Why Yogurt (and Other Fermented Foods) May Help Keep Your Mouth Healthy

vintage milk adAsk someone to name a food associated with good dental health, and you’re apt to hear “dairy.” You can thank its calcium content and decades of advertising for that.

Calcium is one of the key minerals needed to keep tooth enamel strong. (Magnesium and phosphorous are the two other biggies.) And some research has suggested that it might play a role in maintaining healthy gums, as well.

But a new study in PLoS ONE suggests that it may not be the calcium at all but probiotics in fermented dairy products such as yogurt.

Researchers analyzed periodontal and nutritional data from over 6100 Korean adults. They found that those who ate less yogurt had more gum disease than others. Those who consumed less milk or calcium, on the other hand, didn’t exhibit more periodontal issues.

In conclusion, periodonitis was significantly associated with the less intake of yogurt among the Korean adults, but the calcium contained in yogurt is not likely to cause it.

What makes yogurt different, of course, is its probiotic content – helpful microbes that help defend against disease – and previous research appears to support this.

kombuchaOf course, yogurt is hardly the only source of probiotics. Fermented foods of all kinds can be wonderful additions to your diet. These include kombucha, kimchi, tempeh, lassi, sauerkraut, raw apple cider vinegar, kefir, miso, and fermented cod liver oil.

Naturally fermented foods have been proven to show many benefits in cultures around the world. According to one recent paper in Frontiers in Microbiology, for instance,

The highest longevity observed among the people of Okinawa prefecture in Japan is mostly due to their traditional and cultural foods such as natto, miso, tofu, shoyu, fermented vegetables, cholesterol-free, low-fat, and high bioactive-compounded foods in addition to active physical activity, sound environment, happiness and other several factors.

Probiotics can also be taken with prebiotics (a/k/a synbiotics) for an even bigger impact. According to research in the Journal of Medicine and Life,

It appears that synbiotics increase survival of probiotic bacteria, stimulating their growth in the intestinal tract and improving the balance of health-promoting bacteria.

Good dietary sources of prebiotics include raw asparagus, raw garlic, onion (both raw and cooked), raw dandelion greens, raw leeks, under-ripe bananas, raw chicory root, and raw Jerusalem artichokes. (Why so much raw? Cooking can break down a lot of the helpful elements in some prebiotic foods.)

Pro- and prebiotics can be an easy addition to your daily routine for improving oral and systemic health alike, physical and mental. Maybe consider grabbing a bottle of kombucha for your next holiday party rather than that bottle of wine.

That Warrior Pose Could Be Good for Your Gums, Too!

Warrior 2 poseYoga is traditionally thought of as a way to strengthen muscles, increase flexibility, and reduce stress. Sure, it does all of that, but did you know that it’s linked to healthier teeth and gums, too?

One way is by improving blood flow. As a recent post at India’s Tribune noted,

The strength of our teeth is directly related to the strength of our bones. The organ responsible for stimulating the growth of bones is the pituitary gland. So any posture or asana like sirshasana [a headstand pose], which will stimulate more blood to this gland will increase the strength of bones and teeth.

Here are more poses that can help with circulation.

Then there’s yoga’s well-known ability to reduce stress. Chronic stress is one of the major risk factors for gum disease. It can also lead to bruxing – habitual clenching and grinding – which can cause gum recession and damage teeth.

But there’s another way in which stress can have a negative impact on your oral health. As a paper earlier this year in the International Journal of Dentistry Research noted, it can lead us to neglect our oral health.

People who are stressed are less likely to give their teeth and gums the proper oral care. Yoga is one of the most effective treatment[s] for stress. Yoga reduce[s] the stress, improve[s] the [oxidative] status of body, improve[s] the immune system, and reduces chronic gingival inflammation. Yoga also improve[s] the life style more towards the natural. All these effects help…in better maintenance of oral hygiene, and reduction in gingival inflammation and prevention of dental diseases.

Other benefits the authors note include maintaining a healthy balance of saliva, preventing autonomic dysregulation, and managing health overall.

Other research has shown yoga’s ability to reduce inflammation. For instance, a 2015 study in the Journal of Clinical and Diagnostic Research found that regular yoga practice lowers levels of two key markers of inflammation, tumor necrosis factor alpha (TNF-α) and Interleukin-6 (IL-6).

It also reduces the extent of increase of TNF-α and IL-6 to a physical challenge of moderate exercise and strenuous exercise. There is no significant gender difference in the TNF-α and IL-6 levels. Regular practice of yoga can protect the individual against inflammatory diseases by favourably altering pro-inflammatory cytokine levels.

Even yoga’s impact on posture can affect your oral-systemic health. As Yoganonymous notes,

Poor posture can affect just about every part of your body, including your mouth. When one’s posture is poor, it can cause the lower jaw to move forward. It can even affect the alignment of the teeth and result in a condition called TMJ disorder. TMJ disorder can result in dental problems, such as teeth grinding. It can also cause a person to have difficulty chewing and swallowing. Additionally, TMJ disorder can cause pain in the face and jaw.

Not to mention the head, neck, and shoulders. Yoga may help prevent TMJ problems from arising in the first place, but it can also be one way to find some relief from the pain (in addition to long-term dental solutions).

Partner yoga with practices like good home hygiene and mindful nutrition, and you only add to the whole-body approach to maintaining healthy teeth and gums.

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Scared of the Dentist? Go for a Brisk Walk!

anxietyPlenty of folks get anxious around dental visits. It’s why we offer sedation options to patients who need them – so fear doesn’t have to stand in the way of getting the care they want or need.

But sedation is hardly the only option.

A new study in the journal Depression and Anxiety found that 30 minutes of walking at a moderate pace right before a dental appointment can significantly reduce stress and anxiety before, during, and after the visit. As Dr Bicuspid reported,

“In the present study, [moderate-intensity exercise] not only led to a significantly stronger reduction of dental anxiety during the anxiogenic challenge (dental procedure), but also to a decreased fear prior to the stressful situation,” the authors wrote. “The additional effect of [moderate-intensity exercise] on anticipatory fear in [dental phobia] is an important clinical finding of the current trial because both aspects of the phobic reaction are important barriers to seek treatment.”

This study monitored patients who scored high on the Dental Anxiety Scale and hadn’t seen a dentist for at least three years. Half of them walked for 30 minutes at a low-intensity treadmill pace; half walked at moderate-intensity. After one week, they switched paces.

Pain intensity was measured using a tool called the visual analog scale (VAS). You can see just how much lower the scores were with moderate-intensity exercise:

You might be wondering how the heck you can fit in 30 minutes of moderate cardio right before your appointment (doctor visits are often squeezed into already jam-packed days). But the good news is that even if you can’t exercise right before your appointment, you may still benefit from incorporating exercise into your daily routine.

For we know that exercise can help reduce anxiety in all settings, not just the dentist’s chair. According to the Anxiety and Depression Association of America, the impacts of exercise can be long lasting.

Science has also provided some evidence that physically active people have lower rates of anxiety and depression than sedentary people. Exercise may improve mental health by helping the brain cope better with stress. In one study, researchers found that those who got regular vigorous exercise were 25 percent less likely to develop depression or an anxiety disorder over the next five years.

And there’s another benefit to exercise: It appears to support good gum health, too. One key study out of Case Western Reserve “found that individuals who exercised, had healthy eating habits and maintained a normal weight were 40 percent less likely to develop periodontitis, a gum infection that can result in loss of teeth.” A contemporary study had even more startling results.

People who never smoked and took regular exercise were about 54% less likely to have periodontitis than people who never smoked but did not engage in physical activity. Rather surprisingly, the prevalence of periodontitis in former smokers was 74% lower for physically active than inactive individuals.

Better oral health and less anxiety plus all the other health benefits of exercise, physical and mental alike? What are you waiting for?

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Treating Gum Disease May Lower Blood Sugar Levels

gum diseaseEarlier this week, folks observed World Diabetes Day in response to growing concerns about the global epidemic. A joint project of the International Diabetes Federation and World Health Organization, the annual campaign reaches a billion people in 160 countries around the world.

But despite casting such a wide net, half of all people with diabetes will stay undiagnosed. Considering that more than 370 million have the condition, that’s more than a few in the dark about their health. And those numbers are only expected to grow.

What you may not know is that the mouth suffers right along with the rest of the body when it comes to diabetes. As a 2012 study in the Journal of Pharmacy & BioAllied Sciences puts it,

Diabetes is a systemic disease which is a serious oral co-morbidity. Most oral complications occur in uncontrolled diabetics, involving the periodontium, the calcified tissue, and the oral mucosa. Therefore, poor metabolic control, periodontal disease, dental caries, xerostomia (dry mouth), and fungal infections go hand in hand.

The good news? Treating your gum disease may actually lower your blood sugar levels and keep diabetes in check.

Another great video for getting to know more about the link between your mouth and diabetes is Dr. Evie Lalla’s “Unscrambling the Periodontitis-Diabetes Connection.” Though her talk is geared toward doctors, don’t let that scare you. It’s valuable information. It’s also likely to spark questions you can ask your dentist or doctor.

We see education as a vital component of good oral health. It provides a foundation of understanding – the first step toward action. Good oral practices can prevent or control inflammation, helping you return to your desired state of health.

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Your Mouth Is the Gateway to Your Body

In honor of October’s designated status as National Dental Hygiene Month, we’d like to share an excellent video we recently ran across – “Gums to Guts: Periodontal Medicine,” Professor Mark Ryder’s talk on oral health and its relationship to the body’s systematic health.

It not only offers great visuals and useful info on markers of health and disease; it supports the importance of seeing the mouth as an integrated part of the body, not a separate feature.

If it’s been awhile since your last hygiene visit and exam, remember this key message: The mouth is a gateway to the body and has much to do with what’s going on in your body. Good oral health not only supports good body health and wellness; it’s a key factor in it.

Dietary Balm for Gum Disease

toothy grin with gum diseaseYou do all the right dental things. You brush at least twice a day. You floss (even if some insist there’s “no scientific evidence”). You schedule your next hygiene appointment before you leave your last one. Still, you have gum disease.

So what base might you be missing? It could well be diet.

A recent pilot study suggests that switching to a low inflammation diet may help that gum disease finally heal.

The small study focused on 15 adults with gingivitis and an apparent appetite for carbs – a major contributor to chronic inflammatory conditions. Ten of them followed a low-carb, anti-inflammatory diet. They were also directed to increase their intake of omega-3 fatty acids, vitamin C, vitamin D, and antioxidants.

The remaining five served as the control group and kept on eating their typical high-carb diet. All participants were told to stop using floss or other interdental cleaners but otherwise keep up their usual oral hygiene habits. Each group followed their plan for six weeks.

After the four observational weeks, the experimental group showed significantly reduced gingival and periodontal inflammation compared with the group who did not change their diet. Specifically, reducing carbohydrates led to a significant improvement in gingival index, bleeding on probing, and periodontal inflamed surface area. In addition, increasing omega-3 fatty acids and fibers improved plaque index.

The improvements pose many questions for further studies to explore. First, since the periodontal health indicators occurred despite both groups showing no change in periodontal values, the authors question the actual role plaque plays in the development of gum disease.

Further research will likely be done to determine if one particular component of the anti-inflammatory diet was more significant than another. But one thing’s certain from this very limited study: Dietary pattern plays a significant role in the development of periodontal disease.

In the meantime, you don’t need to wait. You, friend, can be an experiment of one. Give the study’s protocol a try:

  1. Put the kibosh on carbs.
  2. Get on your omega-3 fatty acids.
  3. Welcome the vitamin C and vitamin D.
  4. Eat a rainbow of antioxidants.
  5. Fiber up!

And by all means, keep practicing your effective oral habits!

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Your Body Requires Maintenance

None of us are getting any younger. And the truth is, as we age, we end up spending more time on body maintenance than our younger selves did. Along the way, most of us learn to identify and fine-tune what keeps us in our optimal health zone.

The benefit of all those years as they add up? We acquire a certain level of body wisdom.

Still, it’s a good thing that science is almost as keen on aging-related topics as we are. Case in point? The Journal of Gerontology’s recent study on age-related bone loss.

CoQ10 capsulesLooking at the specialized tissue that supports our teeth – the alveolar bone – the authors evaluated the effect of a life-long low coenzyme Q10 dosage along with one of two types of unsaturated fat based diets: polyunsaturated (omega-6), or monounsaturated (omega-6/omega-3 ratio).

Need a quick primer on omega-6 vs. omega-3 fatty acids? Here you go.

Fats are a hot topic these days. Much of what folks have believed over the last 40 years is being turned on its head. In 2013, the British Medical Journal stunned with a study that showed that “replacing saturated animal fats with omega-6 polyunsaturated vegetable fats is linked to an increased risk of death among patients with heart disease.”

And the American Heart Association was left scratching its head.

It’s not that omega-6 fatty acids are “bad” in and of themselves.. But they must be in a balanced ratio with omega-3 fatty acids for optimal health.

Similarly, saturated fats are turning out to be not at all the demon that the mainstream medical industry has made them out to be. In fact, a diet too high in polyunsaturated fatty acids and too low in saturated fats may actually cause oxidative damage to weak cell membranes.

In addition to heart disease, a high level of omega-6 fatty acids has also been correlated with bone loss and periodontal disease. Turns out, when it comes to your body’s ability to remodel its bone, too much omega-6 diminishes your ability to produce prostaglandin. Prostaglandin is critical to bone development.

And this is where our CoQ10 study comes in.

Results [showed] that exacerbated age-related alveolar bone loss previously associated to n-6 polyunsaturated fatty acid diet was attenuated by coenzyme Q10.

In other words, CoQ10 may mitigate the bone damage seen with high omega-6 diet. Gene expression analysis suggested that CoQ10 might increase that little powerhouse in your cells known as your mitochondria, restoring their ability to adapt to aging in gingival cells. This is likely due to an increase cell turnover and better oxidative and respiratory balance.

Considering that the typical American diet contains up to 25 times more omega-6 fatty acids than omega-3s, increasing CoQ10 intake could help a lot of people. But considering how badly it tends to drag down health overall, adjusting diet so you get a more balanced intake of omega-6 and omega-3 seems the more sensible route for long-term health and well-being.

However you approach your body’s maintenance, remember that reaching your goals requires daily habits that support the outcome you desire. When it comes to oral health, the daily habit of good nutrition combined with effective brushing and flossing techniques go a long way to keeping you at the level you consider to be optimal for you.

Your Mouth Is Trying to Tell You Something

woman biting moneyDid you know that paying attention to the signals your mouth is giving you can result in saving money on healthcare?

A 2014 analysis of insurance company data showed that treating gum disease can improve overall health and lessen complications with other medical conditions. Medical costs were as much as 74% lower for those who had their gum disease treated.

As material from Cigna puts it,

Every dollar spent on preventive dental care could save $8 to $50 in restorative and emergency treatments – and potentially more in additional types of medical treatment.

* * *

Our nationally published study supports an association between treated gum disease and lower medical costs for individuals with diabetes, cardiovascular disease and stroke. When compared with patients undergoing initial treatment for gum disease, patients who were previously treated for gum disease and were receiving maintenance care had reduced medical costs.

Dental & Medical Integration

Routine dental care helps address minor problems before they become major. Program outcomes from studies show that the integration of good preventative dental care and visits with a primary care doctor positively impacts medical health for diabetes, heart disease and stroke. One report from Aetna found that an integrated approach

  • Lowered medical costs by an average of 17%.
  • Improved diabetes control by 45 percent.
  • Reduced the need for major and basic dental services by almost half.
  • Required 3.5% fewer hospital admissions.

Inflammatory Concerns

As a biological dental practice, we’re excited about the possibility of integrating dentistry and medicine. We see it as a promising change in healthcare. When it comes to your health, developing a rich exchange between physicians and dentists has always been the ideal. We know that what we see in your mouth is connected to your entire body’s system.

Oftentimes, your mouth will give the first signs of inflammation in the body. Gum disease, or a tooth abscess, will create inflammation because the body is responding to a bacterial assault, either localized or systemic.

When these acute issues go unchecked, inflammation can become chronic. Chronic inflammation is a potentially dangerous shift because it affects your body in a systemic way, contributing to or exacerbating heart disease, stroke and diabetes — three of the leading causes of death in the US.

Numerous studies have shown the same pathogenic bacteria found in clients diagnosed with gum disease have been found in the blood clots of patients who have suffered a heart attack. This correlation suggests that these oral pathogens can contribute to heart disease and stroke.

Type 2 diabetes is another inflammatory disease that is closely linked to mouth health. One study of nearly 3000 patients found that 93% of those with periodontal disease are at a heightened risk of diabetes. According to the study’s author, Dr. Shiela Strauss of NYU,

In light of these findings, the dental visit could be a useful opportunity to conduct an initial diabetes screening, an important step in identifying those patients who need follow-up testing to diagnose the disease.

Dentists are the only doctors who can diagnose – and treat – gum disease. But for best results, YOU take an ACTIVE role. Prevention is not only a choice; it’s also a vital component of reaching personal health goals — especially if they include saving money and staying out of the hospital.

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Know Your Nutrients: Iron

Periodontal disease isn’t just about your gums. It’s not even about your mouth. It’s about your whole body health.

The latest reminder? A follow-up study in the Journal of Indian Society of Periodontology recently confirmed that periodontitis – severe, advanced gum disease – may lead to anemia of chronic disease (ACD), a form of anemia seen in chronic infection and chronic inflammation. The researchers also found that treating the gum disease can improve anemic status.

iron from periodic tableGum disease triggers inflammation. In the short-term, this is exactly how your body should react. Over the long-term, though, inflammation is damaging, and that chronic inflammation is part and parcel of gum disease. Among other things, it interferes with your body’s ability to absorb iron.

Other factors that can lead to iron deficiency include blood loss, intense exercise or simply not getting enough through diet – especially during times of increased need, such as pregnancy, growth spurts, and lactation.

Lack of iron is a big problem. Your blood cells need it. Without enough, your red blood cells can’t carry enough oxygen throughout your body. Fatigue, dizziness, difficulty concentrating and other symptoms of anemia are the result. Your body isn’t getting what it needs to work properly.

It is getting more vulnerable to infections and illness.

So how much iron do you need? The general recommendation is 8 mg daily for men, 18 mg daily for women under 50, and 8 mg for women over 50. (Recommendations are even higher for women during pregnancy and lactation, and vary for children according to age.)

While iron supplements are available, your best first source is – always and again – real whole foods. Meats and other animal source foods provide heme iron, while plants provide non-heme iron. Since non-heme iron isn’t absorbed as well as heme, it’s especially important for vegans to watch their intake and eat in ways that promote iron-absorption. Especially iron-rich foods include

  • Liver and other organ meats
  • Red meat
  • Egg yolks
  • Oysters, clams, mussels and squid
  • Chickpeas
  • Beans
  • Lentils
  • Spinach
  • Tofu and edamame (be sure to get non-GMO)
  • Quinoa

For healthy adults, there’s little risk of overdoing it with dietary iron. Iron supplements, however, – like all supplements – are best taken under a health practitioner’s guidance, as overconsumption can cause problems (as well as interfere with your ability to absorb other essential nutrients, such as zinc). If you are taking any pharmaceutical medications, talk with your doctor before you start taking any kind of supplement to avoid any potential negative interactions.

Image via Bertucio Design @ Shapeways

The Mouth-Body Connection: Obesity and Gum Disease

obese man in waiting areaThe numbers are not encouraging.

According to the latest numbers from Gallup and Healthways, the US obesity rate has climbed once again, nearing 28%. That’s more than one in four of us. Not just overweight but obese. Here in Texas, the rate is even higher: 30%.

Meanwhile, cancer specialists speaking at the annual meeting of the American Society of Clinical Oncology in Chicago cautioned that obesity may overtake smoking as the leading cause of cancer within the decade. According to Harvard oncology specialist Jennifer Ligibel, the relationship between the two conditions is “clear.”

“It’s the case with breast cancer, a prostate cancer, cancer of the colon and all the gynaecological cancers,” she said. She highlighted research showing that obesity increased the risk of womb cancer sixfold.

Experts said obesity was driving cancer because it results in hormones imbalances that can fuel tumour growth.

Cancer and obesity are also both inflammatory conditions – like periodontal disease, which has also been linked to both.

The obesity link, in particular, has been highlighted by recent studies, such as the new research review just published in the Journal of Clinical Periodontology. The studies that met the authors’ criteria included more than 42,000 subjects and all together showed that those

who became overweight and obese presented higher risk to develop new cases of periodontitis…compared with counterparts who stayed in normal weight.

A review in the Journal of Periodontology similarly found “that overweight, obesity, weight gain, and increased waist circumference may be risk factors for development of periodontitis or worsening of periodontal measures.”

Research published earlier this year in the same journal found more pronounced markers of periodontitis (advanced gum disease) among those who were overweight and less physically fit.

So are exercise and more healthful eating the ticket? Perhaps not entirely. For one of the other findings in the Gallup/Healthways report was that social and economic factors may be fueling the rise in obesity rates, as well. Environmental factors also play a role. For instance, a new study in Environmental Health Perspectives showed how BPA may be contributing to the obesity crisis, as well:

The study is the first to find that people’s bodies metabolize bisphenol-A (BPA) — a chemical found in most people and used in polycarbonate plastic, food cans and paper receipts — into something that impacts our cells and may make us fat.

The research, from Health Canada, challenges an untested assumption that our liver metabolizes BPA into a form that doesn’t impact our health.

“This shows we can’t just say things like ‘because it’s a metabolite, it means it’s not active’,” said Laura Vandenberg, an assistant professor of environmental health at the University of Massachusetts Amherst who was not involved in the study. “You have to do a study.”

Like most modern chronic health problems, obesity is multifactoral. But eating better and getting more active do make a great start. Ramped up oral hygiene and nutritional therapy can offer big help, as well, in putting the brakes on chronic inflammation.

Image by Tony Alter