Xerostomia

• Consuming multiple nicotine products at the same time, including authorized nicotine replacement therapy products, or varenicline (a prescription smoking cessation drug), may increase the adverse effects of nicotine.
• Use authorized nicotine pouches only as directed:
  To date, Health Canada has authorized only one nicotine pouch , containing 4 mg of nicotine per dose.
• Nicotine replacement therapies, including nicotine pouches, are not authorized for recreational use or for use by nonsmokers and people under 18 years old.
• There are no authorized nicotine pouches in Canada that contain more than 4 mg of nicotine per dose.

Herbal medicinal product: Silybi mariani fructusArray, F: Assessment finalised

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• These treatments have side effects, such as dry mouth, the development of antimicrobial resistance and increased blood pressure.
• But research has indicated that a molecule called nitrate, which is found in leafy green vegetables, has fewer side effects and offers greater benefits for oral health.
• Periodontitis is a more advanced form of gum disease, causing damage to the soft tissues and bones supporting the teeth.

Leafy greens may be the secret

• Leafy greens and root vegetables are bursting with vitamins, minerals, and antioxidants – and it’s no secret that a diet consisting of these vegetables is crucial for maintaining a healthy weight, boosting the immune system, and preventing heart disease, cancer and diabetes.
• The multiple health benefits of leafy greens are partly because spinach, lettuce and beetroots are brimming with nitrate, which can be reduced to nitric oxide by nitrate-reducing bacteria inside the mouth.
• However, in the mouth, it helps to prevent the overgrowth of bad bacteria and reduces oral acidity, both of which can cause gum disease and tooth decay.
• Antimicrobial resistance is a global health concern, predicted to cause 10 million deaths yearly by the year 2050.

In contrast, dietary nitrate is more targeted. Nitrate eliminates disease-associated bacteria, reduces oral acidity and creates a balanced oral microbiome. The oral microbiome refers to all the microorganisms in the mouth. Nitrate offers exciting potential as an oral health prebiotic, which can be used to prevent disease onset or limit disease progression.

How many leafy greens for pearly whites?

• As a rule of thumb, a generous helping of spinach, kale or beetroot at mealtimes contains about 6-10 mmol of nitrate and offers immediate health benefits.
• For example, consuming lettuce juice for two weeks reduced gum inflammation and increased healthy bacteria levels in patients with gum disease.

Mia Cousins Burleigh has previously received funding from The Royal Society of Edinburgh. Siobhan Paula Moran does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.