Mouth Ulcers
some get them; some don’t

Dr. Al Danenberg ● Nutritional Periodontist

March 2, 2020

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Mouth Ulcers

 

Hippocrates was a Greek physician who lived over 2000 years ago. Today, he is known as the “Father of Modern Medicine”. Reportedly, he succinctly stated: “All disease begins in the gut.” And most often, mouth ulcers can be traced back to problems in your gut.[1]

 

It is critical to realize that the mouth is not an island unto itself. Whatever happens to one cell in the body ultimately can affect every other cell in the body. As a matter of fact, the mouth may be one of the first visible areas of the body which can show signs and symptoms of many systemic diseases.

 

 

Your Gut

Your gut has more beneficial bacteria than you have human cells in your body – about 38 trillion bacteria cells and about 30 trillion human cells. The microbes in your gut perform so many tasks that help you survive and thrive. The bacteria stimulate and enhance the immune system, prevent the overgrowth of harmful bacteria, manufacture various vitamins, and produce short-chain fatty acids from the fermentation of various amino acids and dietary fibers.

 

Short chain fatty acids are vital to your health. They are a source of energy for the cells making up the wall of the colon (colonocytes). They assist in sugar metabolism, curb your hunger, and help with weight loss. In addition, short chain fatty acids improve the absorption of minerals, reduce systemic inflammation, and improve overall intestinal health. All this is accomplished by the short chain fatty acids that are created by the beneficial garden of bacteria that live in your gut.

 

But what would happen if these bacteria got out of balance and bad guys began to overgrow?

 

 

Gut Dysbiosis

The result, which is called “gut dysbiosis”, would be havoc. Havoc in the gut, havoc in the blood system, and havoc in your mouth and other areas throughout your body.

 

Harmful cascading events occur when there is gut dysbiosis.

 

The epithelial barrier, which is the outer wall of the gut, starts to break down. This barrier is made up of only one cell layer. These cells are held together by “tight junctions”, which are like hinges that hold a door in place. These “tight junctions” become weakened when there is gut dysbiosis and become unhinged, creating opening between cells. Stuff in the gut that should never leak into the blood system starts passing through these unhinged openings and contaminating the blood system. This is called a “leaky gut”.

 

At the same time, the unhealthy growing mass of gut bacteria stimulates the immune system leading to an explosion of inflammation. If gut dysbiosis is not treated quickly, the inflammation continues and spreads throughout the body affecting every cell and organ system in the body.

 

Chronic diseases and autoimmune diseases have their origin in this untreated and unhealthy gut. Some of the specific diseases associated with gut dysbiosis are ulcerative colitis, Crohn’s disease, obesity, type 2 diabetes, nonalcoholic fatty liver, rheumatoid arthritis, multiple sclerosis, cardiovascular disease, allergies, systemic lupus erythematosus, Hashimoto’s hypothyroidism, food intolerances, cancer, periodontal disease, and mouth ulcers – just to name a few!

 

 

Mouth Ulcers and Lesions

Have you had sores on your tongue, sores on the inside surface lining of your cheeks, sores on your gum tissues, or sores in the corners of your mouth? Many of these ulcers and lesions are painful. Some are red and inflamed, some look like white lines, some appear to be clear “pimples”. But all are signs of your body reacting to something going wrong in your immune system. Most of the time, gut dysbiosis is the source of these disturbances. These ulcers and lesions have different names. Examples are aphthous ulcers, angular cheilitis, glossitis, lichen planus, etc. These ulcers and lesions may heal and disappear if the health of the gut is restored.

 

 

Treatment

To heal mouth ulcers and lesions, which have resulted from a disturbance in the healthy garden of bacteria in the gut, the gut must be healed. To do this, whatever factors that caused gut dysbiosis also must be understood and corrected. If the causes are not identified and removed, then the gut could never heal.

 

For example, if you had a splinter in your finger, the area could not heal until the splinter was removed. Likewise, if there are irritants or “splinters” causing your gut to become unhealthy, there would be no way to return to a healthy gut until all the “splinters” were eliminated.

 

The gut microbiome and the epithelial lining of the gut become damaged from many different irritants. Some of these irritating influences are:

 

    • Stresses on the body (including emotional, physical, or chemical)
      These could be serious but unrecognized causes. A significant chemical stress to the gut is glyphosate herbicide (Roundup) that damages the DNA in human cells; inhibits the growth of healthy bacteria, and directly causes leaky gut. In addition, stress to the immune system from metal ions leaking from titanium implants placed in the body and chemicals leaking from breast implants can cause chronic systemic inflammation, damaging the gut microbiome. Also, failing dental work; toxic dental materials; and oral infections in the gum tissues, teeth, and jawbone could be significant factors.

 

    • Other lifestyle and environmental stresses to the body
      Included are heavy metal toxicity, over exercising, lack of exercise, sleep deprivation and sleep apnea, continuous exposure to dirty electromagnetic fields, excessive blue-light exposure especially in the evening, smoking, alcohol consumption, and lack of proper sunlight that is essential for the production of vitamin D3.

 

    • Processed foods
      Overly processed vegetable and seed oils, hydrogenated and partially hydrogenated fats and oils, packaged prepared foods, processed sugars and carbohydrates, or other junk and chemicals in foods will have a harmful effect on the gut.

 

    • All plant foods
      Plants have the potential to irritate the gut by way of their anti-nutrients. Substances like phytates, oxalates, and lectins that exist in plants could damage the gut bacteria and intestinal barrier. Eliminating all plant foods for a period of time could assist the gut in healing itself. Then, plant foods could be reintroduced individually and slowly later. The Carnivore Diet could be used as an elimination diet to allow the gut to heal.

 

    • Specific medications
      Over-the-counter and prescription medications such as non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, alcohol, narcotics, antibiotics, chemotherapy drugs, hydrogen peroxide, and birth control pills could result in leaky gut.

 

    • Low dose ionizing radiation
      X-rays have a cumulative harmful effect. In our society, excessive dental and medical x-rays over the course of time can cause damage to the gut bacteria and the epithelial lining.

 

At the same time that irritants to the gut are removed or avoided, the healthy garden of gut bacteria must be restored, and the gut epithelial barrier must be repaired. I have prepared two PDFs that I give to my patients: Dr. Danenberg’s 30-Day Transition to the Carnivore Diet and a Protocol to Restore Normal Gut Bacteria.

 

 

From Me to You

Recently, I was asked to write a chapter for a peer-reviewed medical textbook tentatively titled, “Digestion, Metabolism and Immune Health”. My chapter is titled, “The Etiology of Gut Dysbiosis and its Role in Chronic Disease”. It will be one of 25 tentatively scheduled chapters for the book. My chapter has been accepted by the publishers. The tentative date of publication is the end of 2020 or early 2021. However, I have prepared an extensive paper that I titled, Your Gut is Killing You, which is based on my chapter. As more research comes to my attention, I have been updating this paper regularly. Currently, it is over 12,200 words in length and includes 260 cited peer-reviewed references.

 

My goals at this juncture in my life are to “give back” and “pay it forward”. If you would like a copy of Dr. Danenberg’s 30-Day Transition to the Carnivore Diet, my Protocol to Restore Normal Gut Bacteria, and my updated paper Your Gut is Killing You, send an email to me (Dr.Danenberg@iCloud.com), and I’ll get those PDFs to you.

 

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6834154/

 

 

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Melatonin & Periodontal Disease
– A Curious Connection –

Dr. Al Danenberg ● Nutritional Periodontist

February 10, 2020

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What do you know about melatonin?

 

When I asked several friends that question, basically they said, “It’s a supplement that helps you go to sleep.” That would have been my response before learning the numerous and diverse functions of melatonin in the body – especially the curious connection with periodontal disease. Another unusual fact is that melatonin is not only produced in the brain; it’s also independently synthesized in the gut?

 

Let me guide you down the path to understand some of the fascinating functions of melatonin in your body. Then, I’ll suggest some ways to improve your levels of melatonin naturally.

 

 

Melatonin

Melatonin is the “sleep hormone”, but it’s so much more than that.

 

The pineal gland produces melatonin. This gland is a small structure located near the center of the brain. Melatonin is generally known for the regulation of your sleep cycle (also called the circadian rhythm). Your pineal gland begins secreting melatonin around sundown and peaks around 2 – 4 AM. As melatonin increases in your brain and then your circulation, your body begins to prepare for sleep. You will become tired. However, if you use artificial light at night, your body will slow down its production of melatonin. Falling asleep could become a problem. That’s when many people turn to melatonin supplements to help them fall asleep.

 

Supplements are available in a natural form or a synthetic form. If you do take a supplement of melatonin, the long-term use could cause your pineal gland to reduce its production of melatonin or even shut down its production if you’re using a high dose for an extended period of time. A better option might be to eat foods high in tryptophan, an amino acid that is the precursor to melatonin. To help your body produce more melatonin naturally, I’ll summarize some ideas at the end of this article.

 

Melatonin has many other functions other than affecting sleep. It turns out that melatonin has been identified in the gut. And its synthesis in the gut is independent to the production of melatonin by the pineal gland. As a matter of fact, the gut contains at least 400 times more melatonin than the pineal gland. The creation of melatonin in the gut is not related to the sleep cycle or light exposure. It appears that melatonin production in the gut helps with all healthy gut functions.

 

Another function of melatonin is that of an energy hormone. When melatonin levels increase, your energy level goes down. Conversely, when melatonin levels decrease, your energy level goes up. Melatonin is also an effective antioxidant. It might function in the body as a cancer-preventing biochemical. In addition, melatonin has positive effects on the function of your brain, heart, gut, circulatory system and your immune system. That’s a lot of work coming from the simple hormone called melatonin.

 

Two major effects of melatonin are to protect mitochondria and to repair dysfunctional mitochondria. The mitochondria are the batteries of your cells creating the necessary energy that every cell in your body must rely on to function efficiently. Mitochondria are like the batteries in a flashlight. When the batteries start to run down in a flashlight, the light will dim. Eventually, if the batteries lose all their power, the light from the flashlight will go out. Likewise, if the mitochondria are functioning less than they should, the cellular tissue cannot function properly, and it will slow down. If the mitochondria fail to create the necessary ATP for the cell, the cell could ultimately die. However, melatonin has potential to recharge weakened mitochondria and restore its ability to continue to produce ATP efficiently for the cell.

 

Melatonin also works with Vitamin D to prevent diseases which are intimately and intricately affected by the status of vitamin D and melatonin in your body.

 

 

Melatonin and Periodontal Disease

There are so many biological functions for melatonin as I already described. But this hormone also is necessary of periodontal health.

 

A medical trial published in 2013 reported that patients with active periodontal disease had reduced levels of melatonin compared to healthy individuals. And as early gum inflammation progressed to more advanced periodontitis, the levels of melatonin in the saliva and the gum tissues decreased.

 

Since melatonin has been shown to have anti-inflammatory actions in general, a study was designed to evaluate melatonin’s targeted effects on periodontal disease. Participants in the study consisted of those who had active periodontal disease and diabetes. Healthy subjects were used as controls. The researchers used a topical solution of melatonin and applied it to the gum tissues of those with active periodontal disease and those with healthy gums. The results of the experiment were published in 2015 and showed that topical melatonin would help heal the gums of those patients with active periodontal disease. Specifically, gum bleeding and pocket depths decreased as well as systemic biomarkers of IL-6 and CRP decreased.

 

To delve a little deeper, a detailed study was published in 2016. This study investigated the effects of melatonin on the virulent bacterium Porphyromonas gingivalis (P. gingivalis) and the severe inflammation caused by this bacterium. P. gingivalis is one of the most pathological bacteria involved with periodontitis – the aggressive form of periodontal disease that destroys the jawbone surrounding the roots of the affected teeth. The investigators showed that melatonin could inhibit the growth of P. gingivalis and its surrounding biofilm. The takeaway message from this study is that melatonin could be used as adjunctive treatment for patients with active periodontal disease.

 

Another study published in 2014 proved that melatonin can help bone grow. This is important since active periodontitis causes bone loss in the bone surrounding the infected teeth. If melatonin will help bone grow, it might be beneficial during the treatment of periodontitis.

 

So, melatonin has the potential (1) to repair mitochondria that become dysfunctional in periodontal disease, (2) to inhibit the pathological growth of P. gingivalis, (3) to decrease inflammation, and (4) to potentially assist with bone repair.

 

It appears that your natural production of melatonin can prevent periodontal disease or help heal the body from periodontal infection. However, if your sleep cycle is disturbed because of use of light at night (especially blue light from computers and artificial lighting), working the night shift, or disease of the pineal gland, then you will produce significantly less melatonin and be more susceptible to periodontal disease and bone damage. Also, if your gut is not healthy, then the production of melatonin in the gut could be compromised.

 

 

Natural Ways to Increase Melatonin

Eat nutrient-dense anti-inflammatory foods and especially avoid processed foods which contain chemicals and other harmful substances.

 

  • Include foods high in tryptophan (ex. chicken, eggs, cheese, fish, turkey).
  • Try to sleep between 7 to 9 hours per night.
  • Stop drinking caffeine or eating caffeine foods after 2PM.
  • Don’t eat shortly before bed.
  • Avoid exercise before bed.
  • Sleep in a dark and cool room. (Electronic devices like a computer screen, a cell phone, and a TV will emit blue light, which greatly suppresses melatonin and prevents you from getting sleepy. If you must use an electronic device, use the adjustment for “night shift” to filter out the blue light.)
  • Use relaxation techniques like meditation before bed.

 

 

The impact of melatonin on our body is impressive. Its relationship to a healthy mouth is one more reason to be sure your sleep cycle is healthy so that it produces melatonin efficiently. But also, the fact that the gut produces its own melatonin is another compelling reason to maintain a healthy gut through diet, efficient exercise, stress reduction, and restorative sleep.

 

 

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What to Eat
For a Healthy Mouth

Dr. Al Danenberg ● Nutritional Periodontist

January 27, 2020

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What to Eat For a Healthy Mouth

 

Well, you definitely should not be devouring an egg sandwiched between processed cheese on a muffin, drinking a glass of orange juice, and finishing with a donut for breakfast. And then sipping on a 20-ounce Venti of coffee loaded with sugar to get your day started. This “energy breakfast” is not healthy at all. On the contrary, it’s practically all carbs and added sugars that will damage your gut bacteria, compromise your immune system, and create chronic systemic inflammation. And ultimately, this “food” would change the bacteria and acid levels in your mouth to start the ball rolling in the direction of gum disease and tooth decay.

 

So, what should you do about breakfast? What about the rest of your day? What are better choices for your mouth? Should you just think about removing bad stuff, or should you replace bad choices with appetizing substitutes, which will continue to satisfy you? Let’s get into this discussion.

 

First, take a deep breath. You could ease into any dietary changes that may interest you. You don’t need to jump all in at once with both feet. Take your time and make changes appropriate for your personality, comfortable for you family, and eventually effective to get you to your end goal. If you seem to get off track, that’s also OK. Just review what you want to accomplish; get back to your program; and proceed at your own pace once again.

 

My Patients’ Nutrition

When patients come to me interested in proper nutrition and wanting to make changes in what they have been doing, I provide a program to help them. Initially, they and I need to understand what they actually are eating. I give them a 3-Day Food Journal, which they will complete over the course of 3 continuous days. It’s amazing how people believe they are eating healthy until we go over their detailed Food Journal. They also fill out a health questionnaire. I review their food choices and other health issues with them, and I comment about what’s good and what’s bad about their current eating habits. We’ll also discuss what might be missing in their meals that is necessary for a healthy mouth as well as a healthy body.

 

In addition, I give them a summary of the general food groups that are not healthy choices. I specifically recommend substitute foods to replace their unhealthy choices, which they have included in their Journal. Then, both of us create a plan to make necessary changes – slowly and methodically. Whatever time it takes for them to change their eating lifestyles is perfectly OK. Whatever works for each patient works for me.

 

You can email me, and I’ll send you a PDF of the 3-Day Food Journal with my written guide to assist you in interpreting your personal 3-Day Food Journal by yourself. The PDF also includes some tasty substitutes to replace specific bad food choices in your daily diet. Dr.Danenberg@iCloud.com

 

Generally, a healthy diet will eliminate as many processed carbs and added sugars as possible. Be especially aware of sodas and juices. These contain strong acids that can demineralize your teeth and start the tooth decay process. Sodas and juices also contain a huge amount of sugar that feeds bad bacteria in your mouth, which are initiating factors causing tooth decay and gum disease. Also understand that the artificial sweeteners in zero-calorie drinks can damage your healthy gut bacteria, which affect your overall health as well as your mouth. So, consider eliminating sodas and fruit juices of all kinds and find satisfactory substitutes that you can enjoy. Water, teas, seltzers, and coffee may be ideal substitutes for you. If you need a sweetener, use organic stevia or monk fruit that do not cause tooth decay and are not artificial.

 

I recommend various ways of eating as long as they are doable for the patient and meet the strict criteria I encourage – no foods that are inflammatory to the body and all foods that nourish the body.

 

This is important: Don’t think that a “diet” is a temporary way to eat and then you would go back to old habits. My concept of a healthy diet is truly a lifestyle change in eating protocols that may take time to institute – something that eventually happens comfortably and without constant thought, stress, or effort. Diets like the Mediterranean Diet, a Low-Carbohydrate Diet, the Paleo Diet, the Ketogenic Diet, and even the current Carnivore Diet may be excellent lifestyle changes to investigate. If any of them appeals to you, make plans to transition into it at your own pace. Here is a short description of each of them:

 

 

Eating Lifestyles

Mediterranean Diet: This type of diet consists of eating: (a) high levels of vegetables, fruits, cereals (mostly whole grains), nuts, and legumes; (b) low levels of saturated fat, sweets, and meat; (c) high levels of unsaturated fat (mainly olive oil); (d) medium-high levels of fish; (e) moderate levels of wine; and (f) medium-low levels of dairy products (mainly yogurt and cheese).

 

Low-Carbohydrate Diet: Restricting processed carbohydrates and sugars avoids high blood sugar levels and high blood insulin levels. Low-carb improves the garden of beneficial gut bacteria. Processed carbohydrates can be replaced with resistant starch (ex: oats, raw potato starch, cooked and cooled rice, green bananas).

 

Paleolithic Diet: A paleolithic (paleo) diet today mimics the diet of our ancestors during the Old Stone Age. This style of eating was prevalent during the course of human existence. A paleo diet today consists of: (1) High consumption of fruits, vegetables, and various herbs and spices; (2) Moderate-to-high consumption of meats, organs, fish, and eggs; (3) Moderate consumption of nuts and seeds; and (4) Exclusion of all processed foods, legumes, grains, pasteurized dairy products, and processed vegetable and seed oils (except olive and coconut oil).

 

Ketogenic diet: Ketogenic (keto) diets represent an extremely low-carbohydrate diet. A keto diet reduces carbohydrate intake to less than 50 g/day. At this level, insulin is kept to low levels and cortisol levels are slightly elevated. This will induce the production of ketone bodies in the liver, which will be used as the main energy source for the body.

 

Carnivore Diet: The carnivore diet is an extreme of the keto diet. The carnivore diet is similar to a ketogenic diet but with all fruits, vegetables, nuts and seeds removed.  A ketogenic diet reduces carbohydrates and increases healthy fats to a level where the body’s metabolism shifts away from burning carbs to burning fat and ketones for energy. The carnivore diet requires eating only wild-caught and pastured animals from nose-to-tail. Since the carnivore diet completely eliminates all plants, it importantly avoids the abundance of antinutrients (i.e. lectins, oxalates, and phytic acid) found in plants that have the potential to cause many gut problems.

 

 

My Personal Eating Plan

Prior to 2012, I was eating the Standard American Diet (SAD). My eating lifestyle was loaded with unhealthy carbs and unhealthy fats. In 2012, I shifted my SAD lifestyle to a paleo-type diet. Some withdrawal symptoms occurred as I eliminated excess carbohydrates. These included achy joints, deep cravings for carbs, stomach discomfort, and overall weakness like dealing with the flu. Then after three weeks or so, all those ailments were practically gone, and I was on a positive roll. I continued with my paleo diet with some tweaks along the way until 2020. On January 1, 2020, I transitioned to my modified carnivore diet. This has been perfect for me; maybe it could be perfect for you.

 

If you would like, I will send you PDFs on my healthy paleo-type diet and my healthy carnivore diet. Email your request to me at: Dr.Danenberg@iCloud.com

 

 

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Periodontal Disease
Could Be Killing You

Dr. Al Danenberg ● Nutritional Periodontist

December 30, 2019

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Periodontal Disease Could be Killing You

 

Periodontal disease could be killing you. It is often considered a causal factor for many chronic diseases. But you need to know the complete story – not just part of it. While periodontal disease could be a nidus for chronic systemic inflammation and spread of infection, this is only part of the story. The story has a Beginning, a Middle, and an Ending. Let’s start in The Middle.

 

 

The Middle

Dental plaque is healthy until it’s not healthy.[1]

 

Periodontal disease develops from unhealthy dental plaque. Unhealthy plaque results when healthy plaque is transformed into unhealthy dental plaque because of an underlying compromised immune system and unhealthy food choices. It’s fundamental for you to appreciate that a compromised immune system has its roots in unhealthy changes in the gut (i.e. gut dysbiosis) [2],[3], which causes chronic systemic inflammation.

 

A compromised immune system and unhealthy food choices could allow the hundreds of bacteria in dental plaque to get out of balance and become unhealthy.[4],[5] Then, unhealthy bacteria could proliferate and cause the progression of advanced gum disease[6].

 

One of the most virulent bacteria in periodontal disease is Porphyromonas gingivalis (P. gingivalis).[7],[8] Among other self-protective measures, this bacterium produces a biofilm, which is resistant to the body’s immune defenses.[9] As the body continues to fight the resistant P. gingivalis, additional chronic inflammation results. This chronic inflammation can cause the tissues surrounding the infected gum spaces to break down allowing their toxic elements to leak into the general circulation. Additionally, autoimmunity may play a role in the progression of periodontal disease.[10]

 

It is important to remove unhealthy plaque through an efficient personal oral hygiene protocol performed daily. However, it is also critical to understand that gut dysbiosis leads to pathological changes in the healthy community of bacteria in the mouth. Therefore, gut dysbiosis must be treated to restore oral health, along with removing unhealthy dental plaque. I must emphasize that it is unhealthy to indiscriminately kill bad bacteria as well as good bacteria in the mouth by using antimicrobial mouthwashes or antibiotics on a daily basis.[11]

 

It also is vital to be aware of periodontal disease because its prevalence is at epidemic proportions. In 2010, a published paper demonstrated that 93.9% of adults in the United States had some form of gingivitis.[12] And in 2012, the Centers for Disease Control and Prevention (CDC) published their results in the Journal of Dental Research. The report was recently updated in 2015 in the Journal of Periodontology.[13] It showed the prevalence of periodontitis was estimated to be 47.2% for American adults (approximately 64.7 million people). For adults 65 years old and older, the prevalence jumped to 70.1%. These findings were the result of the most comprehensive periodontal evaluation performed ever in the US.

 

So, statically you most likely have some form of periodontal disease, and it must be treated completely. Otherwise, once periodontal disease is established in the mouth, its pathological byproducts can seep into the bloodstream, lymph fluid, and bone structures to cause spread of infection and inflammation to all areas of the body. This mechanism of seeping into the body’s circulation is similar to the way that an unhealthy gut causes leakage of toxic elements into the bloodstream (i.e. leaky gut) – both creating chronic systemic inflammation.

 

The eventual result of chronic systemic inflammation is chronic disease.[14],[15],[16] The Centers for Disease Control and Prevention stated that 60% of Americans live with at least one chronic disease, and chronic diseases are responsible for 70% of deaths each year in the United States.[17] Therefore, periodontal disease could be a source of degenerative chronic diseases originating from chronic systemic inflammation.

 

 

 

The Beginning

Interestingly, there are three human research studies that showed a healthy diet alone can improve the health of the mouth. These studies also determined that removing dental plaque by brushing and flossing was not essential to improve oral health as long as diet was corrected. Specifically, the investigators demonstrated that changing from a diet abundant in high-processed-carbohydrate and inflammatory foods to a diet excluding high-processed-carbohydrate and inflammatory foods will decrease signs of gum inflammation.[18],[19],[20] However, active periodontal treatment will be necessary if gum inflammation progresses into periodontitis, which destroys the jawbone surrounding the teeth.

 

In February 2019, a medical research article was published in Biomedical Journal[21] entitled, “Association between periodontal pathogens and systemic disease”. The authors describe the correlation between periodontal disease and various chronic diseases and outcomes such as cardiovascular disease, gastrointestinal and colorectal cancer, diabetes and insulin resistance, Alzheimer’s disease, respiratory tract infections, and adverse pregnancy outcomes. The authors go on to state that there are conflicting studies, which try to prove causal relationships. However, there is significant research to show a strong correlation.

 

In another article published in August 2019 by Hashioka et al[22], the authors reviewed medical research that indicates a causal relationship between periodontal disease and various neuropsychiatric disorders including Alzheimer’s disease, major depression, Parkinson’s disease, schizophrenia, as well as the neurological event of ischemic stroke. The initiating cause of these neurological diseases is neuroinflammation, which is induced by chronic systemic inflammation. Periodontal disease causes chronic systemic inflammation by the release of pro-inflammatory cytokines and the invasion of periodontitis bacteria (specifically P. gingivalis) along with their inflammatory components (lipopolysaccharide or LPS) into the systemic circulation. Chronic systemic inflammation will activate the microglia, the immune cells in the brain, creating neuroinflammation.

 

But I want to emphasize again that systemic chronic inflammation is the result of a leaky gut from gut dysbiosis in most cases.

 

In essence, my research suggests that periodontal disease is not the seed of all systemic disease. As I suggested above, periodontal disease is just one of many chronic diseases occurring on the continuum of the spread of chronic systemic inflammation that starts in the gut. Since the mouth is visible and easy to examine, the mouth may be the first clinical area where disease is diagnosed. And as I mentioned earlier, the prevalence of periodontal disease is at epidemic proportions.

 

Once systemic disease spreads, a vicious cycle begins because all tissues affect all other tissues in the human body. All mucosal tissues use “crosstalk” to communicate with other tissues.[23],[24],[25]

 

I should point out that unhealthy bacteria in the mouth in turn can interact further with unhealthy bacteria in the gut, and vice versa.[26]  In the case of periodontal disease, treatment for cascading chronic diseases must include healing both the unhealthy gut and the unhealthy mouth. But for the most part, the origination of mouth disease is in the gut before becoming visible in the mouth and other areas of the body.

 

 

The Ending

To stop periodontal disease and prevent this infection from entering the systemic circulation, the infection must be treated efficiently. Treatment may often consist of a dentist, hygienist, or periodontist removing irritants that have become lodged under the gum tissues and initiating inflammation and infection. Removing these irritants will assist the body in healing.[27] In more advanced stages, surgical procedures may be necessary to arrest this disease. Whatever treatment is necessary, an effective oral hygiene program should be instituted at a frequency based on the patient’s ability to take care of his or her mouth. The individual also must have a personal oral hygiene protocol to maintain a healthy mouth.

 

But whatever periodontal treatment is required, complete treatment must include repairing the gut, restoring the healthy balance of bacteria in the gut, and avoiding unhealthy processed foods and inflammatory foods.

 

 

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4132376/

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5892391/

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5937375/

[4] https://www.ncbi.nlm.nih.gov/pubmed/28476771

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5126660/

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3653317/

[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4744328/

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276050/

[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4925967/

[10] https://www.ncbi.nlm.nih.gov/pubmed/?term=10.1016%2Fj.autrev.2016.09.013

[11] https://www.ncbi.nlm.nih.gov/pubmed/28353075

[12] https://www.ncbi.nlm.nih.gov/pubmed/?term=20437720

[13] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4460825/

[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5520251/

[15] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359961/

[16] https://www.ncbi.nlm.nih.gov/pubmed/28835673

[17] https://www.cdc.gov/chronicdisease/center/index.htm

[18] https://www.ncbi.nlm.nih.gov/pubmed/19405829

[19] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4962497/pdf/12903_2016_Article_257.pdf

[20] https://www.ncbi.nlm.nih.gov/pubmed/?term=10.1111%2Fjcpe.13094

[21] https://www.sciencedirect.com/science/article/pii/S2319417018302634?via%3Dihub

[22] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695849/

[23] https://onlinelibrary.wiley.com/doi/abs/10.1111/cea.12723

[24] https://www.ncbi.nlm.nih.gov/pubmed/?term=10.1016%2Fj.cyto.2017.01.016

[25] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6266996/

[26] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028810/

[27] https://www.ncbi.nlm.nih.gov/pubmed/31849397

 

 

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Manuka Honey & Mouth Health

Dr. Al Danenberg ● Nutritional Periodontist

December 16, 2019

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Manuka Honey & Mouth Health

 

It’s not just anecdotal; it’s medical science. Raw honey, especially manuka honey, has unique qualities that make it an amazing medicament for the mouth – not to mention the rest of the body.[1] Several recent peer-reviewed articles describe the newest research and come to the same conclusion: manuka honey is at least an adjunctive medicine for the mouth.[2]

 

Manuka honey wears many hats, especially for wound healing.[3] It can be a toothpaste, an antibiotic, an antiviral, an antifungal, a regenerative agent, an anti-cancer substance, an antioxidant, a prebiotic, an anti-inflammatory, and so much more. I’ll discuss what it is, how it works in the mouth, how to use it, and brands to buy (including the one I use personally).

 

 

What is Manuka Honey

Manuka honey is a single flower honey, which comes from the manuka tree. It is native to New Zealand and southeastern Australia. To make manuka honey, beekeepers introduce European honeybees to areas that have a large concentration of wild growing manuka trees during their 6-week blooming period. Manuka trees are grown in a relatively pollution-free environment without exposure to industrial chemicals or pesticides.

 

Manuka honey looks and tastes differently than other honeys. It is thicker than other honeys because of high levels of specific types of proteins. Typically, it has a dark cream or dark brown color, and the flavor is considered to be “more earthy” than other raw honeys.

 

As with almost all honeys, Manuka honey is roughly 80% sugars and 17% water, with the last bit being comprised of minerals, organic acids, enzymes, etc. Its sugar content is made up of about 31% glucose, 38% fructose, and a mixture of more complex sugars that are harder for the body to breakdown.  Honey contains 4% to 5% fructo-oligosaccharides, which are excellent prebiotics to feed beneficial bacteria in the gut.

 

All honeys contain about 200 biologically active chemicals. These raw and unfiltered honeys are a good source of amino acids, B vitamins, zinc, potassium, iron, calcium, magnesium, and phosphorous, but Manuka honey has up to four times the nutritional content of all other flower honeys. Most of the pharmacological effects of honey come from polyphenols, which are found in large concentrations in honey.

 

But Manuka honey has concentrations of a unique compound. Manuka has non-peroxide bacteriostatic properties that are the result of methylglyoxal (MGO).[4] This biologically active compound is not present to any great extent in other honeys, and it enhances wound healing and tissue regeneration by its immunomodulatory properties.

 

In 2017, Niaz et al published a review of the tissue regenerating effects of manuka honey.[5] The authors stated that their research showed, “Manuka honey can inhibit the process of carcinogenesis by controlling different molecular processes and progression of cancer cells.”

 

 

Oral Benefits

More than 100 systemic diseases and more than 500 medications have oral manifestations, with 145 commonly prescribed drugs causing dry mouth. And honey, especially manuka honey, can have beneficial effects on these oral manifestations.

 

For those of you who are fact-checkers, here are a few peer-reviewed papers proving honey has significant medical applications when used in the mouth:

 

  • Honey exerts antibacterial effects on nearly 60 species and prevents the development of resistant strains of bacteria. [6],[7],[8]
  • Manuka honey is effective in preventing growth of biofilm organisms, reducing the production of acids, and reducing gingivitis.[9]
  • Randomized controlled trials indicate honey helps prevent dental caries and gingivitis following orthodontic treatment.[10]
  • A double-blind, randomized controlled trial demonstrates that manuka honey and raw honey are as effective as chlorhexidine as a mouthwash.[11]
  • Manuka honey controls odor and inflammation in wounds secondary to squamous cell carcinoma of the oral cavity.[12]
  • Tualang honey has cytotoxic effects on cultured oral squamous cell carcinomas.[13]
  • Multiple reports indicate honey is beneficial in the treatment of radiation induced mucositis in people undergoing curative radiotherapy for their head and neck cancer.[14]
  • Honey is helpful in treating radiation induced xerostomia in people undergoing curative radiotherapy for their head and neck cancer.[15]
  • Honey enhances wound healing in non-healing or recurrent wounds in the head and neck area after radiotherapy.[16]

 

 

Practical Applications

Because Manuka Honey is thicker than regular honeys, you probably will use smaller amounts.

 

Toothpaste: Put about 1/2 teaspoon of manuka honey in your mouth and spread it around all your teeth using your tongue. Then use an electric toothbrush as you would normally brush.

 

Healing oral soft tissue lesions: Swish 1/4 to 1/2 teaspoon of honey around your mouth for a minute or so, and then swallow. Use as often as necessary.

 

Lips and corner of mouth: Apply manuka honey to dry lips and sore corners of mouth as needed.

 

Systemic benefits: Eat about 1/2 teaspoon of honey 2-3 times a day for systemic benefits like improving a cough and cold symptoms from upper respiratory infections, preventing gastric ulcers, and improving digestive symptoms.

 

A mouthwash: If you feel you need to “freshen” your mouth, swish with 1/4 to 1/2 teaspoon of honey and then swallow.

 

Dry mouth: If you have dry mouth or xerostomia, swish with 1/4 to 1/2 teaspoon of honey as needed and then swallow.

 

 

Purchasing Options

The New Zealand government’s Ministry for Primary Industries (MPI) created the first global standard and scientific definition for manuka honey in early 2018.[17] This is the only government-regulated and approved standard for manuka honey in the world.

 

As of February 5, 2018, all honey labeled as manuka honey and exported from New Zealand is now required to be tested to show that it meets the MPI standard before it can lawfully be exported. The test results from the certifying lab must accompany the export documents for the manuka honey ensuring that product packed in New Zealand is genuine.

 

 

Brands of Manuka Honey

(NOTE: I do not receive any compensation from any company whose products I recommend.)

My favorite is “Manuka Honey KFactor16” from Wedderspoon[18], which I use personally.

 

There are other manuka honeys that I have not personally tried but are highly rated by others. They are:

  • Kiva Raw
  • Manuka Doctor Bio Active
  • Comvita Premium
  • Happy Valley Honey
  • Manuka Health 100% Pure
  • Pacific Resources Fancy Grade

 

Raw honey – especially manuka honey – has been shown to be an effective adjunctive medicament for the mouth. It seems that Mother Nature may know best. Give it a try. I have, and I have been very pleased with the results.

 

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4837971/

[2] https://www.sciencedirect.com/science/article/pii/S1349007918300975?via%3Dihub

[3] https://www.ncbi.nlm.nih.gov/pubmed/28901255

[4] https://www.ncbi.nlm.nih.gov/pubmed/18210383

[5] https://www.ncbi.nlm.nih.gov/pubmed/28901255

[6] https://www.ncbi.nlm.nih.gov/pubmed/?term=Honey%E2%80%93a+remedy+rediscovered+and+its+therapeutic+utility

[7] https://www.ncbi.nlm.nih.gov/pubmed/?term=The+antimycobacterial+effect+of+honey%3A+an+in+vitro+study

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6034044/

[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3220139/

[10] https://www.sciencedirect.com/science/article/pii/S1013905214000327

[11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855267/

[12] https://www.ncbi.nlm.nih.gov/pubmed/25734464

[13] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2949736/

[14] https://www.ncbi.nlm.nih.gov/pubmed/?term=Topical+application+of+honey+in+the+management+of+chemo%2Fradiotherapy-induced+oral+mucositis%3A+A+systematic+review+and+network+meta-analysis

[15] https://www.ncbi.nlm.nih.gov/pubmed/?term=The+effectiveness+of+thyme+honey+for+the+management+of+treatment-induced+xerostomia+in+head+and+neck+cancer+patients%3A+a+feasibility+randomized+control+trial

[16] https://www.ncbi.nlm.nih.gov/pubmed/?term=The+treatment+of+chronic+wounds+in+the+head+and+neck+area+after+radiotherapy+with+medical+honey

[17] https://www.mpi.govt.nz/dmsdocument/17374-manuka-honey-science-definition-infographic

[18] https://wedderspoon.com/pages/frequently-asked-questions

 

 

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Put the Brakes on Dental Disease

Dr. Al Danenberg ● Nutritional Periodontist

November 11, 2019

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Put the Brakes on Dental Disease

 

In my Blog that I posted on 11/5/19, I described how dental disease starts in the gut. I suggested that readers email me for my detailed Protocols to eat a healthy diet, to restore healthy gut bacteria, and to clean your mouth efficiently. I am providing those Protocols as my way of “giving back” and “paying it forward”.

 

In this article, I help you understand exactly what you and your family are eating and how to make healthier choices as necessary.

 

 

Then & Now

Our primal ancestors rarely had dental diseases. In fact, primal societies living today in various parts of the world rarely have dental diseases and rarely have chronic systemic diseases. So, what changed for us in this modern world?

 

Processed foods increasingly have replaced real, organic foods. We eat foods made from processed sugars and processed grains at almost every meal. We also frequently drink beverages like soft drinks and sports drinks, which are extremely sweet and acidic. Sugars, grains, acidic drinks, and the chemicals that have been added to these foods have changed the biology of our mouth and our gut. These “foods” have encouraged pathogenic bacteria in the gut and in the mouth to overgrow and cause tooth decay, gum disease, and various chronic diseases.

 

 

Unhealthy Food choices

  • Free-sugars[1] are sugars that are added to foods plus sugars that are concentrated in the form of processed honey, syrups, and fruit juices. These allow unhealthy bacteria to grow in the gut as well as the mouth. Pathogenic bacteria can produce acid levels below pH 5.5 around the tooth surface, causing tooth decay and gum disease.[2],[3]
  • Grain products have compounds (called phytates) that bind to nutrients in the saliva and on the tooth surface thereby increasing the potential for tooth decay.[4],[5] They also contain lectins and other proteins that can cause an increase in pathogenic bacteria in the gut, irritation to the gut lining, and chronic inflammation throughout the body. All these changes can compromise the body’s immune system and the health of the mouth.[6]
  • Sodas are very acidic – well below a pH of 5.5 – and also feed decay-producing bacteria with free-sugars.[7] Sugar-free sodas do not have added sugars but do contain artificial sweeteners, which can irritate the gut and create unhealthy types of bacteria.[8] Be aware that many “healthy drinks” include added sugars or artificial sweeteners and would be just as unhealthy or acidic as traditional sodas.

 

 

Healthy Food Choices

Specific nutrients present in foods support a healthy mouth as well as a healthy body. Examples are:

  • Omega-3 fatty acids (ex. healthy fish like salmon, herring, sardines, anchovies, shellfish)
  • Vitamin C (ex. citrus, dark leafy greens, bell peppers, broccoli)
  • Vitamin D (ex. cod liver oil, herring, rainbow trout, pastured eggs, wild caught sockeye salmon, shiitake mushrooms)
  • Vitamin A (ex. liver, cod liver oil, king mackerel, salmon)
  • Vitamin K2 (ex. natto, raw cheese, butter from grass-fed cows, egg yolks, dark chicken meat)
  • Antioxidants (ex. dark chocolate, berries)
  • Fiber (ex. fruits, vegetables)
  • Magnesium (ex. dark chocolate, avocados, nuts, seeds)

 

 

 

Organic is Important

Ideally, foods should be organic. For a product to be certified organic, it’s required to meet these requirements:

  • Organic crops cannot be grown with synthetic fertilizers, synthetic pesticides or sewage sludge.
  • Organic crops cannot be genetically engineered or irradiated.
  • Animals must eat only organically grown feed (without animal byproducts) and can’t be treated with synthetic hormones or antibiotics.
  • Animals must have access to the outdoors, and ruminants (hoofed animals, including cows) must have access to pasture.
  • Animals cannot be cloned.

 

 

Organic is important for three main reasons:

  1. Non-organic foods contain residues of pesticides, herbicides, and other chemicals, and you eat them. These toxic substances could cause unhealthy changes in your gut and your immune system, which ultimately would affect your mouth.
  2. When a plant is not exposed to bugs and stressors in its environment, the plant’s internal immune system will have no reason to strengthen. The result is that the plant is rendered weaker. The immune system of the plant (phytonutrients) is what makes the plant a healthy food source for us. So, plants that are exposed to chemicals to ward off bugs and other environmental stressors will be less nutritious than plants that are grown organically.
  3. When animals eat plants that are tainted with chemicals, the toxic elements in the plants are incorporated in the animals’ tissues. When we eat animal products that have eaten these toxic-laden plants, we eat those toxic elements that have been concentrated in the animals’ meat, fat, and other tissues.

 

 

3-Day Food Journal

Removing unhealthy food choices and substituting healthier foods can reduce current dental disease and prevent future dental decay and gum disease. So, to help YOU learn what you and your family are eating, I suggest that each member of your family complete a 3-Day Food Journal. In this simple daily journal, you and each of your family members will be able to see exactly what you are eating and what you are not eating. Then, you could make decisions to replace unhealthy food choices with healthier ones as well as add foods that you should be eating but presently are not.

 

If you would like, I will send you a PDF of my 3-Day Food Journal with instructions including how to fill it out, how to decipher it, and a table of recommendations to replace unhealthy choices with healthier selections. Email your request to me: DrDanenberg@iCloud.com

 

 

 

[1] https://www.who.int/bulletin/volumes/92/11/14-031114.pdf

[2] https://cjdr.quintessenz.de/cjdr_2017_04_s0193.pdf

[3] https://www.ncbi.nlm.nih.gov/pubmed/29190114

[4] https://www.ncbi.nlm.nih.gov/pubmed/7042578

[5] https://www.ncbi.nlm.nih.gov/pubmed/9062561

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3705319/pdf/nutrients-05-00771.pdf

[7] https://www.ncbi.nlm.nih.gov/pubmed/29063383

[8] https://www.ncbi.nlm.nih.gov/pubmed/25231862

 

 

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Dental Disease Starts in the Gut
– Who’d A Thunk It? –

Dr. Al Danenberg ● Nutritional Periodontist

November 5, 2019

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Dental Disease Starts in the Gut

 

Tooth decay and gum (periodontal) disease are the major dental diseases afflicting all of us. The prevalence of these diseases is staggering. About 93% of US adults have had tooth decay during their life. And about the same percentage have some form of active gum inflammation. These statistics suggest there is an epidemic of dental disease in the United States.

 

So, why is dental disease at epidemic proportions? Is dental plaque not being removed completely from around teeth?

 

Dental plaque is not the only reason. Although it is important to clean your mouth appropriately.

 

 

Dental Plaque

We only need to look at our primal ancestors for some answers. If you were to examine human dental jaws from 10,000 years ago to 20,000 years ago, you would find there are minimal tooth decay and minimal damage in the bone around the teeth. In other words, there is little evidence of dental disease.

 

However, these jaws show there is a great deal of tartar (i.e. calculus) at the tooth-jawbone margin. Calculus is mineralized dental plaque. Therefore, our primal ancestors rarely had tooth decay or periodontal disease, but they had huge amounts of dental plaque.

 

So, it’s not healthy dental plaque that is the culprit for tooth decay or gum disease. Science suggests that it is unhealthy dental plaque causing dental disease. Then the question becomes, “How does healthy dental plaque become unhealthy dental plaque?”

 

 

The Gut

The answer lies in our gut and in our immune system. Our immune system is responsible to keep us healthy. It is also responsive to the health of the bacteria in the gut. These “gardens of bacteria” in our gut play many critical roles for the overall health of our body. When the gut microbiome becomes out-of-balance (i.e. gut dysbiosis), then the immune system becomes compromised and gets out of-whack.[1]

 

Once the immune system is compromised, all mucosal tissues in the body are affected. This includes the microbiome in the mouth. When the oral microbiome becomes unbalanced, the composition of dental plaque becomes unhealthy. Pathologic forms of bacteria expand. The pathological bacteria overgrow and result in unhealthy dental plaque. This unhealthy dental plaque is the culprit for tooth decay and periodontal disease.

 

Specific foods like added sugars and over-processed carbohydrates can encourage pathological forms of bacteria to continue to proliferate in the mouth. Also, these foods can aggravate and worsen gut dysbiosis. Now, there is a vicious cycle in play that promotes ongoing disease.

 

Several studies have shown that replacing an unhealthy processed food diet with a nutritious, anti-inflammatory diet will improve the bacterial dental plaque. Even without brushing and flossing, the bacterial plaque will become healthier, and pathologic bacteria will become balanced among the approximately 700 species of bacteria in the plaque. And these three human studies show that it will only take 30 days for this to occur. (HERE), (HERE), and (HERE)

 

Proper diet will accomplish much. But frequently, you can include several supplements in your daily routine to improve the diversity and quality of bacteria in the gut. My protocol to improve the gut bacteria includes these supplements:

 

  • MegaSporeBiotic to repopulate the gut bacteria with healthy and diverse strains
  • MegaPrebiotic to feed the good bacteria in the gut
  • MegaMucosa to improve the mucous layer in the gut the lines the epithelial barrier, which keeps the bad stuff out of the blood system and allows all the necessary nutrients to enter the blood stream.

 

 

Bottom Line

So, to obtain the best health in your mouth, you should:

  • Clean your mouth appropriately
  • Eat nutrient-dense, anti-inflammatory foods
  • Repopulate the healthy bacteria in your gut
  • Feed the healthy bacteria in your gut with necessary fibers
  • Assure the mucous layer in your gut is healthy

 

If you contact me by email, I will send my protocols for (1) a nutrient-dense, anti-inflammatory diet, (2) how to clean your mouth, and (3) how to restore healthy bacteria in your gut. Send your request to: DrDanenberg@icloud.com

 

[1]  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567014/  

 

 

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Does Periodontal Disease Cause Systemic Disease?

Dr. Al Danenberg ● Nutritional Periodontist
April 22, 2019

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Periodontal Disease and Systemic Disease 

x

Yes, but… How’s that for an answer that keeps you hanging? Let me explain.

x

Yes – Once periodontal disease is established in the mouth, its pathological byproducts can seep into the bloodstream, lymph fluid, and bone structures to cause spread of infection and inflammation to all areas of the body. In this way, periodontal disease can cause systemic disease.

x

But… – Although periodontal disease is a focus of infection around the teeth, it has its origin in an area that is remote from the mouth. The gut is the seed to the manifestation of most systemic chronic diseases, which periodontal disease is just one of many.

x

x

Recently Published Article

In February 2019, a medical research article was published in Biomedical Journal[1] titled, “Association between periodontal pathogens and systemic disease”. The authors describe the correlation between periodontal disease and various chronic diseases and outcomes such as cardiovascular disease, gastrointestinal and colorectal cancer, diabetes and insulin resistance, Alzheimer’s disease, respiratory tract infections, and adverse pregnancy outcomes. The authors go on to state that there are conflicting studies, which try to prove causal relationships. However, there is significant research to show a strong correlation.

x

x

Cause of Periodontal Disease

Dental plaque is healthy until it’s not healthy.[2] Periodontal disease develops from unhealthy dental plaque. Unhealthy plaque results when healthy plaque is transformed into unhealthy dental plaque because of an underlying compromised immune system and unhealthy food choices. The compromised immune system has its roots in unhealthy changes in the gut. [3],[4]

x

Interestingly, there are three human studies that showed a healthy diet alone can improve the health of the mouth. These studies also determined that removing dental plaque by brushing and flossing was not critical to improve oral health as long as diet was corrected. Specifically, the investigators demonstrated that changing from a diet abundant in high-processed-carbohydrate and inflammatory foods to a diet excluding high-processed-carbohydrate and inflammatory foods will decrease signs of gum disease.[5],[6],[7]

x

x

My Theory of Systemic Chronic Disease

My research suggests that periodontal disease is not the seed of all systemic disease. I believe that periodontal disease is just one of many chronic diseases on the continuum of the spread of systemic disease that starts in the gut. Since the mouth is visible and easy to examine, the mouth may be the first clinical area where disease is diagnosed. But the ultimate starting point is in the gut before becoming visible in the mouth and other areas of the body.

x

Once systemic disease spreads, a vicious cycle begins because all tissues affect all other tissues in the human body. Tissues use “crosstalk” to communicate with other tissues.[8],[9],[10]

x

My theory starts in the gut. Unhealthy changes in the gut microbiome are called gut dysbiosis.

x

The gut microbiome, the intestinal mucus layer, and the epithelial lining of the gut become damaged from potentially many different influences. Detrimental lifestyle, toxic elements in the environment, and inflammatory foods are major contributors that can damage the gut and create gut dysbiosis. Leakage from a damaged gut into the bloodstream and into the lymph fluid can cause systemic chronic inflammation and a break down in the body’s ability to fight infection. Both will affect all other tissues in the body.

x

I wrote an article where I described my theory of how chronic disease is created in the body. I cite over 30 peer-reviewed medical articles to support my views. My paper, Big Bang Theory of Chronic Disease, was published in-part in 2018 in Well Being Journal, Volume 27, #2. If you would like the PDF of this article, email your request to: Dr.Danenberg@iCloud.com.

x

x

The Mouth

In the mouth, a compromised immune system caused by gut dysbiosis can allow the overgrowth of pathological bacteria. Unhealthy changes in dental plaque and unhealthy food choices will initiate periodontal disease. Then, periodontal disease, as a unique site of infection in the mouth, will begin to spread, causing additional systemic chronic inflammation and chronic diseases.

x

To treat periodontal disease and to avoid chronic disease, active infection in the mouth must be treated efficiently. In addition, irritating and toxic substances must be removed from the mouth and teeth. However, gut dysbiosis must be treated simultaneously. Just treating either the damaged gut or active periodontal disease will be insufficient.

x

x

[1] https://www.sciencedirect.com/science/article/pii/S2319417018302634?via%3Dihub

[2] https://drdanenberg.com/dental-plaque-is-healthy-until-its-not/

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5892391/

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5937375/

[5] https://www.ncbi.nlm.nih.gov/pubmed/19405829

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4962497/pdf/12903_2016_Article_257.pdf

[7] https://www.ncbi.nlm.nih.gov/pubmed/?term=10.1111%2Fjcpe.13094

[8] https://onlinelibrary.wiley.com/doi/abs/10.1111/cea.12723

[9] https://www.ncbi.nlm.nih.gov/pubmed/?term=10.1016%2Fj.cyto.2017.01.016

[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6266996/

 

 

 

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Kathryn Won the Battle
But Not the War

Dr. Al Danenberg ● Nutritional Periodontist
February 4, 2019

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x

Kathryn contacted me for a second opinion. Her problems are not unusual. She told me what she had gone through so far.

x

It started when her dentist told her, “You have a gum infection, which is due to bacteria living under your gum tissues. Let’s kill these bacteria, and we’ll cure your disease.” So, her dentist prescribed an antimicrobial mouth gel to place around her teeth to kill these bacteria. After several weeks, the gum bleeding was gone. Kathryn thought her disease was cured.

x

Then, several months went by, and she returned to her dentist for a dental cleaning. The hygienist told her, “Do you know you have active gum disease?” The dentist came into the room and confirmed that she had active infection. He recommended another round of antimicrobial gel.

x

Kathryn realized something didn’t seem right, so she contacted me for a second opinion. I told her, “It sounds like you won the battle but not the war.”

x

x

The Battle; The War

The “battle” Kathryn won was to end the acute infection in her gum tissues. Killing the bacteria stopped her gums from bleeding. Yet, she lost the war.

x

The “war” she lost was to identify the various causes of her gum disease and to treat the hidden sources of her infection.

x

The causes of periodontal disease are multifold. They relate to dysbiosis in the gut, chronic systemic inflammation, and a significant decrease in the immune response.  Stopping gum infection by killing oral bacteria is not a cure. It is not an effective means to restore overall health. It may be the first step when there is acute infection, but there is more to it. Indiscriminate killing of microbes is detrimental to the balance of bacteria throughout the mouth and the body. Indiscriminate killing of microbes can cause serious systemic problems.

x

To win the war, acute infection in the mouth needs to be treated first as I stated. In addition, all other factors need to be discovered and dealt with effectively and in a timely manner.

x

Most people don’t understand the importance of the gut and its relationship to disease. The gut needs to be treated and the resulting spread of chronic disease needs to be addressed. (I wrote a paper titled, Big Bang Theory of Chronic Disease. I’ll send the PDF article to you at no charge if you are interested. Please, send your request to my email: Dr.Danenberg@icloud.com)

x

x

Two Niduses of Infection

I explained to Kathryn that she has two separate niduses of infection – one in her mouth and one in her gut.

x

Her original nidus of infection started in her gut, which she is completely unaware of because she has no obvious gut symptoms. However, her gut problems created chronic systemic inflammation, which led to various chronic diseases. Gum (or periodontal) disease is just one manifestation of chronic disease.

x

Once she developed periodontal disease, which is an imbalance in the overall oral microbiome, the infection established itself deep under the gum tissues. This became Kathryn’s second nidus of infection. The infection and inflammation around her teeth could spread through capillaries under the gum and eventually enter the blood system. As they course through her circulation, they could affect other organs.

x

To treat this complicated disease, both the mouth and the gut must be treated to regain health. If only the mouth were treated, then out-of-balance bacteria in the gut would continue to be the culprit for further bouts of active periodontal disease and more.

x

x

My Action Steps for Kathryn

After I explained my opinion of what was going on, I made specific recommendations and provided action steps for Kathryn to consider.

x

  1. Do what is necessary to stop acute infection.x
  2. The dentist or the hygienist needs to do a deep cleaning under the gum tissues to remove tartar, which is irritating and acting like a splinter.x
  3. The dentist needs to treat decay, repair any broken or irritating tooth fillings, remove any toxic dental fillings or restorations, and extract any non-treatable teeth.x
  4. The dentist or the hygienist needs to demonstrate efficient tooth brushing, interdental cleaning, and tongue scraping. (How to Clean Your Mouth)x
  5. Kathryn needs to repair her gut by taking spore-based probiotics and specific prebiotics. (Protocol to Restore Normal Gut Bacteria)x
  6. Kathryn needs to change her diet to include nutritious foods that are anti-inflammatory and to remove foods that are inflammatory. (30-Day Reset Diet)

x

If you want the 3 Protocols I recommended to Kathryn (underlined above), send your request to my email: Dr.Danenberg@icloud.com

x

x

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5 Steps to a Healthy Smile

Dr. Al Danenberg ● Nutritional Periodontist
January 7, 2019

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x

x

x

Your SMILE speaks volumes about YOU! In this article, I outline my five steps to assure a healthy smile.

x

Your smile shows your emotions and speaks about your health. Books have been written describing what your smile means. For example, if you search on Amazon[1], there are over 430 books written on the topic of a “Healthy Smile”.

x

Look at your smile in the mirror. Your smile is just a curtain that opens to your mouth. Raise the curtain, and on the other side of your lips is an environment that affects the teeth, the gums, the lips, the breath – even the entire body.

x

In health, this oral environment is in a state of balance. The huge community of living organisms in your mouth play a critical role in health as well as in disease.[2],[3] This community can affect the health of your beautiful smile.

x

x

The Science of a Healthy Mouth

A healthy oral microbiome is made up of viruses, fungi, archaea, protozoa, and bacteria. The far majority of this healthy garden of microbes is bacteria. Researchers have discovered over 700 different species of bacteria, which can make up a healthy oral microbiome. An individual on average may harbor 100-200 of these individual species of bacteria.

x

A healthy gut microbiome not only supports a strong immune system but also maintains a beneficial balance of these numerous types of living creatures in the mouth. In a balanced state, these oral microbes provide many functions that keep your mouth healthy. This garden of microbes prevents harmful bacteria from taking hold and causing disease. In addition, they help down-regulate pro-inflammatory responses to beneficial bacteria. The oral microbiome helps in the early digestion of food and supports the healthy production of nitric acid throughout your body.

x

The plaque around the teeth is a healthy biofilm of microbes that protects teeth and gum tissues. Dental plaque prevents pathological species from overgrowing, controls the proper acid level around the teeth, and allows beneficial nutrients to pass from the saliva to the tooth surface.

x

Saliva is another important element for a healthy mouth. A healthy flow of saliva washes away unhealthy clumps of bacteria and helps buffer a beneficial acid level.

x

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The Science of an Unhealthy Mouth

When there is an overabundance of pathologic species of bacteria in the gut, the immune system is compromised, and the oral microbiome becomes disturbed and unbalanced. Specific foods can increase the acid level in the mouth and can provide sugars that feed pathologic species of bacteria. A decrease in saliva flow also can cause unhealthy growth of bacteria. Pathologic species in the mouth begin to overtake the healthy types of bacteria, and diseases can manifest. A change in the homeostasis of a healthy oral microbiome can begin the process of tooth decay, periodontal diseases, and soft tissue lesions.

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Your smile eventually may be affected by an unhealthy mouth. Oral diseases can cause ulcers, cracks, and other lesions on the surface and corners of your lips.

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5 Steps to a Healthy Smile

Practically speaking, there are ways to assure a healthy smile. A healthy and attractive smile depends on a healthy mouth. Here are five ideas to maintain a healthy smile:

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  1. Nutrient-rich diet: Exclude processed foods containing chemicals, added sugars, and unhealthy and unstable fats. Reduce or eliminate acid drinks like sodas. Include pastured and wild caught animal products, fruits, vegetables, nuts, and seeds.x
  2. Proper airway space: Be sure your dentist is trained to evaluate your bite and the proper function of your tongue position for breathing and swallowing.x
  3. Efficient oral hygiene: Brush efficiently at the gum line, clean between the surfaces of all teeth, and remove unhealthy clumps of bacteria on the surface of your tongue.[4]x
  4. Strong and healthy gut bacteria: Support the quantity and quality of the gut microbiome by taking spore-based probiotics (ex: Megasporebiotic[5], Terraflora[6]) and prebiotic fiber foods (ex: Megaprebiotic[7], PaleoFiber[8]), which feed healthy gut bacteria.x
  5. Biologically-oriented dental visits: Visit a dentist who understands the critical relationships of the gut, diet, lifestyle, and the health of your mouth. 

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[1] https://www.amazon.com/s/ref=nb_sb_noss_2?url=search-alias%3Dstripbooks&field-keywords=healthy+smile&rh=n%3A283155%2Ck%3Ahealthy+smile

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[2] https://www.ncbi.nlm.nih.gov/pubmed/28266108

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[3] https://www.ncbi.nlm.nih.gov/pubmed/?term=in+sickness+and+in+health+-+what+does+the+oral+microbiome+mean+to+us

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[4] https://drdanenberg.staging.wpengine.com/how-should-you-clean-your-teeth-let-me-count-the-ways/

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[5] https://microbiomelabs.com/products/megasporebiotic/

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[6] https://www.enviromedica.com/terraflora/

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[7] https://microbiomelabs.com/products/megaprebiotic/

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[8] https://catalog.designsforhealth.com/PaleoFiber-Powder-Unflavored?quantity=1#PaleoFiber-Powder-Unflavored

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