What’s Really Behind
Periodontal Disease?

Dr. Al Danenberg Nutritional Periodontist

December 11, 2022 [printfriendly]

Periodontal disease is prevalent in our society.

  • 93.9% of adults in the United States had some form of gum inflammation (gingivitis).[1]
  • 47.2% of American adults had advanced periodontal disease (periodontitis) while 70.1% of adults aged 65-years-old and older had periodontitis.[2]

Are you at risk of developing it? And if so, is there a way to avoid it? Read on, and I’ll tell you what’s really behind periodontal disease. I’ll even give you some tips on how you can reduce your risk.


Underlying Causes of Periodontal Disease

For example, three important facts were recently discussed in a couple of peer-reviewed medical journals. One paper was published in October 2022[3] and the other was published in November 2022[4]. The facts are …

  1. The last 25 years have brought a paradigm shift from periodontitis regarded as an infection in the gum tissues around the teeth to an overreactive response of the immune system!
  2. Those with periodontal disease often have overloaded their immune system before they developed periodontal disease with unhealthy habits. Two unhealthy habits were eating unhealthy fats and processed sugary foods. These and other poor food choices have led to the development of chronic diseases related to the disturbance and dysfunction of the gut and of the immune system!
  3. Emotional stress has been implicated as an important causal factor in periodontal disease.


The Gut & The Immune System

Our gut is a tube – like a plumbing pipe. What is inside the tube is isolated from the rest of the body. Our body produces a variety of enzymes to break down ingested food. The process of digestion changes the food we eat into the smallest molecular nutrients. These basic nutrients are allowed to slowly penetrate the lining of the gut to get into your circulation to give the body all the nourishment it requires to be healthy and stay healthy.

To assist our digestion and the overall function of our gut, about 38 trillion microbes make the gut their home. These microbes help with …

  • Breaking down food into bioavailable nutrients
  • Creating their own bioactive substances to support the health of the gut and the rest of the body
  • Signaling the immune system when they sense something is not right in the gut

However, if potentially pathogenic microbes in the gut begin to overgrow, then these bad guys could erode the healthy lining of the gut. The integrity of the gut lining would break down, and stuff inside the gut that should never enter the circulatory system would begin to leak out. Also, certain elements in the food we eat could damage the integrity of the lining of the gut.

This pathological change in the lining of the gut is called a “leaky gut”.

Ultimately, the elements that get into the blood system from the leaky gut can spread far and wide in the body. These elements are toxic to the body. And this toxic waste can cause chronic systemic inflammation affecting every organ system in the body. And it increases a person’s risk of developing chronic diseases and autoimmune diseases. But the manifestations of these diseases may take months, years, or decades to make themselves known.

Below is a graphic of a healthy gut and a “leaky gut”. The picture to the left shows a normal, healthy gut with a balance of good bacteria within the top light blue area and a healthy mucous layer protecting the one-cell-layer-thick epithelial barrier below. To the right is a picture of a “leaky gut” where unhealthy bacteria and toxic elements are breaking down the mucous layer and weaking and penetrating the epithelial lining (the red-colored cells) on their way to affecting the entire body.



All along, the person with a chronic leaky gut could be having a variety of symptoms that seem to be unrelated to the gut. And one of the results of this chronic systemic inflammation is an increase in the risk of periodontal disease.

This inflammation could cause the mouth’s healthy garden of bacteria and immune system to become unhealthy resulting in periodontal disease. The infection and inflammation from periodontal disease could spread into the jawbone, blood vessels, nerve canals, and soft tissues of the body. Debilitating and life-threatening diseases could occur just from this leakage of infection and inflammation from the mouth into the body. According to Alessio Fasano, MD, probably all chronic diseases start with a leaky gut. And dental diseases are chronic diseases.

Below is a graphic of a healthy mouth and a “leaky mouth”. The picture on the left shows a normal, healthy tooth in the jawbone. To the right is a picture of periodontal disease (the red area) beginning to penetrate the jawbone on its way to affecting the entire body.



Poor Food Choices & the Gut 

A diverse garden of microbes in the gut and the mouth are important to maintain health. The gut or mouth microbiome should never be indiscriminately destroyed. For example, when the garden of bacteria in the gut is compromised from the use of systemic antibiotics and gut dysbiosis occurs, an increase in periodontitis and jawbone loss from around the teeth has been observed in a recent study using mice.

Biologically available, animal-derived nutrients in their natural and balanced ratios with other symbiotic elements can supply our body and our gut with all the nutrients required to thrive. These animal sources can maintain a diverse garden of microbes in the gut. It’s important that these animals must be organically and compassionately raised and humanely slaughtered.

Regenerative rotational farming and animal grazing using no chemicals are methods to provide healthy animal products for our consumption. Some fruits and a very select number of vegetables can be healthy and included in your lifestyle eating plan.

However, many vegetables, processed fats and oils, added sugars, grains, and almost all nuts and seeds contain “antinutrients” that potentially are damaging to the gut, encouraging chronic systemic inflammation, and leading to chronic debilitating diseases – and these include dental diseases. The potentially damaging foods should be avoided if you want to be proactive for the health of your mouth and for your overall wellness.

Here are several resources to help explain how the foods we eat can benefit the health of the gut and the overall health and wellness of the body.

  • This seminal paper published in 2021 explains the evolution of the human species over 2.5 million years.
  • The International Center for Medical Nutritional Intervention in Budapest, Hungary publishes Case Reports of their successes with their patients. This clinic has treated over 6,000 patients with severe and sometimes “incurable” chronic diseases and cancers. Their patients have been treated and sometimes cured using a strict animal-based diet with no supplements and no prescription drugs. Go to their website and then click on “Scientific Work and Articles”. The doctors at the clinic state that a healthy gut and intact gut lining are essential for success with their patients.
  • This peer-reviewed article describes the critical importance of a healthy gut.


Stress & the Gut

Stress can cause serious damage to your gut and eventually to your mouth.

Stress is one of those things that most people know about, occasionally think about, and often never do anything about. Yet stress can be one of the most important factors that can destroy your body slowly without you knowing it – until it’s too late.

Let me introduce you to a patient whom I will call Emma.

Emma is a 30ish-year-old woman who came to the dental office with the complaint of sore, bleeding gums. From a dental standpoint, there were no obvious causes for her oral problem. She had very little dental plaque around her gum tissues. And her dental x-rays did not indicate any active periodontal destruction in her jawbone.

Below are a “before photograph” and an “after photograph” of Emma’s mouth. They may seem disturbing because they look unnatural. However, the photography was done with the lips pulled back to show the teeth and gums for better viewing.

Here is how Emma’s mouth looked when she first came to the periodontal practice. You are looking at her red and swollen gum tissues around her teeth:



Since there were no obvious dental reasons for these lesions, she was referred to her medical doctor to check for possible systemic diseases that could be the cause. But no systemic diseases were discovered.

Emma eventually explained that she was continuously dealing with emotional and sexual abuse inflicted by her employer!

Finally, Emma was convinced to quit her current job with her abusive employer and found a new job out of state.

Four months later, she returned to the periodontal office. From the time she originally was seen until the time she returned after her move, she did not receive any medical or dental treatment for her mouth lesions. Her only treatment was the 100% removal of her emotional stress.

Here is the picture of her mouth after she returned to the office. All the gum lesions were gone – no soreness and no bleeding. Her original mouth condition was caused by severe emotional stress; her cure was the direct result of eliminating this stress from her life:



Unfortunately, most people who experience emotional stress from whatever sources are unable to reduce that stress completely. But Emma is a real-life example of a person who suffered the manifestation of severe psychological stress and healed completely after totally removing that stress from her life.

Emotional stress damages the gut microbiome, increases intestinal permeability (i.e. Leaky Gut), and increases systemic inflammation as a result of the immune system trying to heal itself.

If you were able to reduce your stress levels, you could improve your gut health and lower the levels of inflammation circulating in your body. That would improve your immune system’s ability to fight the fight that it is designed to fight.

Here are some studies that demonstrate how stress affects the gut …

  • This study published in 2013 looked at 37 military troops. They were involved in prolonged and intense combat-training. As expected, this training induced increases in stress, anxiety, and depression. However, the results also showed gastrointestinal symptoms, pro-inflammatory immune activation, and increased intestinal permeability – all resulting from acute stress.
  • In this study published in 2017, 73 soldiers were subjected to intense military training, which created significant emotional stress. No matter what these soldiers ate, stress caused unhealthy changes in the gut bacteria and the way bacteria metabolized nutrients. These changes resulted in increased markers of inflammation and leaky gut.
  • In this 2019 peer-reviewed paper, researchers used a mouse model to study the effects of stress. The investigators divided the mice into a control group and an experimental group which were subjected to severe emotional stress. This research showed that stress can cause negative and long-term changes to the gut microbiome by altering the composition and behavior of specific gut bacteria. These changes in the garden of gut bacteria could lead to destructive changes in the body’s immune system. Changes to both the gut microbiome and the immune system could make the mice more vulnerable to many chronic diseases.

The results of these three studies help explain how Emma’s stress affected her gut microbiome, her immune system, and ultimately her gum tissues. And when Emma was able to completely remove the emotional stress that affected her gut and immune system, the lesions in her mouth resolved. For Emma, these immune system changes were not permanent, probably because the stress was completely removed in short order.


My Thoughts

What we put into our body affects the gut. Our lifestyle choices and how we deal with stress affect our gut. And the health of the gut affects the immune system which affects the entire body. And that includes the health of the mouth[5],[6].

It only makes sense to me to understand why gum disease is not just a disease of improper oral hygiene. While an efficient oral hygiene program at home is very important, there is much more to the story. Prevention and treatment of periodontal disease must address the underlying causes which include unhealthy food and lifestyle choices, emotional stress, damage to the gut and its epithelial barrier, and the resulting dysfunctional effects on the immune system.

Do you have questions? I am here to help you. Check out my consultation services and coaching programs if you are interested.

[1] https://www.ncbi.nlm.nih.gov/pubmed/?term=20437720

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4460825/

[3] https://link.springer.com/article/10.1007/s00005-022-00662-9

[4] https://link.springer.com/article/10.1007/s10266-022-00768-8

[5] https://aap.onlinelibrary.wiley.com/doi/10.1002/JPER.21-0374

[6] https://www.frontiersin.org/articles/10.3389/fcimb.2021.752708/full

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Bleeding Gums?
You’ll Need to Read This

Dr. Al Danenberg Nutritional Periodontist

June 5, 2022 [printfriendly]


Have you been brushing your teeth a little too rough and noticed your gums bleeding?

Or maybe you were flossing a bit too intensely and noticed a few spots of blood?

You’re not alone!

93.9% of the US population has some form of bleeding or inflamed gums! 

If your gums are healthy, a little aggressive brushing (while not recommended for many reasons) isn’t going to make your gums bleed. Bleeding gums are your warning sign that your mouth is experiencing early stages of gingivitis or periodontal disease.

Even if you notice bleeding in just one area occasionally, it is a sign of gum disease. Your gums should never bleed unless you cut them. For example, it you cleaned your fingernails with a nail brush, you wouldn’t expect the cuticle areas to bleed. Your gum tissues are as strong as the cuticles of your nails. As I said, if they are healthy, they should never bleed unless you cut them!

Today, we’re going to look at what bleeding gums mean, and I’ll share a unique way to halt the progression of periodontal disease.


Bleeding Gums

Bleeding gums are signs of the early stages of Periodontal Disease, which includes gingivitis and periodontitis. Gingivitis is infection only in the gum tissues. Periodontitis is an advancing stage of gingivitis that progresses into the jawbone creating severe damage.

In 2010, a published paper suggested that 93.9% of adults in the United States had some form of gum inflammation or bleeding gums [1], which frequently has its origin in an unhealthy gut.[2],[3]

As I mentioned, the infection causing bleeding gums (gingivitis) can progress under the gum tissues to damage the jawbone, which is known as periodontitis. But not all cases of gingivitis turn into periodontitis. When periodontitis occurs, it can destroy the jawbone, eventually causing teeth to be lost.

In 2012, the Centers for Disease Control and Prevention (CDC) published their results in the Journal of Dental Research, which was updated in 2015 in the Journal of Periodontology.[4] It showed the prevalence of periodontitis was estimated to be 47.2% for American adults (approximately 64.7 million people at the time of the original study in 2012). For adults 65 years old and older, the prevalence jumped to 70.1%. These findings were the result of the most comprehensive periodontal evaluation performed ever in the US.

An unhealthy gut, poor food choices, inefficient oral hygiene, and toxic lifestyle choices contribute to bleeding gums and other forms of periodontal disease. I’ve summarized this in Leaky Gut, Leaky Mouth.[5]

One thing is certain. If you have bleeding gums, then inflammation and infection will continue to spread from your mouth to other areas of your body. Make no mistake about it. Many chronic diseases have been shown to have their origin from active periodontal disease.[6]


What Should You Do?

To start, you need to improve your diet[7], develop efficient daily oral hygiene protocols[8], and improve your gut health[9].

Next, you’ll also need to have a biologically oriented dentist[10] evaluate your oral health. If you have damage in your teeth, gum tissues, or jawbone, you must have it treated correctly and as soon as possible. The last thing you want to do is “wait and see how it progresses”.[11]


Importance of Mitochondria

This is important:

It appears that active periodontal disease may be the direct result of specific virulent bacteria causing an overproduction of free radicals in the mitochondria of the gum tissue cells. [12]

The mitochondria are like the batteries in a flashlight. The mitochondria provide the electrical energy to power that cell to function as it is designed to function – just as the batteries in a flashlight create the power for the flashlight to work.

This also is critical to understand:

When these free radicals are neutralized, the infection tends to be tamed and further destruction from periodontal disease may be reduced even though the bacteria are still present.[13]

So, that brings up a fascinating question: Is there something that can eliminate the damaging free radical production in the mitochondria of the gum tissues, which could stop the progression of periodontal disease?

The answer is, “Yes!”

It is Molecular Hydrogen.


Molecular Hydrogen

Nanobubbles of molecular hydrogen can be dispersed in water to create hydrogen rich water.

Drinking hydrogen rich water can increase the concentration of molecular hydrogen in blood and tissues. And molecular hydrogen has been shown to neutralize damaging free radicals![14]

Furthermore, drinking hydrogen rich water may neutralize the excess free radicals and inflammatory reactions in the gum and surrounding tissues. Here are a few peer-reviewed medical papers demonstrating the actions of hydrogen rich water on periodontal disease.

  • In a 2013 study[15], researchers demonstrated in vitro that hydrogen rich water had antibacterial effects on specific pathogens that caused periodontal disease.
  • And in a 2015 randomized control trial involving 13 human patients with periodontitis[16], investigators demonstrated that drinking hydrogen rich water enhanced the effects of non-surgical periodontal treatment by further reducing inflammation in the tissues.
  • In a 2017 paper[17], the authors proved that hydrogen rich water was able to neutralize free radicals in infected gum tissues cells in vitro and to protect them from oxidative damage as well as promote wound healing.
  • Finally, in a study published in 2022[18], molecular hydrogen suppressed periodontitis progression by decreasing gingival oxidative stress, which is the result of excess free radical production.

So, drinking molecular hydrogen dispersed as nanobubbles in water appears to be an excellent adjunctive treatment for periodontal disease.

I wrote about molecular hydrogen and hydrogen rich water in January 2022.[19] In my paper, I discussed the documented medical research showing the overall health benefits from molecular hydrogen as well as why and how I drink hydrogen rich water.


How To Use Molecular Hydrogen

The product I use is HRW Rejuvenation Tablets. These patented tablets contain magnesium. Chemically, when magnesium nanoparticles react with water, nano-sized bubbles of hydrogen gas are produced by the following chemical reaction; Mg + 2H2O → Mg (OH)2 + H2.

One recent study suggested that 7.5mg/L (15 PPM) of molecular hydrogen per day will provide significant clinical results.[20] Here’s how to consume a dose of 7.5mg/L a day:

Dissolve 1 tablet of HRW Rejuvenation in 250 mL (about 8 ounces) of spring water in the AM and do the same in the afternoon.

When you’re ready to drink the hydrogen water, drop the tablet into room temperature water, which must not be carbonated. The tablet will dissolve and make the water look very “cloudy”. The “cloudy look” is the nano-sized molecular hydrogen bubbles dispersed in the water. It is important to let the tablet completely dissolve. Then drink the solution immediately all at once. If the “cloudiness” goes away, the hydrogen gas will be gone, and the benefit of the hydrogen-infused water will be lost.

You should consume each dose on an empty stomach.

You may have increased benefits if you double the dose. That’s what I do. To reach a dose of 15mg/L per day, dissolve 2 tablets in 500 mL in the AM and another 2 tablets in 500 mL in the PM.

I use Mountain Valley Spring water[21] as my source of natural spring water. I also add 1 teaspoon of SOLE[22] to my morning drink containing the molecular hydrogen.

A side benefit of using HRW Rejuvenation tablets is that the magnesium used to create the molecular hydrogen will provide additional magnesium for your body.


Your Takeaway

If your gums bleed or if you have more advanced periodontal disease, you need to be proactive as I suggested:

  • Improve your diet[23]
  • Develop efficient daily oral hygiene protocols[24]
  • Improve your gut health[25]

You can improve your periodontal health by reducing the free radical production in the mitochondria of unhealthy gum tissue cells. Excess free radicals allow this infection to progress. By consuming hydrogen rich water, you can help neutralize these free radicals and assist periodontal tissues to heal.

As an additional and significant benefit, drinking hydrogen rich water will provide molecular hydrogen to all parts of your body and will help neutralize unhealthy and damaging excess free radicals wherever they exist.

Finding the right dental professional can be a challenge. I created this blog post, 10 Questions to ask your Biological Dentist, to help you ensure you are getting the proper treatment from a doctor who looks at the body holistically, not the mouth as an isolated topic.

While I am no longer in active practice, I am available for consultations. I can review your dental x-rays and help steer you on a path of care. To book a consult with me, click here.


[1] https://www.ncbi.nlm.nih.gov/pubmed/?term=20437720

[2] https://aap.onlinelibrary.wiley.com/doi/10.1002/JPER.21-0374

[3] https://www.frontiersin.org/articles/10.3389/fcimb.2021.752708/full

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4460825/

[5] https://drdanenberg.com/leaky-gut-leaky-mouth-both-must-be-treated/

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8688827/

[7] https://www.amazon.com/Better-Belly-Blueprint-strengthen-immune-ebook/dp/B08DX9N9RB

[8] https://drdanenberg.com/wp-content/uploads/2022/05/PDF-4-Steps-To-A-Healthy-Mouth-5.9.22.pdf

[9] https://drdanenberg.com/wp-content/uploads/2022/02/Protocol-to-restore-healthy-gut-bacteria-2.23.22.pdf

[10] https://drdanenberg.com/wp-content/uploads/2021/11/10-Questions-to-Ask-Your-Biological-Dentist-11.21.21.pdf

[11] https://drdanenberg.com/wp-content/uploads/2021/04/Shoddy-Dentistry-4.19.21.pdf

[12] https://www.spandidos-publications.com/10.3892/etm.2021.9861

[13] https://www.ncbi.nlm.nih.gov/pubmed/?term=10.1016%2Fj.yexcr.2016.08.007

[14] https://pubmed.ncbi.nlm.nih.gov/31738389/

[15] https://www.koreascience.or.kr/article/JAKO201321353486492.page

[16] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4665424/

[17] https://link.springer.com/article/10.1007/s13577-016-0150-x

[18] https://link.springer.com/article/10.1007/s11010-021-04262-7

[19] https://drdanenberg.com/molecular-hydrogen-health-my-experiment/

[20] https://www.sciencedirect.com/science/article/abs/pii/S0531556521003569?dgcid=author

[21] https://www.mountainvalleyspring.com/

[22] https://drdanenberg.com/hydration-bun-what-i-learned/

[23] https://www.amazon.com/Better-Belly-Blueprint-strengthen-immune-ebook/dp/B08DX9N9RB

[24] https://drdanenberg.com/wp-content/uploads/2022/05/PDF-4-Steps-To-A-Healthy-Mouth-5.9.22.pdf

[25] https://drdanenberg.com/wp-content/uploads/2022/02/Protocol-to-restore-healthy-gut-bacteria-2.23.22.pdf


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Leaky Gut … Leaky Mouth
– Both Must Be Treated –

Dr. Al Danenberg Nutritional Periodontist

January 2, 2022 [printfriendly]

A “leaky gut” and a “leaky mouth” are like “leaky plumbing pipes”. If your plumbing pipes are leaking, you’ve got to get them fixed – all of them, not just one of them!

Think about your home’s plumbing pipes.

If they were “leaky”, toxic stuff could leach out of your pipes and infiltrate into the surrounding ground. From there, all the toxic elements could affect the immediate area but also spread to other areas of your yard and neighborhood. These toxic elements could slowly penetrate deep into the earth contaminating wells, aquifers, and other sources of groundwater. Entire communities could be poisoned without realizing the source of the toxic junk was leaky plumbing pipes.

Why is the pipe “leaky”?

One cause could be something in the pipe had damaged the structure of the pipe. Corrosion and other chemical changes could affect the integrity of the pipelining itself. And once the structure of the pipe was weakened and began to break down, stuff inside of it that should have stayed inside the pipe starts leaking out.

Of course, a specific question would be, “What is in the pipe to cause it to break down?”

And another obvious question would be, “How do you repair the leak?”

I’ll take this analogy and apply it to two areas of the body that can become “leaky”. They could cause havoc not only in the immediate area of the leak, but also throughout the rest of the body. I’m referring to a “leaky gut” and a “leaky mouth”.


A Leaky Gut

Our gut is a tube – like a plumbing pipe. What is inside of the tube is isolated from the rest of our body. Our body produces a variety of enzymes to break down ingested food. The process of digestion changes the food we eat into the smallest of molecular nutrients. These basic nutrients are allowed to slowly penetrate the lining of the gut to get into your circulation to give the body all the nourishment it requires to be healthy and stay healthy.

To assist our digestion and the overall function of our gut, about 38 trillion microbes make the gut their home. These microbes help with (1) breaking down some food into bioavailable nutrients, (2) creating their own bioactive substances to support the health of the gut and the rest of the body, and (3) signaling the immune system when they sense something is not right in the gut. Without this friendly and balanced garden of microbes in our gut, we would die.

Yes, die!

If pathogenic microbes in the gut begin to overgrow and damage the healthy bacteria, then these bad guys could erode the healthy lining of the gut. The integrity of the gut lining would break down, and stuff inside the gut that should never enter the circulatory system would begin to leak out. Also, certain elements in the food we eat could change the integrity of the lining of the gut.

This pathological condition is called a “leaky gut”.

Just like a leaky plumbing pipe, the damage can spread far and wide in the body. Because of this toxic waste causing chronic systemic inflammation, every organ system in the body is at risk of developing chronic diseases and autoimmune diseases. And the manifestations of these diseases may take months, years, or decades to make themselves known. All along, the person with a chronic leaky gut could be having a variety of symptoms that seem to be unrelated to the gut.


Do You Suffer from a Leaky Gut? 

Many of the symptoms of a leaky gut are commonly mistaken for other ailments. Unfortunately, by only treating the symptoms, they will continue to flare up until the underlying cause is diagnosed and treated appropriately. Also, many chronic illnesses stem from a leaky gut. You can fix the problem once and for all by fixing your gut health. Do any of these symptoms or illnesses sound familiar?  …

  • Acid reflux
  • Allergies and food sensitivities
  • Anemia
  • Autoimmune diseases
  • Bleeding gums and tooth decay
  • Brain fog
  • Depression and anxiety
  • Fatigue
  • Joint and muscle pain
  • Overweight as well as underweight
  • Skin lesions, rashes, and pimples


Healthy Gut – Leaky Gut

Below is a graphic of a healthy gut and a “leaky gut”. The picture to the left shows a normal, healthy gut with a balance of good bacteria within the top light blue area and a healthy mucous layer protecting the one-cell-layer-thick epithelial barrier below. To the right is a picture of a “leaky gut” where unhealthy bacteria and toxic elements are breaking down the mucous layer and weaking and penetrating the epithelial lining (the red-colored cells) on its way to affecting the entire body.



A Leaky Mouth

Chronic systemic inflammation caused by a “leaky gut” will affect the mouth. This inflammation could cause the mouth’s healthy garden of bacteria and immune system to become unhealthy resulting in periodontal disease and tooth decay. If periodontal disease or tooth decay becomes severe, teeth could be lost. Infection and inflammation could spread into the jawbone, blood vessels, nerve canals, and soft tissues of the body. Debilitating and life-threatening diseases could occur just from this leakage of infection and inflammation from the mouth into the body. This is called a “leaky mouth”.

One problem is that most healthcare professionals don’t realize that a “leaky gut” could be a dominant causal factor in a “leaky mouth”. A PubMed abstract published in December 2021 demonstrated how this could happen. In my mini-eBook, Is Your Gut Killing You?, I go into details citing over 295 peer-reviewed medical articles about the gut and its causal effects of chronic diseases, especially dental diseases.


Healthy Mouth – Leaky Mouth

Below is a graphic of a healthy mouth and a “leaky mouth”. The picture on the left shows a normal, healthy tooth in the jawbone. To the right is a picture of periodontal disease (the red area) beginning to penetrate the jawbone on its way to affecting the entire body.



The Solution

According to Alessio Fasano, MD, probably all chronic diseases start with a leaky gut. And periodontal disease and tooth decay are chronic diseases.

But don’t despair! Here’s what to do about it.

If you only treated a “leaky gut” but there already were advancing dental disease, the existing diseases in the mouth still will leak into the rest of the body if not treated appropriately. And if you only treated the dental problems without addressing a “leaky gut”, then there still would be chronic systemic inflammation coursing through the body from the damaged gut microbiome and its broken epithelial barrier.

Both niduses of infection must be treated simultaneously. Both the gut and the mouth are critical areas to be addressed.

A biologically oriented dentist could treat the mouth and gut at the same time. However, if the dentist was unfamiliar with the treatment of a “leaky gut”, he or she must refer the patient to a healthcare professional who knows the gut protocols for regaining gut health.

If a gut specialist is treating the gut but is unaware if there is a mouth infection, then he or she must refer the patient to a biologically oriented dentist for a thorough examination to determine if dental treatment is required.

Once again, I want to emphasize that both areas of infection and inflammation – a “leaky gut” and a “leaky mouth” – must be treated correctly and concurrently to stop the spread of disease to other parts of the body.


More Information

While a biological dentist can diagnose a “leaky mouth”, a “leaky gut” is harder to diagnose.

In my one-on-one, customized coaching program, I review your dental health, diet, gut health, medical history, and current symptoms. We take a holistic approach to your health and understand that everything is connected (because it is!). Also, I can work directly with your biological dentist.

What if you do suffer from a “leaky gut”? It is very treatable! A change in diet, enhancement of the gut microbiome, repair of the gut lining, and modification of some lifestyle choices make all the difference.

If you are wondering if you are suffering from a “leaky gut” or “leaky mouth”, let’s talk. I offer a complimentary 30-minute consultation. I’ll answer your questions, and together we’ll determine if we need to pursue a more detailed consultation process to get you back on track.


Schedule a ”30-Minute Free Consult” with me to answer some of your questions and determine if we are a good fit for a coaching program! CLICK HERE.


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Why Does Rick Have
No Dental Disease?

Dr. Al Danenberg Nutritional Periodontist

June 13, 2021 [printfriendly]

Meet one of your primal ancestors. He’s not your immediate relative, but he may be the origin of the human species. The picture above is his lower jaw (i.e., mandible).

This mandible is the oldest discovered remains of Homo Sapiens. It was dated to be about 300,000 years old and was unearthed in Morocco.

Let me personalize this guy. I’ll call him, Rick.


Rick’s Dental Health

I don’t know how old Rick was when he died. But by looking at Rick’s teeth, I would say he is at least 25-years old. I may be way wrong. He may be much older! Here is my reasoning.

Rick has all 16 of his lower teeth. The third molars (i.e., wisdom teeth), which are the last teeth to erupt in human jaws, appear in the mouth between the ages of 17 to 21. The red arrows in the picture below point to the wisdom teeth. So, he is at least 17 – 21 years old.

In addition, all the mandibular teeth have significant wear on the chewing surfaces. The wear patterns occur from chewing hard foods for a long time. Because of this, my guess is that he is at least in his mid-twenties.

But there is a fascinating lack of dental disease in this jaw. Rick does not have any tooth decay or periodontal disease that I can see. How can I tell?


Look at the yellow arrows in the picture below …

The yellow arrows point to healthy jawbone surrounding the roots of the teeth. If Rick had periodontal disease, the bone around the teeth would be melting away from the infection associated with periodontal disease. And if he had tooth decay, I would see obvious break down in the enamel structures of the teeth, which is not evident on these photos.

So, the next big question is, “Why does Rick have no tooth decay and no periodontal disease?”

We know that Rick did not go to his dental cave to have his teeth cleaned every six months or to have fluoride applied to his teeth to prevent decay. We also know that Rick didn’t have a toothbrush or dental floss to keep unhealthy dental plaque from building up around his teeth.


Look at the blue arrows in the picture below …

The blue arrows point to some “junk” between the teeth at the bone level. I believe this is dental calculus (i.e., dental tartar), which is the calcified dental plaque that was present in his mouth while he was alive.

Yes! Dental plaque was present in Rick’s mouth, and he didn’t have tooth decay or periodontal disease.

How could that be? Doesn’t dental plaque cause tooth decay and periodontal disease?


Dental Plaque is Healthy, Until It’s Not

Diet and the health of the gut play important roles in the health of the mouth.

Rick did not eat the junk food which civilized societies eat today. Also, his food didn’t include chemicals which are abundant in our food supply. In addition, he primarily ate large animals, nose-to-tail. We now know this from the research that Dr. Miki Ben-Dor published in his March 2021 peer-reviewed article in American Journal of Physical Anthropology.

Rick and his contemporaries had ideal nutrition.

Since their diet was healthy, their gut microbiome was healthy. I can assume their garden of gut bacteria was balanced and flourishing. A nutritious diet and robust gut allowed our primal ancestors’ immune system to function at peak performance. A healthy diet, a thriving gut microbiome, and an efficient immune system would create a balance in their mouth bacteria.

Essentially, all cells in the body communicate with one another in some fashion.

Rick’s healthy dental plaque around his teeth helped prevent tooth decay and periodontal disease. Healthy dental plaque is a natural biofilm, which provides three primary functions:

  1. The hundreds of bacterial species in healthy dental plaque together produce hydrogen peroxide to kill any invading pathogenic bacteria from getting into the gum crevices. If infection penetrated the gum margins around the teeth, it could lead to infection spreading under the gum, destroying the jawbone, and entering the blood system.
  2. Chemical buffers in healthy dental plaque help prevent acid levels from dropping below a pH of 5.5 around the teeth, which then could cause tooth decay.
  3. Healthy dental plaque acts as a gatekeeper allowing minerals from the saliva to enter the root surfaces 24 hours a day, 7 days a week to remineralize the tooth as needed.

In the US today, poor diets and gut dysbiosis are rampant. The result is a compromised immune system which leads to a leaky gut and chronic systemic inflammation. Systemic inflammation affects the mouth bacteria negatively and allows potentially pathogenic microbes to overgrow. In this compromised state, dental plaque changes into an unhealthy biofilm that causes tooth decay and periodontal disease. And the overgrowth of pathogenic microbes are fed by a poor diet consisting especially of refined sugar.

I go into more detail about this in my mini-eBook, Is Your Gut Killing You? In it, I cite 295 peer-reviewed medical papers to support my conclusions about the gut microbiome and its relationships to periodontal disease and other chronic diseases.



Rick had no visible dental disease because:

  • His diet was nutritious and anti-inflammatory
  • His gut bacteria were in balance and supported healthy digestion, absorption of necessary nutrients, and an intact gut lining
  • His immune system efficiently defended him from outside invading microbes
  • His healthy biofilm around his teeth (i.e., healthy dental plaque) maintained an environment of protection from tooth decay and periodontal disease

If we were to change our diet and lifestyle, we could prevent dental diseases and most other chronic diseases from getting a foothold. This may sound like Pollyanna talk, but it is possible and doable. An effort needs to be made, but you can achieve it.

I could guide you if you needed one-on-one assistance. I am here for you. Here is a link to my 12-Week Coaching Program.


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Periodontal Disease
– Doesn’t Start in the Mouth –

Dr. Al Danenberg Nutritional Periodontist

October 18, 2020 [printfriendly]



Periodontal disease does not start in the mouth! But it can spread from the mouth to everywhere else in the body.


It is true that irritations in the mouth from poor dental work, misalignment of teeth, broken teeth, chemicals in dental fillings, and various forms of trauma can cause inflammation and eventually infection in the mouth. I wrote a Blog where I discussed 14 hidden mouth splinters.


But most of the time, periodontal disease begins with unhealthy changes in the gut. Clearly, food starts its pathway into the body through the mouth. But if these foods are inflammatory, they can damage the gut and disturb the garden of bacteria.


If the gut becomes unhealthy, chronic inflammation will spread from there to all other areas of the body through the bloodstream and the mucosal tissues of the body. It will travel like the spikes of a wheel out from the center hub. The mouth is just one stop on the continuum of the progression of disease moving out from the gut.


I wrote a mini eBook in which I go into detail about the manifestation of chronic diseases emanating from the gut. In my eBook, I cite 295 peer-reviewed medical papers supporting my conclusions. I titled it, Is Your Gut Killing You?



The Dentist

The dentist has the perfect platform to identify periodontal disease. He or she sees their patients once or twice a year for checkup appointments. If there are signs and symptoms of gum disease, the dentist can begin educating the patient and treating the infection.  Treatment also should include definitive recommendations for gut health and nutritional counseling.


Unfortunately, most dentists don’t follow all these steps.


Of course, dentists treat the acute infections. In addition, they have their hygienist clean under the gums while reinforcing better flossing and brushing techniques. The dental team repairs the damage caused by periodontal disease. But treating the gut and providing personalized nutritional counseling are often neglected.


Here is a question for dental professionals: “How often does the same patient return for future checkup appointments with continued bleeding gums and progressing periodontal problems?” Repeated oral hygiene instruction – visit after visit – may not provide the anticipated results. Repeated antibiotic treatment may not resolve the disease permanently but will cause collateral damage.


I suggest an in-depth evaluation of the patient’s eating habits. A patient could record what she or he eats in a 3-Day Food Journal. This document could be repeated annually and become a permanent part of the patient’s dental record. A patient’s food journal will become a history of how and what he or she eats.


I also suggest a thorough program to repair and restore the health of the gut.


This complete treatment plan that includes active periodontal therapy, diet intervention, and gut healing will assure more lasting improvements.



Active Periodontal Treatment

Active infection must be addressed ASAP. Again, the dentist is the perfect professional to start oral treatment. Dentists are trained extremely well to treat damage in the mouth. No other healthcare professional is equipped to do what a well-trained dentist can do.


Sometimes, a therapeutic mouthwash or antibiotic for a few days is required at first to bring the acute infection under control. Sometimes extractions, fillings, or repair of broken teeth must be started immediately. Possibly, all that might be necessary is good oral hygiene and maybe a deep cleaning around the teeth to take care of early inflammation and infection. In more advanced cases, surgical procedures as well as cutting-edge laser treatment to repair and regenerate bone destruction might be required.


But the underlying biological causes need to be discussed and corrected. Only treating the mouth without treating the gut and improving the diet is akin to only prescribing pain medicine for a headache with serious underlying causes.



Diet & Gut

Three specific human studies[1],[2],[3] show that improving the diet will return the oral microbiome to a healthy state, reduce bleeding of gums, and prevent periodontal disease from getting started. These benefits occurred within 30 days without the participants performing regular oral hygiene! The nutrients in the diet and the avoidance of harmful irritants in processed foods improved the gut, the immune system, and the health of the mouth with no other treatment required.


Other studies have shown that repairing the gut will reduce chronic systemic inflammation.[4],[5],[6] The gut epithelial barrier is the most reparative tissue in the body. Within 5-7 days, the entire gut lining is renewed and will stay that way unless it is repeatedly irritated over and over again.


Therapeutically, the quickest and most efficient means to treat the underlying causes of periodontal disease is to embrace a nutrient-dense, anti-inflammatory way of eating. In addition, spore-based probiotics and other supplements will improve the garden of bacteria in the gut and heal its lining.


My Better Belly Blueprint describes a proven diet to support the body’s requirements of nutrition. My Protocol to Restore Healthy Gut Bacteria is a verified method to assist gut healing. Let me know if you have questions. (Dr.Danenberg@iCloud.com)



Summing Up

For the most part, periodontal disease starts in the gut. However, treatment (especially if the infection is acute) must start in the mouth as soon as it is diagnosed.


But a comprehensive treatment plan needs to involve the mouth and the gut. Treating an unhealthy gut and advocating a nutrient-dense, anti-inflammatory diet will help prevent chronic systemic inflammation emanating from the gut. In the dental world, that means a healthier mouth free of periodontal disease. It also means improved overall wellness.


[1] https://pubmed.ncbi.nlm.nih.gov/19405829/

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4962497/pdf/12903_2016_Article_257.pdf

[3] https://pubmed.ncbi.nlm.nih.gov/30941800/

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6834154/

[5] https://pubmed.ncbi.nlm.nih.gov/31894861/

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561432/



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COVID-19, Gum Disease, & Diet

Dr. Al Danenberg Nutritional Periodontist

May 18, 2020 [printfriendly]



You might be scratching your head and asking yourself, “What is he talking about? Is he just trying to catch my attention? Maybe even confuse me?”


Well, I’m talking about the correlation between COVID-19, Gum Disease, and Diet. That connection is our immune system. And yes, I want your attention so I can share my thoughts about this association, your overall health, and your well-being. I certainly don’t want to confuse you.




New research is suggesting that the COVID-19 virus could be life-threatening by initially damaging red blood cells[1] and causing hypoxia[2]. The theory goes like this:


  • The virus attacks red blood cells by attaching to the iron portion of its hemoglobin.
  • The virus oxidizes the iron and releases it into the bloodstream.
  • Then, the COVID-19 virus replaces the iron with itself in the red blood cell.
  • The virus controls the red blood cell, which now is unable to carry necessary oxygen to other cells and organ systems. This results in hypoxia.
  • The oxidized iron pours into the bloodstream causing severe oxidative stress, which causes systemic inflammation initiated by the immune system.
  • Zinc in the body mobilizes itself to offset the damage from the free-floating oxidized iron thereby depleting the body of its necessary levels of zinc. This can cause a loss of smell and taste among other effects.
  • The oxidative stress from excessive iron, severe systemic inflammation as a result of the immune system’s overproduction of inflammatory chemicals (cytokines), and hypoxia can cause the lungs and other organs to fail, possibly leading to death from COVID-19.



This is just a theory. So much is being learned about the virus day by day. But this theory makes sense. It could result in the clinical signs and symptoms of this pandemic that are being observed and documented throughout the world.[3]



Gum Disease

The gum tissues in your mouth are susceptible to chronic systemic inflammation. The oxidative stress occurring from an excess of unhealthy oxidized iron causes the immune system to create acute and chronic systemic inflammation. These physiological changes cause dysfunction in the immune system – especially if the immune system was already weakened or dysfunctional from emotional stress, environmental toxic substances, an unhealthy gut, or poor diet choices.


Active gum disease will increase as the immune system fails to control the overgrowth of harmful bacteria in the mouth. Periodontal infection will release virulent bacteria and inflammatory elements into the bloodstream complicating the already spreading systemic inflammation. Inflamed and bleeding gums will increase the potential for increasingly destructive forces occurring from the COVID virus.




A diet including inflammatory foods and lacking nutrient-dense foods will damage the gut’s garden of bacteria, its mucous layer, and its epithelial barrier. The result will be the leakage of toxic substances into the bloodstream from the lumen of the gut. The immune system attempts to gobble up these toxic substances by releasing various chemicals and cells to fight the invasion. These immune system actions create inflammation that spreads throughout the circulatory system to all organ systems. However, if you have periodontal disease and if the COVID-19 virus is present, then your immune system already could be overwhelmed.



Vicious Cycle

A weakened immune system, active periodontal disease, and unhealthy food choices continue to promote chronic systemic inflammation. If COVID-19 invades the body, the existing chronic systemic inflammation will exacerbate the potential virulence of the virus.


So, there could be a vicious cycle escalating exponentially.


Fortunately, the far majority of infected people will not succumb to death. Their body’s immune system will overcome the virus at a point where the virus is inactivated by the antibodies that are naturally produced by the adaptive immune system. Other negative feedback pathways will go into effect and reduce the immune system’s production of inflammatory chemicals. But there are proactive precautions that uninfected individuals could take to enhance their immune system.


I’ve talked about how to improve the immune system in previous blogs – especially HERE. But in summary, a nutrient-dense, anti-inflammatory diet along with lifestyle changes will enhance the health of the gut and provide the immune system with many of the necessary ingredients to defend your body.


Supplements of vitamin C, vitamin D, glutathione, and zinc have been suggested to help prevent or possibly treat COVID-19 infection. However, along with lifestyle changes, the nutrient-dense, anti-inflammatory diets I have recommended will provide most of these nutrients in their natural states as they exist in real, unprocessed foods.


Medical research will come up with an adequate treatment protocol to deal with the acute and life-threatening manifestations of the COVID-19 virus. Scientists also may develop an effective vaccine or an array of vaccines to protect people prior to the invasion of the COVID-19 virus. But your proactive efforts to support your immune system will also help with fighting the virus, preventing periodontal disease, and avoiding other chronic diseases. A healthy immune system will go a long way in maintaining your well-being.



[1] https://chemrxiv.org/articles/COVID-19_Disease_ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin/11938173

[2] https://www.hemob.org/covid19-news/2020/4/8/coronavirus-pneumonia-and-hydroxychloroquine

[3] https://www.jillcarnahan.com/2020/04/16/emerging-theories-that-may-help-us-solve-the-covid-19-puzzle/



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Melatonin & Periodontal Disease
– A Curious Connection –

Dr. Al Danenberg Nutritional Periodontist

February 10, 2020 [printfriendly]



What do you know about melatonin?


When I asked several friends that question, basically they said, “It’s a supplement that helps you go to sleep.” That would have been my response before learning the numerous and diverse functions of melatonin in the body – especially the curious connection with periodontal disease. Another unusual fact is that melatonin is not only produced in the brain; it’s also independently synthesized in the gut?


Let me guide you down the path to understand some of the fascinating functions of melatonin in your body. Then, I’ll suggest some ways to improve your levels of melatonin naturally.




Melatonin is the “sleep hormone”, but it’s so much more than that.


The pineal gland produces melatonin. This gland is a small structure located near the center of the brain. Melatonin is generally known for the regulation of your sleep cycle (also called the circadian rhythm). Your pineal gland begins secreting melatonin around sundown and peaks around 2 – 4 AM. As melatonin increases in your brain and then your circulation, your body begins to prepare for sleep. You will become tired. However, if you use artificial light at night, your body will slow down its production of melatonin. Falling asleep could become a problem. That’s when many people turn to melatonin supplements to help them fall asleep.


Supplements are available in a natural form or a synthetic form. If you do take a supplement of melatonin, the long-term use could cause your pineal gland to reduce its production of melatonin or even shut down its production if you’re using a high dose for an extended period of time. A better option might be to eat foods high in tryptophan, an amino acid that is the precursor to melatonin. To help your body produce more melatonin naturally, I’ll summarize some ideas at the end of this article.


Melatonin has many other functions other than affecting sleep. It turns out that melatonin has been identified in the gut. And its synthesis in the gut is independent to the production of melatonin by the pineal gland. As a matter of fact, the gut contains at least 400 times more melatonin than the pineal gland. The creation of melatonin in the gut is not related to the sleep cycle or light exposure. It appears that melatonin production in the gut helps with all healthy gut functions.


Another function of melatonin is that of an energy hormone. When melatonin levels increase, your energy level goes down. Conversely, when melatonin levels decrease, your energy level goes up. Melatonin is also an effective antioxidant. It might function in the body as a cancer-preventing biochemical. In addition, melatonin has positive effects on the function of your brain, heart, gut, circulatory system and your immune system. That’s a lot of work coming from the simple hormone called melatonin.


Two major effects of melatonin are to protect mitochondria and to repair dysfunctional mitochondria. The mitochondria are the batteries of your cells creating the necessary energy that every cell in your body must rely on to function efficiently. Mitochondria are like the batteries in a flashlight. When the batteries start to run down in a flashlight, the light will dim. Eventually, if the batteries lose all their power, the light from the flashlight will go out. Likewise, if the mitochondria are functioning less than they should, the cellular tissue cannot function properly, and it will slow down. If the mitochondria fail to create the necessary ATP for the cell, the cell could ultimately die. However, melatonin has potential to recharge weakened mitochondria and restore its ability to continue to produce ATP efficiently for the cell.


Melatonin also works with Vitamin D to prevent diseases which are intimately and intricately affected by the status of vitamin D and melatonin in your body.



Melatonin and Periodontal Disease

There are so many biological functions for melatonin as I already described. But this hormone also is necessary of periodontal health.


A medical trial published in 2013 reported that patients with active periodontal disease had reduced levels of melatonin compared to healthy individuals. And as early gum inflammation progressed to more advanced periodontitis, the levels of melatonin in the saliva and the gum tissues decreased.


Since melatonin has been shown to have anti-inflammatory actions in general, a study was designed to evaluate melatonin’s targeted effects on periodontal disease. Participants in the study consisted of those who had active periodontal disease and diabetes. Healthy subjects were used as controls. The researchers used a topical solution of melatonin and applied it to the gum tissues of those with active periodontal disease and those with healthy gums. The results of the experiment were published in 2015 and showed that topical melatonin would help heal the gums of those patients with active periodontal disease. Specifically, gum bleeding and pocket depths decreased as well as systemic biomarkers of IL-6 and CRP decreased.


To delve a little deeper, a detailed study was published in 2016. This study investigated the effects of melatonin on the virulent bacterium Porphyromonas gingivalis (P. gingivalis) and the severe inflammation caused by this bacterium. P. gingivalis is one of the most pathological bacteria involved with periodontitis – the aggressive form of periodontal disease that destroys the jawbone surrounding the roots of the affected teeth. The investigators showed that melatonin could inhibit the growth of P. gingivalis and its surrounding biofilm. The takeaway message from this study is that melatonin could be used as adjunctive treatment for patients with active periodontal disease.


Another study published in 2014 proved that melatonin can help bone grow. This is important since active periodontitis causes bone loss in the bone surrounding the infected teeth. If melatonin will help bone grow, it might be beneficial during the treatment of periodontitis.


So, melatonin has the potential (1) to repair mitochondria that become dysfunctional in periodontal disease, (2) to inhibit the pathological growth of P. gingivalis, (3) to decrease inflammation, and (4) to potentially assist with bone repair.


It appears that your natural production of melatonin can prevent periodontal disease or help heal the body from periodontal infection. However, if your sleep cycle is disturbed because of use of light at night (especially blue light from computers and artificial lighting), working the night shift, or disease of the pineal gland, then you will produce significantly less melatonin and be more susceptible to periodontal disease and bone damage. Also, if your gut is not healthy, then the production of melatonin in the gut could be compromised.



Natural Ways to Increase Melatonin

Eat nutrient-dense anti-inflammatory foods and especially avoid processed foods which contain chemicals and other harmful substances.


  • Include foods high in tryptophan (ex. chicken, eggs, cheese, fish, turkey).
  • Try to sleep between 7 to 9 hours per night.
  • Stop drinking caffeine or eating caffeine foods after 2PM.
  • Don’t eat shortly before bed.
  • Avoid exercise before bed.
  • Sleep in a dark and cool room. (Electronic devices like a computer screen, a cell phone, and a TV will emit blue light, which greatly suppresses melatonin and prevents you from getting sleepy. If you must use an electronic device, use the adjustment for “night shift” to filter out the blue light.)
  • Use relaxation techniques like meditation before bed.



The impact of melatonin on our body is impressive. Its relationship to a healthy mouth is one more reason to be sure your sleep cycle is healthy so that it produces melatonin efficiently. But also, the fact that the gut produces its own melatonin is another compelling reason to maintain a healthy gut through diet, efficient exercise, stress reduction, and restorative sleep.



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Periodontal Disease
Could Be Killing You

Dr. Al Danenberg Nutritional Periodontist

December 30, 2019 [printfriendly]




Periodontal Disease Could be Killing You


Periodontal disease could be killing you. It is often considered a causal factor for many chronic diseases. But you need to know the complete story – not just part of it. While periodontal disease could be a nidus for chronic systemic inflammation and spread of infection, this is only part of the story. The story has a Beginning, a Middle, and an Ending. Let’s start in The Middle.



The Middle

Dental plaque is healthy until it’s not healthy.[1]


Periodontal disease develops from unhealthy dental plaque. Unhealthy plaque results when healthy plaque is transformed into unhealthy dental plaque because of an underlying compromised immune system and unhealthy food choices. It’s fundamental for you to appreciate that a compromised immune system has its roots in unhealthy changes in the gut (i.e. gut dysbiosis) [2],[3], which causes chronic systemic inflammation.


A compromised immune system and unhealthy food choices could allow the hundreds of bacteria in dental plaque to get out of balance and become unhealthy.[4],[5] Then, unhealthy bacteria could proliferate and cause the progression of advanced gum disease[6].


One of the most virulent bacteria in periodontal disease is Porphyromonas gingivalis (P. gingivalis).[7],[8] Among other self-protective measures, this bacterium produces a biofilm, which is resistant to the body’s immune defenses.[9] As the body continues to fight the resistant P. gingivalis, additional chronic inflammation results. This chronic inflammation can cause the tissues surrounding the infected gum spaces to break down allowing their toxic elements to leak into the general circulation. Additionally, autoimmunity may play a role in the progression of periodontal disease.[10]


It is important to remove unhealthy plaque through an efficient personal oral hygiene protocol performed daily. However, it is also critical to understand that gut dysbiosis leads to pathological changes in the healthy community of bacteria in the mouth. Therefore, gut dysbiosis must be treated to restore oral health, along with removing unhealthy dental plaque. I must emphasize that it is unhealthy to indiscriminately kill bad bacteria as well as good bacteria in the mouth by using antimicrobial mouthwashes or antibiotics on a daily basis.[11]


It also is vital to be aware of periodontal disease because its prevalence is at epidemic proportions. In 2010, a published paper demonstrated that 93.9% of adults in the United States had some form of gingivitis.[12] And in 2012, the Centers for Disease Control and Prevention (CDC) published their results in the Journal of Dental Research. The report was recently updated in 2015 in the Journal of Periodontology.[13] It showed the prevalence of periodontitis was estimated to be 47.2% for American adults (approximately 64.7 million people). For adults 65 years old and older, the prevalence jumped to 70.1%. These findings were the result of the most comprehensive periodontal evaluation performed ever in the US.


So, statically you most likely have some form of periodontal disease, and it must be treated completely. Otherwise, once periodontal disease is established in the mouth, its pathological byproducts can seep into the bloodstream, lymph fluid, and bone structures to cause spread of infection and inflammation to all areas of the body. This mechanism of seeping into the body’s circulation is similar to the way that an unhealthy gut causes leakage of toxic elements into the bloodstream (i.e. leaky gut) – both creating chronic systemic inflammation.


The eventual result of chronic systemic inflammation is chronic disease.[14],[15],[16] The Centers for Disease Control and Prevention stated that 60% of Americans live with at least one chronic disease, and chronic diseases are responsible for 70% of deaths each year in the United States.[17] Therefore, periodontal disease could be a source of degenerative chronic diseases originating from chronic systemic inflammation.




The Beginning

Interestingly, there are three human research studies that showed a healthy diet alone can improve the health of the mouth. These studies also determined that removing dental plaque by brushing and flossing was not essential to improve oral health as long as diet was corrected. Specifically, the investigators demonstrated that changing from a diet abundant in high-processed-carbohydrate and inflammatory foods to a diet excluding high-processed-carbohydrate and inflammatory foods will decrease signs of gum inflammation.[18],[19],[20] However, active periodontal treatment will be necessary if gum inflammation progresses into periodontitis, which destroys the jawbone surrounding the teeth.


In February 2019, a medical research article was published in Biomedical Journal[21] entitled, “Association between periodontal pathogens and systemic disease”. The authors describe the correlation between periodontal disease and various chronic diseases and outcomes such as cardiovascular disease, gastrointestinal and colorectal cancer, diabetes and insulin resistance, Alzheimer’s disease, respiratory tract infections, and adverse pregnancy outcomes. The authors go on to state that there are conflicting studies, which try to prove causal relationships. However, there is significant research to show a strong correlation.


In another article published in August 2019 by Hashioka et al[22], the authors reviewed medical research that indicates a causal relationship between periodontal disease and various neuropsychiatric disorders including Alzheimer’s disease, major depression, Parkinson’s disease, schizophrenia, as well as the neurological event of ischemic stroke. The initiating cause of these neurological diseases is neuroinflammation, which is induced by chronic systemic inflammation. Periodontal disease causes chronic systemic inflammation by the release of pro-inflammatory cytokines and the invasion of periodontitis bacteria (specifically P. gingivalis) along with their inflammatory components (lipopolysaccharide or LPS) into the systemic circulation. Chronic systemic inflammation will activate the microglia, the immune cells in the brain, creating neuroinflammation.


But I want to emphasize again that systemic chronic inflammation is the result of a leaky gut from gut dysbiosis in most cases.


In essence, my research suggests that periodontal disease is not the seed of all systemic disease. As I suggested above, periodontal disease is just one of many chronic diseases occurring on the continuum of the spread of chronic systemic inflammation that starts in the gut. Since the mouth is visible and easy to examine, the mouth may be the first clinical area where disease is diagnosed. And as I mentioned earlier, the prevalence of periodontal disease is at epidemic proportions.


Once systemic disease spreads, a vicious cycle begins because all tissues affect all other tissues in the human body. All mucosal tissues use “crosstalk” to communicate with other tissues.[23],[24],[25]


I should point out that unhealthy bacteria in the mouth in turn can interact further with unhealthy bacteria in the gut, and vice versa.[26]  In the case of periodontal disease, treatment for cascading chronic diseases must include healing both the unhealthy gut and the unhealthy mouth. But for the most part, the origination of mouth disease is in the gut before becoming visible in the mouth and other areas of the body.



The Ending

To stop periodontal disease and prevent this infection from entering the systemic circulation, the infection must be treated efficiently. Treatment may often consist of a dentist, hygienist, or periodontist removing irritants that have become lodged under the gum tissues and initiating inflammation and infection. Removing these irritants will assist the body in healing.[27] In more advanced stages, surgical procedures may be necessary to arrest this disease. Whatever treatment is necessary, an effective oral hygiene program should be instituted at a frequency based on the patient’s ability to take care of his or her mouth. The individual also must have a personal oral hygiene protocol to maintain a healthy mouth.


But whatever periodontal treatment is required, complete treatment must include repairing the gut, restoring the healthy balance of bacteria in the gut, and avoiding unhealthy processed foods and inflammatory foods.



[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4132376/

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5892391/

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5937375/

[4] https://www.ncbi.nlm.nih.gov/pubmed/28476771

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5126660/

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3653317/

[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4744328/

[8] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4276050/

[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4925967/

[10] https://www.ncbi.nlm.nih.gov/pubmed/?term=10.1016%2Fj.autrev.2016.09.013

[11] https://www.ncbi.nlm.nih.gov/pubmed/28353075

[12] https://www.ncbi.nlm.nih.gov/pubmed/?term=20437720

[13] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4460825/

[14] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5520251/

[15] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5359961/

[16] https://www.ncbi.nlm.nih.gov/pubmed/28835673

[17] https://www.cdc.gov/chronicdisease/center/index.htm

[18] https://www.ncbi.nlm.nih.gov/pubmed/19405829

[19] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4962497/pdf/12903_2016_Article_257.pdf

[20] https://www.ncbi.nlm.nih.gov/pubmed/?term=10.1111%2Fjcpe.13094

[21] https://www.sciencedirect.com/science/article/pii/S2319417018302634?via%3Dihub

[22] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6695849/

[23] https://onlinelibrary.wiley.com/doi/abs/10.1111/cea.12723

[24] https://www.ncbi.nlm.nih.gov/pubmed/?term=10.1016%2Fj.cyto.2017.01.016

[25] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6266996/

[26] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5028810/

[27] https://www.ncbi.nlm.nih.gov/pubmed/31849397



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Dental Disease Starts in the Gut
– Who’d A Thunk It? –

Dr. Al Danenberg Nutritional Periodontist

November 5, 2019 [printfriendly]




Dental Disease Starts in the Gut


Tooth decay and gum (periodontal) disease are the major dental diseases afflicting all of us. The prevalence of these diseases is staggering. About 93% of US adults have had tooth decay during their life. And about the same percentage have some form of active gum inflammation. These statistics suggest there is an epidemic of dental disease in the United States.


So, why is dental disease at epidemic proportions? Is dental plaque not being removed completely from around teeth?


Dental plaque is not the only reason. Although it is important to clean your mouth appropriately.



Dental Plaque

We only need to look at our primal ancestors for some answers. If you were to examine human dental jaws from 10,000 years ago to 20,000 years ago, you would find there are minimal tooth decay and minimal damage in the bone around the teeth. In other words, there is little evidence of dental disease.


However, these jaws show there is a great deal of tartar (i.e. calculus) at the tooth-jawbone margin. Calculus is mineralized dental plaque. Therefore, our primal ancestors rarely had tooth decay or periodontal disease, but they had huge amounts of dental plaque.


So, it’s not healthy dental plaque that is the culprit for tooth decay or gum disease. Science suggests that it is unhealthy dental plaque causing dental disease. Then the question becomes, “How does healthy dental plaque become unhealthy dental plaque?”



The Gut

The answer lies in our gut and in our immune system. Our immune system is responsible to keep us healthy. It is also responsive to the health of the bacteria in the gut. These “gardens of bacteria” in our gut play many critical roles for the overall health of our body. When the gut microbiome becomes out-of-balance (i.e. gut dysbiosis), then the immune system becomes compromised and gets out of-whack.[1]


Once the immune system is compromised, all mucosal tissues in the body are affected. This includes the microbiome in the mouth. When the oral microbiome becomes unbalanced, the composition of dental plaque becomes unhealthy. Pathologic forms of bacteria expand. The pathological bacteria overgrow and result in unhealthy dental plaque. This unhealthy dental plaque is the culprit for tooth decay and periodontal disease.


Specific foods like added sugars and over-processed carbohydrates can encourage pathological forms of bacteria to continue to proliferate in the mouth. Also, these foods can aggravate and worsen gut dysbiosis. Now, there is a vicious cycle in play that promotes ongoing disease.


Several studies have shown that replacing an unhealthy processed food diet with a nutritious, anti-inflammatory diet will improve the bacterial dental plaque. Even without brushing and flossing, the bacterial plaque will become healthier, and pathologic bacteria will become balanced among the approximately 700 species of bacteria in the plaque. And these three human studies show that it will only take 30 days for this to occur. (HERE), (HERE), and (HERE)


Proper diet will accomplish much. But frequently, you can include several supplements in your daily routine to improve the diversity and quality of bacteria in the gut. My protocol to improve the gut bacteria includes these supplements:


  • MegaSporeBiotic to repopulate the gut bacteria with healthy and diverse strains
  • MegaPrebiotic to feed the good bacteria in the gut
  • MegaMucosa to improve the mucous layer in the gut the lines the epithelial barrier, which keeps the bad stuff out of the blood system and allows all the necessary nutrients to enter the blood stream.



Bottom Line

So, to obtain the best health in your mouth, you should:

  • Clean your mouth appropriately
  • Eat nutrient-dense, anti-inflammatory foods
  • Repopulate the healthy bacteria in your gut
  • Feed the healthy bacteria in your gut with necessary fibers
  • Assure the mucous layer in your gut is healthy


If you contact me by email, I will send my protocols for (1) a nutrient-dense, anti-inflammatory diet, (2) how to clean your mouth, and (3) how to restore healthy bacteria in your gut. Send your request to: DrDanenberg@icloud.com


[1]  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6567014/  



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Newest News:
Gut, Periodontal Disease, & RA

Dr. Al Danenberg Nutritional Periodontist

October 7, 2019 [printfriendly]




Newest News


Dentists need to be aware; medical doctors need to be aware; patients need to be aware.


The newest news and research are uncovering an important truth. The truth is that a healthy gut and its healthy microbiome are critical for the avoidance of most – if not all – chronic diseases. And a damaged gut could be the source of many diseases. It’s interesting that over 2,000 years ago, Hippocrates was reported to say that “all disease begins in the gut”. Maybe he knew something that we are just beginning to comprehend and to prove.


As you know, I have written about the gut microbiome and the importance of restoring it to a healthy state. The food we eat, the substances we avoid, and our overall lifestyle affect the gut. Specifically, these affect the bacteria in the gut, the gut’s protective mucosal layer, and the all-important epithelial layer that separates the lumen of the gut from the rest of our body. The healthy gut lining is the gatekeeper that allows nutrients that our body requires to enter our bloodstream and protects us from all the other junk in the gut that the body does not need.


Many scientific articles have been published that prove the direct causal effects of the gut microbiome on the health of various organ systems.


A 2019 medical article published in the International Journal of Molecular Sciences reviews the newest research and discusses the potential connections between periodontal disease, rheumatoid arthritis, and the health of the gut.


In essence, this paper supports the theory that periodontal disease and rheumatoid arthritis may have their beginnings in an unhealthy gut. Yes, the gut!


If this theory is correct, then effective treatment should include the restoration of a healthy gut as well as specific treatment modalities for both periodontal disease (PD) and rheumatoid arthritis (RA).



Periodontal Disease

PD is the most common cause of tooth loss and one of the world’s most prevalent chronic inflammatory diseases. Pathologic bacteria around the tooth margins at the gum line penetrate the tissues and create a cascading progression of inflammation in the soft tissues. Often this leads to bone destruction around the roots of the teeth. The causes of this chronic disease are considered to be multifactorial. Genetic predisposition and a compromised immune system are two major factors that allow an unhealthy balance of bacteria in the mouth to progress to PD.


Rheumatoid Arthritis

RA is a chronic autoimmune disease. Patients with RA experience synovial inflammation and hyperplasia leading to irreversible damage of the cartilage and bone in the joints, loss of function, chronic pain and progressive joint disability. The causes of rheumatoid arthritis are multifactorial like periodontal disease, and these causes are similar to those of PD.



Gut Connection

Unhealthy changes in gut bacteria will create a series of changes in the immune system. These changes will cause specific bacteria (P. gingivalis and A. actinomycetemcomitans) to proliferate. Both of these bacteria can lead to local protein alterations by process called “citrullination”. Citrullination is the conversion of the amino acid arginine into the amino acid citrulline. Evidence suggests that increased citrullination may participate in tissue destruction associated with periodontal disease and rheumatoid arthritis. Citrullination may be a key mechanism allowing both PD and RA to affect one another.


Treating an unhealthy gut will not automatically treat periodontal disease or rheumatoid arthritis. But a healthy gut could be an important therapeutic result for an inclusive treatment plan for both diseases.


I have developed a Protocol to Restore Normal Gut Bacteria, which I could send in a PDF. Email me at Al@DrDanenberg.com, and I will send it to you.



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