Mouth Bacteria & Blood Pressure

Alvin H. Danenberg, DDS Nutritional Periodontist
June 5, 2017 [printfriendly]



Mouth Bacteria & Blood PressureNew research is revolutionizing the way physicians and dentists will appreciate the beneficial role of healthy mouth bacteria. There is a relationship between killing good bacteria in the mouth and increasing the risk of elevated blood pressure. Medical and dental professions should help educate their patients to the dangers of killing good bacteria in the mouth.


Good Mouth Bacteria

I wrote an article in 2016 about the balance of bacteria in the mouth. In early 2017, I posted a blog titled, Want Healthy Gums? In this article I explained the importance about good mouth bacteria and a critical biological process where these bacteria help create necessary nitric oxide for the body. New medical research is proving there are harmful consequences to our blood pressure and heart health if these healthy mouth bacteria are destroyed indiscriminately.


“Nitrate to Nitrite to Nitric-Oxide” Pathway

Specific and naturally occurring anaerobic bacteria on the top surface of your tongue play a necessary role in overall health. These bacteria eventually initiate the development of a large percentage of nitric oxide throughout the body.


Here’s how it happens:


After you eat leafy greens that contain natural nitrates, your body absorbs these nitrates through your upper GI tract. About 25% of these nitrates are concentrated into your saliva. The normal anaerobic bacteria on your tongue change the nitrates in the saliva into nitrites. Then, you swallow the nitrites. Nitrites then move throughout your body and are further changed into nitric oxide (NO). Nitric oxide is critical for overall health.


Some of the functions of nitric oxide are to reduce blood pressure, reduce the risk of cardiovascular disease, improve athletic performance, and improve gum health.


Review of Blood Pressure Research

In 2017, Nathan S. Bryan and coauthors reviewed the current research describing the importance of oral bacteria on the nitrate/nitrite/nitric-oxide pathway. The authors concluded,


With the loss of NO signaling and homeostasis being one of the earliest events in the onset and progression of cardiovascular disease, targeting microbial communities early in the process may lead to better preventative interventions in cardiovascular medicine.


The authors further stated at the end of their article:


  • Disruption of nitrite and NO production in the oral cavity may contribute to the oral-systemic link between oral hygiene and cardiovascular risk and disease.
  • It may be time to discourage the use of antiseptic mouthwash.
  • Therapeutically, then, perhaps an effective strategy to promote NO production and overcome conditions of NO insufficiency may “be targeted to” specific oral nitrate-reducing bacterial communities and increasing the consumption of nitrite and nitrate enriched foods and vegetables.
  • Because NO signaling affects all organ systems and almost all disease processes described to date, this novel approach to NO regulation has the potential to affect the study and treatment of many diseases across all organ systems.


Take Away Points

  • Don’t use antimicrobial mouthwashes on a regular basis.
  • Eat organic leafy greens daily that are high in naturally occurring nitrates (examples: Arugula, Spinach, Butter Leaf and Oak Leaf Lettuces, Swish Chard, and Beet Greens).



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Want Healthy Gums?
Then, Don’t Use Mouthwash

Alvin H. Danenberg, DDS Nutritional Periodontist
January 9, 2017 [printfriendly]





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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