Let me introduce myself. My name is Mark Sisson. I’m 63 years young. I live and work in Malibu, California. In a past life I was a professional marathoner and triathlete. Now my life goal is to help 100 million people get healthy. I started this blog in 2006 to empower people to take full responsibility for their own health and enjoyment of life by investigating, discussing, and critically rethinking everything we’ve assumed to be true about health and wellness...Tell Me More
With conventional wisdom’s take on oral care, we’re left with a pretty superficial understanding of oral health. What if, for instance, cavities imply more than bad brushing habits? What if we changed the entire template from one focused on cosmetic and sensory criteria to an understanding founded on whole health principles? Answer: we’d be much closer to the truth.
Consider this. A recent study involving over 37,000 dental patients found that “patient-reported general health and risk factors were negatively associated with an overall composite oral health score,” with study authors noting their results supporting a “growing body of evidence linking oral and systemic health.” As for the particular health connections, you’d be surprised at the span of influence: cardiovascular disease, pneumonia, diabetes, even pregnancy issues.
As we speak, diagnostic tests are even being developed using oral cells and saliva to detect anything from hormonal imbalances to specific diseases. Clearly, the mouth is where it’s at in more ways than one. Maybe that manic focus on brushing and mouthwash really does fall a little short, no? As usual, there’s more to the picture than we’re led to believe.
As a nation convinced that it has health at the forefront, our dental stats are pretty shabby. Data from the National Health and Nutrition Examination Survey found that 91% of adults had cavities. What’s more, almost a third of all adult Americans have teeth issues that are going untreated. Some 64.7 million American adults are contending with periodontal disease, an inflammatory bacterial disease of the gums. For those 65 and up, the percentage is a jaw-dropping 64%.
As far as culprits go, let’s kick things off with one that’s easy to swallow: sugar. Dentists the world over would have you thinking that it’s public enemy number one, and research certainly seems to back this one up. Just as it does in your gut, sugar provides food for deleterious bacteria lurking in the recesses of your mouth. Frequently infusing your oral biosphere with sugar acidifies your mouth, whittling away at your tooth enamel. Less tooth enamel means greater risk of infection.
Which brings us around to acid. Might that be the real public (oral) enemy number one? Denise Minger certainly thinks it’s worth considering, as as she shared a few years ago in her story of dental rehabilitation. She found that a diet rich in fruit (what many consider to be a “healthy” diet) was dramatically increasing the acidity in her mouth. By carefully selecting those fruits with a high pH, and shunning those with a low pH (among other changes), Denise was able to see dramatic reductions in her tooth damage and a literal rebuilding of her enamel.
Fermented foods, as Denise highlighted, can be another factor. While they certainly provide our gastrointestinal system with a much-needed boost, fermented foods like sauerkraut and kimchi are actually quite acidic. If your oral health is already hurting, it might be wise to opt for a quality probiotic supplement instead.
The erosive effects of both acid and sugar can be seen in raw vegans. A study of 130 raw foodies found “median daily frequency of ingesting citrus fruit to be 4.8” and average consumption of fruit amounted to a hefty 9.5 kg of fruit. That’s a lot of fructose, and a truckload of acid. Chances are, there was also plenty of phytic acid from nuts, grains and legumes in the mix. The authors concluded that “a raw food diet bears an increased risk of dental erosion compared to conventional nutrition.” And that’s compared to conventional nutrition. It would be interesting to see how Primal eaters throw off that curve.
And then there’s the feedback between certain inflammatory diseases and poor oral health. Gluten sensitivity/intolerance has been shown to cause serious oral damage. One study demonstrated direct correlations between celiac disease in children and enamel degradation, along with increased incidence of cavities. It’s hard to say whether this is due to the inevitable malabsorption side effects for celiacs, or the inflammation. Probably both. Likewise, a similar effect can be expected for those suffering from other gut diseases and disorders, especially Crohn’s or ulcerative colitis.
Then there’s diabetes…. The association between poor oral health and diabetes is well documented, with patients showing greater risk for tooth loss, far greater risk of developing periodontal disease, and an increase in cavities. The previous study indicates a greater incidence of bacterial strains that are linked to cavities and periodontitis. But it’s a bit of a chicken or egg scenario: is it the poor oral health contributing to diabetes (via less efficient sugar breakdown and therefore glycemic spikes), or is the inflammation brought on by diabetes to blame? Or perhaps (quite likely), they work together to create a vicious feedback loop.
There’s one thing all of these scenarios have in common: a poor nutritional foundation. Our teeth rely on a steady ingress of certain vital nutrients. Simplifying your diet and getting plenty of nutrient-dense foods like leafy greens, quality meats and organs, grass-fed butter, and lots of colorful produce should ensure a well-rounded edible spectrum that encourages healthy oral maintenance.
But what if we’re already working with compromised oral health? Solid Primal nutrition is the base, but some of us need a little more strategizing.
Which brings us to vitamins A, D, and K2. Weston A. Price wrote at length about the powerful role these nutrients play in oral health (along with overall health, of course). Unfortunately, Price appears to have been way ahead of his time, and the world is still chewing on his data (and in most cases, unfortunately spitting it back out). But the anecdotal evidence (Denise Minger being one of the more notables) continues to accumulate, and there are a few studies that verify Price’s astute observations. Both pregnant women and children, for instance, have shown a greater tendency towards periodontal disease when vitamin D deficiency is present. Vitamin A intake has been associated with lower incidence of cavities. As for vitamin K2, several studies suggest it may be one of the most pivotal of nutrients. The catch is that these nutrients work synergistically to be fully beneficial, meaning you’re far more likely to see oral results when you consume them simultaneously.
Next, there’s acidic foods. Limit acidic produce, a handy list of which you can find in Denise’s post. Admittedly, the list is long, but most Primal types favor vegetables over fruit anyway. Consider the list more of a guide.
As for acidic ferments, if your dental health is good, don’t sweat it. If you have concerns about enamel density and cavities, cut back and rinse your teeth with water or an alkaline drink as you eat them.
As for sugar and gluten, well, there’s already plenty of reason to kick those to the curb. If you need yet another, there you go.
This brings us full circle. When we dial in the nutrition, what should a Primal-style dental routine look like? First, there’s the modern toothbrush and all of it’s flaws. Many people are making a shift back towards chewing sticks, as preliminary evidence suggests that these may remove more plaque and promote better gingival health than the average toothbrush. While the appeal of getting back to ancestral basics has a certain appeal, apparently you need some pretty in-depth training to get the technique right. And while it has it’s flaws, I know my toothbrush, and I know how to wield it without slicing off a chunk of gum every time. Sometimes it comes down to convenience.
But there may be a happy common ground for those who seek it. A company called OraWellness has developed oral care products (and techniques) that offer an alternative—especially for those with sensitivities. Check them out if this appeals.
And as for toothpaste, you can either go with a tried-and-true natural formula like Squigle Tooth Builder or Claybrite. Squigle uses xylitol to discourage pathogens from setting up shop and adds minerals that presumably aid in re-mineralization. Claybrite also uses xylitol but throws in mineral-rich clay. As I shared a few weeks ago when I talked about my own personal care routine, I use these on occasion and offer them to guests.
Alternatively, you could make your own tooth powder recipe. Do your own research on this one and consider your personal needs, but you’ll find everything from baking soda to hydrogen peroxide (what I often use). As an aside, I know a lot of people who’ve had luck with activated charcoal for whitening. (A fun way to freak out the kids, too.) As always, share your own favorite brands and recipes on the comment board.
Thanks for reading, everyone. Have you struggled with oral health? Found anything within the Primal sphere that’s helped you on the road to recovery? Share your thoughts, and have a great end to the week.