Oral health: a key component of adequate nutrition

Oral health encompasses the condition of the mouth, teeth and other associated structures. These can be affected by a wide range of conditions and issues including dental caries, oral cancer, genetic abnormalities, injury, nutritional intake and/or deficiencies, neurological conditions and some chronic conditions such as diabetes, eating disorders and heart disease.

Lifestyle choices like smoking or vaping, excess alcohol consumption and dietary intake of food and drink with a high free sugar content or acidity level are well known to have a negative impact on oral health.[1,2]

Socioeconomic status influences oral health too, with data from UK government oral health surveys, cancer registers and NHS service activity showing that there are marked inequalities in oral health.[3] The data included the prevalence of dental decay and related quality of life measures.[3]

Socioeconomic disparities in oral cancer incidence are also evident, with individuals in the lowest socioeconomic groups being nearly three times more at risk when compared with those in the highest socioeconomic groups.[4]

Diet and nutrients play a key role in the development of oral health and dentition. The overall composition of the diet throughout life can affect both of these factors. Let’s take a look at some key micronutrients that are of particular importance in maternal health and early life.

Vitamin D is well known to be vital for bone health and influences bone and tooth development. Supplementation during pregnancy may reduce enamel defects in the child/children.[5] In addition, vitamin D is key in the absorption of calcium.

Calcium has a critical role in bone and teeth development and health. It’s essential for tooth mineralisation and the regulation of tooth formation.[5]

Maternal vitamin A deficiency can lead to abnormal or delayed cranial and dental development.[6] Aside from its role in this structural development, vitamin A also promotes saliva production and supports the integrity of mucous membranes, which are vital for maintaining a healthy mouth.

Adequate fluoride intake helps to strengthen bone and enamel, meaning they become more resistant to demineralisation. However, excess intake of fluoride can lead to a condition known as fluorosis. This is characterised by discoloured or mottled teeth, stiff and painful bones and joints.[5]

Oral health is a significant determinant of nutritional status. Poor or diminished oral health can impact on the mechanical processes of eating – chewing, lip closure, forming a bolus, control of food/bolus or fluids in the oral cavity and swallowing. It can also affect taste, food choice options and overall enjoyment.

As oral function declines, the texture of food and viscosity of liquids may need to be modified for safety, comfort and to facilitate effective eating and drinking. Often shifting to a narrower range of softer foods at this stage, there is the risk of nutrient deficiencies, weight loss and reduced overall health status. This can affect people across the lifespan but older people are commonly affected due to tooth loss, poor dentition, dry mouth or frailty.

Studies have shown a correlation between poor oral health and poorer nutritional status in older people. Khoury et al (2022) found that French older adults were at greater risk of malnutrition if xerostomia (dry mouth) was present, regardless of other factors that affect oral health.[7]

A meta-analysis conducted in 2002 by Hussein et al reviewed whether poor oral health is associated with a higher risk of malnutrition.[8] From the 33 studies included, it found that older people (65 years or above) often experience dependence on others for assistance with oral care, have decreased access to oral healthcare and reduced efficient chewing capacity. It concluded that there is an increased risk of malnutrition where poor oral health is present.

In 2023, a review by Chan et al looked at the evidence-based summary of the relationship between diet and nutrition and oral health in older adults and its implications.[9] It revealed that nutrition and oral health are interrelated, in that good nutrition and healthy eating enhance oral health, with good oral health (function and dentition) supporting nutritional intake. It also concluded that cohesive nutritional and dental care education is vital to ensure awareness and promotion of oral health. The researchers recommended that oral health should be part of the general health care system to ensure that older adults receive integrated and coordinated treatment.

In 2025, the Department of Health and Social Care updated its guidance on oral cancer with a view to delivering ‘Better Oral Health’. It released an evidence-based toolkit to support dental teams in improving their patients' oral and general health.[4,10] The guidance seeks to prevent oral disease with a consistent UK-wide approach.

Oral cancer refers to cancers which affect three different sites – the mouth (oral cavity), throat (oropharynx) and lip.[4] These cancers can and do cross anatomical boundaries, which can create significant issues with speech, eating and drinking.

Risk factors include tobacco use and excess alcohol consumption. Infection due to the human papillomavirus (HPV) is a particular risk for oropharyngeal cancer. Excessive exposure to UV light is also a risk factor for lip cancer.[4]

There’s limited new evidence regarding dietary risk factors associated with oral cancer. However, it is well documented that fruit and non-starchy vegetables contain substances such as vitamins, minerals and antioxidants, which help to protect against cancer. Therefore, current evidence supports the promotion of increased fruit and vegetable consumption as a part of a healthy diet.[11]

References:

1. Oral Health Foundation (2026) Diet and oral health. National Smile Month: Diet and oral health

2. Queen Victoria Hospital NHS Foundation Trust (2024) Oral health advice for adults. Oral-Health-Advice-for-Adults-0708-Web-Version.pdfPublic Health

3. England (2021) Research and analysis Inequalities in oral health in England: summary. Inequalities in oral health in England: summary - GOV.UK

4. Department of Health and Social Care (2025) Guidance - Chapter 6: oral cancer. Chapter 6: oral cancer - GOV.UK

5. Nørrisgaard, P.E. (2019) Association of High-Dose Vitamin D Supplementation During Pregnancy With the Risk of Enamel Defects in Offspring: A 6-Year Follow-up of a Randomized Clinical Trial. Association of High-Dose Vitamin D Supplementation During Pregnancy With the Risk of Enamel Defects in Offspring: A 6-Year Follow-up of a Randomized Clinical Trial - PMC

6. Chandan, S.N. & Rao, S. (2022) Dietary interventions and nutritional impact on oral health and development: a review. Dietary interventions and nutritional impact on oral health and development: a review - PMC

7. Khoury, C. et al. (2022) The association between oral health and nutritional status in older adults: a cross-sectional study. The association between oral health and nutritional status in older adults: a cross-sectional study | BMC Geriatrics | Springer Nature Link

8. Hussein, S. (2022) Association of Oral Health and Mini Nutritional Assessment in Older Adults: A Systematic Review with Meta-analyses. Association of Oral Health and Mini Nutritional Assessment in Older Adults: A Systematic Review with Meta-analyses

9. Chan, A.K.Y. (2023) Diet, Nutrition, and Oral Health in Older Adults: A Review of the Literature. Diet, Nutrition, and Oral Health in Older Adults: A Review of the Literature | MDPI

10. Department of Health and Social Care (2025) Guidance - Delivering better oral health: an evidence-based toolkit for prevention. Delivering better oral health: an evidence-based toolkit for prevention - GOV.UK

11. Department of Health and Social Care (2025) Guidance - Chapter 10: healthier eating. Chapter 10: healthier eating - GOV.U