3 Failures in Dentistry

Dr. Al Danenberg Nutritional Periodontist

May 6, 2019 [printfriendly]


3 Failures in Dentistry


Dentists help repair or remove broken, damaged, and diseased teeth. Dentists also help replace missing teeth, correct bite and airway problems, and create beautiful smiles. And dentists help treat the results of many acute and chronic infections in the mouth. Unfortunately, dentistry fails the public in several other critical areas.


Here is my take on 3 Failures in Dentistry:


  1. Not informing patients of potentially toxic elements that are used in dental treatment and their potential consequences in the body.
  2. Not educating patients adequately and in-depth about the obscure and underlying causes of dental diseases.
  3. Not emphasizing the causal relationships between the gut, the mouth, and the overall health of patients.


I know I will get quite a bit of blowback from my comments in this blog. My intention is to bring to the forefront the weaknesses of my profession so that dental professionals and dental educators can improve the delivery of oral healthcare, which ultimately affects overall health. Also, my intention is to help the public understand the failures I’ve stated and ask intelligent questions to their healthcare professionals.




If dentists were successfully treating and preventing dental diseases, then the prevalence of periodontal disease and tooth decay should be very low. However, dental diseases are at epidemic levels.



Prevalence of Periodontal Disease Today

In 2010, a published paper revealed that 93.9% of adults in the United States had some form of gingivitis.[1]


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.[2] 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.



Prevalence of Tooth Decay Today

The CDC’s National Center for Health Statistics reported from its most recent data approximately 91% of U.S. adults aged 20–64 had dental caries in permanent teeth.[3] The prevalence increases to 93% for those above 65 years old.[4]


The World Health Organization has stated that dental decay is one of the most infectious, non-communicable diseases globally.[5]



Addressing the 3 Failures

1: Understand potential toxicities

Many dental materials, medicaments, and procedures are used routinely in the dental office. And many of them have been shown to be potentially toxic to human cells. Of course, toxicity usually depends on the dose and the frequency of exposure. But if a toxic element is in the mouth 24/7, then its presence could be potentially harmful.


As you may know, I am treating my aggressive form of multiple myeloma through various unconventional protocols. I believe my bone marrow cancer was directly related to my excessive exposure to various toxic elements in dentistry – especially my continued exposure to mercury and ionizing dental radiation while in dental school and during my early years in practice. Yet, there is no way I can prove this.


I’ve listed a few of the substances and procedures that are frequently used in the dental office that might be toxic for some patients and the dental team. I also have provided links to peer-reviewed articles that go into detail about their toxicities:


  • Methacrylate[6]
  • Mercury amalgams[7]
  • BPA in some composite materials[8]
  • Fluoride products[9]
  • Titanium[10]
  • Nitrous oxide[11]
  • Chlorhexidine[12]
  • Antimicrobial mouthwashes[13]
  • Peroxide at-home bleaching[14]
  • Ionizing dental radiation[15]



2: Learn about obscure causes of dental diseases

Three human studies clearly show that nutrition is the critical element to a healthy mouth – Baumgartner (2009)[16], Woelber (2016)[17], Woelber (2019)[18]. I have described these results many times. Each of these studies determined that removing dental plaque by brushing and flossing was not critical to improve oral health as long as diet was corrected. Specifically, the researchers 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 disease.


In a paper published in the Journal of Dental Research in 2015, Aubrey Sheiham summarized many peer-reviewed research articles, which clearly showed that free-sugars were required to cause tooth decay.[19] And the removal of free-sugars from the diet greatly reduced or eliminated tooth decay.



3: Study the causal relationships within the body

Detrimental lifestyle, toxic elements in the environment, toxic substances accumulating in the body, and inflammatory foods are major factors that can damage the gut and create unhealthy gut bacteria (gut dysbiosis). Leakage from a damaged gut into the bloodstream and into the lymph fluid can cause systemic chronic inflammation and a compromised immune system. Both systemic chronic inflammation and a compromised immune system can cause havoc in other body tissues including the mouth.


In the mouth, these may cause an overgrowth of pathological bacteria. Unhealthy food choices will continue to feed the pathological bacteria. As you know, unhealthy bacteria will cause periodontal disease and tooth decay. Dental diseases potentially could affect all other areas in the body causing a vicious back-and-forth cycle between the mouth, the gut, and other tissues of the body.




The 3 failures in dentistry should be addressed and corrected. Dentists need to (1) inform patients about potential toxicity from dental procedures and only use the most biocompatible materials, (2) learn about the obscure causes of dental diseases, and (3) become knowledgeable about causal relationships within the body.



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

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

[3] http://www.nidcr.nih.gov/DataStatistics/FindDataByTopic/DentalCaries/DentalCariesAdults20to64.htm

[4] http://www.nidcr.nih.gov/DataStatistics/FindDataByTopic/DentalCaries/DentalCariesSeniors65older.htm

[5] http://apps.who.int/iris/bitstream/10665/149782/1/9789241549028_eng.pdf

[6] https://www.ncbi.nlm.nih.gov/pubmed/30099197

[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6466133/

[8] https://www.ncbi.nlm.nih.gov/pubmed/25813067

[9] http://www.ncbi.nlm.nih.gov/pubmed/27199224

[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5216395/

[11] https://www.ncbi.nlm.nih.gov/pubmed/29859645

[12] https://www.ncbi.nlm.nih.gov/pubmed/28510277

[13] https://link.springer.com/article/10.1007%2Fs11906-017-0725-2

[14] https://www.ncbi.nlm.nih.gov/pubmed/27091347

[15] https://fb.cuni.cz/file/5700/FB2013A0027.pdf

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

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

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

[19] https://www.ncbi.nlm.nih.gov/pubmed/?term=Diet+and+Dental+Caries%3A+The+Pivotal+Role+of+Free+Sugars+Reemphasized



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Does Periodontal Disease Cause Systemic Disease?

Dr. Al Danenberg Nutritional Periodontist
April 22, 2019 [printfriendly]




Periodontal Disease and Systemic Disease 


Yes, but… How’s that for an answer that keeps you hanging? Let me explain.


Yes – 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. In this way, periodontal disease can cause systemic disease.


But… – Although periodontal disease is a focus of infection around the teeth, it has its origin in an area that is remote from the mouth. The gut is the seed to the manifestation of most systemic chronic diseases, which periodontal disease is just one of many.



Recently Published Article

In February 2019, a medical research article was published in Biomedical Journal[1] titled, “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.



Cause of Periodontal Disease

Dental plaque is healthy until it’s not healthy.[2] 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. The compromised immune system has its roots in unhealthy changes in the gut. [3],[4]


Interestingly, there are three human 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 critical 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 disease.[5],[6],[7]



My Theory of Systemic Chronic Disease

My research suggests that periodontal disease is not the seed of all systemic disease. I believe that periodontal disease is just one of many chronic diseases on the continuum of the spread of systemic disease 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. But the ultimate starting point is in the gut before becoming visible in the mouth and other areas of the body.


Once systemic disease spreads, a vicious cycle begins because all tissues affect all other tissues in the human body. Tissues use “crosstalk” to communicate with other tissues.[8],[9],[10]


My theory starts in the gut. Unhealthy changes in the gut microbiome are called gut dysbiosis.


The gut microbiome, the intestinal mucus layer, and the epithelial lining of the gut become damaged from potentially many different influences. Detrimental lifestyle, toxic elements in the environment, and inflammatory foods are major contributors that can damage the gut and create gut dysbiosis. Leakage from a damaged gut into the bloodstream and into the lymph fluid can cause systemic chronic inflammation and a break down in the body’s ability to fight infection. Both will affect all other tissues in the body.


I wrote an article where I described my theory of how chronic disease is created in the body. I cite over 30 peer-reviewed medical articles to support my views. My paper, Big Bang Theory of Chronic Disease, was published in-part in 2018 in Well Being Journal, Volume 27, #2. If you would like the PDF of this article, email your request to: Dr.Danenberg@iCloud.com.



The Mouth

In the mouth, a compromised immune system caused by gut dysbiosis can allow the overgrowth of pathological bacteria. Unhealthy changes in dental plaque and unhealthy food choices will initiate periodontal disease. Then, periodontal disease, as a unique site of infection in the mouth, will begin to spread, causing additional systemic chronic inflammation and chronic diseases.


To treat periodontal disease and to avoid chronic disease, active infection in the mouth must be treated efficiently. In addition, irritating and toxic substances must be removed from the mouth and teeth. However, gut dysbiosis must be treated simultaneously. Just treating either the damaged gut or active periodontal disease will be insufficient.



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

[2] https://drdanenberg.com/dental-plaque-is-healthy-until-its-not/

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

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

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

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

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

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

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

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




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Dr. Michael Ruscio
Dr. Al Danenberg

Dr. Al Danenberg Nutritional Periodontist
July 4, 2018 [printfriendly]




Dr. Michael Ruscio Interviews Dr. Al DanenbergI met Dr. Michael Ruscio at the Paleo f(x) meeting in Austin in April 2018. Michael suggested we do a Podcast together. So, we made it happen.


Dr. Michael Ruscio is a chiropractor, clinical researcher, and author whose practical ideas on healing chronic illness have made him an influential voice in functional and alternative medicine. Michael also provides post-doctoral continuing education. His research has been published in peer reviewed medical journals, and he speaks at integrative medical conferences across the globe. Currently, he is a lead researcher in a pending IBS (irritable bowel syndrome) study.


In this interview, Dr. Ruscio and I discuss the profound connections between the gut, the mouth, mitochondria, and chronic disease. I talk about my Periodontal Disease Clinical Study that will be implemented following approval by the Institutional Review Board. We also discuss how improper flossing could lead to receding gums, new testing showing that mouth tissue is a window into your mitochondrial health, and how mouthwashes could lead to high blood pressure.


Tooth decay and periodontal diseases are chronic diseases. My research suggests that the gut could be the initial source for chronic disease to manifest. But, once oral diseases take hold, then both the gut and the mouth must be treated in order to gain control of chronic inflammation and further manifestation of chronic disease.


Listen to the Podcast. It lasts a little more than an hour, but I think you’ll find it loaded with “pearls” to take home and act upon immediately.



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Leaky Gut & Periodontal Disease
And All That Jazz

Dr. Al Danenberg Nutritional Periodontist
June 18, 2018 [printfriendly]




Leaky Gut and Periodontal DiseaseLeaky gut, periodontal disease, and all that jazz (meaning all those bacteria) play an important role in chronic disease. The tube that courses through the body (called the digestive tract, gastrointestinal (GI) tract, or the alimentary canal) is the initial setting for many chronic diseases that could manifest over time.


The GI tract starts with your lips and mouth and finally ends at the anus. Interestingly, all of the tissues that line this tube are affected in similar ways. What happens in the small and large intestines will affect the mouth, and what damages the mouth will affect the tissues of the small and large intestines.


The living inhabitants on the surface of the digestive tract are bacteria and other microbes that outnumber the quantity of human cells. These microbes are critical for human survival and affect human metabolism, nutrition, physiology, and immune function. When the microbiome is disturbed and when unhealthy microbes take control, then all Hell could break loose resulting in various chronic diseases.


One portal of entry for toxic elements to move into the systemic system is a leaky gut (increased intestinal permeability). Eventually, chronic inflammation and chronic disease can result. Periodontal disease is just one of those chronic diseases that can manifest once the gut becomes unhealthy. However, once periodontal disease exists, then it provides another major portal of entry for toxic elements to move into the systemic system – a “leaky periodontal pocket”.


Both a leaky gut and a leaky periodontal pocket must be treated.



Current Medical Research

Recently published medical papers provide an increased understanding about the interplay between a leaky gut, periodontal disease, and all those bacteria inhabiting the mucosal tissues of the GI tract.


Read these papers, which offer important medical outcomes. I believe we can connect these “dots” of knowledge and develop a clinical protocol for adjunctive treatment of periodontal disease and more.


This 2015 paper pointed out that damage to the gut actually would decrease the body’s ability to maintain a healthy immune system causing potential for various chronic diseases to manifest.


This 2018 review described intestinal permeability and resulting multiple sclerosis as well as other chronic diseases.


Figueredo, et al. in 2017 demonstrated that inflammatory bowel disease can cause periodontal disease, which is a chronic disease.


Bale, et al. in 2017 reviewed the evidence that periodontal disease contributes to atherosclerosis.


McFarlin, et al. in 2017 performed a double-blind study where individuals significantly improved intestinal permeability by taking a spore-based probiotic for only 30 days without changing their unhealthy lifestyles.


Li, et al. in 2016 showed how periodontal disease is a disease of mitochondrial dysfunction within the gingival fibroblasts.


In 2012, Vos, et al. reported that vitamin K2 could rescue damaged mitochondria in fruit flies. 


This 2018 review described how vitamin K2 transports out of the liver and then disseminates throughout the body to assist in various biological functions including the prevention of mitochondrial dysfunction.



My Thoughts

I believe we can connect these “dots” of knowledge.


Apparently, there is a relationship between gut issues and periodontal disease. It appears there is a progression from dysbiosis to leaky gut, then to decreased host resistance, and finally to mitochondrial dysfunction and the development of various chronic diseases including periodontal disease.


Research suggests that there might be an adjunctive treatment for periodontal disease by treating dysbiosis, repairing the gut membrane with spore-based probiotics, and utilizing vitamin K2 to prevent and repair mitochondrial dysfunction.


My goal is to investigate this possible causal relationship. To that end, Andrew Campbell MD, John Abernethy MD, and I wrote a protocol to study my theory. We submitted our Periodontal Disease Clinical Study to the “Institutional Review Board” (IRB) on 5/31/18.


If our study is approved by the IRB, Microbiome Labs will sponsor our research, which will be double-blind involving approximately 50 individuals with active periodontal disease. Participants will take a placebo or a supplement for 6 weeks. The daily supplement will consist of spore-based probiotics and vitamin K2.


To determine the potential benefits of this supplement, we will measure the depths of infected gum pockets, bleeding in these pockets, and the status of the participants’ mitochondria. At the end of the study, we will repeat these three measurements.


I project that there will be a reduction in pocket depth and bleeding as well as an improvement in the health of the mitochondria.


If our work demonstrates significant benefits, then other investigators could repeat and elaborate on this research. There might be far-reaching inferences that could be considered if our results are positive.


I’m excited to see where this study might go.



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Advice Given to Me

Alvin H. Danenberg, DDS Nutritional Periodontist
February 5, 2018 [printfriendly]




Advice can be found in the most unusual places.


I have been given advice by an astute dental scholar. He encouraged me to understand the science of evidence. There is only one problem. He based his science on the myopic view that the mouth is an island unto itself with little influence from anywhere else in the body. He is a throwback to the times when the Catholic Church ruled that the Earth was the center of the universe. Anyone who doubted that science could be put to death. As a matter of fact, in 1616, Galileo was accused of being a heretic, a person who opposed Church teachings. Fortunately, Galileo was acquitted of the charges.


So, what did this informed dentist have to say about evidence? He said that there is science that antimicrobial mouthwashes are safe and effective. Therefore, ‘nuff said! My concern is that there is better evidence that suggests that daily use of antimicrobial mouthwashes may damage the DNA of cells[1],[2]. In addition, daily use of these chemical mouthwashes might destroy some of the bacteria in the mouth that are critical for the conversion of salivary nitrates eventually into nitric oxide. Nitric oxide is necessary for many bodily functions including blood pressure control, cardiovascular health, and even gum tissue health.[3]


To educate me further, this dental visionary stated that there was little evidence that diet had anything to do with caries and periodontal disease. The cause of dental diseases was improper brushing and flossing. Therefore, I guess I need to ignore these two human studies:


Study 1[4]

In this controlled experiment, ten individuals were not able to brush or floss for 30 days. For the duration of this experiment, their diet consisted of primal foods common to their area in Switzerland about 5,700 years ago. No processed foods were available. These participants had to gather and forage for the majority of their food. At the beginning and at the end of the study, pocket depths and bleeding-on-probing around the teeth were measured, and cultures of bacteria were taken from the plaque and from the tongue.

At the end of the study, there were a significant decrease in bleeding-on-probing and a significant decrease in pocket depths. Amounts of dental plaque increased greatly, but virulent bacteria did not increase in the plaque or on the tongue. Dental plaque and other oral microbes were in a state of homeostasis at the end of the four-week experiment.

Study 2[5]

In this recent study, fifteen people were selected. Only those who had signs of gum disease and were eating a diet heavily based on processed carbohydrates were selected. Ten individuals made up the experimental group, and five individuals made up the control group.

The experimental group had to change their diet. Their new diet consisted of foods low in processed carbohydrates, rich in omega-3 fatty acids, and abundant in vitamins C and D, antioxidants and fiber. The control group did not change their eating habits.

As far as oral hygiene was concerned, all fifteen participants were instructed not to clean between their teeth with dental floss or interdental brushes. However, they did not have to change the way they brushed their teeth with a normal toothbrush.

The study began after each group had two weeks to acclimate to these changes I mentioned above. Then, the four-week study began. The signs of gum disease (bleeding-on-probing, pocket depths, degree of gingival inflammation) in all participants of this scientific project were recorded at the start of the four-week study and at the end.

At the conclusion of the trial, all disease parameters decreased significantly in the experimental group by approximately 50% from the starting point. In contrast, all inflammatory markers increased from the starting point in the control group.


Finally, this dental professional informed me that the dental profession is more than effective in treating dysbiosis, which is the cause of poor oral health. I totally agree that dysbiosis is the cause of poor oral health. But, dysbiosis begins in the gut and progresses to all parts of the body – including the mouth.[6],[7],[8],[9] Dysbiosis in the gut must be treated in conjunction with treatment of dysbiosis in the mouth. Just treating the mouth without addressing what is going on in the gut will not solve the overall problem. The mouth is not an island unto itself.


I always appreciate advice when given. Thanks for setting me straight!



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Connecting The Dots:
HIIT, Mitochondria, Gingivitis

Alvin H. Danenberg, DDS Nutritional Periodontist
May 30 2017 [printfriendly]


Connecting The DotsIn my previously published book, Crazy-Good LIVING, I discuss my Four Pillars of Health. One pillar of health is efficient exercise. I explain how efficient exercise is made up of several activities. One effective activity is High Intensity Interval Training (HIIT). The importance of HIIT and the body’s quick and positive response to it are amazing. HIIT will improve the health of your mitochondria and in turn possibly improve your overall health as well as gingivitis. It’s a matter of connecting the dots.



High Intensity Interval Training is the ultimate beneficial exercise for your mitochondria. You could perform this once a week for eight to twenty-six minutes in total. You might start with a warm up of two minutes before beginning the exercise cycles. Each cycle might consist of (1) seven to thirty seconds of all-out-to-exhaustion pedaling on a recumbent bike or sprinting outside, and (2) rest for about ninety seconds to regain your normal breath. This cycle should be repeated for two to eight times. Then, finish with a two-minute cool down.

I use a Nordic Track Classic Pro Skier®, a cross-country ski machine that is set up in my spare bedroom. Usually I use it once a week for four to six cycles depending how I feel that day. I warm up by “skiing” at a slow pace for two minutes. Then, I “ski” at the fastest speed I can muster for twenty-five seconds, and next I rest for ninety seconds. That completes one cycle, which I will repeat until done. At the end of my routine, I feel exhausted – but great.



Inside almost every human cell, there are little vessels called mitochondria. The only human cells lacking mitochondria are red blood cells.

Mitochondria are like batteries floating inside the cells’ cytoplasm. Some very busy cells may have thousands of these batteries floating inside each cell. Mitochondria produce all the energy the cell needs to do its work. The mitochondria also assist in ridding our body of toxic substances and flushing out old and no longer useful cells. In addition, mitochondria help genes function optimally.

Mitochondria need nourishment. If they do not get all the nutrients they require, they will not function properly. A nutrient-dense diet, as I recommend, is ideal to provide these necessary substances.

Compare mitochondria to batteries in a flashlight. If the batteries are strong, the light shines brightly. If the batteries are weak, the light becomes dimmer, even though it may still work. The weak flashlight just doesn’t live up to the standards expected of it. But if you replace weak batteries with  fresh ones, the flashlight will function as it did when it was brand new.

If our cells’ mitochondria are not firing on all cylinders, individual cells may function, but the cells’ ability to do what they were designed to do will be compromised. Mitochondria must be kept fresh and strong for peak performance.

In this peer-reviewed paper, unhealthy mitochondria were associated with gingivitis and advanced stages of periodontal disease. In contrast, healthy and strong mitochondria might help prevent gingivitis, other forms of periodontal disease, and other chronic diseases.


Connecting The Dots

Connecting the dots is critical. Healthy mitochondrial function is critical to overall health. One method to improve our mitochondria is through efficient exercise. Healthy mitochondria are important for overall health but also could prevent gingivitis and other forms of periodontal disease.

Two recent papers reveal the significant benefits of HIIT.

  • In a study published in 2016, twenty-five sedentary men were divided into three groups: nine performed three weekly sessions of HIIT for twelve weeks; ten performed three weekly sessions of moderate exercise for twelve weeks, and six men served as the non-exercising controls during the study. The details of the study are described in this paper. The final results of this study showed that the men who performed HIIT after twelve weeks improved their biomarkers of heart health and metabolic health easier and faster than those who performed traditional exercise training.
  • In this study published in 2017, HIIT improved mitochondria function better than other exercise programs tested.


Closing Thoughts

Science shows healthy mitochondria promote overall health as well as oral health. Researchers have reported that HIIT is an efficient exercise program that could improve the health of the mitochondria within all the cells of the human body. In my opinion based on the published research, supporting the mitochondria through an efficient exercise program in addition to a nutrient-dense diet could go a long way to possibly supporting periodontal health and preventing gingivitis as well as other chronic diseases.



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Your Gut. Your Health. Your Choice.®
What Does This Mean?


        Alvin H. Danenberg, DDS       December 11, 2015


Dr. Danenberg LogoYour Gut. Your Health. Your Choice.® This is my slogan. But, do you know what it means?


Medical articles are pouring out about the importance of the bacteria in our guts. Since 2002, there have been 508 published peer-reviewed papers in PubMed on the subject of the “importance of the gut microbiome” as of today.


PubMed.gov is the government website that archives all peer-reviewed medical research from around the world. This is the most important source of medical information that has been independently studied and reported for the general and professional public. The most recently published article on the importance of gut bacteria appeared on November 20, 2015 in PubMed.gov. It describes the direct relationship of gut bacteria and autoimmune diseases, specifically lupus.


In fact, periodontal disease has been identified in part as an autoimmune disease.


Autoimmune disease is when your body incorrectly assumes its own cells are “invaders”, and your immune system starts to attack your own cells. Not a good thing. Examples of autoimmune diseases are lupus, sarcoidosis, rheumatoid arthritis, hypothyroidism, inflammatory bowel disease, multiple sclerosis, psoriasis, lichen planus, and type 1 diabetes to name a few.


It makes sense to discover what is causing an autoimmune disease and eliminate it. The health of your gums as well as the health of the overall body will benefit. Dr. Alessio Fasano suggested that autoimmune diseases are a result of harmful foods that irritate the gut and create growth of unhealthy bacteria, both of which causes tears in the gut lining. The bad stuff then leaks into the blood system leading to autoimmune diseases.


So, the health of the gut is critical. It is your choice. Make your gut healthy, and you will improve your overall health including your mouth health.

Paleo and Perio:
Who’da Thunk?

evolution rWho would have thought that a Paleo Diet could improve or prevent periodontal disease (gum disease)? The science is there, and its interpretation is exciting. Here are two papers that have great importance:
In a paper published in 2009, researchers evaluated a group of 10 people who lived for 30 days in a replicated Stone Age environment near the Rhine River in Switzerland. The design of this research required a diet that was devoid of all processed foods. Their diet only consisted of foods that ancient people would have consumed in that geographical area around 5,700 years ago. They were given some basics of raw food, but they had to forage and fish for most of their food. During the 4-week course of the study, these individuals were unable to perform any oral hygiene; they were not given any modern gadgets like toothbrushes or dental floss. At the beginning of the study, any existing gum problems were recorded and the types of bacteria present in their mouths were determined.
At the completion of the 4-week experiment, plaque levels at the gum line around the teeth increased as expected. However, researchers were surprised by a reduction in gum infection. The depths of infected gum pockets decreased significantly (p < 0.001), and bleeding from the gum pockets decreased significantly (p < 0.001). When bacteria in the mouth were examined at the end of the study, those samples revealed a change in the balance of bacteria, which favored healthy types of microbes rather than pathogenic ones. Good bacteria increased; bad bacteria decreased; plaque increased; and the individuals could not perform any oral hygiene for the entire 30 days – the researchers were shocked!
The reasons for the surprise results were the ingestion of nutrient-dense foods (these positively affected the gut and mouth microbiome along with the intestinal lining) as well as the complete avoidance of any processed foods (these would have damaged the gut and mouth microbiome along with the intestinal lining).
A diet that supports this type of healthy outcome is a Paleo-type diet.
It would be helpful if specific nutrients that were contained in foods could be identified that improved mouth health. In a paper that was published in 2013, the authors performed an extensive search of peer-reviewed literature attempting to identify the types of nutrients that could help tissues heal after periodontal surgery and help prevent periodontal disease.
If a diet contained these beneficial nutrients in abundance in their natural states, it probably would be embraced. Nutrients in their natural state and contained in food are much more effective biologically than nutrients that are commercially isolated and unnaturally provided in supplement form.
The authors of this analysis reviewed 37 published papers and concluded, “There is some evidence that a wide variety of dietary components – including macronutrients and micronutrients – are integral for optimal periodontal health as well as healing after periodontal procedures.”
Here is a summary of the nutrients that were reported either to improve healing after periodontal surgery or to reduce the incidence of periodontal disease:

  • Vitamin D
  • DHA (an omega-3 fatty acid that is abundant in fatty fish like salmon)
  • Low ratio of omega-6 fatty acids to omega-3 fatty acids (ideal ratio is 1:1; average US diet consists of ratio about 30:1)
  • Low ratio of omega-6 fatty acids to omega-3 fatty acids (ideal ratio is 1:1; average US diet consists of ratio about 30:1)
  • Low sugar and processed carbohydrates; high fiber
  • Calcium
  • Magnesium
  • Vitamin C

A diet that incorporates all these nutrients within its food choices is a Paleo-type diet.
A Paleo-type diet avoids processed foods that have been identified with gut dysbiosis, intestinal permeability, and chronic inflammation. A Paleo-type diet provides all the nutrients needed for every cell to survive and thrive. Such a diet consists of animal products from head to tail that have been pasture raised or wild caught, fruits, vegetables, nuts, and seeds. There are no acellular carbohydrates, no processed foods, and no unhealthy fats or oils included in a Paleo-type diet.

What Went Wrong?

evolution rIf our primal ancestors ate nutrient-dense foods that allowed them to thrive with no gum disease or tooth decay, then what went wrong? Today there is a 47% prevalence of periodontitis among adults in the United States. Periodontitis is the advanced stage of gum disease where not only the gums are infected, but also the bone surrounding the roots of the teeth are infected and breaking down. For those who are over 65 years old, the prevalence of periodontitis jumps to 70%. When and why did the prevalence of gum disease go from almost 0% to 70%?
It didn’t happen in one day. It was progressive and cumulative.
The major change began with the emergence of civilization. Civilization allowed peoples to come together. Civilization brought many good things to humans – protection from the elements and protection from their enemies. Societies developed farming and agriculture, which brought an abundance of foods like grains to feed the masses. The timeline was about 10,000 years ago.
Unfortunately, some of the cultivated foods were processed into dense, acellular carbohydrates, which were concentrated (or dense) carbohydrates that had their cell walls broken down and removed. These were lacking in nutrients. In time, these acellular carbohydrates began replacing many nutrient-dense foods that used to be the dominant makeup of the human diet.
Healthy carbohydrates are contained in the living cells of plants. When these plants are normally cooked, the cell-to-cell links are broken down, but the cell walls that contain the healthy carbohydrates are not destroyed. When healthy plants are ingested, the body’s digestive system breaks down their cell walls and metabolizes their contents.
Dense acellular carbohydrates do not occur naturally in nature.
Two of the most powerful ways humans created dense acellular carbohydrates were to isolate and concentrate sugars from plants, and to grind dense seeds into highly compacted flour. In both cases, heat and pressure would destroy the original food’s cell walls, resulting in dense carbohydrates. These carbohydrates were dead. They did not spoil over time like healthy, cellular carbohydrates would spoil. The resulting flour and sugars were dense, acellular carbohydrates that caused unhealthy changes in the body.
There is a progression of damage that occurs when we eat dense acellular carbs. The lack of essential nutrients in these foods will starve the body’s cells of what they need to thrive. The acellular carbohydrates not only lead to unhealthy bacterial changes in the mouth and gut but also affect the lining of the gut.
Once the gut lining is damaged, harmful bacterial byproducts (called lipopolysaccharides or LPS) and undigested food particles can leak into the bloodstream. Our immune system reacts to these invaders into the bloodstream and creates cascading events of inflammation, which are highly destructive to many functions of the body. Chronic inflammation leads to increases in degenerative diseases of the whole body.
It was once believed that periodontal disease caused systemic diseases. However, the American Heart Association made a statement that there was no evidence indicating a causal link between periodontal disease and heart disease. The AHA suggested independent factors were causing both periodontal disease and heart disease.
Science now knows that the frequent ingestion of high-density, acellular carbohydrates in flour and sugar products (1) creates a growth of unhealthy bacteria in the mouth and gut, (2) damages the cellular lining of the gut, and (3) produces deficiencies in micronutrients. These unhealthy carbs most likely could be the real root cause of periodontal disease, cardiovascular diseases, and other chronic diseases of modern humans.
Hunter-gatherer populations today eat unprocessed foods, and these societies can thrive on a wide variety of macronutrient ratios (ratios relating fat to protein to carbohydrate), ranging from equatorial tribes like the Kitava of Papua, New Guinea, who consume 65 percent of their calories from carbohydrates, all the way to the !Kung in Africa’s Kalahari Desert who eat large quantities of nuts that are 60 percent fat. What neither of these tribes consumes are carbohydrate-dense, acellular foods. These societies rarely have degenerative diseases or tooth decay or gum disease that plague most modern people today.
Q: What went wrong?
A: Our food supply became dominated with dense, acellular carbohydrates that have led to unforeseen damage in the human body.