4 Steps to a Healthy Mouth

Dr. Al Danenberg Nutritional Periodontist

August 23, 2020

4 Steps to a Healthy MouthWhen I was a kid going to the dentist, my dentist always told me I had to brush harder. What did that mean? When my family moved to another city, my new dentist told me totally different things about brushing my teeth. Wasn’t there a right way, and wasn’t there a wrong way? Then, when I went to dental school, each faculty member had his special technique that contradicted his peers. How confusing!

 

I’ve written about this before. But this is my update with new information.

 

 

Teeth & Dental Plaque are Unique

Here is a little-known fact. The only area of the body where a hard structure pierces the skin and enters into the sterile bony structures is the tooth. Think about this for a moment. Can you imagine the potential havoc that could occur if infection were to move down the tooth into the jawbone? But the body has a solution.

 

The tooth pierces the gum tissue and anchors itself in the jawbone. The body created a “healthy biofilm” to protect this susceptible area to prevent bacteria from sliding down the tooth into the bone. There are other protective structures under the gum that can alert the immune system to fight infections. But first, this protective and healthy biofilm is the initial defense. It is called dental plaque.[1],[2],[3],[4],[5],[6] It serves at least three main functions:

  • Allows necessary nutrients and minerals from the saliva to enter the root of the tooth to remineralize it as necessary 24/7.
  • Produces hydrogen peroxide to kill any potentially pathogenic microbes in the mouth from getting to the gum/tooth margin
  • Buffers the acidity around the gum/tooth margin to maintain an acid level of no more acidic than pH 5.5 to prevent demineralization of the root surface

 

So, dental plaque is healthy – until it’s not. What makes it unhealthy?

 

Unhealthy changes in the garden of friendly bacteria in the gut, systemic inflammation as a result of a “leaky gut”, poor diet, and a compromised immune system play critical roles in the development of unhealthy dental plaque. All these areas must be addressed in order to have a healthy mouth. But proper oral hygiene is also vital for overall health and wellness.

 

 

Oral Hygiene for Mouth Health

Unhealthy levels of bacteria in the dental plaque can create chemicals that can cause tooth demineralization, tooth decay, and gum inflammation. There have been numerous commercial toothpastes and cleaning devices developed along with many cleaning techniques to help remove this junk from around our teeth. Each claims superiority; what is an intelligent person to do?

 

Removing the amounts of unhealthy bacteria from around the tooth is the goal of flossing and brushing. The goal is not to remove healthy dental plaque. And the goal is not to kill all the bacteria in the mouth since much of the bacteria in the mouth is good bacteria. An effective method to clean unhealthy dental plaque is to use (1) something to clean between the teeth and (2) a good toothbrush to clean the other surfaces of the teeth. Also, (3) don’t forget your tongue! Do these methods first thing in the morning and last thing at night. And (4) there is a way to possibly make dental plaque healthier.

 

 

1. Clean Between Your Teeth

I floss between my teeth using dental floss. This can remove food that is stuck between the contacts of teeth. Think about sliding up and down a pole. That is how the floss wraps around the tooth and slides up and down to scrape away food particles and unhealthy dental plaque. However, flossing under the gum tissues could cut the gum.

 

Also, I always use a small brush that is designed to clean between teeth like a pipe cleaner (one brand is called TePe EasyPick®, another is GUM Soft Pick®). Imagine the small bristles of this tiny brush scrubbing away the overgrown unhealthy bacteria as it is pushed in and out between the teeth at the gum line. These small brushes are the best way to remove unhealthy plaque buildup at the base of the tooth and gum margin.

 

 

2. Brush Your Teeth

I like to use an electric toothbrush like the Sonicare® or the Oral B/Braun® because electric brushes are more efficient, and I am lazy. You don’t need to use any toothpaste to brush your teeth effectively. Just brush with filtered water. However, if you want “toothpaste”, wet the bristles of the toothbrush and dip the bristles in a little baking soda. Baking soda is slightly abrasive and will remove some superficial stains from the surface of the teeth. It also can neutralize excess acid in the area. You could keep a small jar of baking soda in the bathroom. Then brush your teeth GENTLY, angling the bristles into the space where the gums meet the teeth on both the cheek side and the tongue side of all teeth. Brush horizontally but GENTLY.

 

I rarely use a mouthwash, because daily use of an antimicrobial mouthwash will kill bad bacteria as well as good bacteria. Killing good bacteria daily will compromise the health in your mouth and the rest of your body.[7] But if you want to use a mouthwash on rare occasions, use about a teaspoon of coconut oil and swish it around for a few minutes. Then, spit it out (called Oil Pulling). If you use coconut oil as a mouthwash, be sure to spit it out into a napkin or paper towel and throw it in the trash. If you spit coconut oil into your sink, it could clog up the pipes!

 

 

3. Brush Your Tongue

Most of the odor-forming bacteria is located on the top and back areas of your tongue, closest to your throat. An effective way to remove overgrown bacteria and food remnants causing odor is to use a teaspoon. Place the inverted teaspoon as far back as is comfortable on the upper side of your tongue. Then, gently glide the teaspoon forward, removing the bacterial film and microscopic food particles. Repeat this 2-3 times, and then wash off the teaspoon.

 

 

 

 

 

 

 

 

 

 

 

4. Consume Spore-Based Probiotics & Vitamin K2:

Spore-based probiotics will attach to healthy dental plaque and may improve the balance of bacteria in this biofilm. Also, vitamin K2 has been shown to improve the energy production of individual cells and improve the immune system, which are compromised in periodontal disease. Both may be significant in the health of the mouth and the health of the gut.[8],[9],[10]

 

So, here is a way to be proactive. During your dinner, take 2 capsules of Vitamin K2 (320 mcg). Then, after cleaning your mouth at bedtime:

  • Open 2 capsules of spore-based probiotics
  • Place their powders in a glass; throw away the empty capsules
  • Add 1-2 teaspoons of water to make a slurry
  • Swish this liquid in your mouth for a minute or so
  • Then, swallow

 

The probiotics will coat the dental plaque, and the liquid will disseminate in the gut quickly after swallowing. Vitamin K2 and spore-based probiotics are resistant to stomach acid and will enter the intestines. The spores will begin to germinate in the intestines creating healthy biochemicals. Both will enhance the immune system and support the growth, diversity, and quality of other friendly gut bacteria.[11],[12],[13],[14],[15],[16] (Send an email to me at Dr.Danenberg@iCloud.com, and I will send you ordering information about the spores and vitamin K2 that I personalize use.)

 

 

Some “No-Nos”

  • Don’t floss aggressively under the gum tissue. You easily could cut the gum and create a wound. That wound might stay sore and heal like a cleft. Aggressive flossing under the gum also could cause gum recession.
  • A water-pick device can be dangerous. It could force food debris and bacteria deeper under the gum tissues if used on a moderate-to-high pressure setting. Also, the force of the water jet could tear gum tissue cells that are trying to heal inside the gum space. If you wanted to use a water-pick device, make sure you use the lowest power settings and don’t angle the water jet under the gum tissues.
  • If you drink very acid drinks, the minerals of the tooth could become “softened” until the acid in the mouth returns to normal. I suggest that you don’t brush your teeth right after drinking any acid drink. Research suggests that you should wait at least an hour before brushing after drinking an acid drink.[17] It would be a good idea to rinse your mouth with water to help remove the excess acid while your mouth regains its normal acid level. It would be wiser not to drink highly acidic drinks in any form.

 

 

That’s it – great ways to remove unhealthy plaque and other harmful microbes from your mouth and support healthy dental plaque as well as a healthy gut.

 

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

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

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

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5034904/

[5] https://pubmed.ncbi.nlm.nih.gov/11039053/

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2147593/

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

[8] https://www.ncbi.nlm.nih.gov/pubmed/?term=10.1126%2Fscience.1218632

[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5953218/ 

[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5448046/

[11] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561432/

[12] https://pubmed.ncbi.nlm.nih.gov/32495964/

[13] https://pubmed.ncbi.nlm.nih.gov/32664604/

[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7146158/

[15] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683014/

[16] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5323449/

[17] https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2818.2012.03630.x
 

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Dental Plaque:
the Good, the Bad, the Ugly

      Alvin H. Danenberg, DDS     January 22, 2016  


 
 
Dental plaque- the Good, the Bad, the UglyWhat’s that ugly stuff around Jason’s teeth in the picture to the right – the white stuff around the necks of the teeth at the gum line?

 

It’s called dental plaque.

 

If it were thick, it might look like cottage cheese around the gum margin. It could smell bad and taste awful. It also could create severe gum disease and dental decay as it did for Jason.

 

Interestingly, there are different stages of dental plaque:

  • A good stage
  • A bad stage
  • An ugly stage

 

In the good or healthy stage, both the dental plaque and the gum tissues maintain a delicate balance allowing the gum and teeth to stay healthy. This is known as homeostasis.

 

In the good stage of dental plaque, a sticky substance first forms on the tooth surface. This is called the pellicle. Various bacteria begin to attach to this and eventually form a complex, multilayered biofilm. This is still the good stage of dental plaque. The outer layers of the biofilm are made up of mainly aerobic types of bacteria (bacteria that live in the presence of oxygen).

 

However, changes may occur that transform this healthy dental plaque into a disease-producing dental plaque – a bad stage. The biological mechanism creating this change is not completely understood.

 

Science suggests that when we eat processed grains and sugars, bad bacteria in the gut and in the mouth can overgrow. Some of these bad bacteria in the plaque can ferment sugar, produce many types of acids, cause imbalance in necessary nutrients, and cause decay on the tooth surface. Other bad bacteria in the plaque could cause bleeding gums or gingivitis. This is the bad stage of dental plaque.

 

Our body’s immune system plays a significant role in determining what types of harmful bacteria develop and overgrow. One of the most aggressive types of bacteria is called Porphyromonas gingivalis (P. gingivalis). As this bug overgrows and then dies, it produces a very potent and destructive substance called LPS (lipopolysaccharide). P. gingivalis is one of the most virulent types of bacteria causing periodontitis, the advanced and very destructive form of periodontal disease. This dental plaque is now in the ugly stage. LPS creates severe inflammation that can destroy the jawbone and can seep into the bloodstream.

 

Research suggests that the bacteria in the gut and in the mouth are interrelated. The development and course of periodontal disease are affected by the stages of dental plaque. The stages of dental plaque appear to be determined by:

  • The foods we eat
  • The bad bacteria that overgrow
  • The strength of our immune system
  • The genes we have inherited

 

Good plaque helps maintain biochemical balance around the teeth. Bad plaque begins the infectious process of dental decay and early gum disease (gingivitis). Ugly plaque causes gingivitis to progress to periodontitis, which (1) destroys the jawbone, (2) causes loss of teeth, and (3) may spread to other areas of the body.

 

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