Mouth Cancer:
New Research – Old Enemy

Alvin H. Danenberg, DDS Nutritional Periodontist
September 25, 2017 [printfriendly]



Mouth CancerMouth cancer accounts for 2% – 4% of all cancer cases; however, mouth cancer is increasing in frequency. A specific mouth cancer, oral squamous cell carcinoma (OSCC), makes up 90% of all mouth cancers. Unfortunately, the 5-year survival rate for patients with OSCC is 40% -50%. Since there is relatively no pain with OSCC, early detection is critical but rare.


If we knew what was causing mouth cancer, we might be able to nip it in the bud. There is new research suggesting that OSCC might be caused or aggravated by an old enemy – Porphyromonas gingivalis (P. gingivalis).[1] 


Porphyromonas gingivalis

P. gingivalis is a major bug in chronic periodontitis. Its aggressive behavior in dental plaque may be a direct result of chronic systemic inflammation and a compromised host response.[2] Once P. gingivalis becomes pathogenic, the immune system has a difficult time killing it.


Resulting damage to the jawbone from periodontitis is more than a result of bacteria. It is predominantly a result of chronic inflammation created by activation of the immune system to try to kill off P. gingivalis.[3] It is interesting that P. gingivalis can penetrate into epithelial cells and exit from epithelial cells, all along increasing chronic periodontal infection.[4] This bacterium can also penetrate other cells and travel to various parts of the body, leading to other diseases.[5]


Research & OSCC

Research has shown that P. gingivalis will spread to initial lesion sites of OSCC in the soft tissues of the mouth.[6] Another study found that oral cancer cells and cancer stem cells became more aggressive after repeated infection by P. gingivalis.[7] Tumor-like changes appeared to occur with long-term infection from P. gingivalis.


If periodontal disease were diagnosed and treated as soon as possible, then the tendency for P. gingivalis to increase the potential for epithelial cells to become malignant might be halted.


Treatment of Periodontitis

One of the most effective methods to destroy P. gingivalis, which can live inside epithelial cells and in the infected spaces under the gum tissues around teeth, is the LANAP(R) laser protocol. LANAP (Laser Assisted New Attachment Procedure) also has been shown to stimulate regeneration of damaged jawbone, periodontal ligament, and cementum on the tooth root surface.[8] Here is an animated video that shows how the LANAP laser procedure is performed.[9] This procedure does not require cutting the gum tissues or placing stitches. Patients usually go about their normal routine the next day.


In addition to treating periodontitis, the practitioner should emphasize nutrition and lifestyle changes. It is also important to enhance the immune system and eliminate chronic systemic inflammation. A nutrient-dense, anti-inflammatory diet will go a long way in assisting the body to heal and protect itself going forward.



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7 Things I Used To Know
That Just Ain’t So

      Alvin H. Danenberg, DDS     March 7, 2016   [printfriendly]

7 things I used to knowJosh 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.”


As a periodontist, I have been treating patients now for 42 years. That is a long time. You would think that I should know everything that there is to know about gum disease – its causes, its treatment, and its prevention. If any medical doctor or dentist or any other professional told you that he or she knew everything that there was to know about a subject, run as fast as you could to the nearest exit.


I live and breathe “outside of the box.” I have an open mind about almost everything. It is exciting for me to learn new things and even change the way I currently do things if a better method or newer knowledge were proved. I am still aware that these newer and better ideas may still be changed or disproved in the future. I will continue to learn until I die. This invigorates me.


So, with that said, here are seven hard and true dental facts that I have learned in the past during my professional career that no longer are valid or accurate. I have included peer-reviewed research LINKs:

  1. Brushing and flossing are all that is necessary to prevent gum disease and tooth decay: Disease-producing dental plaque is clearly unhealthy. Brushing and flossing properly will remove it. But, eating processed foods is actually the more important culprit of increasing harmful bacteria in the gut and in the mouth. LINK.

  3. Killing all the bacteria in the mouth is the goal for a healthy mouth: Healthy plaque actually is made up of numerous microbes that benefit one another. If they were to be destroyed, or if their delicate balance were to be altered, tooth decay and gum disease would ensue. LINK. LINK.

  5. Antibiotics should be used to treat infections in the mouth: While some acute infections must be brought under control through the use of systemic antibiotics, the indiscriminate use of antibiotics will damage good bacteria in the gut as well as in the mouth. LINK.

  7. Traditional gum surgery (including cutting open the gum tissues, cutting the damaged jawbone, and using sutures) is the treatment of choice for treating advanced periodontal disease: Research has shown that a specific type of laser can kill the virulent bacteria that cause periodontitis and increase the potential for some of your own damaged jawbone to regrow. LINK . This procedure is called Laser Assisted New Attachment Procedure (LANAP), and does not require scalpels or sutures. You probably would be able to return to your regular routine the next day.

  9. Mercury fillings are the best way to treat a decayed tooth: The science is out there. Today, dental fillings incorporating biologically compatible materials are excellent choices to repair decayed teeth. Mercury fillings are not one of them. Mercury is a toxic heavy metal that can interfere with numerous biological pathways in the human body. LINK.

  11. Fluoride is necessary to remineralize a tooth and prevent tooth decay: While locally-applied fluoride preparations can harden susceptible tooth surfaces, diet is more important. Nutrient-dense foods that also are anti-inflammatory can provide the building blocks to strengthen and remineralize tooth surfaces. LINK.

  13. Mouth problems are independent from what is going on in the rest of the body: P. gingivalis (an aggressive bacterium causing periodontitis) can invade other tissues and potentially may cause other systemic diseases. LINK. LINK.


I will be the first to declare that what I am doing is no longer valid when science demonstrates that it is no longer effective. Is your health professional open to new knowledge? He or she should be!


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Dental Plaque:
the Good, the Bad, the Ugly

      Alvin H. Danenberg, DDS     January 22, 2016   [printfriendly]
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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