Image by klimkin from Pixabay

“The oral microbiota is stable and in harmony with the host, unless disturbed by medication, disease, low pH, or significant changes in the diet.” 1

What is all this talk about acid and teeth? Do you really need to worry about the pH in your mouth? Indeed, whether your mouth is acidic or basic has an impact on the health of your teeth. Why? Because teeth are made of minerals. They constantly are being broken down and rebuilt. A critical factor in whether your teeth are primed to dissolve or rebuild is the pH in your mouth.

Over the course of a tooth’s life, it will go through many demineralization/remineralization cycles. Don’t be scared off by those big words. Demineralization means teeth are losing their minerals. On the flip side, remineralization means teeth are getting stronger, building up their mineral structure. These words are very important because they set the stage for whether your teeth are prone to cavities or resistant to them. One in three Americans has untreated tooth decay.2 It’s widespread and it’s no fun. Cavities cause toothache, tooth sensitivity, holes or pits in teeth, pain when eating or drinking, and stains on the surface of the tooth. And children are victims of this tooth damage all too often!

There is good news! Demineralization can be reversed. It already is happening on a daily basis. We will review treatments to remineralize teeth naturally, especially the best foods for teeth. You’ll find out how refined flour works double-time to demineralize teeth. Clinicians and consumers will walk away with the nutrients and dental care products needed to remineralize those pearly whites (scroll to the bottom of this blog). Meanwhile, we’ll reveal how the oral microbiome helps balance pH to defend against tooth decay.  And if you are like me and want to dive into the nitty gritty on saliva pH, you’ll find it as you keep reading.

We are grateful to our sponsor, Risewell, for making this blog possible.

Visit and get 10% off of their natural, effective, and safe oral health products with code “CASS10.”

Tooth Rebuilding

Dental enamel is made of minerals, 96% calcium phosphate to be exact. Dentin is the material that makes up most of the tooth, which is a mix of water, type 1 collagen, and 70% minerals. It is primarily calcium, phosphorus, oxygen, and hydrogen called hydroxyapatite crystal, which is the fundamental hard ingredient in teeth and bones.

Under normal healthy conditions, the mouth has a neutral pH (6.5-7) and the teeth are happy, strong, and intact. Bathed in saliva, the teeth are being remineralized. Saliva carries minerals to help balance the pH in the mouth. Minerals also provide additional building blocks for teeth.3 Saliva is wonderful for the friendly bacteria in the mouth. Its pH is favorable for the growth of most bacterial species. It provides moisture and nutrients.4 The oral microbiome changes in response to pH changes in the saliva.4 The reverse happens too: the oral microbiome can also influence the pH in the mouth.

“A healthy oral ecosystem is expected to be at equilibrium regarding acid-alkali balance.”5

Tooth Breakdown or Tooth Demineralization

As we said, everything is going well in a healthy mouth with a neutral pH. But when acidic conditions hit the mouth (pH of 5.5 or less), teeth lose their minerals. This process is known as tooth demineralization, and in plain language means tooth breakdown.3 When the teeth start to dissolve, they get weak and they are prone to damage. They are vulnerable to attack. That’s the beginning of tooth decay. What is the cause for the downward spiral into acidic pH?

Two things contribute to acidic conditions in the mouth: foods that promote acidic pH and bacteria that make acids. One-two punch!

Teeth are incredibly hard and tough, but they are no match for a high acid environment and a bunch of acid-producing bacteria.

Sugar is the Pits

If you are like me, you’ve been told that sugar is bad for your teeth one million times. But do you know why? Sugars and their products cause acidic pH in the mouth.6 After a single taste of the sugar sucrose, the pH of the teeth goes down to 5.5 for 20 to 50 minutes. That’s very acidic. At that critical pH, teeth lose their minerals. They demineralize or break down. Sugary and acidic soft drinks are also an archnemesis of healthy teeth.7

Sugar is not the only food on the black list. Other foods can promote acidic pH in the saliva. Examples are grains, meat, eggs, dairy, and alcoholic beverages. We will dive more into acid-forming foods and how the Western diet is too high in them, so keep reading.

Think you are in the clear because you are eating a low-sugar diet? Not so fast. Another notorious guilty party for sending the mouth into acidic conditions? Refined grains and cereals. By eating these everyday food items, refined carbohydrates acidify the mouth ecosystem.

While these acid-forming foods damage teeth, the problem can get even worse… Enter your oral bacteria.

Image by Sabrina B. from Pixabay

Acid-producing Bacteria

Sugar doesn’t only put your teeth into instant breakdown mode by boosting acidity, it also feeds bad bacteria in your mouth. Bacteria ferment sugar and simple carbohydrates and produce acids. As things get more acidic in the mouth, it encourages even more acid-loving bacteria to climb on board.1 What do they do? Make more acid!5

In terms of acid production, eating something like refined wheat flour is a double-whammy. First refined grains like wheat flour creates acidic saliva, then it feeds oral bacteria, which make acidic saliva.

When high levels of acid damage the enamel (the protective, hard layer on the teeth), the tooth breaks down and is vulnerable to further attack from bacteria. Teeth are demineralizing. This is how tooth decay begins.

Is it a coincidence that these foods are also harmful to your blood sugar, metabolism, and heart? I think not!

Signs of Demineralization

  • Tooth sensitivity
  • White spots
  • Dark brown spots
  • Tooth infections & toothache

Acid-forming and alkaline-forming foods. Image credit:

Deciphering pH and Acidic Foods

Many clinicians and health-conscious consumers throw around the term “acidic foods” or “alkaline foods.” I have heard integrative and functional medicine practitioners talk about it. I have heard dentists talk about it. But what are they really talking about and what is the scientific evidence behind it?

If you remember from high school chemistry, pH tells you if something is an acid, a base, or neutral. A pH of 0 is highly acidic. A pH of 15 means it is a strong base, or alkaline. Water has a pH in the middle, around 7, or neutral. Simple, right?

pH is extremely important for maintaining health. The human body keeps tight control of pH. Different parts of the body have different pH. Blood has a neutral pH around 7. The stomach is very acidic at a pH of 3.5, which helps to break down food effectively. When blood pH gets out of balance in “acidosis” or “alkalosis,” there can be serious consequences for health.

Some resources focus on the pH of foods themselves. You might have dentists tell you to avoid acidic foods to protect the enamel on your teeth. Or your doctor may tell you to avoid acidic tomatoes for reflux. They are looking at the pH of the food itself. By this method, even common vegetables and fruits are categorized as being acidic.

However, the pH of a food is different than how a food affects the pH of your saliva.  By this measurement, acid-forming foods are generally considered to be meats, eggs, poultry, fish, grains, milk products, and alcoholic beverages. Alkaline-forming foods are usually fruits, vegetables, and plant-based proteins.8,9

You may have heard of the ”alkaline diet” or the “acid ash diet.” This dietary recommendation has appeared on and off the wellness scene for many years. The concepts are also found in the medical literature.8,9 The alkaline diet recommends eating more alkaline-forming foods to counteract the “acidic” Standard American diet (which is high in grains, meats, and sugar, known as acid-forming foods).

How does a food get labeled as acid-forming or alkaline-forming? After a food is metabolized in the body, the residue that remains may be acidic, alkaline, or neutral. An acid-forming food shifts the blood into a more acidic state. An alkaline-forming food would promote a more alkaline (basic) pH in body fluids.

When thinking about tooth health, don’t abide by the pH of a food by itself when trying to shift your teeth into a rebuilding state. An alkaline-forming food will promote a more alkaline salivary pH, which will benefit your oral health. Neutral pH or slightly alkaline salivary pH helps to remineralize teeth. On the other hand, acid-forming foods will promote more acidic pH in saliva and demineralize teeth.

For example, many fruits have acidic pH, but are alkalinizing in the body. On the flip side, meat protein has an alkaline pH, but once consumed, it shifts body fluids to an acidic pH. Still, meat has nutritional benefits that make it worth eating, in moderation.

“When comparing plant-based to animal-based diets, it’s quite complex. Both can produce acid, but plant-based foods tend to have more minerals which can balance the acids,” Tianying Wu, public health researcher said. She recommends a balance of 75% alkaline-forming foods and 25% acid-forming foods as an ideal diet.

For this reason, you will not hear me say, “avoid acidic foods.” You don’t necessarily need to avoid foods with an acidic pH. You need to avoid acid-forming foods.

Eating an alkaline diet may have benefits for bone health, kidney stones, reflux, and pain. While the alkaline diet for treatment of disease is controversial, the recommendations to eat a diet high in vegetables has undeniably good outcomes across-the-board. Here is a good website for alkaline-forming foods and acid-forming foods.

As mentioned earlier, a person’s oral bacteria adds another layer of acidic conditions to the mouth– on top of the diet. But you can make good bacteria work to your advantage, as I discuss later. For now, let’s discuss what I think is the number one factor in your tooth health- your food and nutrition.

Photo by Don Pinnock on Unsplash

Eat a Remineralizing Diet for Strong, Healthy Teeth

What you eat every day has a tremendous impact on the pH in your mouth and whether your teeth are dissolving or building themselves back up. So why aren’t dentists everywhere recommending healthier diets to patients? Avoiding sugary candy, juice, and soda isn’t enough to reverse demineralized teeth.

When prehistoric humans switched from hunting and gathering to eating farmed plants and animals, their oral health took a nosedive. Cavities and gum disease increased. Mouth bacteria changed for the worse. Bacteria that produced and thrived in acid grew exponentially. But that didn’t do us in nearly as bad as the Industrial Revolution, when processed foods became the standard! We hardly stand a chance against the Westernized Diet or Standard American Diet (SAD) of farmed animal meats, dairy products, refined vegetable oils, carbonated drinks, fruit juice,10 and processed cereal grains.

In the United States, carbohydrates make up > 50% of calorie intake, with refined cereal grains making up >85% of total grains consumed. Refined sugar makes up approximately 20% of calorie intake.11 Our teeth are in a constant standoff against acidic conditions.

With the Industrial Revolution, came steel roller mills that stripped grains of the fiber and nutrients in their outer bran layer, but left the starchy carbohydrate (flour) for us to eat.11 We got all of the taste with none of the nutrients or fiber to help offset it. It set us on a path for high sugar, acidic mouth pH, and tooth demineralization.

Dentists and clinicians, help your patients discover a healthier diet. It’s a necessity. Give them resources to implement it on a daily basis, such as a health coach.

To remineralize teeth, turn the Standard American Diet on its head. Eat like a hunter-gatherer instead. Choose whole foods, not processed foods like bread, pasta, crackers, chips, tortillas, pizza, and pastries. Avoid sweets like cake, ice cream, candy, soda, sweetened beverages like coffee, and fruit juice. Do not sip sweetened drinks or snack on refined carbohydrates/sweets frequently throughout the day. Teeth will never get a chance to remineralize.5 You can still have it on special occasions, but not on a daily or weekly basis. Let your taste buds get used to lower-sugar flavors. You’ll be amazed how your preferences can change once you de-sugar your diet!

Eat a rainbow of vegetables, meats, fish, eggs, healthy fats, fruit in moderation, nuts, and seeds. Enjoy salads loaded with toppings. If you can cut it down, pick it off a plant, dig it up, hunt it, fish it, or gather it from nature, then it’s a good food for your teeth.

Friendly Mouth Bacteria Promote Tooth Remineralization

Bacterial superheroes to the rescue! Good bacteria can make alkaline beneficial byproducts, increasing the pH in your mouth to be more alkaline. When they do this, they encourage remineralization or tooth rebuilding. When good bacteria help the mouth recover a healthy pH, it is called “re-establishing pH homeostasis.”6

Since the 1940s it has been well-established that after getting a hit of sugar, cavity-causing bacteria will keep the mouth environment acidic. That low pH demineralizes teeth, as we mentioned earlier. However, healthy mouth bacteria will push the mouth environment back to a neutral pH more quickly after carbohydrates. This is called the “Stephan response” and shows that a healthy mouth with friendly bacteria wants to bounce back to a normal pH. In fact, when scientists have looked further, they were surprised to find that mouth bacteria had many alkali-generating pathways.12 This could be one factor explaining why some people are more vulnerable to cavities than others, even when they eat the same dietary sugar and carbohydrates. Maybe their good bacteria make alkaline substances to counteract the acid production.

Friendly mouth bacteria can take urea or arginine and make ammonia, helping the mouth become more basic (or alkaline). Good bacteria that make arginine, ornithine, citrulline, glutamate, serine, threonine, and urea help to counteract acidic mouth environments. 6 Some of the good bugs that help prevent cavities by counteracting an acidic mouth and sugary diet are: Streptococcus salivarius, Actinomyces naeslundii, S. gordonii, S. sanguinis, S. parasanguis, S. rattus, Veillonella, oral haemophili, and some lactobacilli.13

Here is an example. Healthy children showed acidic mouth pH after consuming carbonated drinks, fruit juice, potato chips, and cream biscuits. However, the pH never reached 5.5 because the kids’ saliva and good bacteria effectively buffered the acidic challenge within about 30 minutes.10

Good bacteria also help fight off the cavity-causing, acid-making bad bacteria in the mouth. In a healthy mouth, normal, harmless forms of Streptococcus make up 95 percent of bacteria on the teeth. Meanwhile, the cavity-causing “bad bug” Streptococcus mutans is only found in 2 percent of the bacterial biofilms in a healthy mouth.14 The good bugs keep the bad ones at bay when all conditions are good. For this reason, friendly mouth bacteria have been proposed to treat or prevent cavities (caries).5

Learn more about the oral microbiome in my book, Heal Your Oral Microbiome and sign up for my monthly e-newsletter.

Vitamins and Minerals for Strong Teeth

Nutrition comes into play for whether a tooth is primed to break down or rebuild. Calcium, phosphorus, magnesium, potassium, and sodium help build teeth and keep teeth strong. All of your teeth began forming when you were in the womb. Whether your mother had good nutrition when she was pregnant with you15 and how robust your nutrition is today can influence your teeth. If you didn’t have the nutritional building blocks for making strong teeth, it would set you up for weak teeth that are prone to being attacked. If you don’t have adequate minerals in your saliva, then your body cannot put your teeth back into a rebuilding state. Minerals also help to balance against acidic pH in the saliva. Poor levels of iron and zinc can slow down saliva production, which can send teeth into a state of breakdown. Vitamins A and D are necessary for healthy tooth enamel, while vitamins D and K direct tooth formation. Vitamin C is necessary for making healthy teeth. If you have depleted nutrition, then the immune system in your mouth may be operating at a disadvantage, unable to suppress acid-making bad bacteria. Learn the best vitamins for teeth in my blog, “Vitamins for Oral Health.”

Signs of Remineralization

  • Smooth tooth surface
  • Decreased teeth sensitivity
  • Lack of white spots on teeth
  • Better appearance of teeth


Hydroxyapatite Toothpaste Remineralizes Teeth

Hydroxyapatite is the fundamental hard ingredient in teeth and bones, made from calcium, phosphorus, oxygen, and hydrogen. Hydroxyapatite has been used in medicine and dentistry for more than six decades. It’s been used in Japan since the 1980s when they realized it could counteract demineralization of teeth and bone in astronauts. Certain hydroxyapatite combinations are nearly identical in chemical structure to that found in teeth.16 Hydroxyapatite rivals fluoride as a toothpaste ingredient, fighting cavities.17,18 However, it does fluoride one better, actually producing a remineralizing effect on teeth, strengthening them, and making them smooth. It whitens and brightens teeth, too. Without any harmful side effects and a great safety profile, if you want to naturally remineralize your teeth, hydroxyapatite is a toothpaste ingredient you don’t want to miss.

Risewell has an excellent line of hydroxyapatite toothpastes that can build up tooth structure. They were the first company to bring this to the United States, though it was already in use around the world.

Hydroxyapatite as a remineralization treatment:

  • Decreases tooth sensitivity and pain19,20
  • Fights cavities to the same degree as fluoride16,19,20
  • Makes the tooth surface smoother20
  • Promotes a remineralizing environment in the mouth for building teeth (extra calcium and phosphate)16
  • Reduces demineralization19
  • Regenerates and repairs enamel19

Oral Health Products that Remineralize Teeth

There are many dental hygiene products that can help to remineralize teeth. Fluoride is one of the mainstays for remineralizing teeth in the mainstream dental community.3 However, I don’t feature it here because there are some questions about its adverse effects. Better, safer options are now available, such as hydroxyapatite. Avoid conventional mouthwashes. Standard mouthwash kills bacteria and reduces the pH recovery mechanisms in the mouth, leading to a more acidic mouth.11 It also dries the mouth, setting up for demineralization. Alkalinizing mouthwashes, toothpaste, and mints can be used to build up teeth in conjunction with the dietary and nutritional recommendations made here. Check the ingredients! Glycerrhiza uralensis mouthwash6, calcium phosphate, and dentin phosphoprotein are other products shown to remineralize tooth structure.3

Other Root Causes of Tooth Demineralization

Tooth demineralization doesn’t happen in a vacuum. We can already see that there are many factors at play, including the makeup of the teeth themselves, the diet, the oral microbiome, and the saliva. In difficult-to-treat cases of demineralization, look for other root causes. Celiac disease causes tooth enamel defects in 85% of patients. It also causes higher rates of cavities in children. Food allergies can influence how enamel develops on teeth. Problems in the gut could be contributing to inflammation or tooth infections. Any imbalance of blood sugar is going to make it difficult to shift to a remineralizing tooth environment.

  • Celiac disease
  • Chronic illnesses
  • Diabetes and/or high blood sugar6
  • Dry mouth due to medications or autoimmune conditions
  • Gastrointestinal disease6
  • Food allergies (IgE)21
  • Lead exposure22
  • Malabsorption
  • Malnutrition
  • Poor mineral status due to reflux medications (PPIs)
  • Reflux or heartburn
  • Vomiting


Rebuild Teeth with a Comprehensive Natural Health Strategy

You can turn the tides of demineralization and save your teeth. Tooth decay requires a tooth that is weak and vulnerable. Eating foods that produce acidic conditions in the mouth wreak havoc on teeth and the oral microbiome. The result? Tooth decay and an acidic mouth that encourage more of the same. While sweets, carbonated and/or sweetened beverages, and fruit juice are damaging for teeth, refined cereal grains are the ones that we don’t talk about enough. Turn your diet completely on its head to start naturally remineralizing teeth and resisting tooth decay. Optimize the oral microbiome, which plays a critical role in balancing acidic conditions in the mouth. Healthy saliva flow and oral health products that promote remineralization- instead of demineralization- are a must. One example is hydroxyapatite toothpaste. By eating foods that are good for teeth, restoring healthy conditions to the mouth, and promoting a healthy oral microbiome, tooth decay and demineralization can be stopped in their tracks.



Photo by Anna Shvets


Follow These Steps to Remineralize Teeth Naturally and Help Reverse Tooth Decay


Tooth Remineralization Diet

  • Eat a hunter-gatherer alkaline-forming diet rich in whole foods, plants, fiber, meats and fish, eggs, healthy fats, nuts, and seeds.
  • Eat a wide variety of colorful veggies and use them to cover 50% – 75% of your plate. Eat fruits in moderation. These are alkaline-forming foods.
  • Make home-cooked meals.
  • Give all packaged/processed foods the boot (bread products, breakfast pastries, muffins, crackers, pasta, cereal, corn tortillas, corn flour, rice noodles, etc.). These are acid-forming foods.
  • Avoid the worst foods for teeth: cakes, cookies, chips, ice cream, sugar, candy, and sweeteners, especially processed sweeteners like corn syrup or high fructose corn syrup. These are acid-forming foods.
  • Avoid soda, sports drinks, alcoholic beverages, fruit juices, or flavored or sweetened drinks.
  • Do not sip sweetened drinks, snack on refined flour products or sweets for long stretches of the day, or all day long.

Ensure a healthy flow of saliva

  • Drink lots of water, more than 8 glasses a day.
  • Address mouth breathing if present.

Balance the oral microbiome

  • Take dental probiotics.
  • Take dental prebiotics: arginine, urea, nitrate.6
  • Eat a whole foods prebiotic-rich diet as described above.

Dental hygiene and oral care products

  • Keep up with brushing, flossing, and dental checkups to keep bad bacteria under wraps.
  • Brush with hydroxyapatite toothpaste, such as Risewell ’s new 15% nano- and microhydroxyapatite toothpaste. Leave it on the teeth; don’t rinse.
  • Avoid drying mouthwashes.
  • Look for remineralizing oral care products designed with salivary acid-alkaline balance in mind.

Vitamins for teeth

  • Take a well-rounded multivitamin containing vitamins A, D, K and more.
  • Take a multimineral product containing calcium, zinc, and magnesium.
  • Replenish iron levels if deficient.


  • Check your saliva pH with strips.
  • Test for mineral status in blood or urine.
  • Test the oral microbiome for imbalances of good and/or bad bacteria.



Many thanks to Dr. Winston Cardwell, ND,  doctor, colleague, and friend, who contributed to my research on this topic.


RiseWell is an oral hygiene brand that was developed by dentists and leading experts to create safe oral care that is clinically proven to work. Unlike many natural toothpastes, we didn’t just remove the toxic ingredients found in traditional toothpastes, we swapped in 100% safe and natural alternatives that clean and protect just as effectively. We use only the best ingredients, no matter the cost, to bring 100% clean, naturally effective oral care to you and your family. Our products will not only keep you safe and healthy, but they will also spark joy and ignite happiness, so you can start every day well.



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Cass Nelson-Dooley, M.S.

Cass Nelson-Dooley, M.S.

Cass Nelson-Dooley, MS, is a researcher, author, educator, and laboratory consultant. She studied medicinal plants in the rain forests of Panama as a Fulbright Scholar and then launched a career in science and natural medicine. Early on, she studied ethnobotany, ethnopharmacology, and drug discovery at the University of Georgia and AptoTec, Inc. She joined innovators at Metametrix Clinical Laboratory as a medical education consultant helping clinicians use integrative and functional laboratory results in clinical practice. She owns Health First Consulting, LLC, a medical communications company with the mission to improve human health using the written word. Ms. Nelson-Dooley is an oral microbiome expert and author of Heal Your Oral Microbiome. She was a contributing author in Laboratory Evaluations for Integrative and Functional Medicine and Case Studies in Integrative and Functional Medicine. She has published case studies, book chapters, and journal articles about the oral microbiome, natural medicine, nutrition, laboratory testing, obesity, and osteoporosis.