Why You Need to Tend to Your Teeth: Meet the Bacteria in Your Mouth

S. mutansSome are good guys; others, not so much. Good oral health means maintaining a proper balance of good to bad – and not just bacteria, but fungi and other microbial critters that hang out in even the cleanest of mouths. (In fact, recent research has shown that the yeast Candida interacts with the bacterium S. mutans to create especially strong oral biofilms [plaque].)

Unfortunately, those bad guys don’t necessarily stay confined to the mouth. And that’s the beginning of the link between gum disease and other inflammatory health problems such as heart disease, diabetes, stroke, rheumatoid arthritis, Alzheimer’s, cancer, and more.

This excellent short video will help you visualize what’s happening in your mouth when the balance is upset and how bacteria get from there to other parts of your body:


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.

Image by AJC1






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.

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

Green Tea for Healthy Gums

green tea leaves in bowlTeeth alone don’t make a smile. They need healthy gum and bone tissue to support them. The way to do that, of course, is through optimal hygiene, nutrition and overall healthy habits. Supplements, herbal medicaments and other natural substances can give a boost to those measures. Case in point? Green tea.

We’ve looked before at some of the oral health benefits of green tea. Now a more recent study – small but compelling – adds to the earlier evidence.

Subjects were split into two groups. One brushed with conventional fluoride and triclosan toothpaste; the other brushed with a green tea paste. After four weeks, the researchers looked for changes in several aspects of oral health, including pocket depth, bleeding upon probing, plaque and clinical attachment level (an estimate of a tooth’s stability). Both groups showed improvement in most areas, but by the end of the study, the green tea group had improved more.

The research was published in the International Journal of Dental Hygiene.

One of the virtues of green tea is that it is loaded with antioxidants that help keep your body’s cells healthy. It may boost levels of glutathione, a super antioxidant that is especially helpful in heavy metals detox. It is also has antimicrobial properties, having been shown effective in controlling growth of Candida – a yeast which may team up with S. mutans to make tooth decay even worse.

And, of course, green tea’s benefits are hardly limited to the mouth.

Despite the benefits, some find it hard to drink green tea on a regular basis. They may not be big fans of tea. They may find the mild flavor gets boring after a while. But whether you’re a novice tea drinker or an old pro, there are lots of ideas and recipes out there for jazzing up your brew. Here are a few for starters:

And keep in mind that there are other ways to enjoy green tea beyond brewing it. For instance, you could cook a green tea cake or Japanese green tea rice ororor

Image: Brandie Kajino

Stress & Periodontal Disease

stressed out personAs we mentioned last time, stress may increase your chances of developing poor oral health.

Recent research out of Tufts University shows that emotional and oral health are connected, as both bruxism (teeth grinding) and gum disease may be triggered by stress.

Stress can even the most oral-health conscious person to become lax about oral hygiene. Ineffective flossing and brushing allows bacteria to build up in your mouth.

Consider: More than 150 species of bacteria live in a person’s mouth. As many as a billion bacteria can cover the surface of a tooth in forming biofilm (plaque). That bacteria releases toxins whose goal, says Tufts professor Evangelos Papathanasiou, “is to create more space so more bacteria can form.”

Those toxins attack your gums, creating holes where the bacteria live and reproduce. In turn, your gums swell. Your body, trying to reduce the irritants, may actually hurt itself.

In a perfect world, immune cells and bacteria are in balance and thus protect teeth and gums. At a certain point, however, immune cells become so numerous that they begin to inflame tissue and hasten disease rather than prevent it—the same way an allergic reaction can cause the body more harm than good. At this point, gingivitis, which is reversible, gives way to bone loss around teeth and full-blown periodontitis, which is not.

Fueling inflammation are the hormones that spike when you’re stressed. One of these is cortisol, which helps you deal by increasing your energy, memory, and pain tolerance. But while it may sound like there’s only an upside, it, too, can cause problems.

When cortisol is produced peripherally in the gums, it stimulates mast cells to produce more proteins, simultaneously increasing inflammation and the progression of periodontal disease.

What’s more, gum disease increases your chances of developing infection elsewhere in your body.

The oral cavity works as a continuous source of infectious agents, and its state often reflects succession of systemic pathologies and various aspects affecting the disease progression must be considered before planning a true treatment plan.

There also appears to be a link between stress and bruxism, which can further put your gums at risk. Bruxism is the habit – often unconscious – of grinding teeth, which some have suggested may be a coping mechanism for stress. It can also do a real number on your teeth and gums. Not only can it wear down the teeth and damage enamel; the excess pressure inflames your gums, as well.

Even after all that, it’s important to remember that not all stress is bad. Sometimes it helps you survive. Your stress response can help you rescue a kitten or finish the annual report before the deadline.

But stress shouldn’t consume your life. Most health conditions linked to stress happen when you are exposed to daily pressure, known as chronic stress:

This is stress resulting from repeated exposure to situations that lead to the release of stress hormones. This type of stress can cause wear and tear on your mind and body. Many scientists think that our stress response system was not designed to be constantly activated. This overuse may contribute to the breakdown of many bodily systems.

While chronic stress is not good, you can control how you respond or cope. Typically, there are two response types: 1) emotion-focused coping and 2) problem-based coping. Emotion-focused coping may address your emotional needs and keep your mind off of the experience, but it’s often at the expense of finding a solution. In comparison, problem-based coping searches for practical solutions, but often does not do enough to soothe and calm your emotions.

Both responses may be appropriate, but again, it depends on your situation.

The main thing is that coping skills matter. One study found that poor coping skills may double your likeliness of developing a periodontal disorder. Another found that coping style can affect the severity of gum disease.

But again, how you deal depends on your specific situation and needs. Still, some general guidelines may be helpful to most anyone:

Stress & Sleep: A Match Not Made in Heaven

insomniaDo you wake up every morning feeling refreshed? For many people, that doesn’t happen. Stress keeps them tossing and turning all night, often waking up for unusual stretches of time.

You already know that stress is the bane of life. It makes you feel gloomy, irritable, hyper, tense, pressured. It’s effects are physical, as well. Chronic – ongoing – stress is a drag on health, as well. A recent poll from the Robert Wood Johnson Foundation found that

People who identified as being in poor health were more than twice as likely (60%) to report experiencing a ‘great deal’ of stress within the past month. Eight in 10 (80%) of those in poor health reported that their own health problems contributed to their stress, and more than half (58%) attributed the health problems of a family member.

Just this month, a new study found that stress raised the risk of stroke or “mini stroke” by nearly 60%!

Stress compromises your body’s immune system, increasing your chances of getting sick. For instance, normally, your body is typically able to fend off oral pathogens. But under stress?

this delicate balance is thrown off. Inflammation tends to increase due to stress, allowing bacteria to thrive and cause gingivitis, a precursor to periodontal disease.

The biological effects of stress don’t end when you fall asleep. As University of Pittsburgh sleep researcher Martica Hall recently explained to NPR, this is because chronic stress keeps you in “fight or flight” mode.

Stress hormones, such as cortisol and adrenalin, are pumped out, your heart rate goes up, sugar is released into the blood, and more blood is sent to your brain and muscles. Hall says it’s really hard to stay asleep through all that biological activity. She has found, for example, that cortisol — which surges to deal with that deadline or cope with that car payment — stays elevated throughout the night. So, even if you’re sound asleep, cortisol is constantly nudging your brain to wake up, deal with danger — real or perceived.

“Daytime stress follows you into the night,” Hall says.

And so you wake up intermittently during the night, don’t reach REM sleep, and don’t feel energized and refreshed the next day. Stress-induced bruxing – habitual clenching or grinding of teeth – may also interfere with sleep.

A pattern of unnatural sleep disruptions may have long-term health consequences – diabetes, obesity, heart disease, muscle aches, and brain damage. Yes, brain damage.

In one recent animal study, sleep deprived mice lost 25 percent of the neurons located in their locus coeruleus, a nucleus in the brainstem associated with wakefulness and cognitive processes. The research also showed that “catching up” on sleep on the weekend will not prevent this damage.

Other research published in the journal Neurobiology of Aging suggests that people with chronic sleep problems may develop Alzheimer’s disease sooner than those who sleep well.

Luckily, lifestyle changes you make today can greatly benefit you today and tomorrow. You’ll find some excellent tips for better sleep here and here and here.

True, one night of poor sleep isn’t going to cause too many issues, but you should still be mindful of the effects that stress has on your body. Overall, you want to make sure you’re getting quality sleep for approximately 7 to 9 hours a night – not 7 to 9 hours in bed but 7 to 9 hours actually sleeping.

Good sleep is needed to recharge you. After all, you’re not the energizer bunny… you can’t just keep going and going and going…

Image by Sarah

Oral Health Benefits of Green Tea

Chinese character for tea formed with teaGreen tea mouthwash may help ease pain caused by the swelling of oral tissue. That’s according to a small but promising study published last month in the International Journal of Oral & Maxillofacial Surgery.

The research involved 97 participants suffering from acute pericornitis, a condition in which the gum tissue around erupting or impacted wisdom teeth becomes infected and swollen. Two of the major symptoms are pain and difficulty opening the mouth.

After having their teeth cleaned, participants were told to either use chlorhexidine mouthwash (a common antiseptic) or a 5% green tea mouthwash for seven days. Evaluating each for changes in pain and jaw mobility, the authors found that those who used the green tea rinse had less pain than those in the control group, while also showing improved jaw mobility. Their conclusion?

Green tea mouthwash could be an appropriate and effective choice for the control of pain and trismus [limited mouth opening] in acute pericoronitis.

This is far from the only study suggesting green tea’s oral health benefits. A paper published earlier this year in Geriatrics and Gerontology International summed up some key benefits:

Green tea, a time-honoured Chinese herb, might be regarded as a functional food because of its inherent anti-oxidant, anti-inflammatory, antimicrobial and antimutagenic properties. They are attributed to its reservoir of polyphenols, particularly the catechin, epigallocatechin-3-gallate. Owing to these beneficial actions, this traditional beverage was used in the management of chronic systemic diseases including cancer. Recently, it has been emphasized that the host immuno-inflammatory reactions destroy the oral tissues to a greater extent than the microbial activity alone. Green tea with its wide spectrum of activities could be a healthy alternative for controlling these damaging reactions seen in oral diseases, specifically, chronic periodontitis, dental caries and oral cancer, which are a common occurrence in the elderly population.

And a meta-analysis published that same month in Oral Oncology concurred that green tea may aid in protecting against oral cancers.

Green tea can be found as an ingredient in a variety of products, but enjoying a simple cup of green tea (while reading this blog, of course!) may be the most relaxing. To make sure you are getting the most out of it, WebMD makes the following suggestions:

  • Don’t add green tea to boiling water. It’s bad for catechins, those healthy chemicals, in the tea. Better: 160-170 degree water.
  • Add lemon. Vitamin C makes the catechins a easier to absorb. Dairy, on the other hand, makes it harder to absorb them.
  • Nutrient levels in green tea can vary. Pricier teas usually have more, and canned green-tea drinks generally have less.

Of course, green tea is hardly the only herbal ingredient good for your oral health. For instance, another study from earlier this year found that an Ayurvedic herbal rinse was “effective in treatment of plaque induced gingivitis and can be effectively used as an adjunct to mechanical therapy with lesser side-effects.” This particular blend included Pilu, Bibhitaka, Nagavalli, Gandhapura taila, Ela, Peppermint satva, and Yavani satva.

The benefits of herbal mouthwashes change depending on the ingredients, but some of the common ones you’ll find include sage, peppermint, licorice root, clove, cinnamon lemongrass and eucalyptus, among many others.

Image by Toby Oxborrow, via Flickr

Coffee: Damaging to Your Teeth & Gums – or Not?

coffee_teethLook at any list of teeth-wrecking habits, and you’re apt to find coffee drinking among them (here, for instance), mainly due to its power to stain. Some claim it even contributes to gum disease (such as here and here). And that may be true for those who drink coffee blisteringly hot, which may cause some gum damage and pave the way for further perio problems.

However, recent research published in the Journal of Periodontology suggests that when it comes to periodontal health, coffee may actually have some benefit. Most likely, this comes courtesy of its being rich in antioxidants and anti-inflammatory factors.

Given the beneficial role of such factors in periodontal disease, we explored whether coffee intake is associated with periodontal disease in adult men.

What they found was a “small but significant” improvement in terms of bone loss – a hallmark of advanced periodontal disease – and zero indication of harm. Their conclusion?

Coffee consumption may be protective against periodontal bone loss in adult men.

An earlier analysis by the same authors – presented last year at the annual meeting of the American Association for Dental Research – suggests that coffee may also reduce gingival bleeding.

Pocket depth was the only aspect evaluated that didn’t seem to be affected by coffee consumption. This means there are still ideal colonizing conditions for perio pathogens: They love the dark, moist, low-oxygen space that pocketing around the teeth provides. Intensive hygiene – at the dentist and at home – is required to shrink those pockets and control bacteria.

Of course, ramped up home care – with the use of tools like oral irrigators (e.g., WaterPik) and interproximal or “proxy” brushes in addition to regular brushing and flossing – will also do more than any coffee guzzling can ever do to keep your teeth and gums healthy.

Learn more: What science has to say about some other health benefits and risks of coffee.

Image by Brandon Heyer, via Flickr