Alvin H. Danenberg, DDS • Nutritional Periodontist
January 9, 2017
Doesn’t mouthwash kill bacteria? Don’t bacteria cause gum disease? What about healthy gums?
Yes, antibacterial mouthwash kills bacteria. Yes, bacteria can cause gum disease. Yes, you want healthy gums.
But before you think I’ve gone bonkers, give me a moment to explain. Bacteria, when the good guys and the bad guys are in balance, serve many necessary purposes in your mouth. Healthy gums are dependent on healthy bacteria. One benefit is to allow a specific pathway of digestion to occur that is critical for health.
I have written about the balance of bacteria in the mouth in past articles. When bacteria are killed indiscriminately, harmful bacteria and good bacteria are both killed. This delicate balance of bacteria goes awry. When a healthy balance is disturbed, tooth decay and gum disease are likely to occur.
Here is one of the many benefits of mouth bacteria. They play a unique role in the chemical pathway of certain foods. Specifically, the chemical pathway of “nitrate-to-nitrite-to-nitric oxide” is dependent on specific anaerobic bacteria in the mouth.
“Nitrate to Nitrite to Nitric Oxide” Pathway
Nitrate is naturally abundant in certain vegetables. It is converted into nitrite and then into nitric oxide and other nitrogen products during digestion. One end product, which is nitric oxide, has major benefits throughout our body. Nitric oxide reduces blood pressure, reduces the risk of cardiovascular disease, improves athletic performance, and improves gum health to name a few. Your mouth bacteria play an important role in the path of creating nitric oxide.
The pathway is somewhat technical, but it is good stuff. If you’re not interested in the details, then skip to the next section.
The pathway goes like this: The foods that are high in natural nitrate are chewed up in our mouths and swallowed. Nitrate is absorbed in our stomach and upper small intestine. A large percentage of the absorbed nitrate gets concentrated into our saliva. Once nitrate is in our saliva, the naturally occurring anaerobic bacteria on our tongues convert this “nitrate” into “nitrite”. Then we swallow.
Yes, we swallow this nitrite, which goes into our guts. Some nitrite is changed into nitric oxide by the acids in our stomach. Some nitrite is absorbed into our blood system and circulates to all of our cells where nitric oxide is formed. Still, some nitrite is converted into “nitric oxide” by bacteria in our intestines. There are many biological ways that nitrite is converted into nitric oxide and other nitrogen products.
In the mouth, nitric oxide has significant effects. Nitric oxide gets into the gum tissues and is strongly anti-inflammatory. It also has antimicrobial effects on pathogens. In this clinical study, nitric oxide derived from salivary nitrate helped reduce gingivitis. This study was a randomized, double-blinded clinical trial that was published in the Journal of Clinical Periodontology in 2016.
Don’t Kill The Bacteria
If you killed the bacteria in your mouth and on your tongue with antiseptic mouthwash, salivary nitrate wouldn’t be converted into nitrite. With less nitrite in your system, you would produce less beneficial nitric oxide.
So, if nitrate is healthy, then what foods are the best sources? Here are some vegetables with the highest concentrations of naturally occurring nitrate. These vegetables are part of a nutrient-dense diet I recommend:
- Butter Leaf and Oak Leaf Lettuces
- Swish Chard
- Beets and beet greens
One caveat: The artificial nitrate and nitrite that are added to processed meats and other foods are not healthy and should be avoided. Their chemistry is different from that of naturally occurring nitrate.
- Eat foods high in natural nitrate.
- Don’t use any mouthwash that can disturb the natural and healthy balance of bacteria in your mouth.