Oral Health & Diet

Dr. Al Danenberg Nutritional Periodontist

April 24, 2022 [printfriendly]

Our primal ancestors generally had healthy mouths. But how could that be since …

  • They never brushed their teeth with commercial chemical toothpastes?
  • They never flossed with manufactured cotton string?
  • They never went to their neighborhood dental cave to get fluoride treatments?

So, what were the reasons for their generally healthy mouths?

They had healthy mouths because …

  • They didn’t eat junk foods; processed foods; or chemical additives.
  • They consumed a high percentage of animal protein and animal fat[1], and
  • They ate low to moderate amounts of healthy carbohydrates occasionally.

Basically, our primal ancestors ate a healthy diet – full of bioavailable nutrients. As a result, they most likely were in a state of dietary ketosis most of the time but still cycled out of ketosis when their level of carbohydrates increased.

In this article, I will …

  1. Share 3 peer-reviewed medical papers that show how diet can alter the health of the mouth
  2. Describe dietary ketosis
  3. Suggest 3 biohacking tests that can help you predict the degree of health in your mouth


Peer-Reviewed Medical Papers

Study #1

In 2009, Dr. Baumgartner reported a study that was set in an area of Switzerland.[2]

In this controlled experiment, ten individuals were not able to brush or floss for 30 days. Their diet consisted of primal foods endemic to their area in Switzerland about 5,700 years ago. No processed foods were available. These participants had to gather and forage for most of their food.

At the beginning and at the end of the study, the gum space between the teeth and the degree of bleeding gums around the teeth were measured, and cultures of bacteria were taken from the dental plaque around the teeth and from the tongue.

At the end of the study, there were a significant decrease in bleeding in the gum tissue and a significantly healthier gum space around the teeth. Amounts of dental plaque increased greatly, but pathogenic bacteria did not increase either in the plaque or on the tongue. Dental plaque and other oral microbes were in a state of balance at the end of the four-week experiment.

The researchers were surprised with the results.

Bottom line: A diet that completely removes over-processed foods reduces the signs and symptoms of gum disease. This type of diet allows the interactions of bacteria in dental plaque to become and stay balanced and healthy.


Study #2

Dr. Johan Woelber and researchers performed a randomized clinical trial, which they reported in 2016.[3]

Fifteen people were selected for this trial. Only those who had signs of gum disease and were eating a diet heavily based on processed carbohydrates were selected for the study. Ten individuals made up the experimental group, and five individuals made up the control group.

The experimental group had to change their diet. Their new diet consisted of foods low in processed carbohydrates, rich in omega-3 fatty acids, and abundant in vitamins C and D, antioxidants, and fiber. The control group did not change their unhealthy eating habits.

As far as oral hygiene was concerned, all fifteen participants were instructed not to clean between their teeth with dental floss or interdental brushes. However, they did not have to change the way they brushed their teeth with a normal toothbrush.

The study began after each group had two weeks to acclimate to these changes I mentioned above. Then, the four-week study began. The signs of gum disease (i.e., bleeding gums, infected gum spaces around the teeth, and the degree of gum inflammation) in all participants of this experiment were recorded at the start of the four-week study and at the end.

At the conclusion of the trial, all disease parameters decreased significantly in the experimental group by approximately 50% from the starting point. In contrast, all inflammatory markers increased from the starting point in the control group.

Bottom line: A diet that eliminates free-sugars and processed grains and includes healthy foods can reduce the signs and symptoms of gum disease. Therefore, a healthy diet can maintain dental plaque in a healthy state.


Study #3

Dr. Sheiham reported on the pivotal role of free-sugars in dental decay.[4]

He and his associate published their paper in 2015, which evaluated many previous research studies. The authors concluded:

  • Dental decay is diet mediated.
  • Free-sugars are the primary and necessary factors to develop dental decay.
  • Acid-producing bacteria and other factors facilitate the development of decay, but free-sugars are required.
  • Processed food starches possess very low decay potential.

Free-sugars include all sugars added to foods in any way.

Bottom line: Dental caries is a diet-mediated disease. Free-sugars are the primary and necessary factors in the development in dental decay. These free-sugars cause an imbalance of gut bacteria, compromise the immune system, and feed decay-producing bacteria in healthy plaque. Health plaque then becomes unhealthy plaque. Free-sugars allow potentially pathogenic bacteria to overgrow and produce excessive acids that cause tooth decay.


Dietary Ketosis

Dietary ketosis is a healthy metabolic state, where your body burns fat instead of carbohydrates for fuel. It is also known as physiologic ketosis or nutritional ketosis. It creates a clean energy source for the body, and reduces the inflammation caused by eating a diet high in carbohydrates (especially sugars and the standard American diet). It is characterized by elevated serum ketones and normal blood glucose and blood pH. Eating a high fat diet (which I describe in my Better Belly Blueprint plan) can do wonders for your mouth, brain, and entire body.

You can get into ketosis through methods that increase the breakdown of fatty acids by the liver. Ketosis can be obtained by fasting; prolonged exercise; or high fat, moderate protein, low carbohydrate ways of eating. In dietary ketosis, blood ketone levels generally remain between 0.5 – 3.0 millimoles per liter (mmol/L).

Ketosis helps maintain maximum energy efficiency, reduces Reactive Oxygen Species (ROS) production, and stimulates the body’s production of glutathione and other endogenous antioxidants. In addition, mitochondria become healthier when ketones are metabolized as opposed to some other fuels, especially glucose.

And most importantly, dietary ketosis allows for a healthy gut microbiome and a healthy gut lining, which improve the immune system. A robust immune system helps maintain a healthy and diverse garden of microbes in the mouth. With a balanced oral microbiome, tooth decay and periodontal disease hardly ever become a problem.

But our metabolism needs to cycle out of ketosis and burn carbs cyclically to improve insulin metabolism. This allows for metabolic flexibility, which I have discussed in a previous Blog.


Three Biohacking Tests

Biohacking tests give you a sense of what your body is doing. Here are three that can identify healthy gut bacteria, a healthy gut lining, and a healthy balance of mouth bacteria …

  • BiomeFx
    The health of the mouth is directly affected by the health of the gut. Therefore, this is a stool test that can identify many different species of bacteria in the gut. But one of the most important results of the BiomeFx test is your Alpha Diversity.

Alpha Diversity is the amount of different species of bacteria in your gut and the number of each of these species.

In this stool test, your Alpha Diversity is ranked as a percentile within the general population. So, if your Alpha Diversity were in the 87th percentile, that would mean that 87% of the population had less Alpha Diversity than you and that 13% would have more Alpha Diversity than you.

The higher your percentile reading of Alpha Diversity, the better equipped your gut would be to crowd out bad bacteria and other unhealthy microbes.

This blood test can show the health of your gut’s epithelial barrier. In other words, it can identify if you have a “leaky gut” or not.

This is a home saliva test that measures the different microbes in your saliva. It indicates the extent of healthy and potentially unhealthy microbes in your mouth. But it does not measure the health of your dental plaque, which is a completely different community of microbes compared to your saliva’s garden of microbes. Also, I don’t agree with Bristle’s recommendations of how to clean your mouth, which I describe in 4 Steps to a Healthy Mouth. and in Just Because It’s In Toothpaste Doesn’t Mean It’s Safe.



Our primal ancestors generally had healthy teeth and healthy gums. Their diet was the main factor which created a balance of healthy bacteria in the gut, a healthy gut lining, and a balance of healthy bacteria in the mouth. In addition to a healthy diet, irritants to the gut and mouth like chemicals and other toxic substances were practically nonexistent in their days.

If you’re experiencing issues with your dental health, look to your diet first and then other environmental factors. The takeaway for us is that we can mimic the ancestral way of eating as well as avoid toxic elements to maintain our gut and dental health.

Also, incorporate a daily oral hygiene programs as I describe in my 4 Steps to a Healthy Mouth, which I referred to earlier.

I offer one-on-one consults – we look at your dental health, as well your diet to pinpoint the cause of irritants and find a course of treatment that will provide lasting results. If you’re interested in learning more, send me an email with any questions or book your consult here.


[1] https://onlinelibrary.wiley.com/doi/10.1002/ajpa.24247

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

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

[4] https://www.ncbi.nlm.nih.gov/pubmed/?term=Diet+and+Dental+Caries%3A+The+Pivotal+Role+of+Free+Sugars+Reemphasized


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