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Everyone wants an attractive smile, but healthy teeth are only part of the picture. Healthy gums are just as important, not only for a confident smile but also because they play a vital role in our overall health.
Gum disease is caused by a build-up of plaque below the gumline, which provides a fertile breeding ground for bacteria. Untreated, this eventually destroys the ligaments and bones that hold our teeth in place, leading to tooth loss. But unfortunately, it goes further.
Research increasingly associates gum disease with around 50 health conditions – from diabetes to dementia; from IBS to rheumatoid arthritis; from heart disease, stroke and asthma to erectile dysfunction and complications in pregnancy.
Our gums need all the help they can get, and a new study shows that what we eat – or don’t eat – can have an impact. Research from King’s College London, published last month (June) in the Journal of Clinical Periodontology, found that a five-day low-calorie diet of between 750 and 1,000 calories reduced the inflammation associated with gum disease.
“Over the last decade, periodontal research has increasingly moved towards understanding how health and lifestyle factors influence gum disease,” says Dr Giuseppe Mainas, periodontist and lead author of the King’s College study. “We now know that periodontitis (severe gum disease) is not simply an infection caused by bacteria; it is also driven by the body’s inflammatory response. Good oral hygiene and regular professional care remain essential and irreplaceable. However, they are only part of the picture.”
So what other surprising lifestyle hacks might help boost gum health?
Six health hacks for healthy gums
Adopt the Mediterranean diet
In a previous study, the King’s College team found that following the popular Mediterranean diet, known for its emphasis on fruit, vegetables, whole grains and healthy fats, could lead to better gum health, with lower levels of disease and inflammation. “A nutrient-dense, plant-rich diet could play a role in improving gum health,” says Luigi Nibali, professor of periodontics at King’s College and lead author of the study. He says it’s challenging to pinpoint the “single responsible factor”, as the diet involves many components, but that it is clear it is “associated with better periodontal health and lower levels of systemic inflammation”.
Eating less meat seems to be part of the picture – those who eat diets high in red meat tend to be more prone to gum disease, the study found. All vegetables are good, but some seem to have superpowers when it comes to helping our gums. Nitrate-rich vegetables such as beetroot, spinach, rocket and celery may support both cardiovascular and oral health. “Dietary nitrate can be converted into nitric oxide, which influences blood flow, inflammation and potentially microbial ecology,” says Dr Mainas. “They’re a sensible addition to most diets.”
Consider an aged garlic supplement
A randomised double-blind trial of adults with periodontitis, reported in the Journal of Clinical Biochemistry and Nutrition, found that taking aged garlic extract (AGE) for 18 months reduced the depth of pockets below the gumline. AGE is made by slicing raw garlic, placing it in an ethanol solution and ageing it for up to 20 months. The process converts the unstable sulphur compounds in raw garlic into highly stable antioxidants. Research indicates that AGE could improve peripheral circulation, reduce inflammation and enhance immunity.
“The anti-inflammatory and antioxidant properties of garlic-derived compounds are biologically plausible,” says Dr Mainas. He wouldn’t recommend pinning all your hopes on the supplement (which is readily available from health stores), but he does think it could “form part of an overall healthy dietary pattern”. In other words, it can’t hurt.
Exercise regularly but not too much
“Regular physical activity is emerging as being associated with better periodontal health,” says Dr Mainas. He points out that a 2023 meta-analysis found that regular physical activity reduced the risk of periodontitis by 23 per cent. “There’s a significant correlation between exercise and a lower occurrence of periodontitis,” he says.
Dr Mainas says that “the exact mechanisms are still being explored, but exercise appears to reduce systemic inflammation, improve insulin sensitivity and support immune regulation”. Insulin sensitivity keeps our blood sugar lower, which reduces oral inflammation and starves plaque-forming bacteria. He adds that “regular moderate exercise” is the key. The World Health Organization (WHO) recommends 75 minutes of vigorous exercise, such as running, or 150 minutes of moderate-intensity exercise, such as brisk walking, per week (other forms of aerobic exercise, such as cycling, swimming or dancing, are just as good – anything that gets your heart rate up).
“There is no evidence that extreme training provides additional periodontal benefits,” says Dr Mainas. On the contrary, research suggests it could actually be harmful. Some studies have found that elite athletes can have poor gum health despite good oral hygiene practices. Intense exercise dries the mouth and reduces saliva, which helps fight off harmful bacteria. Equally, sugary and acidic sports drinks can feed plaque, triggering gum inflammation.
Eat mackerel and other oily fish
“This is one of the most promising nutritional areas in periodontology,” says Dr Mainas. “Omega-3 fatty acids, commonly found in oily fish such as mackerel, sardines and salmon, have well-established anti-inflammatory properties.”
A study published in the Journal of the American Dietetic Association, which analysed data from more than 9,000 adults, found that the more omega-3 fatty acids (specifically DHA and EPA) people ate, the less likely they were to have periodontitis. These fatty acids reduce inflammation in the mouth and, as we now know that periodontitis is an inflammatory condition, it makes good sense to increase our intake of omega-3s.
“Several studies suggest they may enhance the response to periodontal treatment, although further research is needed before we can make specific recommendations,” says Dr Mainas. NHS guidelines suggest eating at least one portion (140g when cooked) of oily fish per week. While it’s tempting to eat more, oily fish contain higher levels of pollutants than other types of seafood. This is particularly important for girls, women planning a pregnancy, and pregnant and breastfeeding women, as pollutants may build up in the body and affect the future development of a baby in the womb, according to the NHS.
While plants such as flaxseeds, walnuts, hemp seeds and chia seeds do contain omega-3 fatty acids, our bodies convert very little of the plant form (ALA) into EPA and DHA, so vegetarians and vegans could consider an algal oil (microalgae) supplement.
Drink green tea
Green tea originated in ancient China where, even 4,000 years ago, it was considered a medicine. A landmark study published in the Journal of Periodontology in 2009 found that people who drank at least one cup of green tea per day had significantly healthier gums, reduced pocket depth and less bleeding. A randomised clinical trial in 2018 confirmed these findings.
Green tea contains high levels of bioactive compounds known as catechins, including epigallocatechin gallate (EGCG), which have powerful antibacterial and anti-inflammatory properties.
EGCG can help combat destructive oral bacteria, such as P. gingivalis, stopping them from breaking down gum tissue and creating deep pockets (which exacerbate gum disease). In addition, catechins can help maintain a balanced pH in the mouth, lowering the acidity of dental plaque, which can trigger gum irritation. “Observational studies suggest that regular green tea drinkers may have better periodontal health,” says Dr Mainas. “While the evidence is not yet strong enough to consider green tea a treatment, incorporating it into a healthy lifestyle is unlikely to be harmful and may offer additional benefits.”
Prioritise good sleep
Poor sleep is implicated in a raft of health conditions, and gum disease seems to be one of them. “There is certainly a growing body of evidence that factors such as sleep quality may influence periodontal health,” says Dr Mainas.
A 2024 meta-analysis published in Biomedical Reports is unequivocal: “Adequate sleep is essential for maintaining good oral health.” It cited various mechanisms. Primarily, poor sleep quality exacerbates stress and inflammation as, when we’re sleep deprived, our bodies produce higher levels of inflammatory cytokines, which aggravate the gums and can speed up gum disease. Secondly, we produce less saliva, which is bad news because saliva naturally washes away bacteria. Chronic insomnia also increases cortisol levels, which are associated with teeth grinding (bruxism), which in turn contributes to the wearing down of gum and bone tissue.
So how much sleep do we need to help protect our gums? Data from the US National Health and Nutrition Examination Survey, which surveyed 10,921 adults between 2009 and 2014, showed that regularly getting fewer than seven hours’ sleep is linked to a higher chance of gum disease, while getting seven to eight hours is associated with the healthiest gums.
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