Never self-supplement yourself or a child with fluoride, as this mineral is toxic in large quantities.

Healthy teeth and gums depend on a diet with optimal amounts of ALL the vitamins and minerals. It's so important to consume plenty of servings from each of the food groups: vegetables, fruits, whole grains, and legumes. A vegan multivitamin/mineral supplement is also recommended. If the diet does not contain reliable sources of vitamins B12 and D, at least these 2 nutrients should be included in a supplement.

A diet with too many refined carbohydrates, such as sugar and processed flours, puts us at risk for dental problems. This is because bacteria feed on the carbohydrates we eat and that are left in the mouth, promoting tooth decay and gum damage. The more carbohydrates present, the more bacteria, and the more decay. This is true not only for "junk" like candy but also for healthy foods such as dried fruits. For this reason, frequent brushing and flossing are recommended, especially after meals and snacks, even more especially if the meal or snack has a high sugar content.

Here are the general recommendations for vegetarians to maintain healthy, white smiles:

DURING PREGNANCY: The gums are more susceptible to bleeding during pregnancy. Also, some studies show that women with untreated gum problems during pregnancy have a higher risk of having a low birth weight baby. It is especially important to brush and floss regularly to prevent infection. Always brush (or at least rinse your mouth very well) after vomiting, should have morning sickness. See a dentist at the first sign of problems (pain, bleeding, inflammation, infection). Although it's controversial, most dental health experts do recommend a fluoride-containing toothpaste; there are many natural pastes with fluoride. You should go to the dentist for a checkup and cleaning at least once during pregnancy. Be sure to tell the dentist you're pregnant; you don't want any x-rays, and you may want to avoid certain chemicals used in a procedure. Eat plenty of fresh foods, meeting special energy and nutrient needs. Baby's teeth develop during pregnancy, and an adequate maternal diet is necessary for proper tooth and enamel development.

BIRTH - 6 MONTHS: Clean gums and newly erupted teeth with moist, soft, child's toothbrush or clean washcloth after feedings and before bed; treat mouth cleaning as a regular part of the daily routine. Toothpaste is not recommended. Never put a child to sleep with a bottle containing anything other than water. Minimize dependence on pacifiers. Thoroughly clean teething rings and other toys that the baby puts in the mouth.

6 MONTHS - 1 YEAR: Continue oral health care without using any toothpaste. Use a child's toothbrush with water, and begin to teach the child how to brush; use gentle, back and forth motions along gum line. During this time, take your child to the dentist for the first visit. Avoid constant use of bottles or sippy cups containing anything other than water. Use bottles and cups for feeding times only. If your child uses a bottle, try to wean by 1 year of age (this does not mean you should wean from the breast by then). Offer healthy meals and snacks; remember, good habits start this early!

1 YEAR - 2 YEARS: Continue oral health care without using any toothpaste until 18-24 months. When you introduce toothpaste, get a fluoride-free variety first. Use a pea-sized amount of toothpaste, and teach the child to spit it out. Once this skill is learned, use fluoridated toothpaste, still only a pea-sized amount for each brushing. If the child is fond of swallowing toothpaste, be patient and avoid fluoride until spitting out toothpaste becomes routine. Seek and address risky oral health behaviors, such as excessive thumb sucking or refusal to wean from the bottle. If these problems persist, visit with a specialist.

2 YEARS - 3 YEARS: Start regular dental visits (twice a year). Encourage unsupervised teeth brushing (if you're sure the child will spit out the toothpaste). Begin gentle flossing where teeth are close together; floss once per day and brush after meals. Limit sweets and juice intake.

3 YEARS AND BEYOND: Regular dental visits are key, because dentists can often detect problems that may worsen and become reversible over time. Better to get a tiny cavity filled than to wait until it becomes a huge hole. Dentists also watch for tooth growth patterns, and can predict the risk of issues such as speech disorders and chewing problems. Nutrition is always important. During times where it's challenging to meet nutrient needs, do take a multivitamin-mineral supplement, and try to get back on a healthy plan. Opt for healthy snacks, like baby carrots with hummus, over sugary snacks like cookies (even if they are vegan)! Get yourself and your children in the habit of carrying a travel brush and paste to work and school. If you absolutely cannot brush when you'd like to, it is somewhat helpful to rinse well with water or mouthwash, or to chew sugar-free gum. Dried fruits have a way of attracting bacteria and putting us at risk for cavities, so always brush after eating raisins and other sticky foods.