Oral Health: Why Oral Care Deserves To Be On Your Daily Self-care Priority List!

An Evidence-based Blog about Health, Compassion & our Environment

By Dr. Fern Moreno

I’d like to start by saying—that I not only hope, but I do trust—that this blog will be more enjoyable than a visit to the dentist.  Whether you’ve had a challenging oral care history or not, you’ll find that certain topics discussed here could very well influence your future daily oral care forever.   There are connections between oral health and the most common chronic illnesses in the United States that may shock you. If you’ve ever had root canal treated teeth, crown(s), extraction(s), implant(s), cavities, dental plaque, gum inflammation, halitosis (bad breath), or wish to avoid these at all costs, this is written for you. If you have a chronic illness or wish to avoid chronic illnesses, this is especially for you.

I’m here to tell you that the condition of your teeth, gums, and oral microbiome can determine your current and future health more than we have been made to believe.

Most people who consider health a priority have dabbled in eating healthily, staying active, improving sleep quality, and even mental health, but many people may not prioritize oral health. I want to share why I’ve concluded that oral care should be at the top of our personal self-care list for wellness and longevity and why this is a public health concern that deserves our attention. 

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Topics discussed:

  • The Connection Between Oral Care & Common Chronic Illnesses
  • At-Home Oral Care:
    • Daily Oral Hygiene
    • Oral Care Tools & Products
    • Lifestyle for Oral Health
    • Supplements for Oral Care
  • Professional Oral Care & Further Questions

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Oral Care & Chronic Illness are Connected

Many of us end up in a dentist office when we have pain, discomfort, or a glaring tooth or gum concern we wish to address. Waiting for tooth or gum pain to address oral health may be too late… Here’s why:

Periodontitis is a fancy word for inflammation due to an infection in the gums; mild periodontitis is quite common (but not normal).  Chronic apical periodontitis (CAP) is the advanced form of periodontitis; in CAP, the infection will creep down the tooth, past the gum line, and spread to the root tip deep in the jaw bone, seemingly unnoticed 47. CAP is often painless and commonly found only by accident during routine 2D dental X-rays.  Both periodontitis and CAP will increase circulating pathogens (initially found in the mouth) all over the body through the lymphatic and circulatory system; this leads to whole-body inflammation and chronic oxidative stress 24. Simply put, chronic inflammation from an oral infection increases the risk of all-cause mortality 40! Periodontitis alone has been correlated with the most common degenerative diseases affecting Americans, including heart disease, diabetes, cancer, pulmonary disease, metabolic syndrome, and many more 40.

Image source

I want to review only a few disease connections with you here—it can be overwhelming to learn the many disease connections to oral health— I promise to share with you various tips, tools, and practices to improve your oral health and put many of your concerns that may arise at ease 🙂

Cardiovascular Disease

According to the Center for Disease Control, heart disease is the leading cause of death for men and women in the United States. We now understand that atherosclerotic plaques in arteries first start with inflammation in the endothelial lining (the inner layer) of arteries; this inflammation is often initiated by infections or colonies of pathogens –> followed by artery injury –> and later plaque build-up in an attempt to heal the wound. 46. Thus, it should be no surprise that those with periodontitis have a 25% increased risk of coronary heart disease; males younger than 50 years old are 72% more likely to develop coronary heart disease than those with good oral health 9. Oral infections can begin not only in the gums but also in root canal-treated teeth. DNA of oral pathogens (specifically from root-canal treated teeth) have been found in blood clots aspirated from coronary and carotid arteries of post-mortem bodies; these pathogens were completely absent in those without root-canal treated teeth 37, 17, 28, 36. Oral pathogen DNA was also found in ruptured aneurysms 39 and the pericardial fluid of heart disease victims 27.

FERN FACT: Periodontal disease is strongly associated with acute myocardial infarction (heart attacks); treatment of periodontal disease alone can be used as an intervention to prevent heart attacks! 26

Cancer

According to the American Cancer Society, each of us has about a 40% chance of developing cancer in our lifetime. Studies have found that those with advanced periodontitis have a 2.5 fold increase in cancer (breast, colon, pancreatic, head, neck, oral, lung) 42, 7, 55, 44, 5, 31, 48. Infections that lead to oxidative stress often occur prior to the development of malignancies (cancer).  For example, one specific microbe found only in the mouth, called fusobacterium, has been found in malignant breast tissue and is now strongly linked to colon cancer 18, 23.

Cognitive Decline

The Alzheimer’s Association reports more than 5.8 million Americans, 65 and older, living with Alzheimer’s Disease.  Alzheimer’s and cognitive decline is now linked to periodontal pathogens; In fact, elevated antibodies to these pathogens are often found years before cognitive decline even begins 51, 34.  Periodontal pathogens found in the mouth and body, are also associated with Parkinson’s disease 10, 20 and seizures that are unresponsive to treatment 6.

FERN FACT: Those with periodontitis have an increased risk of depression, making periodontal disease an independent risk factor for depression. Conversely, depression is a predictor for missing teeth due to poor oral care during times of stress.

Metabolic Syndrome

Metabolic syndrome is a condition made up of elevated glucose, triglycerides, total cholesterol, lowered high-density lipoproteins 21. Metabolic syndrome is often paired with hypertension, which also happens to be more severe in those with advanced periodontal disease 41. There may be a cause-and-effect relationship between periodontal disease and metabolic syndrome.  It is known that those diagnosed with metabolic syndrome have a more severe and longer length of periodontal disease 21.  Research shows that treating periodontal disease alone improved total cholesterol and low-density lipoprotein levels, without other interventions 12, 43.

Pulmonary Disease

Periodontal pathogens can make their way to the lungs and contribute to recurring infections; Research found that first treating periodontal infections could prevent recurring lung infections 8 and improve lung function 57. Patients with chronic obstructive pulmonary disease (COPD) are more likely to have severe periodontal disease making oral infection a risk factor for COPD 53. Those with asthma and periodontal disease are 5 times more likely to develop bronchial inflammation 15.

FERN FACT: Our mouth has a microbiome (colonies of bacteria that live, feed, and reproduce) that is different than the microbiome in our gut. A single infected tooth harbors bacteria that release endotoxins to every single healthy tooth in the mouth.

Arthritis

Periodontitis often occurs before the diagnosis of rheumatoid arthritis (RA) and may play a role in the development of RA 2. DNA from common periodontal pathogens has been found in the blood and synovial fluid from the joints of RA patients 35, 32. Treating periodontal disease alone decreased the severity of RA, as seen in lab results and physical symptoms 22, 49.

FERN FACT: There are over 15 million root canal procedures performed each year in the U.S. 13. One study found that 100% of 5,000 root canal-treated teeth were infected 50. Root canal-treated teeth have had miles of blood supply, nerves, and connective tissue completely removed. These treated teeth have no communication with the rest of the body and become a breeding ground for painless infections, completely undetected and unaddressed by the immune system 29

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Are you still with me?! Great! Hang in there. Now is the fun part…

At-Home Oral Care Tips

I want you to feel confident that all the effort you put into your health every day truly pays off. Here are effective Daily Home-Care Tips to help you achieve and maintain optimal oral health!

Daily Oral Hygiene:

  1. Tongue scraping every morning before drinking or eating.
    • Gently remove the surface-layer of build-up on your tongue using a tongue scraper, starting as far back on your tongue as you can.
    •  May take 5-10 gentle swipes to remove buildup.
    • Rinse mouth with water or mouthwash after.
  2. Carefully brush your teeth at least twice per day (morning and before bed).
    • Add a brush or mouthwash session after high carb meals.
    • Change your toothbrush every 2-3 months or when bristles start to fray and fade.
    • Check for mold growth or musty smell on or near oral care products daily.
  3. Gently floss teeth DAILY.
    • Avoid causing bleeding gums.
    • Replace with mouthwash or Waterpik (on a lower setting) if gums are too inflamed and easily bleed.
  4. A Waterpik is an alternative to string flossing.
    • Fully fill the tank with filtered water (you may add 1 tsp of salt or 1-5 oz of mouthwash to water).
    • Aim water in between gums and teeth and in between teeth at the gum line. Use 3-7X per week.
  5. Oil pulling- May do 1-5X per week depending on oral health status.
    • Add 1/2 teaspoon of oil of choice in mouth and swish and pull for 10-20 minutes, while continuing other tasks (cleaning, cooking, computer work, etc.)
    • Brush teeth before and after coconut oil pulling.
    • Throw your finished oil pulling solution from your mouth in the trash, not in the sink; It may clog the sink because oil solidifies.
  6. Keep your sinuses clear by using a nasal rinse 2-3X per week or daily. Infections in teeth and jawbone can creep up into sinuses.
    • You may consider a humidifier for your home during dryer seasons – do not exceed 50% humidity indoors.

Oral Care Tools & Products

I want to share with you some of my favorite oral care products that I use daily and recommend to family, friends, and patients!

  1. Any stainless steel tongue scraper (they last a lifetime).
    • Rinse tongue scraper with soap and water or rubbing alcohol daily.
  2. Soft toothbrushes made from bamboo and charcoal (BPA-free, biodegradable).
    • You may consider a breathable toothbrush cover with antimicrobial properties in it.
  3. Toothpaste without fluoride, foaming agents, artificial sweeteners, preservatives, colors, or flavors.
  4. A natural mouthwash that is Dye Free, Microbeads Free, Paraben Free, Formaldehyde Free, Fluoride Free, Sodium Laureth Sulfate (SLES) Free, Artificial Sweeteners Free, Mineral Oil Free, Triclosan Free (antibiotic), Polyethylene Glycol (PEG) Free, Phthalate Free, Gluten Free, Alcohol-Free, Artificial Flavors Free.
  5. Any floss that is BPA-free and biodegradable.
    • Find various options HERE!
  6. PurO3 Ozonated Pulling Oil for Teeth and Gums & other ozonated products. These are some of my favorites!
  7. GoodBye Gum Disease – Natural Remedy for Gingivitis – Omega 3 & 9 oils infused with Clove and Neem essential oils.
  8. Any saline solution nasal rinse to help clear nasal sinus.
Buy pulling oil

Lifestyle for Oral Health

  • Diets to consider: Mediterranean diet 25, Ketogenic diet 56, vegetarian or plant-based diet 52, have all been shown to improve oral health outcomes.
    • 6-8 servings of vegetables per day
    • 5-6 servings of fruits per day
    • LOW SUGAR. The best sweeteners are stevia, date sugar, coconut sugar, but use in moderation.
  • Diets to avoid: CARBatarian (high carbohydrate, low vegetable vegetarians), Standard American Diet (SAD) (high in processed and packaged foods)
  • Drink tea 2-3 cups /day – Any herbal tea, but especially Green Tea:
    • Green tea reduces oral inflammation, prevents bone resorption, and limits the growth of bacteria associated with periodontal disease. Green tea also has naturally occurring fluoride 4.
  • Coffee – no additives
    • Coffee, with no additives, protects against dental caries, though it may stain teeth with time if not brushed or rinsed after drinking 1
  • Low alcohol consumption (<1 drink/day) 
    • Alcohol consumption is an independent risk factor for periodontitis 38
  • If you prefer to chew gum, aim for xylitol-based gum that is aspartame-free. Xylitol is antimicrobial.
  • Walk daily!
    • Walking is associated with lower odds of periodontitis 16
  • If you are a mouth-breather during the day or at night, re-train yourself to breathe from your nose; you may require an evaluation if you have blocked nasal passages.
    • Mouth breathing increases gum inflammation, pathogenic bacteria in the mouth, cavities, and oxidative stress 11.

Supplements for Oral Health

First ask your doctor what is best for you.

  • Vitamin D3 – 2,000 IU’s – 5,000 IU’s /day as a maintenance dose
    • Get direct sunlight daily!
    • Vitamin D helps maintain bone density, decreases gum inflammation, stimulate post-operative healing, and decreases the risk of chronic periodontitis 19
  • Vitamin C – 1 gram – 2 grams /day
    • Ascorbic acid improves outcomes of those with gingivitis and periodontitis with diabetes 14
  • Magnesium – 300-400 mg /day
    • Magnesium improves periodontal health 30
  • Fish Oil – 1g – 2g DHA/EPA /day
    • DHA significantly improves periodontal outcomes and reduces inflammation 33
  • Broad spectrum probiotic – 25 billion /day
    • Including S. Salivarius M18 strain, shown to reduce bacteria that cause dental caries 3

You may find these supplements & related quality products HERE!  A 15% discount is automatically applied.

Professional Oral Care & Further Questions

It is important to rule out infections not only in the gums and adult teeth but also in root canal-treated teeth, extracted teeth—which can result in cavitations (non-visible painless infections in the jaw bone)—implanted teeth, crowns, and sinuses.  Anyone with a chronic degenerative disease, particularly cancer and heart disease, should highly consider an oral pathology evaluation as a part of their routine medical care.

  1. Routine 2D X-rays may not always capture oral infections deep in the jaw; A 3D Cone Beam examination is more effective at detecting infections in the jaw and sinuses 45.
  2. A holistic biological dentist may be better equipped to detect and treat silent, chronic infections:
    • Therapies such as ozone injections can help address oral infections deeper in the jawbone.
    •  Platelet-rich plasma (PRP) injections can help heal and rebuild tissue after surgery.
    • Oxidative stress from infections can be managed and improved with nutrition, supplementation, and lifestyle.
  3. Search the International Academy of Oral Medicine & Toxicology for a qualified dentist near you.
    • Search for a dentist who is SMART-certified, who has multiple years of experience, and has experience with dental cavitations.

You are the master of your wellbeing.  With knowledge, support/resources, and ACTION, you can prevent, improve and recover from the most common illnesses. 

Your daily actions add up; Where you wish to see yourself in 5 years, starts with your daily routine today.  Take care of yourselves and give your oral health the love it deserves!

Disclaimer: The information presented is not meant to diagnose, treat or provide medical advice. Dosing and recommendations may vary depending on the individual. Please consult your doctor or speak with a naturopathic or integrative doctor during an official consultation to receive medical advice.

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