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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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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Kathryn Won the Battle
But Not the War

Dr. Al Danenberg ● Nutritional Periodontist
February 4, 2019

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

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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.

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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.

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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.”

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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.

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

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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.

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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.

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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)

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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.

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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.

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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.

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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.

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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.

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  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)

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

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5 Steps to a Healthy Smile

Dr. Al Danenberg ● Nutritional Periodontist
January 7, 2019

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

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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”.

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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.

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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.

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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.

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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.

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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.

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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.

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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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Tooth Decay
– 5 Things You May Not Know –

Dr. Al Danenberg ● Nutritional Periodontist
August 27, 2018

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Tooth DecayTooth decay is an epidemic in the civilized world today. The CDC (Centers for Disease Control) has determined that 92% of adults have had tooth decay! However, the fact is that teeth are not designed to rot.

 

Take a look at animals in the wild. Rarely do they have tooth decay. In addition, our primal ancestors rarely had tooth decay. When we examine the mouths of some isolated primal societies living today, it is rare to find tooth decay. The fact is that dental decay is predominantly the result of lifestyle factors that plague our civilized world.

 

 

Dentistry’s Answer to Tooth Decay

Several years ago, while I was working as a periodontist in a general dental office, I remember several parents who brought their children into the office. These parents asked, “Why do my kids have so much tooth decay?” The disconnect was that these parents were holding a bottle of “Mountain Dew”. For that reason alone, their families were at a high risk for tooth decay primarily because of bad food choices.

 

To offset the risk and damage of tooth decay, dentistry developed various “barriers” to coat the teeth to prevent and stop decay. Also, chemicals were discovered and created to kill bacteria in the mouth as well as to help remineralize teeth. These products could decrease tooth decay and possibly repair damage. Unfortunately, some of these barriers and chemicals could produce unhealthy effects in the body. While barriers and chemicals may help stop and repair decay, it would be more productive, less expensive, and healthier to prevent this disease naturally.

 

Fortunately, there are biological reasons for tooth decay that we can control. We just need to know. We need to be proactive. Here are 5 things that you may not know.

 

 

5 Things You May Not Know

  1. A healthy gut supports a healthy mouth: If you increase the diversity of healthy bacteria in the gut, you will increase the healthy balance of bacteria in the mouth. More variety of bacteria in the mouth is healthy. Balanced bacteria in the mouth help to prevent tooth decay.
  2. A healthy immune system can prevent unhealthy changes in the bacteria in the mouth: The body is always fighting off unhealthy bacteria. If it didn’t, we would die as soon as we took a deep breath or got a cut on our finger. A healthy immune system is an important factor to maintain a healthy balance of bacteria in the mouth.
  3. Saliva carries necessary nutrients: Saliva constantly bathes the teeth. Nutrients in the saliva can neutralize excess acids and can provide calcium and phosphate ions to remineralize the tooth surface 24/7.
  4. Dental plaque is healthy until it’s not: Plaque provides at least 3 beneficial effects to the tooth surface. The family of bacteria in dental plaque maintains a healthy acid level around the teeth, kills off other pathogenic bacteria that try to invade the space, and allows necessary nutrients to enter the surface of the tooth to repair early decay.
  5. Sugars feed decay-causing bacteria, and acids demineralize teeth: Sugars will feed unhealthy bacteria to produce acids that decay teeth. Also, drinking soda and eating highly acidic foods can damage the balance of bacteria in dental plaque. Unhealthy changes in dental plaque, which cause excess acids, will weaken the surface of teeth. The end result is tooth decay.

 

 

Be Proactive

  • Provide healthy food choices that don’t damage the gut and that don’t feed bad bacteria in the mouth. I have written about nutrient-dense, anti-inflammatory foods many times in the past. Here is one article.
  • Learn the correct way to clean your mouth efficiently. Here is an article I wrote that explains how to do it.
  • Consider taking spore-based probiotics. These have been shown to survive stomach acid and improve gut health. Here is research published in 2017 that supports this benefit.
  • Schedule dental appointments regularly with a dentist who understands the biological needs of the mouth and practices preventive dentistry.

 

 

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WellnessMama
Interviews
Dr. Al Danenberg

Dr. Al Danenberg ● Nutritional Periodontist
August 10, 2018

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WellnessMama Interviews Dr. Al DanenbergI had the privilege to be interviewed by Katie Wells, better known as the Wellness Mama.

 

Katie is a mom of six with a background in journalism. Years ago, she took health into her own hands and started researching to find answers to her own health struggles. Her research turned into a blog and podcast. Her website, WellnessMama.com, is one of the most read health websites on the Internet. She’s been called “a thought leader for the current generations of moms”.

 

The interview was published on 8/9/18. In the interview, we discuss:

  • The reason plaque isn’t always bad
  • Why our ancestors didn’t get gum disease and we do
  • The real reason animals in the wild don’t have tooth decay and domesticated animals do
  • A fascinating way that what we eat affects our oral health
  • The factor that is just as important as brushing to keep healthy teeth
  • How our mouth affects the nitric oxide levels in our body
  • The surprising way that certain mouthwash products can raise blood pressure!
  • How the gut microbiome affects the oral microbiome
  • The three primary and important reasons for dental plaque
  • How leaky gut and leaky gums are connected and what to do about it
  • How to clean the tongue correctly

 

It will take about one hour out of your life to listen to the interview. You may find something that you’ve never heard before or something that gets you motivated and excited. Here is the link to the interview.

 

 

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Dr. Michael Ruscio
Interviews
Dr. Al Danenberg

Dr. Al Danenberg ● Nutritional Periodontist
July 4, 2018

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Dr. Michael Ruscio Interviews Dr. Al DanenbergI met Dr. Michael Ruscio at the Paleo f(x) meeting in Austin in April 2018. Michael suggested we do a Podcast together. So, we made it happen.

 

Dr. Michael Ruscio is a chiropractor, clinical researcher, and author whose practical ideas on healing chronic illness have made him an influential voice in functional and alternative medicine. Michael also provides post-doctoral continuing education. His research has been published in peer reviewed medical journals, and he speaks at integrative medical conferences across the globe. Currently, he is a lead researcher in a pending IBS (irritable bowel syndrome) study.

 

In this interview, Dr. Ruscio and I discuss the profound connections between the gut, the mouth, mitochondria, and chronic disease. I talk about my Periodontal Disease Clinical Study that will be implemented following approval by the Institutional Review Board. We also discuss how improper flossing could lead to receding gums, new testing showing that mouth tissue is a window into your mitochondrial health, and how mouthwashes could lead to high blood pressure.

 

Tooth decay and periodontal diseases are chronic diseases. My research suggests that the gut could be the initial source for chronic disease to manifest. But, once oral diseases take hold, then both the gut and the mouth must be treated in order to gain control of chronic inflammation and further manifestation of chronic disease.

 

Listen to the Podcast. It lasts a little more than an hour, but I think you’ll find it loaded with “pearls” to take home and act upon immediately.

 

 

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5 Questions to Help Your Patients
Self-Motivate

Dr. Al Danenberg ● Nutritional Periodontist
May 7, 2018

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My hygienist came to me last week totally flustered. She saw a patient who was not taking care of her mouth – nothing new. But this patient has been seen in our office for a while. Yet, she was not taking the steps to help herself – she was not self-motivating.

 

Lacy

I’ll call this patient “Lacy”. Lacy has been coming to our office regularly for over two years for her 3-month hygiene appointments. My hygienist would clean her teeth and monitor her gum health. She would show Lacy what was going on in her mouth with a mirror and would review and demonstrate the necessary cleaning techniques that might improve the health of her mouth. I also had discussed the importance of gut health and how it could affect her mouth health and overall health.

 

Lacy has had an unhealthy mouth, and she still has an unhealthy mouth. Although my hygienist always reemphasizes for Lacy what she needs to do for her teeth and gums, Lacy still presents at each cleaning appointment with lots of gum disease and lots of unhealthy dental plaque.

 

Understandably, my hygienist was frustrated, and she asked me, “What should I do with Lacy? It appears that Lacy has no idea what “compliance” means.”

 

Just the Facts

Sometimes (probably most times), just facts are not enough to make someone react in a positive way. No person can motivate someone else. No person can make another become compliant. Telling a person to get motivated is not going to work. Motivation must develop from within that person and often emanates from an emotional response. A person must believe in the “Why” to make a change. A person must self-motivate to move forward.

 

Self-Motivate

The science of helping people to self-motivate is complex. Each situation must be dealt with individually. However, there are some basic guidelines that might suggest a dialogue with the patient to help her.

 

I suggested 5 questions for my hygienist to ask Lacy, who apparently was not taking care of her mouth and not taking care of her overall health as we believed she should. The questions are designed to help the patient take personal responsibility for her actions and the eventual outcomes from these actions. Of course, the response to each question would determine the way the next question would be asked.

 

  1. “Lacy, are you interested in making your mouth healthier?”
  2. “What are your three main reasons to make this change?”
  3. “What do you think could happen if you don’t make this change?”
  4. “If you want to make a change, what do you think you need to do to be successful?”
  5. “What steps do you want to take for us to help you make that change?”

 

These questions emphasize “you”. They might help Lacy understand her “why”. They also could strike an emotional core within Lacy to spark her into action. Lacy may respond in a proactive way to make the change and to ask us how we can help her to make this happen.

 

Moving Forward

My hygienist already scheduled Lacy with a follow-up appointment in one month. At that appointment, I suggested that my hygienist ask these questions and listen to Lacy’s answers. Our goal is for Lacy to become emotionally involved with, and responsible for, her outcome. If Lacy begins to own her responses as well as the course of her health, then Lacy might ask us for the specific steps our office can take to help Lacy make a difference for herself going forward.

 

 

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… BEAUTY …
it’s an inside thing
(4 active steps)

Alvin H. Danenberg, DDS ● Nutritional Periodontist
March 5, 2018

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Beauty ... it's an inside thing

Several years ago, my dental colleague, Dr. John, told me about his patient, whom I’ll call Gloria. John told me Gloria was fixated on beauty. She dressed immaculately, wore expensive perfume, and must have taken a long time to apply her makeup. She went to Dr. John to have her upper front six teeth crowned to make her look “more beautiful”. John told her that she had many back teeth that were broken down and needed repair, but she only was concerned with her front teeth. Her response to John was, “These front teeth are the ones that people see when I smile”.

 

My dental colleague explained to Gloria that she had active gum disease and active tooth decay. However, facts only confused Gloria. She wasn’t motivated to change her lifestyle and nutrition to recover from the chronic diseases of tooth decay and gum disease. Gloria reemphasized that she only wanted her upper front teeth to be beautiful.

 

What is Beauty?

Beauty is defined as, “a combination of qualities – such as shape, color, or form – that pleases the aesthetic senses, especially the sight.” The problem with this definition is that it focuses attention on external beauty only.

 

To me, beauty goes far beneath the superficial surface. As a matter of fact, external beauty is often the end result of internal beauty. I see real beauty as an inside thing.

 

The inner workings of our amazing machine we call the human body affects not only the inside of us but also the outside of us. When you start making yourself beautiful from the inside, beauty reveals itself on the outside.

 

Some Examples

 

  • Most people want to smell good, so they use various soaps and perfumes to create a fragrance they think is pleasing to others. Certainly, we all want to smell good, and everyone should clean their body to remove unhealthy bacteria and dead cells. But, to use artificial fragrances made from various chemicals and to apply them on the skin in excess may be masking other internal problems. In my way of thinking, it would be best to understand and repair the internal problems in order to improve the external manifestations.
  • Some people use various mouthwashes several times a day to conceal odors in the mouth because these odors are offensive to others. While antibacterial mouthwashes may kill many bacteria that may cause unpleasant mouth odor, these mouthwashes also kill very important and beneficial bacteria in the mouth. The “bad” bacteria are overgrown in the mouth because of unhealthy bacteria in the gut, unhealthy food choices feeding these offensive mouth bacteria, a compromised immune system, and poor oral hygiene.
  • Others may use various chemical preparations on their skin to cover up pimples and kill bacteria and other microbes. However, these skin blemishes are frequently the result of a compromised immune system, poor nutrition, and damage to the healthy gut bacteria.

 

The common denominator to much of what is happening on the outside of the body is a result of what is happening in the gut and in the overall immune system. In fact, when a person begins an internal beauty program to improve the inside of his or her body, many of these outward “offensive” body odors, mouth problems, and skin ailments diminish or disappear. Real beauty is an inside thing.

 

Beauty on the Inside

So, how does a person get beautiful on the inside? What is the “inside thing” that has to occur?

 

The four most important proactive steps you can take to repair that “inside thing” are:

  1. Create diversity, quality, and quantity of balanced gut bacteria, which a unique blend of spore-based bacillus probiotics may provide
  2. Remove most grain products, added sugars, over-processed seed oils, and pasteurized milk products from your diet
  3. Include organic vegetables, fruit, nuts, seeds, healthy fats and oils, and animal products that have been raised humanely in their natural environments and allowed to feed in their natural way
  4. Remove or reduce any chemical and toxic exposures to your food, air, skin, and the water supply.

 

Here are some links to articles I have written about gut bacteria, mouth bacteria, healthy eating, and toxic exposures: HERE, HERE, HERE

 

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Dentists & Physicians
Have Gum Disease

Alvin H. Danenberg, DDS • Nutritional Periodontist
January 8, 2018

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Dentists & Physicians Have Gum DiseaseMany dentists and physicians, whom I know, have some degree of gum disease. How do I know? I can diagnose gum disease when I do a periodontal examination. Sometimes, I can see gum disease when a person smiles. Occasionally, I can smell gum disease on the breath.

 

There are primarily two stages of gum disease: gingivitis and periodontitis.

 

Gingivitis is inflammation and infection in the gum tissues, which do not involve the bone of the jaw. Sometimes, gingivitis can progress to the advanced stage of gum disease called periodontitis. Periodontitis involves infection in the gum tissues as well as the surrounding jawbone that supports the teeth.

 

Cause of Gum Disease

So, why do these healthcare professionals have gum disease?

 

Occasionally, it is because they don’t brush and clean between their teeth properly. Just because a person is trained to be a healthcare professional, he or she doesn’t necessarily take care of his or her mouth correctly. However, there is an underlying cause of gum disease that is independent of how well a person cleans his or her mouth.

 

A change in the bacteria in the gut can change the bacteria in the mouth. Then, a give-and-take can occur between unhealthy bacteria in the gut and unhealthy bacteria in the mouth. [1] The change from a healthy balance of bacteria to an unhealthy level of pathogenic bacteria is called dysbiosis.

 

There are many factors that can cause an increase in unhealthy bacteria (or dysbiosis) in the gut. Some of these factors include poor food choices, chemicals in food, stress, poor sleep, some prescription and over-the-counter medications, low-level electromagnetic fields, over-exercising, and sleep apnea.

 

As I mentioned, medical research shows that dysbiosis of the gut microbiome and dysbiosis of the oral microbiome affect one another. Therefore, both the gut and the mouth must be addressed if a healthy result is the goal. If only the gut or only the mouth were to be treated independently, the other location of dysbiosis could continue to spread back and forth.

 

Prevalence of Gum Disease

Gum disease is not a stranger in today’s modern world. The prevalence of gum disease in the US is staggering, in my opinion.

 

A study was published in 2010 in the American Journal of Dentistry. This peer-reviewed paper demonstrated that 93.9% of adults in the United States had some form of gum inflammation or gum bleeding. [2]

 

In 2012, the Centers for Disease Control and Prevention (CDC) published their results in the Journal of Dental Research. [3] It showed the prevalence of periodontitis was estimated to be 47.2% for American adults. For adults 65 years old and older, the prevalence jumped to 70.1%.

 

Be Proactive

I encourage everyone to evaluate their diet and lifestyle. The choices we make can improve our overall health and the health of the mouth. [4] From my point of view, dental diseases are frequently a sign that healthy bacteria in the mouth have gotten out of balance. Pathogenic bacteria have taken control, leading to dysbiosis.

 

Poor food choices certainly feed gum disease, tooth decay, and pathogenic bacteria. However, published science [5], [6], [7], [8], [9] suggests that the overgrowth of harmful bacteria in the mouth is a direct result of (1) the friendly bacteria in our gut becoming overwhelmed by pathogenic bacteria, (2) the gut lining becoming damaged, allowing toxic elements to seep into the blood system (called “leaky gut”), and (3) our immune system becoming compromised.

 

Once gum infection is allowed to progress, toxic substances in the infected gum spaces could enter the blood system. Chronic systemic inflammation could result from a “leaky gum space” just as chronic inflammation could result from a “leaky gut”.

 

No one is immune to gum disease. My medical and dental colleagues certainly are not immune to gum disease. Since there is an epidemic of gum disease in the US [10] based on the prevalence of dental disease, it is no surprise that many dentists and physicians have fallen victims to this disease. The goal should be to regain homeostasis of the gut and oral bacteria along with practicing efficient oral hygiene.

 

 

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