Dr. Al Danenberg ● Nutritional Periodontist
October 7, 2019
Dentists need to be aware; medical doctors need to be aware; patients need to be aware.
The newest news and research are uncovering an important truth. The truth is that a healthy gut and its healthy microbiome are critical for the avoidance of most – if not all – chronic diseases. And a damaged gut could be the source of many diseases. It’s interesting that over 2,000 years ago, Hippocrates was reported to say that “all disease begins in the gut”. Maybe he knew something that we are just beginning to comprehend and to prove.
As you know, I have written about the gut microbiome and the importance of restoring it to a healthy state. The food we eat, the substances we avoid, and our overall lifestyle affect the gut. Specifically, these affect the bacteria in the gut, the gut’s protective mucosal layer, and the all-important epithelial layer that separates the lumen of the gut from the rest of our body. The healthy gut lining is the gatekeeper that allows nutrients that our body requires to enter our bloodstream and protects us from all the other junk in the gut that the body does not need.
Many scientific articles have been published that prove the direct causal effects of the gut microbiome on the health of various organ systems.
A 2019 medical article published in the International Journal of Molecular Sciences reviews the newest research and discusses the potential connections between periodontal disease, rheumatoid arthritis, and the health of the gut.
In essence, this paper supports the theory that periodontal disease and rheumatoid arthritis may have their beginnings in an unhealthy gut. Yes, the gut!
If this theory is correct, then effective treatment should include the restoration of a healthy gut as well as specific treatment modalities for both periodontal disease (PD) and rheumatoid arthritis (RA).
PD is the most common cause of tooth loss and one of the world’s most prevalent chronic inflammatory diseases. Pathologic bacteria around the tooth margins at the gum line penetrate the tissues and create a cascading progression of inflammation in the soft tissues. Often this leads to bone destruction around the roots of the teeth. The causes of this chronic disease are considered to be multifactorial. Genetic predisposition and a compromised immune system are two major factors that allow an unhealthy balance of bacteria in the mouth to progress to PD.
RA is a chronic autoimmune disease. Patients with RA experience synovial inflammation and hyperplasia leading to irreversible damage of the cartilage and bone in the joints, loss of function, chronic pain and progressive joint disability. The causes of rheumatoid arthritis are multifactorial like periodontal disease, and these causes are similar to those of PD.
Unhealthy changes in gut bacteria will create a series of changes in the immune system. These changes will cause specific bacteria (P. gingivalis and A. actinomycetemcomitans) to proliferate. Both of these bacteria can lead to local protein alterations by process called “citrullination”. Citrullination is the conversion of the amino acid arginine into the amino acid citrulline. Evidence suggests that increased citrullination may participate in tissue destruction associated with periodontal disease and rheumatoid arthritis. Citrullination may be a key mechanism allowing both PD and RA to affect one another.
Treating an unhealthy gut will not automatically treat periodontal disease or rheumatoid arthritis. But a healthy gut could be an important therapeutic result for an inclusive treatment plan for both diseases.
I have developed a Protocol to Restore Normal Gut Bacteria, which I could send in a PDF. Email me at Al@DrDanenberg.com, and I will send it to you.