De invloed van voeding op parodontale gezondheid. Vitamine C, andere antioxidanten en vetzuren.

Nele
Van Houdt

Over flosdraad en vitamientjes…

De dag van vandaag worden we langs alle kanten bestookt met adviezen over gezonde voeding. Jonge mensen denken dan vaak aan de slanke lijn, oudere mensen eventueel aan hun hoge cholesterol. Wat de meesten niet weten, is dat gezonde eetgewoonten ook voor de tanden zeer belangrijk zijn. Hierbij gaat het niet enkel over het laten van zoete en zure tussendoortjes om gaatjes te voorkomen. Ook de kwaliteit van de fundamenten van de tanden, namelijk het tandvlees en het kaakbot, kan beïnvloed worden door voedingsmiddelen. Of toch niet? In ieder geval: tandvleesontstekingen komen nog veel te vaak voor en daar wil elke tandarts wat aan doen.

Eén van de grootste redenen dat mensen soms aan valse tanden toe zijn, is ‘parodontitis’. Dat is een ontsteking van de weefsels die de tanden vasthouden. Op jonge leeftijd is meestal enkel het tandvlees ontstoken, wat zich kenmerkt door bloedend tandvlees als je je tanden poetst. Vanaf een jaar of 40 is er meer kans dat ook het kaakbot onder het tandvlees ontsteekt, waardoor de tanden los komen te staan en vaak zelfs getrokken moeten worden. Vraag maar eens aan je grootmoeder; zij kan vast en zeker beamen dat een vals gebit niet haar leukste accessoire is.

Het zijn bepaalde bacteriën in de tandplak die voor de ontsteking zorgen. Het is ook een feit dat rokers meer risico lopen om parodontitis te krijgen. Je zou dus kunnen denken dat door goed te poetsen en door te stoppen met roken, parodontitis te vermijden is. Spijtig genoeg is dat gemakkelijker gezegd dan gedaan. Bijna iedereen heeft een lichte of zware vorm van tandvleesontsteking en tandverlies door parodontitis komt bij ouderen nog heel vaak voor. Dit komt omdat veel mensen vergeten om de ruimten tussen de tanden te reinigen, bijvoorbeeld door te flossen. Daardoor blijft een groot aantal bacteriën ter plaatse. De risicofactor roken blijkt bovendien ook zeer moeilijk op te lossen.

Wat de behandeling van parodontitis betreft, bestaan er op zich eenvoudige maatregelen. De ondiepe tandvleesontsteking is te genezen door het uitvoeren van een goede mondhygiëne. Dat houdt in dat je elke dag één keer tussen alle tanden flost en twee keer per dag grondig je tanden poetst. Na ongeveer een week goed poetsen zal het tandvlees weer gezond zijn. Dan is het natuurlijk ook nog een kwestie van volhouden! De diepere ontsteking is echter niet volledig te genezen. Een grondige reiniging door de tandarts samen met een goede mondhygiëne en rookstop door de patiënt kan de ontsteking wel stabiliseren. Zo kan tandverlies vermeden worden. Spijtig genoeg klinkt ook dit allemaal weer gemakkelijker dan het is.

Als er één ding is dat tandartsen niet willen zien, is het ontstoken tandvlees. Daarom is men op zoek naar dat extra duwtje in de rug dat de mensheid nodig heeft om parodontitis te voorkomen en/of te genezen. Omdat parodontitis een ontstekingsziekte is, denkt men nu in de richting van middelen die ons immuunsysteem helpen vechten tegen de bacteriën. Daarvoor komen bepaalde voedingsmiddelen in aanmerking, waaronder vitamine C, antioxidanten en vetzuren. Deze bevinden zich bijvoorbeeld in groenten & fruit, groene thee en vette vis (bijvoorbeeld zalm).

In theorie milderen deze voedingsstoffen de ontstekingsreactie of helpen ze het zieke weefsel te genezen. In het laboratorium onderzoekt men dus niet alleen of het innemen van deze nutriënten tandvleesontstekingen helpt voorkomen maar ook of het de genezing kan bevorderen. Nu is natuurlijk de vraag of tandartsen op basis van de onderzoeken die in het laboratorium op cellen gebeurd zijn, voedingsadvies kunnen geven aan hun patiënten. Met andere woorden: doen de vitamientjes hun werk ook in real life?

Om dat te kunnen ontdekken, zijn er studies uitgevoerd die verschillende groepen mensen een bepaald voedingssupplement geven en dan nagaan wat het resultaat is. Men geeft bijvoorbeeld gedurende een aantal maanden een groep patiënten met parodontitis een vitamine C tablet en vergelijkt daarna de toestand van hun tandvlees met patiënten die geen tablet namen. Het voordeel van zo’n voedingssupplementen is dat ze geen schadelijke neveneffecten hebben. Men kan dus met een gerust hart experimenteren en dat is ook wat men de laatste jaren gedaan heeft. Door al deze studies te vergelijken, kan een voorlopig globaal resultaat opgemaakt worden.

Dit resultaat houdt ten eerste in dat gezonde voeding voor het lichaam enorm belangrijk is en ook de mondgezondheid enkel ten goede kan komen. Zo kan je best dagelijks vijf porties groenten en/of fruit eten, twee keer per week vette vis op het menu zetten en andere vette voeding en zoetigheden zo veel mogelijk beperken. Het is echter niet aangewezen om voedingssupplementen te nemen om te vermijden dat je parodontitis krijgt. Bij mensen die reeds een diepe tandvleesontsteking hebben, hebben supplementen ook geen nut als de grondige reiniging door de tandarts en goede mondhygiëne thuis niet gebeuren. Wel kunnen sommige voedingsmiddelen deze reiniging en mondhygiëne ondersteunen en de behandelresultaten van parodontitis verbeteren.

Er kan besloten worden dat een goede mondhygiëne een absolute must is én blijft om tandvleesontsteking te voorkomen of te genezen. De grootste oorzaak van de ontsteking zijn immers de bacteriën in de tandplak, dus die moet weg. Ter ondersteuning is een gezonde voeding wel nuttig. Samen met een goede mondhygiëne zou dit moeten volstaan om de oppervlakkige tandvleesontsteking tegen te gaan. Voor de diepe ontsteking zijn er reeds veelbelovende resultaten over bepaalde combinaties van voedingsmiddelen die de mensen zouden kunnen helpen bij hun strijd tegen de parodontitis. Verder onderzoek is natuurlijk nog nodig maar het zou dus wel eens kunnen dat een optimistische tandarts jouw vader een voedingspilletje voorschrijft. Dan weet je hoe laat het is en let je best goed op dat je vader ook elke dag zijn tanden flost. Net als jij trouwens :). 

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Universiteit of Hogeschool
KU Leuven
Thesis jaar
2013
Thema('s)
Geneeskunde
Kernwoorden
paradontale gezondheid,
tandheelkunde,
gezondheid,
Gezondheidszorg,
vitamine C,
antioxidanten,
vetzuren