Clinical tips: Best practices for discussing nutrition with hygiene patients

As prevention experts, dental hygienists are well-versed in various products and procedures that contribute to patients' oral and systemic health. We have no trouble recommending home-care practices that can assist patients in reducing their risk for caries and periodontal disease. One area where, I believe, many of us struggle is having confident conversations with patients about diet.

We tell patients to consume less sugar, drink more water, and eat fewer processed foods—but many more opportunities lie in the nutritional counseling segment of the routine hygiene visit that are often left untapped and overlooked. We all complete a nutrition course in hygiene school, but for many of us, the information doesn't stick long-term. Why is this?

Perhaps it's due to condensed appointments, where time must be dedicated to "productive" services like radiographs, prophylaxis, or in-office fluoride application. Still, my position is that no number of services or aids can override a diet lacking in proper nutrition.

H2O is king

One of the first questions I ask my patients during nutritional counseling is what beverage they drink the most during the day. I find that many patients drink little to no water, relying mainly on coffee, tea, or flavored beverages. Aside from potential concerns with sugar content, my more common concern is the acidity—especially in today's world of "zero-sugar" indulgences.

Patients often assume that if their drink contains artificial sweeteners, they can drink these beverages with no adverse effects. The truth is, however, that the level of acidity is just as harmful. This is especially true for carbonated drinks like sparkling water, seltzers, energy drinks, sodas, and others.¹ Recommending a gradual transition from these beverages to plain, flat water can make a tremendous difference in an individual's caries rate, as you can see in Table 1.

Vitamins and minerals

The American diet saw a slow shift from whole, home-cooked foods to prepackaged, processed foods after the start of the industrial age, where convenience became more important than nutritional value.² These foods are often touted as being low-fat, low-carb, or low-calorie, but we've learned that by removing healthy fats and complex carbohydrates, many vital nutrients are lost. Factoring in high-fat fast foods with empty calories only complicates matters.

When the body is lacking vital nutrients, oral health will most definitely suffer, along with systemic health. Dental decay and periodontal disease will run rampant. Encouraging patients to eat a variety of fresh vegetables, moderate amounts of fruit, and lean meats can help to restore the balance. Table 2 displays popular nutrients and their role in oral health.

What have we learned? Natural is best

There is a supplement for everything these days, and many people view adding extra pills to their daily regimen as "hacking" their health. But it's important for patients to know that the body does not absorb synthetic nutrients nearly as well as whole-food forms. Supplements may be necessary in some cases, but it's best to recommend a consultation with a physician or nutritionist to determine when this is appropriate.

Editor's note: This article appeared in the January/February 2026 print edition of RDH magazine. Dental hygienists in North America are eligible for a complimentary print subscription. Sign up here.

References

1. Nutrition and oral health. American Dental Association. https://www.ada.org/resources/ada-library/oral-health-topics/nutrition-and-oral-health

2. Everts S. Processed: Food science and the modern meal. Science History Institute. January 5, 2014. https://www.sciencehistory.org/stories/magazine/processed-food-science-and-the-modern-meal/#:~:text=“The%2520big%2520change%2520comes%2520in,on%2520its%2520way%2520to%2520industrialization