Want Healthy Gums?
Then, Don’t Use Mouthwash

Alvin H. Danenberg, DDS Nutritional Periodontist
January 9, 2017

 

 

 

 

Want Healthy Gums

Doesn’t mouthwash kill bacteria? Don’t bacteria cause gum disease? What about healthy gums?

 

Yes, antibacterial mouthwash kills bacteria. Yes, bacteria can cause gum disease. Yes, you want healthy gums.

 

But before you think I’ve gone bonkers, give me a moment to explain. Bacteria, when the good guys and the bad guys are in balance, serve many necessary purposes in your mouth. Healthy gums are dependent on healthy bacteria. One benefit is to allow a specific pathway of digestion to occur that is critical for health.

 

Mouth Bacteria

I have written about the balance of bacteria in the mouth in past articles. When bacteria are killed indiscriminately, harmful bacteria and good bacteria are both killed. This delicate balance of bacteria goes awry. When a healthy balance is disturbed, tooth decay and gum disease are likely to occur.

 

Here is one of the many benefits of mouth bacteria. They play a unique role in the chemical pathway of certain foods. Specifically, the chemical pathway of “nitrate-to-nitrite-to-nitric oxide” is dependent on specific anaerobic bacteria in the mouth.

 

“Nitrate to Nitrite to Nitric Oxide” Pathway

Nitrate is naturally abundant in certain vegetables. It is converted into nitrite and then into nitric oxide and other nitrogen products during digestion. One end product, which is nitric oxide, has major benefits throughout our body. Nitric oxide reduces blood pressure, reduces the risk of cardiovascular disease, improves athletic performance, and improves gum health to name a few. Your mouth bacteria play an important role in the path of creating nitric oxide.

 

The pathway is somewhat technical, but it is good stuff. If you’re not interested in the details, then skip to the next section.

 

The pathway goes like this: The foods that are high in natural nitrate are chewed up in our mouths and swallowed. Nitrate is absorbed in our stomach and upper small intestine. A large percentage of the absorbed nitrate gets concentrated into our saliva. Once nitrate is in our saliva, the naturally occurring anaerobic bacteria on our tongues convert this “nitrate” into “nitrite”. Then we swallow.

 

Yes, we swallow this nitrite, which goes into our guts. Some nitrite is changed into nitric oxide by the acids in our stomach. Some nitrite is absorbed into our blood system and circulates to all of our cells where nitric oxide is formed. Still, some nitrite is converted into “nitric oxide” by bacteria in our intestines. There are many biological ways that nitrite is converted into nitric oxide and other nitrogen products.

 

In the mouth, nitric oxide has significant effects. Nitric oxide gets into the gum tissues and is strongly anti-inflammatory. It also has antimicrobial effects on pathogens. In this clinical study, nitric oxide derived from salivary nitrate helped reduce gingivitis. This study was a randomized, double-blinded clinical trial that was published in the Journal of Clinical Periodontology in 2016.

 

Don’t Kill The Bacteria

If you killed the bacteria in your mouth and on your tongue with antiseptic mouthwash, salivary nitrate wouldn’t be converted into nitrite. With less nitrite in your system, you would produce less beneficial nitric oxide.

 

High-Nitrate Foods

So, if nitrate is healthy, then what foods are the best sources? Here are some vegetables with the highest concentrations of naturally occurring nitrate. These vegetables are part of a nutrient-dense diet I recommend:

  • Arugula
  • Spinach
  • Butter Leaf and Oak Leaf Lettuces
  • Swish Chard
  • Beets and beet greens

 

One caveat: The artificial nitrate and nitrite that are added to processed meats and other foods are not healthy and should be avoided. Their chemistry is different from that of naturally occurring nitrate.

 

Take-Home Pearls

  • Eat foods high in natural nitrate.
  • Don’t use any mouthwash that can disturb the natural and healthy balance of bacteria in your mouth.

 

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How should you clean your teeth?
Let me count the ways!

Alvin H. Danenberg, DDS     Nutritional Periodontist
June 15, 2014 (updated January 17, 2020)  

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When 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!

 

The Purpose of Cleaning Your Teeth & How To Do It Right

Everybody knows that bacteria accumulate at the gum line, and unhealthy levels of bacteria 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 us 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 kill all the bacteria in the mouth since much of the bacteria in the mouth are good bacteria. An effective method 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.

 

1. Cleaning Between Your Teeth:

I floss between my teeth using dental floss. 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 that could get caught between the contacts of the teeth. 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 the overgrown bacterial film away 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. Brushing 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 do not need to use any toothpaste to brush your teeth effectively. Just brush with filtered water. However, if you want toothpaste, dip the bristles in a little coconut oil (I keep some which stays solid at room temperature in a small jar in my bathroom), and then dip these bristles into a little baking soda (I also keep some in a small jar 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. If you want to use a mouthwash occasionally, use some coconut oil and swish it around for a minute or so. 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. Brushing 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 this 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. Perform this tongue-cleaning method in the morning and then in the evening before bed.

 

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 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 wait at least an hour before brushing after drinking an acid drink. 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.

 

That’s it – great way to remove unhealthy plaque and other harmful microbes from your mouth.

 

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