Dr. Al Danenberg ● Nutritional Periodontist
March 5, 2023
Everybody wants to get on the bandwagon about “mouth health”.
Several companies are making their marks. A few want you to take a saliva test which will be the answer to your oral problems. Some are promoting specific probiotics and newly developed enzymes that only are designed to alter the bacteria in the mouth. Still others are producing a host of natural toothpastes that are touted to be healthy but still contain various chemicals to indiscriminately kill the bacteria in the mouth.
The mouth is not an island unto itself. It is an integral part of the human body. It would be unrealistic to think that the successful treatment of the mouth could be an isolated process. Whatever happens to one cell in the body can affect every other cell eventually.
I am a Periodontist (i.e., a dental specialist who treats gum disease and its associated complications). I had an active practice treating my clinical patients for 44 years. Also, I am a Certified Functional Medicine Practitioner and Certified Primal Health Coach. If you “google” Nutritional Periodontist, I’ll be one of the first names to pop up.
Because of my experience, I am here to tell you that the methods I just mentioned and others which are designed only to “treat the mouth” are not the methods to make your mouth healthy. They are treating the manifestations of disease and not the cause.
You may think I am off my rocker, but I know what I am talking about. After all my years in the clinical practice of periodontics and my research, I can share with you what works and what doesn’t work.
In addition, I do not sell any products, but I recommend products I use personally. And I offer my time for personal consults for a fee. I am not like some of the health professionals who go on and on about the merits and medical science supporting a new-fangled supplement or gadget that you cannot live without and then try to get you to purchase it from their website.
Our Primal Ancestors
If you want to know what is necessary for a healthy body, you must first investigate the evolution of our species.
If we go back to our primal ancestors and determine their oral health, we will discover there was very little gum disease and tooth decay.
Certainly, our ancestors did not have a toothpaste with lots of chemicals to brush their teeth, and they never went to their nearby dental cave to get fluoride painted on their teeth.
Our ancestors ate a healthy diet which was devoid of toxic chemicals. This way of eating supported a healthy gut microbiome. Even for the few primal societies in existence today around the world, all this is still true. Primal societies is the past rarely had (and primal societies living today rarely have) chronic diseases or dental diseases. And these peoples did not use any toothbrush, toothpaste, or antimicrobial mouthwash to keep their mouths healthy.
Looking at the animal kingdom, wild animals rarely have tooth decay or gum disease. But when animals are domesticated and live in our homes and eat commercially created animal foods, they develop chronic diseases and mouth diseases.
The underlying fact is that a nutritious diet supports a healthy gut, which is critical for a healthy mouth. Almost 2,500 years ago Hippocrates got it right when he declared, “All disease begins in the gut.”[1]
A Healthy Gut – A Healthy Mouth
If we can mimic some of the eating habits and lifestyle of our primal ancestors, we can have a healthy mouth (and incidentally a healthy body).
I am not suggesting that we live like our primal ancestors. They had a hard life and had many disasters befall them. But there is much to learn about our species’ requirements to thrive and become the dominant animal on this planet. And most of these requirements center around diet and lifestyle. If we understand these details, we can integrate them with other facts to help us thrive and be the best we can be.
I describe these facts below in my 6 Principles for Mouth Health. But first, let me share an analogy about how a healthy environment can turn into a toxic environment.
A Toxic Environment
Years ago, my son owned a 125-gallon saltwater aquarium. I wrote an allegory about it in a Blog titled We Swim in a Polluted Sea. The pristine water in the aquarium became polluted over time because of commercially prepared fish food and a change in the balance of healthy bacteria. My son had no idea that the slow degradation of the healthy water in the aquarium was becoming toxic to the fish and other aquatic living things.
And statistics suggest that a “polluted sea” is occurring in the mouths of most of the U.S. population.
- In 2010, a published paper demonstrated that 93.9% of adults in the United States had some form of gum inflammation (gingivitis)[2], which frequently had its origin in an unhealthy gut.[3],[4]
- In 2015, the CDC published an update in the Journal of Periodontology.[5] It showed the prevalence of severe periodontal disease (periodontitis) was estimated to be 47.2% for American adults. For adults 65 years old and older, the prevalence jumped to 70.1%.
- In data published and reviewed in 2022 by the CDC, approximately 91% of U.S. adults aged 20–64 had dental caries in permanent teeth.[6] The prevalence increased to 93% for those above 65 years old.[7]
6 Principles for Mouth Health
Putting all this knowledge into a practical approach, I’ve summarized 6 principles below which will assure a healthy mouth.
These principles may seem simplistic. But they are some of the fundamental facts for a healthy mouth. Also, these six pathways are not exhaustive. There are other healthy lifestyle activities that are important for overall wellness and mouth health. However, these 6 Principles are essential building blocks.
For each of these 6 Principles, I included links to articles which go deeper into an explanation.
First, there must be a healthy gut microbiome and an intact gut epithelial barrier. The gut microbiome is made up of approximately 38 trillion microbial cells. And humans only have about 30 trillion human cells.[8] In essence, humans are more microbial than human!
Our microbiome plays lifesaving and lifegiving roles for our body. So, if we damage them, all our body mechanisms can be affected. And that includes the mouth.
Second, the diet must exclude any foods that feed potentially pathogenic bacteria. Specifically, processed sugars can make unhealthy bacteria abundantly grow in the mouth and cause gum disease and tooth decay.
Third, the diet must include nutrient-dense, anti-inflammatory foods to nourish the entire body. Like high quality gasoline provides the energy for efficient function of a high-performance car engine, bioavailable nutrients must be absorbed through our gut lining to feed every cell in our body. Each cell has its own purpose (i.e., heart cell, brain cell, nerve cell, gum tissue cell, etc.) so that they will function as they were designed to function.
Fourth, all irritants or toxic elements which we have control over must be avoided or removed from our food supply and our environment. Toxic elements are like dirt that clogs up an engine’s pistons. The accumulation of toxic elements in the body will hinder and eventually stop our cells from performing properly.
Fifth, each of us should carry out a daily efficient oral hygiene program (correct brushing, flossing, tongue cleaning, interproximal brushing). Dental plaque starts off as healthy and remains healthy until it’s not!
You must understand that healthy dental plaque serves at least three important biological processes. It …
- 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.
Unhealthy dental plaque is made up of pathogenic microbes that are stimulated by an unhealthy gut microbiome and unhealthy food choices. Unhealthy dental plaque forms on top of healthy dental plaque.
Properly performed oral hygiene will help remove the unhealthy dental plaque. The Oral Hygiene Program I recommend demonstrates the techniques to effectively clean the gum/tooth margins and the tongue.
Sixth, any inflammation and infection in the teeth, gums, and jawbone must be appropriately treated by a knowledgeable dentist. If there is a broken filling, an ill-fitting dental restoration, a necrotic tooth with an abscess, damage in the bone from an extraction, or anything else that is irritating the mouth tissues, they could act like a splinter. If you had a splinter in your finger, you would need to remove it before the skin could heal. If there is a “splinter” in your mouth, you must remove it before the mouth can heal.
The Result
Following these principles will ultimately balance the complex garden of microbes in the gut and in the mouth. When the body is provided with all the nutrients required for efficient metabolism, the garden of bacteria in the mouth will become and stay balanced. Homeostasis in the mouth will assure healthy gums and healthy teeth.
These principles are also necessary for a healthy body. Keep in mind the quote from Hippocrates, “All disease begins in the gut.” Every organ system is dependent on a healthy gut.
Do you have some questions about your mouth, your gut, or your health? I am here to help answer your questions. Schedule a free 30-minute consult with me to discuss your concerns.
[1] https://doi.org/10.1093/brain/awy017
[2] https://pubmed.ncbi.nlm.nih.gov/20437720/
[3] https://aap.onlinelibrary.wiley.com/doi/10.1002/JPER.21-0374
[4] https://www.frontiersin.org/articles/10.3389/fcimb.2021.752708/full
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4460825/
[6] http://www.nidcr.nih.gov/DataStatistics/FindDataByTopic/DentalCaries/DentalCariesAdults20to64.htm
[7] http://www.nidcr.nih.gov/DataStatistics/FindDataByTopic/DentalCaries/DentalCariesSeniors65older.htm
[8] https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.1002533
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