What’s Really Behind
Periodontal Disease?

Dr. Al Danenberg ● Nutritional Periodontist

December 11, 2022

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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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What’s In Our Blood?
SURPRISE!

Dr. Al Danenberg ● Nutritional Periodontist

July 31, 2022

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We’ve talked at great length about your gut health being an indicator of chronic illness, but have you given much thought to what’s in your blood? Recent studies have shown that it’s not as sterile as we once believed! So, what does this mean for you?

 

What’s In Our Blood?

Our circulatory system contains microbes that were never believed to be there because old methods of culturing bacteria would not grow them. But recent DNA sequencing methods reveal that each milliliter of blood contains around 1,000 bacterial cells. These cells are dormant in the blood and can reside in healthy individuals. But they can be revived.

When iron is available in the blood, the dormant bacteria may be revived and can begin secreting lipopolysaccharides (LPS). LPS are molecules on the cell walls of gram-negative bacteria that stimulate the immune system which in turn creates inflammation. LPS is a highly toxic element. And systemic inflammation is a major initiating factor in the manifestation of practically all chronic diseases.

Researchers who published their study in 2016 in the Journal of the Royal Society Interface[1] stated, “We think bugs are involved in all these diseases”. They observed that the addition of tiny concentrations of bacterial LPS to both whole blood and platelet-poor plasma of normal, healthy donors led to marked changes in fibrin and caused progression of chronic inflammatory diseases.

The body normally keeps levels of free iron in the blood low to keep bacteria dormant and block their growth.

Another group of researchers published a paper in 2022 in Frontiers in Cellular and Infection Microbiology.[2] The authors explained that these dormant bacteria come from the gut and the oral cavity. Microbial translocation into the bloodstream can occur via different routes, including through the oral and/or intestinal mucosa. As I said, these contribute to chronic inflammation.[3]

The authors of that study also described how science has developed equipment that is sensitive enough to find microorganisms among the body’s own cells. Studies in both animals and humans have shown that bacteria can be in tissues and organs like the liver, adipose tissue, and brain tissue. Often these findings are linked to disease. For example, researchers have found bacteria and fungi in the brains of people with Alzheimer’s disease. Also, bacteria have been detected in cancerous tumors.

However, there is controversy about the ultimate relevance of these blood microbes. Some researchers have concluded that the same bacterial groups often seem to recur in healthy individuals. In other words, these scientists suggest that a level of microbes in the blood of healthy individuals may be normal.[4]

 

Leakage of Microbes into the Circulatory System

As I said, the research suggests that microbes can enter the bloodstream via different routes, including through the intestinal mucosa as well as the oral mucosa.[5] And there is easy access to the bloodstream when there is a “leaky gut” and when there is a “leaky mouth”.

 

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.

 

 

Healthy Mouth – 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”.

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.

 

 

When it comes to periodontal disease, there is a specific bacterium called Porphyromonas gingivalis. This is an aggressive gram-negative bacterium with some unique qualities. One of these qualities is that it can enter cells and become dormant.[6],[7] It also can bind to red blood cells and enter the circulatory system. In fact, the red blood cells protect P. gingivalis from contact with circulating phagocytes from the immune system without affecting its viability. In this way, P. gingivalis could be transported to other organ systems to reemerge and cause serious diseases.[8]

 

Unique Treatment to Destroy P. Gingivalis

For the six years leading up to my leaving private practice in 2018, I was using a unique laser (PerioLase Laser) to treat advancing periodontal disease. This laser uses a wavelength of 1064 nm (nanometers). It is the 1064 nm wavelength that enables the laser to selectively kill P. gingivalis that resides in the periodontal tissues and blood around the tooth without harming healthy cells.[9],[10],[11]

The beam from the PerioLase Laser also can penetrate epithelial cells where P. gingivalis can enter the cell and become dormant. The laser will destroy the dormant virulent bacterium without destroying the cell.

In addition, the laser beam can stimulate precursor bone cells in the jawbone around the periodontally damaged teeth to regenerate damaged bone.

Millennium Dental Technologies is the company the developed the laser and the clinical protocols. The procedure is called LANAP (Laser Assisted New Attachment Procedure). Recently, the name of the procedure was changed to LAR (Laser Assisted Regeneration), which emphasizes the regenerative capacity of the laser beam.

Here is a video simulation of the LANAP (or LAR) procedure in action:

 

 

Final Thoughts

The high level of chronic disease in the US population could be partly due to dormant bacteria in the circulatory system, which has gone undetected until recently. Some of these microbes may be bound to red blood cells, which offer protection to these bacteria. Some of these microbes may embed themselves into blood cells, which can transport these potentially virulent bacteria to other organ systems. And some of them may be floating freely in the bloodstream.

While some researchers believe that there may be a normal level of microbes living in the bloodstream of healthy individuals, my guess is that these microbes may be the culprits in the development of serious chronic diseases.

 

[1] https://royalsocietypublishing.org/doi/10.1098/rsif.2016.0539

[2] https://www.frontiersin.org/articles/10.3389/fcimb.2022.892232/full

[3] https://www.frontiersin.org/articles/10.3389/fcimb.2022.892232/full

[4] https://www.frontiersin.org/articles/10.3389/fcimb.2019.00148/full

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9110890/

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4557090/

[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2772519/

[8] https://onlinelibrary.wiley.com/doi/10.1111/jre.12388#

[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2772519/

[10] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8860761/

[11] https://pubmed.ncbi.nlm.nih.gov/15389740/

 

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Bleeding Gums?
You’ll Need to Read This

Dr. Al Danenberg ● Nutritional Periodontist

June 5, 2022

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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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Periodontitis – Rheumatoid Arthritis:
Which Came First?

Alvin H. Danenberg, DDS • Nutritional Periodontist
September 5, 2017

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Periodontitis - Rheumatoid ArthritisPeriodontitis is a chronic inflammatory disease. Rheumatoid arthritis (RA) also is a chronic inflammatory disease. In addition, both have autoimmune characteristics. Many people who have periodontitis have rheumatoid arthritis. Likewise, many people who have rheumatoid arthritis have periodontitis. Which came first? Current medical research offers a robust discussion. Yet, the dilemma continues – which came first?

 

There is another question that may be more basic: Could there be a common cause for both diseases?

 

Chronic Inflammation

A common cause for periodontitis and rheumatoid arthritis might be chronic systemic inflammation. If that were the case, then the manifestations of periodontitis and rheumatoid arthritis could depend on individual genetic predispositions and host response.

 

Chronic systemic inflammation is a complex system of “healing events”, which does not shut off naturally. Inflammation doesn’t shut off because an acute injury, which created the inflammatory response in the first place, persists.

 

In a healthy situation, when the body is harmed, the immune system creates inflammation to heal the injury. However, if the insult to the body becomes constant, then the body cannot turn off its internal “emergency reaction”. The immune system continues to be activated. Normal inflammation becomes chronic. Elements of chronic inflammation begin to destroy healthy tissue throughout the body and manifest into many chronic diseases.

 

Medical Research

Here are some thoughts from current medical research:

 

  • Chronic inflammation causes many chronic degenerative diseases. In this paper, the authors use the lens of evolution to describe various factors that affect the development of chronic inflammation. If insults, which create acute inflammation, are not removed within three to eight weeks, the body begins a destructive path leading to chronic diseases.

    •  

  • Dental plaque is made up of many types of microbes, which are in a balanced state during health. What can cause the dental plaque to become unhealthy? Environmental factors affect a person’s immune system. If the immune system is compromised, then the host response can be altered and become destructive. A compromised immune system and a negative change in the host response can allow various bacteria in dental plaque to overgrow and become extremely pathogenic. Some of these harmful bacteria are resistant to the immune system’s attempt to kill them. The result is further development of chronic inflammation. In turn, there is damage to the jawbone and potential spread of infection as well as elements of chronic inflammation to various parts of the body. This article helps explain this process.

    •  

  • A specific virulent bacterium associated with periodontitis, Porphyromonas gingivalis, uniquely produces an enzyme called peptidylarginine deiminase (PPAD). This research has linked this production of PPAD by P. gingivalis to the creation of specific antibodies, which might cause the development of rheumatoid arthritis. These antibodies can be identified many years before the patient experiences clinical symptoms of RA.

 

Summary

Chronic inflammation causes many different types of chronic disease. Specifically, the apparent initial cause of periodontal disease and rheumatoid arthritis is chronic systemic inflammation. Once periodontitis has become active, the production of PPAD and its resulting antibody production may cause the development of rheumatoid arthritis or aggravate existing rheumatoid arthritis. A vicious cycle is at work between periodontitis, rheumatoid arthritis, and chronic inflammation. So, what is a person to do?

 

First and foremost, whatever is causing the progression of chronic inflammation must be eliminated completely. If there are foods and chemicals in the diet that are stoking the flames of inflammation, these must be avoided. Other irritating environmental factors need to be identified and removed. If there is damage to the gut lining or an increase in pathogenic microbes in the gut, these must be treated. If there is active gum disease or any other source of active infection, these must be resolved. Eliminating all sources of chronic inflammation is essential for a healthy outcome. Only treating the symptoms of periodontitis and rheumatoid arthritis would not assure a healthy outcome.

 

So, which came first – periodontitis or rheumatoid arthritis? It could be a toss up, but treatment must eliminate the ultimate and common cause, which is chronic inflammation.

 

 

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Gum Disease:
When Bad Bugs Revolt

Alvin H. Danenberg, DDS • Nutritional Periodontist
February 27, 2017

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gum disease: when bad bugs revoltWhen bad bugs revolt, the result is gum disease.

 

The most obvious signs of gum disease are bleeding gums and gum infection. The most obvious causes are unhealthy clumps of dental plaque around the gum margin and irritating tartar located under the gums. I’ve written about dental plaque and dental tartar in the past. But, before there is unhealthy dental plaque and irritating tartar, there usually was something bad going on in the gut.

 

Something makes the normal level of healthy bacteria in the gut become out-of-balance. The bad microbes become “bullies”. They start to overwhelm the garden of healthy gut bacteria. These “bullies”, along with remnants of undigested foods and toxic irritants, can damage the one-cell-layer-thick gut lining. Once this lining is breached, these irritants can leak into the blood system. Then, cascading problems develop:

  • The immune system gets out of control
  • Chronic inflammation begins circulating throughout the body
  • Other organs become damaged
  • The bacteria in the mouth start to change for the worse

 

The obvious and necessary treatment for unhealthy gums includes removing the unhealthy plaque and the irritating tartar. But, that is not all that needs to be done. In addition, the gut must be made healthy; and nutrient-dense, anti-inflammatory foods must be introduced into the diet to replace bad food choices.

 

But after all this, what if gum diseases still persist? What could be the causes of further gum bleeding and gum infection? The answer might be that stubborn and virulent microbes still are playing havoc under the gums. These bad guys could leak into the blood system, creating problems throughout the body. Let’s take it to the next step.

 

Cutting-edge research

Brad Wilson, DDS from Houston, TX has been doing cutting-edge research with PathoGenius Laboratory. Dr. Wilson has created a protocol to discover the bad bugs that continue to be out-of-control in the mouth. I am using this test to investigate those bad guys in my patients’ mouths.

 

The protocol begins with the patient brushing into his or her gum tissues. This will loosen dental plaque. Then the patient will give a saliva sample. Next, the sample is sent to PathoGenius Laboratory, which will test the saliva for microbes.

 

This innovative analysis determines ALL bacteria and yeast species in the sample using each bug’s unique DNA structure. The resulting lab report identifies the most harmful, disease-producing bugs in the mouth. The report also points out antibiotics that could kill the bad guys with minimal harm to the good bacteria. It is important to avoid a broad-spectrum antibiotic, which kills bad as well as good bacteria. Only the bad guys should be targeted, leaving the healthy bacteria to function normally.

 

If the lab results show harmful bacteria detected in large numbers, the patient moves on to the next stage to destroy them.

 

Methods to kill the bad bugs

If there are no deep pockets of bacteria and if there is no advanced jawbone destruction, I will recommend an antimicrobial to destroy these bad bugs. Choices are a systemic antibiotic or a localized antibiotic as suggested by PathoGenius Laboratory. Sometimes I recommend a natural product like raw honey to eliminate the bad bugs. I have written about the medical benefits of raw honey several times. (HERE. HERE. HERE.)

 

However, if gum infection is advanced and significant bone destruction has occurred around the teeth (known as periodontitis), I recommend a unique laser protocol called LANAP® (Laser Assisted New Attachment Procedure). LANAP will destroy any remaining harmful bacteria and will assist the body in regenerating new bone.

 

Summary

Gum disease is usually the direct result of unhealthy clumps of dental plaque and buried tartar under the gums. Deep tartar irritates the gum areas like embedded splinters irritate the skin of a finger. Unhealthy plaque and irritating tartar need to be removed. But, nutrient-dense foods and a healthy gut are critical for ongoing health of the mouth. I teach my patients how to change their diet to improve their mouth and to improve the rest of their body.

 

If there are any significant amounts of pathogenic bacteria in the mouth, they must be identified and eliminated. Bacteria-specific antibiotics or natural remedies may be necessary to reduce these bad guys. In advanced periodontal disease, not only resistant bad bugs need to be destroyed but also damaged jawbone needs to be regenerated. For the patient with advanced periodontal disease, the LANAP protocol has been documented to be an excellent treatment to return the area to health. LANAP is my choice of treatment for patients with this level of periodontitis.

 

 

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Cannabinoids:
Can They Treat Gum Disease?

Alvin H. Danenberg, DDS • Nutritional Periodontist
September 6, 2016

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Gum Disease - New ResearchI’m a periodontist; I treat gum disease; and I have been doing this for 42 years. I have written about how I treat gum disease and how our diet and lifestyle are huge factors in the development and progression of gum disease. HERE. HERE. HERE.

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Periodontitis is the advanced stage of gum disease. It is a destructive, chronic inflammatory infection that breaks down the jawbone surrounding the roots of teeth. It affects 47% of the adult population in the US and is a factor in other diseases throughout the body.

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New Research

Research is just research. It is information that may make a difference in humans once it has been tried and tested in humans.

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I have found interesting research that could enhance the treatment of periodontitis. The dental profession has not adopted this new research yet. But, I see the potential.

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The new research revolves around biochemicals that are manufactured by various cells in the body naturally. The specific biochemicals described in the research are called cannabinoids. They affect numerous functions in the body. When cannabinoids are damaged or prevented from doing their work in the body, the body suffers. These biochemicals are also available from external sources and could support those made by the body.

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Specifically, cannabidiol (CBD), one of the cannabinoids, is available from the hemp plant. It is not THC (tetrahydrocannabinol), which is another cannabinoid compound that is the active ingredient in marijuana creating psychoactive “highs”. CBD has no or minimal psychoactive effects or toxic affects, and is available as an over-the-counter supplement.

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Science & Periodontitis

Destruction of the jawbone in periodontitis is related to specific mediators causing inflammation and resorption of bone. New research in animal studies has shown that CBD will decrease this inflammation and prevent destruction of the jawbone that is part of the progression of periodontitis. It is possible that supplemental CBD could improve healing following periodontal treatment by reducing these damaging affects caused by advanced gum disease.

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In contrast, another published paper suggested that using CBD as a supplement could possibly cause an overgrowth of gum tissue, especially if there was existing gum infection.

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Future Potential

In the future, clinical trials need to be performed to demonstrate that CBD would be beneficial in the treatment of periodontal disease. Only then could my profession consider embracing its potential. Other questions that need to be answered include:

  • How much CBD would a patient need to consume to improve healing?
  • Since many structural forms of CBD are available, which one would be most biologically available to the body?
  • Are there any side effects from supplemental CBD on the rest of the body?

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These questions must be answered before I could recommend CBD as a supplement in periodontal treatment. However, I must emphasize the best prevention for gum disease is a nutrient-dense, anti-inflammatory diet as well as proper oral hygiene as I described in this series of blogs. HERE. HERE. HERE.

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Unfortunately, science at times has created medicines or supplements processed from natural sources only to learn the intended benefits are not what they should be or the side effects prove to be harmful. That said, I am eager to learn what CBD might be able to do for my periodontal patients.

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Buy My New Book

Crazy-Good Living

I Write A Lot. I Read A Lot.
But, I Don’t Believe Everything I Read

      Alvin H. Danenberg, DDS   •   Nutritional Periodontist
      August 18, 2016  

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I Write A Lot; I Read A LotI write a lot; I read a lot, but I don’t believe everything I read. I am always reading papers of peer-reviewed research on PubMed.gov. PubMed is the go-to site for me to search what’s available in the worldwide archives of published science.

 

I was scanning through recent articles about periodontal disease on PubMed when I came across this paper. The title is, Primary prevention of periodontitis: managing gingivitis. It was published in the prestigious publication of the Journal of Clinical Periodontology in April 2015. Great article title, if you were a dental geek like me. Detailed review, if you wanted to delve into results of many published papers. But, way off the mark in its conclusions, in my opinion.

 

Just because you read peer-reviewed research that has been scrutinized by experts before it is published doesn’t mean it’s “correct”. The words “published” vs. “correct” may be as confusing as “normal” vs. “healthy”.

 

It may be “normal” to have occasional bleeding in the gums, but that condition certainly would not be “healthy”. “Normal” means the far majority of the population exhibits a particular condition. Occasional bleeding gums are “normal” because most people have that condition, but any bleeding gums certainly are not “healthy”.

 

This article presents information that was “published” many times before, but the conclusions are not “correct” because the human species over 2.5 million years of evolution proves otherwise.

 

Here is what the article concluded: “All people should brush their teeth twice a day for at least 2 minutes with fluoridated dentifrice”. Also, for patients with advanced gum disease, “2 minutes are likely to be insufficient.” In addition, patients with gum disease would need to clean between their teeth and use “chemical plaque control agents”.

 

I agree that brushing for at least 2 minutes and the use of interdental cleaning brushes are the best ways to clean around and between the teeth. I recommend that to all my patients. However, evolutionary dentistry clearly shows that tooth decay and gum disease are primarily a result of a lack of a nutrient-dense diet and the abundance of unhealthy gut bacteria. (HERE. HERE.) The human species is not deficient in chemical plaque control agents. We were not born with a genetic deficiency in fluoride. If anything, chemicals disturb the balance of healthy bacteria in the gut and mouth. (HERE.)

 

So, what should you do if you had gum disease or if you wanted to prevent gum disease? If you had gum disease, first the disease would need to be treated properly. Once it was treated, or if you only were trying to prevent this disease in the first place, you should be eating nutrient-dense foods and you should maintain a healthy and balanced level of good bacteria in your gut. (HERE.) Proper brushing and cleaning around your teeth are important, but proper diet and healthy bacteria are critical for health going forward.

 

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Vitamin D & Your Mouth:
5 Steps to Take

Alvin H. Danenberg, DDS     March 17, 2016  

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5 Steps to TakeIt’s not a catchy title, but the science is profound.

 

I have written about the importance of Vitamin D and periodontal disease before. HERE.  However, before you start gobbling up Vitamin D supplements to cure gum disease or any other mouth lesions, these five things are a must:

 

  1. You must have a dentist carefully evaluate your mouth for gum disease and any other lesions. HERE.
  2. You must get a blood test to determine your Vitamin D levels. The test is called 25-Hydroxy Vitamin D test. HERE.
  3. You must remove the unhealthy plaque that is growing around your teeth at the gum margins through proper oral hygiene. HERE.
  4. You must have a hygienist remove any calcified remnants of bacteria (tartar) that can be lodged under your gum tissues doing what splinters would do under the skin of your finger.
  5. You must change your diet to one that is nutrient-dense and anti-inflammatory. HERE.

 

Importance of Vitamin D

 

The biochemical functions in the human body are unbelievably complex. It’s like dominos falling. If one domino were to fall, the consequences would be widespread. Vitamin D is no exception. As a matter of fact, Vitamin D plays pronounced and critical roles throughout our human machine. Michael Holick, MD has stated, “Every cell in the body has a vitamin D receptor protein. It’s estimated that upwards of 2,000 genes are directly or indirectly regulated by vitamin D.”

 

Gum Disease

 

Advanced gum disease causes damage to the jawbone that surrounds the teeth. Periodontitis is the name for this advanced stage of gum disease. Anatomically, teeth are attached to the jawbone by a series of fibers that function in the same way as the strings that support a hammock between two trees. Aggressive bacteria have been shown to damage these fibers and progressively damage the jawbone. What is fascinating is that the destruction of these fibers and eventually the jawbone may be turned off with adequate levels of Vitamin D, as reported here.

 

Mouth Sores

 

Some sores in the mouth may be related to Vitamin D deficiency. Current research suggests that Vitamin D may stop frequent canker sores (aphthous ulcers), which are bothersome ulcerations that pop up on the soft tissues in the mouth. HERE, HERE.

 

 

Summary of What To Do

 

  • Have a conscientious dentist examine your mouth.
  • Check your Vitamin D blood levels. You should strive for levels of 25(OH)D around 40ng/ml. You could improve your levels by obtaining healthy sun exposure; eating foods like cod liver oil, oily fish like salmon, Portobello mushrooms, and pastured egg yolks; and supplementing with Vitamin D3 plus K2 capsules. The sun and specific foods are the best sources.
  • Learn how to clean your mouth effectively, and have any tartar removed from under your gums by a dental hygienist.
  • Research and begin a Paleo-type diet and lifestyle.

 

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

      Alvin H. Danenberg, DDS     March 7, 2016  

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7 things I used to knowJosh Billings (the 19th Century humorist) put it so clearly: “It ain’t so much the things we don’t know that get us into trouble. It’s the things we know that just ain’t so.”

 

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

 

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

 

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

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

    2.  

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

    3.  

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

    4.  

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

    5.  

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

    6.  

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

    7.  

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

 

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

 

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Should You Take Antioxidants to Stop Gum Disease?

Alvin H. Danenberg, DDS     February 15, 2016  

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Antioxidants and Gum DiseaseThe short answer is, “No, don’t take antioxidants to stop gum disease.”

 

Unfortunately, they aren’t what they are cracked up to be. Read what I have written about antioxidants in the past.

 

“So, why wouldn’t it be helpful to take antioxidants from a bottle to stop gum disease?”

 

Let’s examine what is really happening in the world of gum disease. My explanation may get a bit scientific, but this is interesting stuff. Try to hang in there.

 

Gum disease is a result of oxidative stress causing damage in the gum tissues. HERE. Oxidative stress is simply the imbalance between the production of free radicals (biological molecules that have lost an electron) and the ability of the body to neutralize their harmful effects through antioxidants (biological molecules that donate an electron). When there is an abundance of free radicals that are trying to steal electrons from other healthy cells, then there is damage to the body.

 

“But wait a minute; it sounds like antioxidants are the answer!”

 

Let me go on.

 

Recent evidence suggests that antioxidant supplements do not offer sufficient protection against oxidative stress or resulting cellular damage. Real foods contain much more effective antioxidants than those sold in bottles. However, it is becoming more obvious that the human body has mechanisms in place within every cell to create its own natural antioxidants. These are the best antioxidants – the ones that are naturally produced by our body.

 

The keys to decrease oxidative-stress-induced damage are to reduce or eliminate those things that are causing oxidative stress and to help the body produce its own natural antioxidants.

 

Oxidative stress to the tissues surrounding a tooth can result from unhealthy bacteria in the dental plaque, from irritation by tartar under the gum tissues, and from toxic chemicals that have damaged individual cells. Oxidative stress also can be caused by a leaky gut, emotional stress, over-exercise, or lack of efficient sleep. The general media would have you believe that antioxidant supplements could take care of the problem. As I have suggested, antioxidants are not what they are cracked up to be.

 

“So, what’s the answer?”

 

The solutions to eliminate gum damage from oxidative stress are to eliminate causes of acute infection, to make necessary lifestyle changes, and to incorporate healthy nutrition.

 

Eliminating acute gum infection includes reducing the damaging bacteria and removing deep tartar causing constant irritation. Lifestyle changes include learning good oral hygiene like proper brushing, flossing, and tongue cleaning. Other lifestyle changes include healing an unhealthy gut, getting enough sleep, engaging in efficient exercise, and reducing overall stress. Healthy nutrition includes eating nutrient-dense foods and avoiding foods that cause inflammation in the body.

 

My personal experiences as well as my research of peer-reviewed articles have brought me to this way of thinking. We can do so much more for our mouth and our entire body if we removed what was causing the problems and then gave our body what it needed to thrive. The last 2.5 million years of our species’ survival have convinced me.

 

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