Last month, the International Academy of Biological Dentistry & Medicine (IABDM) launched a new online course for dental professionals seeking a deeper understanding of the influence of diet on oral/systemic health. Taught by nutritional periodontist, Certified Functional Medicine Practitioner, and Certified Primal Coach Dr. Al Danenberg, this certification course takes dentists and hygienists on a journey through history and science, from the skeletal remains of our primal ancestors to the present, exploring diet, lifestyle, and environmental triggers of chronic and oral diseases alike.
Patients can only benefit from their dentist’s or hygienist’s expanded understanding of the mouth/body connection.
So we asked Dr. Danenberg to talk a little bit about his work, his background, and the intricate ways in which diet drives oral health via the gut…
PART ONE: A Broader View of the Mouth, Nutrition, Body Connection
Tell us about your journey from conventional periodontics to biological dentistry. What got you started on that path? Who were your most important mentors and teachers along the way?
It was 2006, and I had been practicing conventional periodontics already for 32 years. I was 59 years old, and I had a stroke. Conventional medical doctors saved my life, but they put me on seven medications to take for the rest of my life. I was not comfortable with that. I weighed 187 pounds and was 5’ 7”. My diet was basically a Standard American Diet, consisting of refined carbs, sugar, and unhealthy polyunsaturated fats. So, I began to research what I needed to do to turn my life around. My doctors didn’t know. I looked into recommendations from the American Cancer Society, the American Heart Association, and the American Diabetes Association.
Fast forward to when I was 66 years old. It was 2013, and I weighed about the same and still was taking the same seven meds. But I found a course at the Kripalu Center for Yoga and Health that was a 5-day intensive on nutrition for healthcare professionals. The program changed my life. I learned about the nutrition and lifestyle of our primal ancestors.
When I returned home, I convinced my wife to make some changes. We bumped heads at first. Then she gave me 30 days.
We cleared out all the unhealthy foods from our fridge, cupboards, and freezer – seven bags of food that we donated to the local Food Bank. We had practically no food left! So we started shopping for healthy foods, consisting of wild-caught or pastured nose-to-tail animal products, fruits, vegetables, nuts, and seeds. This style of eating is known as a Paleo Diet. We completely excluded all grains and grain products, added sugars, processed vegetable and seed oils, legumes, and pasteurized milk products.
I also began to change my lifestyle by exercising efficiently, sleeping restoratively, and reducing stress.
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I did additional training. I became a Certified Functional Medicine Practitioner and a Certified Primal Coach. With all this new knowledge, I began to incorporate my diet and lifestyle protocols with my periodontal patients’ treatment in 2013. Those who accepted my ideas did extremely well. They healed better. In fact, patients with periodontal disease but no bone destruction healed just from making the dietary changes along with scaling and root planing.
My newfangled ideas actually made me very healthy. By 2015, I was 30 pounds lighter and off all my meds. I considered myself the senior poster boy for a healthy lifestyle.
One of the keys in your new IABDM course on biological nutrition for dentists is that oral health depends on gut health. Will you briefly explain this relationship?
Hippocrates was a Greek physician who lived over 2000 years ago. Today, he is known as the “Father of Modern Medicine”. Reportedly, he succinctly stated, “All disease begins in the gut.”
It is critical to realize that the mouth is not an island unto itself. Whatever happens to one cell in the body ultimately can affect every other cell in the body. As a matter of fact, the mouth may be one of the first visible areas of the body which can show signs and symptoms of many systemic diseases.
Your gut has more beneficial bacteria than you have human cells in your body – about 38 trillion bacteria cells to about 30 trillion human cells. The microbes in your gut perform numerous tasks that help you survive and thrive. The bacteria stimulate and enhance the immune system, prevent the overgrowth of harmful bacteria, manufacture various vitamins, and produce short-chain fatty acids from the fermentation of various amino acids and dietary fibers. However, if these bacteria get out of balance and bad guys begin to overgrow, all hell can break loose.
Imbalance of gut bacteria is called “gut dysbiosis,” which creates havoc – in the gut, in the blood system, in your mouth, and other areas throughout your body. Harmful cascading events occur when there is gut dysbiosis.
The epithelial barrier, which is the outer wall of the gut, starts to break down. This barrier is made up of only one cell layer. These cells are held together by “tight junctions,” which are like hinges that hold a door in place. These tight junctions become weakened when there is gut dysbiosis and become unhinged, creating opening between cells. “Stuff” in the gut that should never leak into the blood system starts passing through these unhinged openings and contaminating the blood system. This is called a “leaky gut.”
At the same time, overgrowing pathogenic gut bacteria activate the immune system leading to an explosion of inflammation. If gut dysbiosis is not treated quickly, the inflammation continues and spreads throughout the body affecting every cell and organ system.
Lipopolysaccharide (LPS) is the cell wall of dead gram-negative bacteria within the gut. When there is a leaky gut, this highly toxic element can leak into the bloodstream with others. This adds to the severe systemic inflammation, which is called metabolic endotoxemia. LPS may travel to all areas of the body, including the mouth.
Chronic diseases and autoimmune diseases have their origin in this untreated and unhealthy gut. Some of the specific diseases associated with gut dysbiosis are ulcerative colitis, Crohn’s disease, obesity, type 2 diabetes, nonalcoholic fatty liver, rheumatoid arthritis, multiple sclerosis, cardiovascular disease, allergies, systemic lupus erythematosus, Hashimoto’s hypothyroidism, food intolerances, cancer, and, of course, periodontal disease – just to name a few!
In a healthy mouth, oral bacteria create a biofilm around the tooth called dental plaque. Dental plaque is healthy – until it’s not. Healthy dental plaque may be made up of as many as 700 species which are in balance, or homeostatic. This healthy biofilm has three major functions:
- It is the gatekeeper that allows minerals from the saliva to pass through to the root of the tooth to remineralize it as necessary 24/7.
- It produces hydrogen peroxide that kills other potentially pathogenic microbes and keeps them from passing through it to the surface of the tooth.
- It contains various buffers that maintain the pH in the plaque at 5.5 or higher. Tooth decay will begin when the pH drops below 5.5 for an extended period of time. So, healthy dental plaque protects the surface of the tooth by maintaining a healthy acid level.
When there is gut dysbiosis and the immune system becomes compromised by constantly being overworked, systemic inflammation and LPS leak out of the gut into the general blood circulation. This will affect the healthy balance of bacteria in the mouth and the dental plaque. Potential pathogenic bacteria already living in the healthy dental plaque begin to overgrow. In addition, poor diet choices, including added sugars and other carbohydrates, will feed the harmful bacteria, encouraging them to overgrow.
A vicious cycle begins. There continues to be leakage of toxic inflammatory elements from the gut into the bloodstream, and now there is leakage of toxic inflammatory elements from an infected periodontal pocket into the bloodstream. And all bacteria on all mucous membranes in the entire body communicate with one another.
In essence, the gut is the control center for the total body immune response, as well as pathological changes in the mouth and elsewhere. To heal periodontal disease, the balance of bacteria in the gut must be restored, the gut epithelial barrier must heal, and the damage from periodontal disease must be treated and repaired…
So how should you eat for optimal mouth/body health? Dr. Danenberg gets into that next week in Part 2 of our conversation…