I get a lot of questions about dental hygiene and health, and for good reason. Dental records of our paleolithic ancestors show a fairly low incidence of caries  when compared to modern teeth. Exceptions exist , but the general trends suggest that Grok  had better teeth than the average contemporary human. Of course, when cavities struck back then, they hit hard and got really ugly, because there were no dentists, drills, or x-rays to fix the problem, but most never got to that point. Also, the adoption of agriculture is generally associated with the emergence of poor dental health, so much so that many researchers use the appearance of dental caries  in a population as strong evidence for the presence of farming. Maize/corn is particularly bad , as is wheat, but the same relationship may not hold true for rice agriculture  in Asian records.
Okay – let’s take a look at a couple common questions I get about dental health:
Mark, this morning as a dental assistant was making my head buzz and my gums hurt with some sort of ultrasonic tooth cleaner, I thought, “what can Grok teach us about tooth care?” Something tells me Grok did not brush his teeth–did he do anything to take care of himself in that way? And if he survived just fine, what does that tell us about “conventional wisdom” that says we should adopt a routine, and buy a medicine cabinet full of stuff to take care of our teeth? I certainly don’t mean to convey that tooth care is bad–but rather am just thinking about what we can learn from the past to harmonize the present.
Thanks for reading this, and thank you for your dedication to better health!
Hey Mark! I’ve recently taken an interest in making my oral regimen more Primal. I’ve read up on a lot of the more natural toothpastes and toothpaste alternatives but I’m undecided. What have you and your wife found to be the safest and most effective way to keep your cavities at bay?? Thanks!
Before resorting to anything reactive, whether it be brushing with homemade toothpaste, dousing your oral cavity with anti-bacterial mouthwash, bypassing the teeth altogether with an IV nutrient feed, or using a dental dam to chew, those seeking excellent dental health should establish a strong dietary foundation of the minerals, micronutrients, and other cofactors that play major roles in the maintenance of teeth.
The Vitamin D/A/K2 Connection
You’ve probably heard about how this holy trinity of micronutrients works together to promote proper bone and tooth mineralization, which means putting calcium and other minerals where they belong (bones, teeth) instead of where they don’t (arteries, dental calculus/plaque). Both Stephan Guyenet  and Chris Masterjohn  have written extensively about the synergistic interplay between the three nutritional factors, so I’ll keep this brief. Get adequate midday sun or take vitamin D  supplements; eat grass-fed butter , hard cheeses, and organs  (especially goose liver, apparently), or supplement with vitamin K2 ; get plenty of vitamin A from liver, egg yolks, and other animal products.
I probably don’t have to tell you to avoid grains,  but for any newcomers who might be reading: ditch the grains, beans, and other legumes  that contain high levels of phytic acid, which is known to bind to and prevent absorption of minerals critical for dental health. Nuts  also contain phytic acid, but we tend not to eat as many nuts as grains or legumes due to the caloric load. It’s a lot easier to eat two cups of whole wheat than it is to eat two cups of almonds. If you do eat nuts on a regular basis, consider soaking and/or sprouting  them to reduce phytic acid content.
It’s not enough to consume the holy mineralization trio and avoid excessive amounts of mineral-binding phytic acid; you also need the raw building blocks. That means getting plenty of minerals in your diet. Leafy greens , grass-fed meat , organs, nuts, roots, and tubers  are all good Primal sources of calcium, phosphorous, magnesium, and other vital micronutrients – vital for general and dental health – so eat plenty of them.
Hate the Toothbrush? Use a Chewstick.
There are numerous examples of traditional cultures using chewing sticks from trees with medicinal or antimicrobial properties, like the neem  in India, the miswak/arak  in Africa, the Mid East, and Asia, or the tea tree, which I mentioned in a previous post . Here’s an example  of a Masai “toothbrush” – it’s a whittled-down branch from a (perhaps medicinal) tree with the end frayed and the fibers splayed out to permit interdental entry. If you don’t have access to a miswak, neem, or tea tree, you can find chew sticks online  quite easily. Toothpicks or floss will also work pretty well as a physical deterrent, albeit without any medicinal qualities.
There isn’t a ton of head-to-head research on the subject, but one study  from 2003 found that miswak chewing sticks removed more plaque and resulted in better gingival health than toothbrushes. The caveat is that chew stick users had to be instructed in the proper use of the implements, whereas toothbrushes are fairly straightforward (not to mention most of us have grown up using them, so we’re well-versed in toothbrushing). It’s notable that chew sticks do not require toothpaste, and they appear to be just as, if not more, effective than toothbrushes. Longer history of use, too. You just have to know how to use it. Miswak appears to be the most studied, so you’ll probably want to use that variety.
If you’re gonna use a toothbrush, do you need the paste? If so, is Crest/Colgate/insert-mainstream-paste-here good, or should you go with an herbal/alternative/insert-paste-available-at-Whole-Foods-here instead?
Toothpaste use increases abrasion  during brushing, while water alone produces less abrasive force. Interestingly, the same study revealed that softer toothbrushes actually cause as much abrasion (and sometimes more) than stiffer toothbrushes. While increased abrasive forces seem like they’d reduce more plaque, that doesn’t seem to be the case. A recent study found that the brushing is the important part, not the paste. In fact, brushing without paste was more effective  at removing plaque than brushing with paste.
An herbal toothpaste made from herbs and plants traditionally used to treat oral disease in India was superior to a placebo toothpaste  in the treatment of gingival bleeding and oral hygiene. Another study  compared herbal toothpastes to conventional fluoride-containing toothpastes in the treatment of established gingivitis and found that both were equally effective.
In another study , a baking soda toothpaste beat an antimicrobial non-baking soda toothpaste in plaque removal and tooth maintenance. Most studies , in fact, show that baking soda is more effective at plaque removal than toothpastes without baking soda. It’s pretty common among older folks to just use straight baking soda to brush, and this seems to be an effective tactic.
If you’ve got all the nutritional and environmental cofactors under control, I don’t think obsessive dental hygiene beyond daily brushing (remember, even if the bristly toothbrush is a recent invention, cleaning our teeth with sticks or picking at them with fingernails is tradition), some toothpicking/flossing, regular dental visits, and/or maybe some chew sticking is necessary. It doesn’t even seem like toothpaste is necessary for good oral health. That said, I do use it – perhaps because I’ve just become conditioned to, or maybe because I need the artificially fresh feeling it provides – but I also don’t feel the pressing need to brush on schedule. I just don’t develop a ton of plaque if I go a bit longer than normal without brushing, nor do I get bad breath. And as anyone who’s been married for more than ten years will tell you, the wife will definitely let you know if things go awry in that area. If you want a cheap toothpaste that isn’t overly sweet, baking soda should do the trick.
How do you folks take care of your teeth? Do you do anything special? Do you have a favorite toothbrush, paste (or paste recipe), or chewing stick? Let us know about it in the comment section!