Periodontal Disease
– Doesn’t Start in the Mouth –

Dr. Al Danenberg Nutritional Periodontist

October 18, 2020 [printfriendly]



Periodontal disease does not start in the mouth! But it can spread from the mouth to everywhere else in the body.


It is true that irritations in the mouth from poor dental work, misalignment of teeth, broken teeth, chemicals in dental fillings, and various forms of trauma can cause inflammation and eventually infection in the mouth. I wrote a Blog where I discussed 14 hidden mouth splinters.


But most of the time, periodontal disease begins with unhealthy changes in the gut. Clearly, food starts its pathway into the body through the mouth. But if these foods are inflammatory, they can damage the gut and disturb the garden of bacteria.


If the gut becomes unhealthy, chronic inflammation will spread from there to all other areas of the body through the bloodstream and the mucosal tissues of the body. It will travel like the spikes of a wheel out from the center hub. The mouth is just one stop on the continuum of the progression of disease moving out from the gut.


I wrote a mini eBook in which I go into detail about the manifestation of chronic diseases emanating from the gut. In my eBook, I cite 295 peer-reviewed medical papers supporting my conclusions. I titled it, Is Your Gut Killing You?



The Dentist

The dentist has the perfect platform to identify periodontal disease. He or she sees their patients once or twice a year for checkup appointments. If there are signs and symptoms of gum disease, the dentist can begin educating the patient and treating the infection.  Treatment also should include definitive recommendations for gut health and nutritional counseling.


Unfortunately, most dentists don’t follow all these steps.


Of course, dentists treat the acute infections. In addition, they have their hygienist clean under the gums while reinforcing better flossing and brushing techniques. The dental team repairs the damage caused by periodontal disease. But treating the gut and providing personalized nutritional counseling are often neglected.


Here is a question for dental professionals: “How often does the same patient return for future checkup appointments with continued bleeding gums and progressing periodontal problems?” Repeated oral hygiene instruction – visit after visit – may not provide the anticipated results. Repeated antibiotic treatment may not resolve the disease permanently but will cause collateral damage.


I suggest an in-depth evaluation of the patient’s eating habits. A patient could record what she or he eats in a 3-Day Food Journal. This document could be repeated annually and become a permanent part of the patient’s dental record. A patient’s food journal will become a history of how and what he or she eats.


I also suggest a thorough program to repair and restore the health of the gut.


This complete treatment plan that includes active periodontal therapy, diet intervention, and gut healing will assure more lasting improvements.



Active Periodontal Treatment

Active infection must be addressed ASAP. Again, the dentist is the perfect professional to start oral treatment. Dentists are trained extremely well to treat damage in the mouth. No other healthcare professional is equipped to do what a well-trained dentist can do.


Sometimes, a therapeutic mouthwash or antibiotic for a few days is required at first to bring the acute infection under control. Sometimes extractions, fillings, or repair of broken teeth must be started immediately. Possibly, all that might be necessary is good oral hygiene and maybe a deep cleaning around the teeth to take care of early inflammation and infection. In more advanced cases, surgical procedures as well as cutting-edge laser treatment to repair and regenerate bone destruction might be required.


But the underlying biological causes need to be discussed and corrected. Only treating the mouth without treating the gut and improving the diet is akin to only prescribing pain medicine for a headache with serious underlying causes.



Diet & Gut

Three specific human studies[1],[2],[3] show that improving the diet will return the oral microbiome to a healthy state, reduce bleeding of gums, and prevent periodontal disease from getting started. These benefits occurred within 30 days without the participants performing regular oral hygiene! The nutrients in the diet and the avoidance of harmful irritants in processed foods improved the gut, the immune system, and the health of the mouth with no other treatment required.


Other studies have shown that repairing the gut will reduce chronic systemic inflammation.[4],[5],[6] The gut epithelial barrier is the most reparative tissue in the body. Within 5-7 days, the entire gut lining is renewed and will stay that way unless it is repeatedly irritated over and over again.


Therapeutically, the quickest and most efficient means to treat the underlying causes of periodontal disease is to embrace a nutrient-dense, anti-inflammatory way of eating. In addition, spore-based probiotics and other supplements will improve the garden of bacteria in the gut and heal its lining.


My Better Belly Blueprint describes a proven diet to support the body’s requirements of nutrition. My Protocol to Restore Healthy Gut Bacteria is a verified method to assist gut healing. Let me know if you have questions. (



Summing Up

For the most part, periodontal disease starts in the gut. However, treatment (especially if the infection is acute) must start in the mouth as soon as it is diagnosed.


But a comprehensive treatment plan needs to involve the mouth and the gut. Treating an unhealthy gut and advocating a nutrient-dense, anti-inflammatory diet will help prevent chronic systemic inflammation emanating from the gut. In the dental world, that means a healthier mouth free of periodontal disease. It also means improved overall wellness.










Check out my new training on the Better Belly Blueprint! You can watch it HERE.


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1 Comment

  1. Thank you for posting this blog. I read the abstracts of the 3 articles that you cited as supporting the premise that, “Improving the diet will return the oral microbiome to a healthy state”. I did not read any mention of the oral microbiome in the last two references. Also, the number of subjects in all 3 of these articles was quite low making it questionable if any significant conclusions can be drawn from any of the results. There also could have been multiple co-variables such as smoking which could have interfered with the results. Lastly, isn’t it very possible that the improvements in periodontal disease seen in these studies was largely due to the reduced carbohydrate intake and its effect on the overall acidity of the oral cavity rather than on the effects on the oral microbiome?

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