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Dental Health, Inflammation, and Your Health

This is an unusual post to see here in Nourition. After all, why is a dietitian talking about teeth? And what do teeth have to do with inflammation?

A lot.

This post is inspired by a seminar I attended at the Integrative Healthcare Symposium presented by Reid Winick, D.D.S, Dentistry for Health. The most important message is that oral health is inseparable from systematic health.

Here are three ways your teeth, nutrition, and your overall health overlap.

Nutrient Deficiencies

Nutrient deficiencies show up in your teeth before anywhere else. This article written by a dentist on the Dr. Oz website is a good simple read on the symptoms of nutrient deficiencies in teeth.

What the article missed:

  • Nutrient deficiencies can mean something more serious. If you eat a varied diet and take dietary supplements and continue to suffer from deficiencies, your body is having a problem with absorption. Your digestive track needs a check up, and it’s a good idea to check for celiac disease.
  • Somatitis (inflamed and sore mouth) are triggered by a variety of reasons including food sensitivities, autoimmune disease (lupus), and Crohn’s disease (inflammatory bowel disease). If there’s no obvious reason why you have sore mouth often, it’s worth investigating digestive and immune conditions.

Gingivitis

How many of you have been told by your dentist that you only have gingivitis? How many of you were sent home with floss and mouthwash? While flossing and brushing are important in PREVENTING periodontal disease, once you have gingivitis–the first stage of periodontal disease–your dentist needs to be more aggressive.

Gingivitis means bad bacteria in mouth. If left untreated, these bad bacteria can enter your blood stream and/or migrate to your intestines, causing inflammation and imbalance between the good and bad bugs.

Periodontitis is an inflammatory mucosal disease – It is not just about bugs

Mucosa is the moist tissue that lines certain parts of the inside of your body. Since your mouth is the beginning of your digestive track, the lining (mucosa) of your mouth is related to the lining (mucosa) of your small and large intestines. Bag bug balance in your mouth can be related to bag bug balance in your intestines, connecting periodontal disease with irritable bowel syndrome (IBS), inflammatory bowel disease (IBD)–Crohn’s and Ulcerative colititis, and small intestinal bacterial overgrowth (SIBO).

The progression of periodontal disease:

  1. Poor brushing and flossing lead to plaque and calculus build-up, the perfect home and food for bacteria to grow.
  2. The bacteria forms colonies. The immune systems comes to the rescue with inflammatory compounds to kill the bacteria. Weakened immune system due to poor nutrition, diabetes, aging, inflammatory bowel diseases, etc, leads to bleeding gums. That’s the first warning sign.
  3. The immune system starts to turn on itself and forms deep pockets. The bacteria transform from normal to disease-causing bacteria. They hide in the pockets and flossing can’t get rid of them. This is when you need a good dentists focused on prevention.
  4. Bacteria move to the blood stream, increasing the risk for diabetes, heart disease, pre-term labor, and systematic inflammation. The bone is now attacked by the immune system causing tooth loss.
  5. Advanced periodontal disease: implants, denture, surgery, bone grafting, etc become necessary.

Periodontal Disease and Chronic Disease

Plaque and calculus are inflammation. They raise your c-reactive protein (CRP) and fibrinogen levels–markers of inflammation and risk factors of heart disease and blood clotting. Periodontitis contributes to the process of heart disease and is an independent risk factor for heart attacks and strokes.

Periodontal disease is linked to diabetes, heart disease, stroke, and pre-term birth

Research also connects periodontal disease to diabetes. Deep pockets are associated with impaired glucose tolerance and with diabetes. Treatment of periodontal disease in people with diabetes reduced HgA1C, which gives a 3-month picture of blood glucose level.

Take home:

  • Visit your dentist and get your teeth cleaned every 6 months.
  • If you have diabetes, heart disease, or high CRP, see your dentist. Your teeth are probably in trouble too.
  • If you have gingivitis or any early stage of periodontal disease, ask your dentist about therapies to kill the bacteria. Flossing isn’t enough. Realize that you are at risk for systematic inflammation.
  • Pregnant women are especially vulnerable to plaque formation and periodontal disease can cause pre-term labor.
  • Eat a nutrient-rich diet. If you’re not sure whether your diet is adequate and whether you need supplements, a nutrition consult is a must. Your teeth need more than calcium.
  • Skip soda and acidic foods. Low pH (high acidity) promotes bag bugs, and high pH (alkaline) promotes good bugs. Foods that promote high pH are cruciferous, leafy, and root vegetables.
  • If you still have nutrient deficiencies, dig deeper. Why isn’t your body absorbing nutrients?

The lining of your mouth is only the beginning of the lining of your intestines. If you have bad bugs up, you might have bad bugs down. Gas, bloating, abdominal pain, diarrhea, and constipation are symptoms of IBS, IBD, and SIBO, conditions related to bad bugs in your gut. Visit your doctor, and don’t forget that nutrition is a major player in these conditions.

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Comments on this entry are closed.

  • lili March 27, 2013, 2:31 pm

    Thank you Nour for this information. Very useful.

  • Dan April 14, 2013, 8:29 am

    Nour this is excellent work. It moves beyond what the dentist tells you and gives you true insight into why nutrition is darn important. And we’re not talking about just eating the food pyramid here…the American diet is so far out of touch with the real nutrition our bodies need (for the most part). Thanks for sharing this.

    Dan.

    • Nour Zibdeh May 6, 2013, 8:59 pm

      Hi Dan… this is great to hear from a dentist! It’s amazing how the teeth and the rest of the body are connected, and it’s unfortunate that they’re often seen as two separate disciplines. Feel free to connect in the future! Nour

  • Jackie Jardine April 17, 2013, 11:52 am

    I have had an interesting experience with dental plaque that relates to nutrition and diet. For a number of years I was on the Adkins diet – during that time plaque began to accumulate on my teeth more rapidly than in the past…until I was getting my teeth professionally cleaned 4 times a year. In between cleanings I had a dental pic that I used to scrape off accumulating plaque. After I went off the Atkins diet the plaque accumulation slowed – but I was still getting my teeth cleaned 2-3 times a year and scraping plaque in between cleanings. Three years ago (because I lost my dental insurance) I decided to limit myself to professional cleanings twice a year and just use the home-dental pic in between. AFter 3 months I had begun to build up such a large amount of plaque that I was concerned about lasting the whole 6 months between cleanings. Then I started a vegan diet…within a month (much to my huge surprise) the plaque on my teeth – that was already present – had disappeared. In the two plus years since I have had zero plaque build up on my teeth.

    • Nour Zibdeh May 6, 2013, 9:40 pm

      Hi Jackie. Interesting observation. Isn’t it amazing when you pay attention to how your body reacts to changes in your food? There are many things that impact teeth. First, the gene x environment interaction. You may be genetically predisposed to plaque formation in certain environments, and eating an Atkins diet may be this environmental trigger. Atkins diet promotes animal proteins,meats, and dairy, all of which promote acidity in the body, and we know that an acidic environment promotes plaque formation. Vegetables and fruits promote alkaline environment (less plaque) and that could be one reason why.
      Have you considered doing a GI Stool Analysis test? Contact me privately for more info. We know that meat products feed certain types of bacteria, and these bacteria can raise your risk for heart disease. And since we know that teeth health impacts overall health, it’s worth checking it out. Often, the bacteria in your gut is similar to the bacteria in your mouth, and the mouth is the first place where they show up. I hope this has been useful! Nour

  • Steve August 6, 2013, 7:36 am

    dental hygiene is a very important aspect of your over all well being..

    • Nour Zibdeh August 18, 2013, 10:05 pm

      indeed! I never miss a day of flossing.. although, the dentist I listened to says flossing won’t help if gingivitis is there already… PREVENTION is my goal!

      • debi September 8, 2013, 8:57 pm

        Actually – gingivitis is 100% reversible – periodontitis (periodontal disease) is not – that must be treated by professional intervention.

        This is a great blog post and I spend a lot of time discussing the link between overall health and oral health with my patients. The majority of cardiac patients have no knowledge about the relationship between oral plaque and vascular plaque. Post operative care for these patients touches on dietary and exercise changes that are needed but never dental care. How can the body heal when it is in a constant state of inflammation from undiagnosed and or untreated dental disease?

        Prevention is the key – but also intervention – the medical and dental communities need to work together to educate our patients.