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May 03 2016

Why Grok Didn’t Have to Floss but You Do

By Guest
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Why Grok Didn't Have to Floss but You Do finalToday’s article is a guest post by Dr. Mark Burhenne, the #1 bestselling author of The 8-Hour Sleep Paradox. As an authority on dental health, he is also on a mission to help shift the conversation about sleep from quantity to quality as the foundation for primal living. As a member of the American Academy of Dental Sleep Medicine, Dr. Burhenne blogs about the mouth-body connection on his website, AsktheDentist.com. Today, he addresses some of the most pressings topics surrounding oral health from an ancestral health perspective, which , if you think about it, can be summed up with the following question: If Grok didn’t floss his teeth, why should I, especially when I’m living a primal lifestyle?

Here we go:

What happens in your mouth affects the rest of your body, which is why your oral health is an essential part of primal living.

There’s no bypassing the mouth. And if you don’t take care of what’s inside of it, you could have more to worry about than just cavities and fillings. Today, our mouths can be a source of many problems that ail us—like poor sleep quality and poor microbiome health. But even more seriously, studies have shown that bad bacteria in the mouth can contribute to cardiovascular disease, dementia, preterm labor, pancreatic cancer, diabetes, and more.

Poor oral health has effects downstream in the body. And poor systemic health in the rest of the body can show up in the mouth—it’s a two-way street.

Obviously, Grok was not aware of this, but he didn’t have to worry about this mouth-body connection. Why? His diet matched his biology, his lifestyle was more suitably adapted to his surroundings, and, as a result, he didn’t have to deal with the onslaught of negative epigenetic influences that we do today.

But let me back up a bit. This story begins when Grok was an infant.

From the moment Grok was born, he was breastfed. Baby Grok sucked on a fleshy (not plastic) nipple, which helped develop a perfect swallow and tongue reflex. There was no transition from sippy cups to soft baby food—he went from mother’s milk to unrefined, unprocessed foods, which had the toughness necessary to stimulate proper jaw development. A well-developed jaw meant his airway had plenty of room at the back of the throat to stay wide open even during the muscle collapse in deep stages of sleep, allowing him to get as much HGH (human growth hormone) as possible each night. HGH bolstered the immune system, warded off disease, and allowed Grok to be his best and brightest each day. His diet was rich in organ meats and bone marrow (Vitamin K2), which also promoted proper development of the lower third of the face, allowing for straight teeth and a wide airway for uninterrupted sleep. Baby Grok was also born vaginally, which exposed him to a host of beneficial bacteria, establishing a robust oral microbiome.

By comparison, modern humans are exposed to sippy cups, pacifiers, plastic nipples, and soft processed foods starting from birth. As a result, the lower third of the face is underdeveloped in most of the population, leading to snoring, sleep-disordered breathing, and sleep apnea even in people who are young and in shape. For modern people, braces are so common they’re nearly a rite of passage, but rarely do we stop to think that those crowded teeth are a result of a jaw that never got to grow to its full size thanks to a childhood diet of applesauce and crackers. Modern humans are also more likely to be born by C-section—a medical necessity in our modern world, but with consequences to the microbiome.

The result? Modern humans suffer from gum disease and cavities at high rates of 60% and 90%, respectively. Instead of addressing the root cause, we scrape away at the problem by brushing and flossing. But brushing and flossing don’t come without a consequence—every time we brush, we create a bacteremia (bacteria in the blood, which is normally sterile). Bacteremia appears within 60 seconds and lasts for at least 20 minutes, which shows just how connected the mouth is to the rest of the body. But those bacteria are quite different from what they used to be during Grok’s day—because of our modern diet, the biofilm is thicker, so there’s less exposure of the teeth to oxygen and saliva, changing the makeup of bacteria in the mouth. The oxygen-hating bacteria (anaerobes) have become much more dominant in the mouth, changing the makeup of our oral microbiome.

To make matters worse, many people use antibiotic mouthwashes on a daily basis. This is like using a nuclear bomb in the mouth—killing off both good and bad bacteria and causing them to grow back in the wrong ratio, making the oral environment even more dysbiotic.

Cavities, crooked teeth, poor sleep, and chronic disease are seen as normal in the modern world, whereas in Grok’s, they were rare.

What happens in the mouth happens in the body

Like I said earlier, oral infection, especially gum disease, may affect the course and the manner of the development of many systemic diseases, such as breast cancer, pneumonia, diabetes, and even low birth weight and preterm delivery.

The most well-known mouth-body connection is the one between gum disease and heart disease, including several studies that show a relationship between gum disease and stroke. A common bug in the mouth that causes gum disease is also found in the endothelial cells in the walls of hardened arteries. It’s clear that inflammation in the mouth isn’t contained—it spreads to the rest of the body. And 70-90% of people living in the US have some sort of inflammation in the mouth.

Pneumonia can result from infection by anaerobic bacteria. Dental plaque and calculus are the source of these bacteria, more likely in patients with periodontal disease. Such patients harbor a large number of bacteria below the gum line where oxygen is less prevalent. Studies have shown that people with respiratory disease have significantly higher oral hygiene issues than people without respiratory disease.

Periodontal disease is also seen as an early complication of diabetes. So much so that a dentist can detect undiagnosed diabetes and even early prediabetic conditions just by performing an oral exam.

Given all these correlations, it shouldn’t come as a complete surprise that gum disease has been regarded as a stronger indicator of total mortality risk than coronary artery disease.

So it’s time to control the environment and not the bacteria—something Grok did every day of his life, just by living his life in a way that matched his evolutionary biology.

So here’s how to optimize your moth-body health the primal way.

Diet is most important

Thankfully, the primal way of eating helps to optimize oral health by protecting teeth from acid attacks and promoting good oral microbiome health. Proper nutrition allows the pulp to heal the tooth from the inside and it nourishes the oral microbiome, allowing the tooth to be healed from the outside. This dual front optimization allows the tooth to continually renew itself.

If you’re able to breastfeed your children, do so

Afterwards, go straight to foods with substance, like sugar snap peas and salmon jerky, which promote proper development of the lower third of the face and airway.

Keep your kids away from sippy cups and pacifiers

Transition kids directly to a stainless steel cup, like Caveman Cups.

See the right dentist

See a dentist who is concerned with facial development, or trained in Orthotropics (I recommend finding an orthodontist here.)

Get enough Vitamin K2

This nurtient helps both kids and adults. In kids, Vitamin K2 promotes straight teeth and proper development, and in adults, it keeps teeth strong, promotes remineralization of the teeth, and prevents heart disease. The modern diet is devoid of Vitamin K2 in large part because our animals are no longer pasture-raised and we no longer consume organ meats.

Throw away your mouthwash

If you’re worried about bad breath, suck on oral probiotic lozenges and get a tongue scraper. Eating the proper foods and taking a probiotic will address the root cause of bad breath.

Floss

For those of you who can truly say you are eating like Grok 100% of the time, then theoretically, you wouldn’t have any need to floss. But we are so removed from our ancestral diets that it is impossible to eat as our ancestors did. In a perfect world, we’d be eating a diet that nurtures the biofilm, instead of eating a diet that alters it to the point where we have to remove it daily to prevent disease. Eating a diet that requires the scrubbing of the teeth afterwards is a perfect example of how we have drifted from the harmonious matching of diet to health.

So even though flossing may not seem like the best fix for this mismatch between our diet today and our evolutionary origins, it’s certainly become a necessity of our modern lifestyle. So don’t stop!

Dr. Mark Burhenne

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90 thoughts on “Why Grok Didn’t Have to Floss but You Do”

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  1. Wow, this is fascinating! I knew oral health was connected to overall health, but this takes it to a whole new level. I breast fed my kids for a long time but was totally guilty of using sippy cups for a long time. I just had a dentist appointment yesterday and I’m happy to report my teeth are in great shape. I do floss regularly but don’t use mouthwash. I also feel that oil pulling has been very helpful.

    1. Hi Elizabeth! I, too, have been doing oil pulling. I’ve been doing it for about a year and a half now, and at my last 2 dentist appointments I had NO TARTAR on my teeth at all!
      I give half the credit for this to my primal/paleo diet (no added sugars/candies, no breads/pastries, no grains), which leaves so much less simple carb stuff in my mouth. But the oil pulling keeps my mouth so much cleaner and healthier than ever before, that I think that is a big part of it, too. My dentist is very much in favor of the practice, and explained that the oil interacts with the lipids in bacterial cell walls to grab and pull them away from teeth very effectively.
      I was delighted to see on this dentist’s website that the dietary patterns I practice help with remineralization, and DON’T cause demineralization! Good information!

      1. Thanks, Elizabeth! I like how your dentist explains the mechanism behind the benefits of oil pulling. Glad you liked the article about remineralization.

    2. And there’s so much more coming out about the oral-systemic connection! Stay tuned. I’ll also be talking more about oil pulling on my blog.

      1. I tried oil pulling and created so much saliva in the first 5 minutes I ended up giving up. How do people do this for 20 minutes and not 1. drown/drool, or 2. end up with like 2% oil left (the rest swallowed) and the rest of the fluid in the mouth as spit? Tips appreciated please! 🙂

        1. I’m not sure exactly what you’re going through, but I think I may know what you’re talking about. I’d recommend experimenting with smaller amounts of oil. I have to use less than is often recommended in order to not overwhelm my small mouth. Yes, your mouth will create a lot of saliva, so I compensate for that on the front end. Good luck! Oil pulling is amazing!

        2. You may also want to slush the oil around slower. I find speed creates more saliva. The instructions I once got was to do it deliberately slowly, don’t think of it as a mouthwash but a more of a solvent.

        3. Furthermore, there’s no rule you have to do the whole 20 minutes with the one dose of oil. If your mouth gets too full, just spit it out, take another spoonfull of clean oil and continue. The oil in your mouth was already infested with bacteria anyway.

      1. You put a tablespoon of oil (olive oil, sunflower oil, or other food oil) into your mouth prior to washing your teeth. You deliberately slowly slush and twirl the oil around in your mouth, not swallowing it, for 20 minutes. It interacts with the lipid-based bacteria on your teeth and removes them from the surfaces. After 20 minutes you spit it out and rinse with some water. Then you do your normal teeth washing routine. This is an old ayurvedic mouth cleaning system and it helps keep the teeth and gums, especially those hard to reach gum pockets cleaner than mere toothbrush ever can.

      2. From a nutritional standpoint it doesn’t matter what oil you use, because you are not going to swallow it, but tastewise there are differences. I prefer sunflower oil because it is one of the most neutral tasting ones, some oils just don’t taste that good considering you have to rinse your teeth with it for 20 minutes. 🙂

  2. So interesting! I’ve never heard of probiotic lozenges. I’m going to give them a try.

  3. Great resource. I’m surprised that there is no mention of how to brush. However, there is lots of info on Burhenne’s website, which is full of other good stuff.

  4. My mouth is doing mighty fine (probably because I do the standard brush twice a day and floss in addition to primal eating). But perhaps a tongue scraper could be of use in special circumstances. Good article.

  5. Hello,
    I want to say I have been living with your dietary and physical fitness logic for a little over three months and I feel great, as Rogan says, “this is just how I eat now” so thanks for existing. That being said, this post leaves me with a burning question: Although I agree with your logic for the most part here, you don’t address the fact that our life expectancy is nearly three times that of “Grok” and I doubt he had great teeth when he died at just 35. I think it is dangerous to make a direct comparison in this case between modern man and Grok. Agree, disagree, thoughts?

    1. Saying that Grok’s life expectancy was 35 isn’t really meaningful. It reflects the high death rate in childbirth of the child and mother. I’m sure someone can give citations for this – hunters and gatherers of all ages generally have good mouths, even elderly hunters and gatherers, unless they are corrupted by “civilization.”

      It certainly isn’t just us old coots who have bad mouths. Little kids do too. Primal has helped my mouth.

      1. The maximum life expectancy for humans has been steady for as long as there’s been humans. Our higher life expectancy is mostly due to less children dying and better sanitation. So if you were healthy you’d live to be around 70. Many of our country’s founding father lived to be 70 or 80 even though the average life expectancy was 40 in their time. So why did they live so long? Most of them were pretty well off. So they had better diets, better medicine, and less dangerous work.

        Let’s say you had two villages. In the first village, the adults all live to be 80 years old. However, half the children die at age 3. So that means the average life expectancy is 41.5 year old (80 + 3 divided by 2 = 41.5) However you either lived to be 80 or you died at 3. So the average doesn’t actually exist.

        Now the next village, the adults all live to be 80, but only 1 in 10 die at age three. Their life expectancy is 72 (80 x 9 + 3 divided by 10). But once again you either die at three or 80.

        So the idea that our ancestors all died at 35 is just pure bunk.

        1. I understand what an average is, and “Pure Bunk” is inaccurate. I get that under ideal terms ancient man would have the same life expectancy as us, but reality did not allow for that. Neanderthals had a 30 – 40 year life expectancy (I have many sited references if you want to take a look), and no(statistically zero) neanderthals as far as we know lived to be 80, please provide a reference if I am wrong on that. Stating that our founding fathers lived to 70 has no relevancy in a conversation comparing ancient life to modern, I’m not sure of your point with that.

          Lets just say that today people live to 95 (we’ll disregard outliers and call this max age) with an average life expectancy of 70, so on average we live to about 77% of our max age of 95. If we take some liberties in correlating this to neanderthals, their life expectancy of 35 give’s a max age of 45 (again disregard outliers, whom still probably only make their 50’s), no where near 80. I realize this is theoretical, but it makes a point.

          I realize a small percentage lived to older ages, but statistically the average neanderthal only had 35 years to do damage to his or her teeth. I realize the high infant mortality rate effects this, but so did disease and environmental factors, so I’m confused with your logic. The average person today has nearly 70 years to do damage, and few people, anecdotally, have their real teeth by that point.

          My original point was that a direct comparison may not serve us completely in the case of maintenance. It is a curiosity that popped into my head upon reading this article, not a criticism but a question. For instance with the mouth wash concerns; I use mouthwash after my coffee in the afternoon to eliminate acidity because I figure this will limit decay or damage in the long term. This is the sort of maintenance that makes sense to me as modern man that would be unnecessary for early hominids (ie. I have twice as much time to worry about keeping my teeth as my very early ancestors). Is this assumption incorrect? That is my question.

        2. Paul Kennedy: “Neanderthals had a 30 – 40 year life expectancy (I have many sited references if you want to take a look), and no(statistically zero) neanderthals as far as we know lived to be 80,…”

          I think what you *meant* to write was: of the (maybe) *couple hundred* Neanderthals we actually have bits to test, those FEW seemed to live to average age of 30-40. Since we have nothing even CLOSE to a representative sample, we have no actual idea what their ‘usual’ lifespan was.

          Try reading here, where the blogger writes: http://mnjwonder.blogspot.com/2009/01/how-many-neanderthal-fossils-have-been.html
          ============
          ‘how many neanderthal fossils’ gives:

          2 from Belgium and Gibralter from before “Neanderthals” were identified as not being H. sapiens
          7 from the Neanderthal “type site” in Germany
          2 from Grotto of Spy d’Orneau in Belgium
          between 24 – 36 individuals from Croatia (remains are fragmentary)
          1 near-complete skeleton from La-Chapelle-aux-Saints in France
          1 from Saint-Cesaire in France
          1 from Arcy-sur-Cure, France
          6 from the Moula-Guercy cave, above the modern Rhone River, France
          9 from the Shanidar cave in Iraq
          *at least* 13 from sites at Tabun, Qafzeh, and Skhul near Mount Carmel, Israel
          …there were more paper references turned up in my search, but I did not track them all down.

          While exact numbers don’t seem to be available from this, simple summing of the ones above yield a minimum number of 66 individuals. I remember seeing somewhere that we actually have remains of almost 200 Neanderthal individuals, but I cannot substantiate that at the moment.
          ============
          and
          ============
          Britannica says:
          … The Neanderthals are now known from several hundred individuals, represented by remains varying from isolated teeth to virtually complete skeletons.
          ============

    2. Great question – according to one study (http://www.pnas.org/content/111/3/954) it looks like ancient hunter gatherers in North Africa had a lower rate of cavities (51.2% for the hunter-gatherers vs. 90% for modern types).

      Life expectancy improvements in modern times can largely be attributed to improvements in medicine, widespread decreases in violent behavior, as well as the notable decline in smoking. I think dental health is important, but vastly less so than these other factors.

      I don’t think Dr. Burhenne is suggesting we adopt an entirely paleo approach to dental health, after all he still encourages brushing and flossing; however I believe he makes good points about the importance of diet, habits, and early childcare in oral hygiene.

    3. I agree, Paul. Some of the conclusions drawn in this article appear to be based purely on speculation. There were undoubtedly plenty of “Groks” who lost their teeth at an early age due to poor oral hygiene, heredity, breakage, disease, etc., regardless of what they ate. Grok and his children probably went hungry a lot and ate anything that would fill their stomachs, nutritious or not.

      The advantage modern man has is the ability and the means to properly care for his teeth–regardless of what he eats. (A Primal diet doesn’t guarantee good teeth.) That many people don’t take proper care of their teeth is a personal decision and has little to do with evolution,

      1. Those “Groks” you mention would have had little in the way of sugar or carbs in their diet, and therefore probably had little decay. Non-nutritious food was not then what it is now… Breakage would probably have been common, what with violence and using teeth as tools. Probably the real issue with oral health in Paleolithic times was periodic starvation, during bad seasons.

    4. I think what you’re saying is a great point. I’m happy to report that many of my patients in their nineties have all of their teeth and those teeth are functioning well. So, I think our genetic potential (or our blueprint) for our teeth’s longevity, if all goes well and if we take care of ourselves, is to have teeth that function many years past the lifespan of Grok.

  6. It’s great to see that there are primal doctors out there who are dedicated to getting to the root of our problems, rather than continuing down the rabbit hole of prescribing palliative care that doesn’t address the real issues. Thanks, Dr. Burhenne!

  7. I’ve heard that there was a connection between oral health and heart disease, but I didn’t realize it extended to a whole host of other diseases, too. Geez. Scary stuff. I’ll make sure to keep eschewing SAD foods for primal ones (along with brushing and flossing, of course).

  8. Dr. Burhenne, what are your thoughts about periodic oil pulling for oral hygiene?

  9. Interesting point about breast feeding and jaw development. I honestly had never heard that one before. Another case for breastfeeding (if possible).

    1. I am a nurse and work with moms after they have a baby and help with breast feeding, therefore I have been to seminars on breast feeding many times over the years. One seminar we heard from a dentist that studied effects of bottle feeding vs breast feeding in regards to sleep apnea because he sees an increase of sleep apnea in people that were bottle fed. Reading MDA today I was pleased to read that he said what the dentist said, that breast feeding is best to have proper development mouth and back of throat to prevent the throat from being more slender. The palate develops a different shape with a baby that has the natural sucking motion with breast feeding that does not occur when babies suck on a bottle nipple. At the seminar a few people that SUFFERED with sleep apnea were helped by this dentist when he helped them figure out what they needed to help them sleep better, and they were bottle fed. It was an unforgettable lecture. He also showed videos of the difference between a baby breast feeding vs sucking on a bottle nipple in regards of the motion of the tongue which develops the proper palate and back of the throat structure that prevents sleep apnea.

  10. I remember Denise Minger talking about how she helped heal her teeth (in part) from K2 supplementation after being a vegetarian for years. I imagine it should probably just be one of those “essential supplements” most people should take. Although, if I can start getting enough offal or natto in my diet, then I can skip out. It’s just that neither is really my cup of tea. 😛

    1. One of my patients came in yesterday—a Japanese physician—and we started talking about Vitamin K2. She grew up eating natto every day. She and her family still eat it and like the taste of natto. I think it’s an acquired taste and worth trying to make it one! I’m still working on it… 🙂

      1. “I think it’s an acquired taste and worth trying to make it one!” I “natto” what you mean!

  11. Weston Price really was ahead of the curve. He was a dentist turned nutritionist due to his observation poor dental health due to the grain and sugar based Western diet. He supported his theory by studying cultures sustained on local indigenous foods and their near perfect mouth structure. Grok did not use waxed string to clean his teeth but would bet he used fish bones, long thorns or some other tool to get at the last bit of his meal.

  12. I started using Evora oral probiotics about 4 months ago. Last week I saw my dental hygenist and she told me my teeth had less tartar and my gums looked great. About $12/month for the probiotics and well worth it I believe.

  13. I’m interested in primal/paleo eating mainly becasue I’m diabetic and have dairy and grain allergy symptoms.

    My question today since we’re talking about teeth is if the primal diet is healthy for teeth why would we have dogs with plaque, etc?

    1. Because dogs are eating kibble, I’d guess. I’d be curious to know if a dog who is fed a raw food diet would also have plaque.

    2. Are you talking about dogs eating their “version” of paleo (which is, I don’t really know, meat and organs with occasional lightly cooked [simulating partial animal digestion] vegetables), or dogs that eat processed human-made dog food?

    3. My dogs are raw fed. Three of them. One (Chloe) was fed kibble for a few years before I learnt of the prey model raw diet. One that was probably on kibble for a couple years before we rescued him. And one that was a stray for a majority before we rescued her.

      My raw fed dogs get muscle meat (80%), organs (10%), bones (10%) with a lot of variety: beef, duck, whole sardines, turkey necks, duck necks, whole eggs with shells, elk, venison, rabbit etc.

      Chloe has some plaque that’s hardened, but the other two not so much. We give them beef ribs every now and again and that has done an amazing job of reducing 80% of the plaque. We will start brushing their teeth once a day with an enzymatic toothpaste till the plaque (hopefully) completely disappears and then we’ll stop the brushing to see how their teeth looks after a few weeks.

      1. Exactly right. I too feed my dogs and cats in a similar way (sounds like you may frequent the Yahoo or FB raw feeding group) and though my dogs have some remnant damage from their previous crappy diet, my cats (who’ve eaten this way all along) have pristine teeth and marvelous health.

        The way we’ve ruined our health with the awful diet of the modern American (and others around the world) is perfectly parallel with what we’ve done to our pets. And the vet profession at large has no clue about nutrition and makes their money selling garbage food and treating the resulting medical conditions.

        1. I wasn’t aware of a FB raw feeding group. I’ll check that out, so thank you. Isn’t it great to watch their coats shine and see them so full of vitality with this diet? Love it.

          Agreed regarding the vet (deliberate or not) ignorance regarding nutrition. A few years ago, I was forced to move on from a vet that I really liked (for her direct no BS manners) because she would not support raw feeding even though she saw that my Dalmatian (Pepper) gained 2 years of pain free and energetic life at the age of 12 (or 13) from changing her diet to prey model raw (but toned down for her teeth or lack thereof).

          As long as I can afford this diet for my four legged fur children, this is how they’ll eat.

          She saw how my younger dogs looked so good and healthy, but she could not reconcile that raw feeding was what was helping them.

      2. I too feed prey model raw, ( approximately 80% muscle/tendon/sinew, etc.and have, 10% bone and 10%) and have since about 2008.
        My German Shepperd/golden mutt, Gully, just turned 15 in January. He was the first to go raw, I was at my whits end with him, he had bad allergies, was losing fur, had teeth that stunk so bad you had to leave the room for fresh air (the smell would start up about a month after his dental cleanings too) horrible oozing hotspots… Just a real mess. I tried most of the high-end kibbles at the time (Orijen taste of the wild etc.), but they didn’t help. (I could have gone the conventional route and kept him on steroids but that was not an option for him or me).

        I bought some boneless pork and never looked back (bones scared me back then, good thing carnivores are equipped to handle them). Tombo, the cat, stole some of Gully’s meat, so he went raw too.
        The first thing that happened was that Gully’s breath improved, and so did his teeth. Then the hotspots healed, the fur started growing back, and his itching subsided. All in all, I saw steady improvement over the course of six months. Another perk was that the grey hair on his muzzle turned back to gold. He moved better and looked better too boot. At thirteen years old he began to look as old as he did when he was seven and on kibble.
        Through helping others transition and my own pets, I have successfully fed raw to eight cats, and four dogs. Most of the cats were kittens that were weaned onto raw.
        As a side note, when I only had Tombo, and when he was on kibble, when he pooped it could stink up the whole house. I now have four cats and there is almost zero odour. (cat pee still stinks, you cannot expect miracles ^_^).
        I have two Great Danes that were weaned onto raw prey model and they had slow, even growth with good muscle definition through out puppy-hood. No bloated belly pudginess that follows kibble fed dogs.
        The only thing that I regularly supplement with is fish oil for the omega threes.
        Pluses for Raw,
        Great teeth. Both the cats and dogs have great teeth and odourless breath.
        No need to pick up dog poop, it completely disintegrates into the lawn in about three days. Longer in the winter due to everything freezing.

        No doggy odour, If I pet a kibble fed dog, there is always a doggy smell left on my hands. Raw fed dogs have almost no odour.

        Dogs and cats are calmer than kibble fed ones. I saw this with Gully and Tombo. Gully was able to focus when I asked him to do things. Tombo stopped flipping out and attacking people for no reason. On kibble, he was a “demon” cat, on raw he became a sweet and loving cat that didn’t flip out for no reason.

        Shedding! Both Gully and Tombo would leave a ring of fur when they would get up. It was a nightmare to keep the house clean because they shedded so much. When I switched to raw their shedding became seasonal, and it drastically lessened. Tombo’s hair balls also diminished, they went from one every few weeks to one-two a year. A year!

        Due to feeding whole large pieces, both the cats and dogs get a “workout” from feeding raw (Great Dane size large hunk of meat is a whole chicken. Cat size is a whole mouse, etc. ). The first cat to eat raw, Tombo, had a bad habit of destroying things. This was because he chewed holes in items. He destroyed a bikini top, some pillows and even blinds (Yes he is a cat!). Anyway, after he went raw, I think his urge to chew was satisfied because he stopped destroying my stuff.

        I feed prey model because it is the basic averaged structure of what a prey animal is made up of. What do wild felines and canines eat int the wild?
        Cats are somewhat easier, as they all have some feralness to them. Look no further than a cat catching mice and feeding themselves (although if the cat is well fed, they probably won’t eat what they catch).
        For dogs, one needs to look at wolves and how they eat.
        I recommend “Wolves: Behavior, Ecology, and Conservation” by David Mech, and the website http://rawfed.com/myths/ and http://www.rawfedcats.org/nature.htm

        1. Oh, and an extended lifespan is more likely. In Great Danes, the average life span is 5-7 years in the United States. In discussion with long time breeders, who have been in Great Danes for 40+ years. When they switched to raw they saw on average, and additional two healthy years added onto their dog’s lifespans. There used to be a European paradox, Great Danes living in Europe had longer lifespans. It was pretty common from what I have been told for these dogs to eat homemade diets. Especially in the poorer countries. Now that the majority of Great Danes are eating kibble (scientifically complete and balanced you know), with generations of kibble eaters behind them, their life spans are starting to mirror what we see in the U.S.
          Some of this can be translated to bad breeding practices through backyard breeders or puppy mills, but that doesn’t account for ethical breeders who have been involved in Great Danes for decades. The life expectancy of a Great Dane 60 years ago was closer to 10-12 years old. Many old timers that I interviewed speak of homemade diets being discarded at this time period and then in the 1960s and 1970s things started changing in regards to lifespans.

    4. Just as with human food, there’s a lot of junky dog food out there. We feed our dental therapy dog a grain-free diet and supplement with pasture-raised freeze dried meat and organ meat treats. Orijen is a great brand.

      1. Dogs are very prone to gum disease. They are the animal model for periodontal disease in humans. Our rescue dog came to us riddled with severe periodontal disease and had several teeth extracted.

      2. Hi Dr. Burhenne,

        While Orijen is a very high end kibble (probably the best of the available kibbles), it is still kibble. The ideal diet for a dog (or cat) is unprocessed raw meat, organs and bones. A search for “Prey Model Raw” will provide a wealth of information. Of course, we do use home-made dehydrated treats (beef lung, duck/ pork hearts) for them when we train them.

        In case you have concerns about feeding them raw, there is a website dedicated to dispelling a lot of myths/ concerns: http://rawfed.com/myths/

        It is work to feed dogs (and cats) raw. But, the results are so obvious and so good (if the feeding is done right) that its well worth the extra 5-10 minutes spent per day feeding them this way. Better coat, better teeth, more (calm) energy, reduced hyper/ frenzied/ nervous energy (at least in my Border Collie), no wet dog smell when they get wet, small non-smelly poop that disintegrates within a day or two… the list goes on.

        All that said, not everyone can afford to spend the time or the money to make this commitment, so I’ll get off my soapbox now.

    5. I have two cats, I used to have cats when I was younger and fed them crappy “premium” cat food. They had bad breath, stained teeth and their poo was always wet and smelly.

      My current cats are fed mice ( I buy them in bulk from shops that sell them primarily to snake owners ), chicken hearts, one-day-old chicks, raw chicken stomachs, raw chicken livers, raw chicken wings,raw pig hearts, raw eggs.
      It’s amazing to see them eat a whole defrosted mouse ( two weeks in a freezer kills off any parasites the mice might have ) in less than a minute, nose to tail. I’d say my cats are totally paleo 🙂

      They chase and eat flies and bugs and are the healthiest cats I’ve ever seen. Their teeth are perfectly white. They are slender. Their poo is dry and incredibly compact. no smell whatsoever.

      I had a heated discussion with a vet who insisted that dogs and cats absolutely “must” have their teeth cleaned by a vet regularly.

      I was lucky to introduce them into this kind of eating from day one. I know older pets might find it difficult to get used to eating raw food.

      I’m not expecting them to get their teeth cleaned anytime soon, if ever. if natural, wholesome, species appropriate diet works for animals, then it most likely works for humans – ( species appropriate that is – not a diet of mice ).

      Another good thing that comes out of it is that I get to share the livers, stomachs and hearts with them. I stay away from the mice though – and i cook the hearts, stomachs and livers 🙂 ( chicken stomach or heart stew is a Polish delicacy yum )

    6. Yes, agree with other comments: dogs are not meant to eat kibble or, even worse, soft canned dog food. They are meant to eat organs, meat, and bones. My dogs are 13-year-old cocker spaniels. We live in China, and started feeding them a BARF (bone and raw food) diet out of desperation 7 years ago when the dog food here started killing the dogs (the same time the milk powder was killing the babies: melamine added to fake a high protein content in tests). When we did that, our dogs’ lives were transformed. One dog had a tumor that had been growing and growing: it began to shrink and didn’t start growing again until this year (cocker spaniels only live to be 12-15, so we’re not treating. He’s had a good long life and is very happy and active still). The other dog had a slipped disc that we thought we’d have to have him put down: but instead he got better and stronger. Their coats got thicker and shiny, their breath stopped reeking, their digestion improved, and they had so much energy it was like they’d regressed to age 3. Now at 13 they sleep a LOT; but when they are awake they are energetic and active. They bounce around like spring lambs when we go out for our walks. They continue to eat raw chicken legs, eggs, beef, organs, bones, and homemade yogurt, With reference to this discussion in particular, they have amazing teeth. No one who sees them, including vets, ever believes they are anything close to 13. Vets regularly comment that they’ve never seen teeth like that in such old dogs.

  14. What a helpful post! I brush twice a day, floss daily, and just started tongue scrapping as an Aryuvedic practice, but could you say something about toothpaste? Also, we have an reverse osmosis water system, which I appreciate for removing contaminants, but I wonder about the beneficial minerals it removes. Any thoughts?

    1. Toothpaste is a big topic! Check my website for some of my articles about toothpaste. As for reverse osmosis, I’m not worried about removal of minerals from water as we get minerals from many other sources. I do take a liquid mineral supplement, but remember, if you don’t want to ingest fluoride, reverse osmosis doesn’t remove it, only distillation does.

      1. Did you mean to say, Brita type filters do not remove flouride? From flouridealert.org: “The three types of filters that can remove fluoride are reverse osmosis, deionizers (which use ion-exchange resins), and activated alumina. Each of these filters should be able to remove about 90% of the fluoride. By contrast, “activated carbon” filters (e.g., Brita & Pur) do not remove fluoride.”

  15. This connection appears to be a reverse case of cause and effect. People who tend to take better care of their teeth also take better general care of themselves, exercise more, eat better, smoke less, aren’t overweight, lower incidence of diabetes, etc. As an aside, I saw an equivalent study that “connected” people who wear expensive clothes with various health attributes. Fat smokers who have diabetes don’t spend much money on their wardrobe.

    My dad retired from teaching dentistry, so this was an area of interest to him. Many studies “linked” oral health problems to other health issues, but none ever established causation. Just like eating meat is “linked” to cancer, which we know isn’t really the case.

    http://www.heart.org/HEARTORG/HealthyLiving/Dental-Health-and-Heart-Health_UCM_459358_Article.jsp

    Its possible that gum disease or infections that aren’t being treated could possibly result in a blood clot in fairly close proximity to the brain/heart.

    This has been an area of interest to me as well, having suffered an ischemic stroke just last month while being in fairly good health. No cause was found and I’ve almost fully recovered from it. A bit interesting to get to see pictures of your brain and watch your heart actually pumping blood on a tv screen.

    More interesting is the hospital food. Basically a big tray full of sugar. For breakfast I got french toast with blueberry syrup, a couple of nasty breakfast sausages, fruit juice, fat free milk, a cut up orange and a biscuit with fake honey and fake butter. Lunch was pasta chicken soup (all pasta), white bread with one slice of turkey and fake fat free mayo, more fruit juice, more fat free milk and another quartered orange. I was told “You aren’t eating much…”

    1. My hospital experiences have been the same except that since I have (controlled) diabetes, I got nasty artificially sweetened foods instead of sugary ones.

    2. I do agree with you that people who tend to take care of their teeth also take better general care of themselves, eat better, exercise, etc. and that in general is always the case. However, gum disease is causative of systemic disease, the mechanisms of which are discussed here: http://cmr.asm.org/content/13/4/547.full In regards to your stroke, I’m sorry to hear, and the hospital food experience is unfortunately all too common. How do they expect you to recover with an inflammatory sugar-laden diet? Have you gotten a sleep study to investigate the possibility of SDB (sleep-disordered breathing)?

  16. I always felt that my teeth health was directly related to my health. When I was feeling awesome, I didn’t have sensitive teeth and when I became sick again, my teeth started hurting once more. I just don’t know how to get to this awesome state again, unfortunately.

    Is oral micro biome easy to transfer between person to person? Because my husband does not floss more than once a month and he never has any cavities while I floss everyday and I always have cavities. So, if he has better micro biome than me, how is it that I manage to not “contaminate” his?

  17. I would love to hear if anyone has found a vit D3 plus K2 supplement for kiddos. I take one myself but each dosage is 5000 IU which would be too high for a child. I can only find kids D3 without the k2. We do, however, at a lot of farm fresh free-range eggs. Would this give my daughter enough vitamin K2? She eats about 5 a week.

    1. They do make d3 in liquid form with K2. Search on Amazon and you will find some. Vitamin D toxicity is a symptom of K2 deficiency. So technically, if you take enough K2, vitamin d toxicity is a nonissue. Thus, megadosing on vitamin d3(50,000 IU/day) is possible.

  18. I have always heard that mouth health reflects what is going on in the body, but I appreciate the different (primal) perspective on this.

  19. Great piece, thank you. It also gives me great anxiety. I’ve always had a hate/ignore relationship with my teeth: top and bottom don’t touch, which leads to great build up of plaque, missing a tooth and have a peg on the top, so not that attractive. But I do need to floss. I know I do. I’ll get a tongue scraper too after reading this.

  20. Great article, thanks! Would love to hear more of your thoughts on other dental practices/procedures, e.g. wisdom tooth removal, braces/retainers, etc. (advice for/against them?)

  21. Wow, I learned so much from this! I have to say, in my own primal n=1 experiment, I’m doing pretty well on my dental health. I used to get multiple cavities per year. Since going primal 4 years ago, I have had ZERO cavities.
    I feel like that’s not a coincidence!

  22. I’ve written a couple of articles on toothpaste, providing links to your website. I’ve been content with using baking soda, a pinch of sea salt, and oil of peppermint for my toothpaste/tooth powder. I found a stainless container with holes in the top that can be closed when not in use. It keeps the baking soda clean and dry as it tends to sit on the bathroom counter. It also prevents one from pouring too much out. An empty spice jar would work just as well. Do you think this is adequate for tooth brushing? I’ve heard about oil pulling, but it seems like a lot of trouble. I’ll revisit the idea on your website, though. The original source for this information was from elsewhere and a bit confusing. I appreciate all of your helpful information.

  23. Great article! General medicine/dentistry mostly ignores the nutrition/facial growth/dental health relationship but the facts are there. As previously mentioned, Weston A Price is the pioneer when it comes to that science and his book Nutrition and Physical Degeneration has plenty of data that supports the ideas expressed in this article. In the 30’s he already knew about the link between the teeth health and potential major disease issues. At the time he was against root canal procedures because he believed that it created a nice breeding ground for bacteria to adapt to the host system and proliferate without being visible to the immune system until it grew strong enough to wreak havoc in the body once it left its nest. Root canal was a very lucrative procedure versus extraction so you can guess why you haven’t heard of Dr Price and why almost every dentist will recommend the said procedure. The WAPF (Weston A Price Foundation) recommends fermented cod liver oil and butter oil as a supplement for general health, especiallty teeth and bone health and have documented cases of self healing cavities with proper diet and supplementation. They promote a diet similar to P.B. high in saturated fat and low in PUFAs, lots of veggies, fermented foods but include grains and beans stressing they must be properly prepared, meaning correctly sprouted and cooked and often fermented. Pasture fed butter oil has a very high amount of K2, which Dr Price had named X-Factor back then when the vitamin was not known of the scientific community, along with fish oil it makes for a hell a supplement mix!

    Tongue scraping : the benefits are incredible! Outstanding difference in my morning breath when i scrape before going to bed. If I am to skip dental care for any reason I will take 20 seconds and do that, it already changes a whole lot. For a few bucks it’s a must.

    The impact of underdeveloped cranial structure can be incredibly great. I suggest you look deeper into this if you have crowded teeth, small jaw, difficulty breathing from the nose or sleep apnea. The issue arises when the body grows if the nutrition is too poor the facial bones will not grow to their full potential, but the cartilage does. This one ends up squeezed into an undersized cranial structure, blocking airways and creating pressures. One can have back or neck issues just because their body instinctively adopts a posture where the head is off center, forward, to allow better airflow to the lungs. This is one example of how it can create issues that would not seem related. Sounds far fetched but this has been fully documented.

    Xylitol is not primal but in small doses it has been proved to help balance mouth bacteria and prevent cavities for decades. It’s mainstream for oral health mostly in European countries. It is a natural substance though they mostly extract it from hard woods and your our bodies actually produces some as well. I also like it to cheat without taking carbs, especially in drinks but as with all polyalcohols if you take it in great quantities and are not used to it may cause bloating or other types of intestinal distress, not great. At least it doesn’t taste horrid like most fake sweeteners it’s more like fresh (cool) sugar, like minty.

  24. I’m thinking that oral microbiome issues are behind any cases of caries and periodontal disease. In my experience, brushing and flossing were probably akin to trimming back brush and mowing weeds when what I needed was a nuke to take everything out and start from scratch. Once I went through an intensive period of killing everything off with ozone, this horrible carifree rinse which is essentially bleach but more expensive and then a low carb diet, I was finally able to turn things around and get decay under control. I maintain with the usual brushing and flossing plus a steady stream of xylitol and green tea.

    This article is a good reminder to get back to vitamin K2. I went off of it while pregnant since I have a couple of MTHFR SNPs and had a couple of miscarriages. I’m unsure of it’s compatibility with conditions when blood thinning may be in order. ??

    On the kid front, I feel really conflicted about feeding tough foods to babies and toddlers. I know it’s important to proper bone development but my mama instincts would lead me to chew or tear apart bits for baby to eat (which I don’t because of my broken microbiome!). So I cook or chop my 1 yr old’s food in a way to prevent choking. I think it takes a little time to work up to things like jerky and raw veggies.

    There are some pretty cool sippy cup alternatives these days like munchkin miracle 360 trainer and wow cup which allow babies to figure out drinking from a regular cup without dumping water everywhere.

  25. My kids learned how to drink out of shot glasses. They’re small and can handle being dropped. They never had a sippy cup.
    All my shot glasses had little handles on them which were perfect for their little hands.
    Worked great until my daughter was about 14 months old and picked it up with her mouth and downed the water in it, without using her hands. I gave her a metal cup after that.

    1. Give me three shots of apple juice, neat- and one ants on a log, stat. It’s been a rough day. First Elmo was far, and near, then back to far. Mind blown.

      1. I may be behind the times, but pretty sure the Near/Far song was Grover

  26. Hey Mark,
    Thanks for bringing me such a new concept. It never come to my mind that the oral health can affect so much….I’ve shared this with my family.
    Great post!

  27. I wonder if it is possible to eat healthy (no processed and no sugar)and not brush our teeth on a regular basis. As an experiment, I went almost 6 months without brushing and my plaque disappeared, and my teeth felt clean, with not bad breath, regardless of what I ate.

  28. Mark mentions our teeth not having adequate access to oxygen and saliva, and oxygen-hating (bad) bacteria becoming more dominant in the mouth. Has anyone had success with gargling with food grade 3% hydrogen peroxide or ozonated water to bring in more oxygen?

  29. Mark, are you available for a phone consult? I’ve had an absess tooth for 4 years now. It doesn’t hurt much, but I keep gaining weight, no matter what I do. Taking vitamin K2 daily hasn’t helped. Is there any way for the tooth to heal itself through the pulp, or is it a case of “once infected, always infected, yank it out”.

      1. The one from Vitacost, it has good amounts of both menatetronone, and menaquinone forms of K2. Great price too.

    1. These are all good questions that need to be answered. You have to go through a very specific diagnostic path to ascertain what the right thing to do is, and it’s important because if we get it wrong, you’re going to have this systemic inflammation which can cause all sorts of other conditions, including weight gain as you mentioned. Here’s my consultation form, I’m happy to help: http://askthedentist.com/consultation-form

  30. Guys I am fascinated By the average lifespan of 35 years. Where did this number come from? It is safe to assume they didnt keep statistics in those days haha. Was it an average of bone samples or something? And was it a true average or “usual life span”. Anybody?

  31. “the Primal way of eating helps to optimize oral health by protecting teeth from acid attacks”

    GIven that the juices of fruits and vegetables – including fermented vegetables -, which form a significant part of the Primal diet, are acidic in nature, I struggle to see how this way of eating could protect teeth from acid attacks.

  32. Great article, Dr. Burhenne! What is your opinion of using water flossers, like the waterpik, instead of regular floss?

  33. {sigh} Dr. Burhenne — what about being unable to floss? I have (alas!) about 6 or 8 (now 20- or 30-yr old) crowns and the floss gets stuck and I have to cut it to get it out. (And I worry that it might loosen or pull an old crown off. Thankfully I have never had much (or any) plaque — used to freak out the hygienist because she’s expect to have some work to do … and … nothing!

    I’m also absolutely (?psychotic?) about dental care. (Call it completely and barely controllably panic-stricken!) My first dentist in my childhood was a sadist! (My parents thought he was good, as he drilled out most of any tooth for however small a cavity.) The sadist thought it was FUNNY that people across the street in the newspaper store could hear me screaming in pain! When the butcher retired, the first new guy would drill-and-fill and not even rinse out the hole he’d made with water, much less anything stronger — and that resulted in pretty short order in about 5-6 root canals (by an actual orthodontist).

    I kinda throw up my hands — I am about 80% sure my mouth is affecting my health (I’m way overweight but seem otherwise mostly healthy — after intensively treating my thyroid and adrenals 8-or-so years ago.) Never drank soda but participated happily the American SAD for many decades.

    I’m going to go read your site, but these last 10 years or so, I have not gotten dental ‘care’ because of (money and) the need to find a dentist (in my new area) who can deal with my fears. I had a great guy for a few years who kept the hypo out on the counter, and would shoot me again when I began wincing — apparently I metabolize the anesthetic WAY WAY faster than normal, and the floods of adrenaline speeds that up! (Oh, and I use as much nitrous as their machine can put out… keeps me from leaping out of the chair and running screaming from the room. (I DID claw at the good guy once, before we know how fast the anesthetic wore off: he pushed the final crown down on a cracked tooth with a live nerve — and O.M.G.!! That glue is SO acidic!)

    So, suggestions? I keep thinking I should try oil pulling, but haven’t yet. Just thinking about dealing with my teeth starts up the adrenaline. I do take Vit D and K2 and calcium and magnesium and avoid drinking fluoride. I use an electric toothbrush and fluoride-free xylitol-sweetened toothpaste (bu also Costco mouthwash — will stop that!). I occasionally chew xylitol gum. I take probiotics (and occasionally kefir with resistant (potato) starch).

    1. Well, if you don’t have any plaque then the vitamins must be working for you.

  34. so why do we need to floss!!!?! where is the proof we need to floss!?!

  35. I suggest looking at the work of Alan Cooper. University of Adelaide. Ancient DNA tells the story. No one has looked at more paleo teeth than Dr Cooper.

  36. I nursed my daughter until she was almost two, and she was born vaginally without an epidural. She is 15, and has terrible stomach ailments and food allergies. My son was given a bottle with formula since the age of 3 months. I felt so guilty for not being able to nurse. He is now 10, gets sick maybe once a year and has no food allergies. Both kids are intelligent. I didn’t put an emphasis on nursing my third child. So far, so good!

  37. I have only flossed a few times in my life. I tried mouthwash for a while and quit I brush every 12hrs. with breaks when I’m too lazy. (commitment problems;)) But surprisingly enough, my teeth are HEALTHY, as in I never wore braces, all my teeth (but one) are straight, and stuff doesn’t get stuck in between my teeth. I asked about my baby diet, and my mom said that she would take adult food and either blend or chew it. I was breast fed and born through the V. And for later on in life, what would you recommend I do? Feed him/her (future baby) food blended, chewed, or normal? Or a mix? And if so don’t you think a baby’s tummy would have trouble with all that whole food, or should I just breastfeed for longer?

  38. I have an inflamed gum per dentist number 1. Taking amoxcyllin for 7 days. Paid for second opinion. Dentist 2 said, I would need to have re-root canal or tooth extraction. My gum does not bleed, but was very sore on day one before antibiodics. My question is: I’ve always cared for my teeth. at age 67, very very upset that I may lose one. I think inplant is healthier than a re-root canal.
    If I believe dentist who think it is just gum infection, would another xray show anything on the root of the tooth?’I just don’t know how to tell which dentist to believe.
    Since antibiotics is clearing up the pain, I am thinking I did have a gum infection. But then again, what do I know and who do I believe? this is serious business for me?