mouth health – Dr. Danenberg

Dr. Al Danenberg ● Nutritional Periodontist

March 5, 2023 [printfriendly]

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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Dr. Al Danenberg mouth health

Alvin H. Danenberg, DDS • Nutritional Periodontist
November 2, 2015 [printfriendly]

Over the course of 2.5 million years, our species evolved into a perfect machine. Dealing with a host of environments and demands, our genetic structure developed the abilities to become the master control center of our well-being. That was the way it was meant to be. But about 10,000 years ago, a train started coming down the tracks, and modern man was not aware of its approach.

The train was in the form of lifestyle changes that would insidiously affect our body’s ability to function as it was designed to function.

Beginning 10,000 years ago or so, our species became progressively at odds with our genetic code. In many aspects we have become an unhealthy people. In many aspects, we have allowed changes to occur in our modern lifestyles that have brought us to a crossroads. Either we will continue on the destructive path affecting our health and well-being, or we will take steps moving forward to repair our body.

Fortunately, for the most part, we have control over our future. You may be surprised that poor lifestyle choices accumulate over time to cause chronic inflammation, which is a major factor in many of today’s chronic diseases. These diseases lead to a decrease in quality of life and a decrease in longevity. The Centers for Disease Control and Prevention estimated that 50% of the US population (approximately 117 million people in 2012) had some form of chronic disease. (Here) Our primal ancestors hardly ever had, and today’s traditional societies hardly ever have, chronic diseases.

Interestingly, almost everything begins with our mouths. Certainly, our nourishment begins with our mouths. And, our mouths have become unhealthy – more unhealthy than ever before in our species’ 2.5 million-year journey. I start my story with the mouth. From there, the whole body becomes its playground.

A study published in 2010 demonstrated that 93.9% of adults in the United States had some form of gingivitis, which is infection and bleeding of the gum tissues surrounding the teeth. (Here)

Another study published in 2015 (discussing data from 2009-2012) showed that 47.2% of the adult population over the age of 30 in the United States had periodontitis (which translated to 64.7 million Americans), and an astounding 70.1% of those over the age of 65 had this disease. (Here)

Periodontitis is more serious than gingivitis. Periodontitis is an advanced stage of gum disease where the gums are infected and the bone surrounding the roots of the teeth are breaking down. This disease leads to bad breath, loose teeth, loss of teeth, sensitive teeth, pain, gum recession, and even spread of infection to other parts of the body.

So, if you have gum disease, you are not alone.

Obviously, our primal ancestors did not have toothbrushes and did not see a dentist every 6 months, but they had relatively healthy mouths. They hardly ever had gum disease or tooth decay. Why?

Today, many people see a dentist every 6 months and also brush and floss daily, but some still have gum disease. How could that be?

What we have learned to believe may not be so. Josh Billings (the 19th Century humorist) put it so clearly: “It ain’t so much the things we don’t know that get us into trouble. It’s the things we know that just ain’t so.”

Your mouth health and your overall health are related to the nourishment you give yourself and the lifestyle you lead. My original question was, “If you knew a train were coming, would you get off the tracks?” If your modern lifestyle could be causing severe health damage going forward, would you change your ways to get and stay healthy? The steps to repair your body are not complicated. I have discussed these steps in previous blogs, and I will continue to emphasize my philosophy in future blogs.

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