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Dental Health And The Paleo Diet: Gingival Sulcus Depth, Periodontal Disease, Systemic Inflammation, and Some N=1 Data
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November 10, 2012
12:50 am
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Cyclops:

I don't know enough about tooth biology to comment.

eddie:

It's more data in support of the central role of systemic inflammation (as opposed to "cholesterol", or any other measured number) in heart disease.

That being said, I suspect high TG and low HDL generally go along with high CRP.

Tom:

I also use interdental brushes instead of flossing.  They're much quicker and easier to use, and I suspect that flossing just pushes a lot of the gunk deeper instead of pushing it out!

Regular cleaning, if performed properly, certainly won't do you any harm, and may well do you a great deal of good...but 3 times a year is excessive.  Every six months is usually enough AFAIK unless your hygiene is terrible, and those of us eating clean Paleo can probably go longer.

Againstthegrain:

I've used a Sonicare since forever, so it's not the cause of my recent improvement.  That's interesting that you found it aggravates your tinnitus!

I've never used a Sulcabrush, but I bet it's magical when you've got braces in the way.  As I said to Tom, I've use interdental brushes instead of flossing for many years...and it seems to be working, so I'll continue.

JS

November 10, 2012
1:23 am
pam
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JS,

what is the unit on the y axis?

my teeth were not too bad to begin with; the pockets were rarely deeper than 4 mm, except few sensitive spots. there was a spot in gum that would get infection or inflammed every 2 years.

when i first switched diet, the first thing i noticed was the improvement dental health before anything else. (didn't have to loose weight so not much too tell).

but i'm still left with receding gum. is there way to regrow it back? it does not give me any discomfort tho.

November 10, 2012
2:44 am
eddie watts
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JS you said "That being said, I suspect high TG and low HDL generally go along with high CRP" i assume CRP means Cancer Rate Production?

November 10, 2012
1:37 pm
Mike B
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Eddie
I believe he means C Reactive Protein.

November 11, 2012
1:48 am
neal matheson
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I had a brush with peridontal disease some years ago, I ate copious amounts of fruit working on a fruit farm along with bread etc.Dental health (which is subsidised but not free in the UK) is the main reason I am tight with my sugar intake despite pretty high sugar (honey) intakes of several Hunter gatherer groups.

I won't allow my daughter (2 years old) to eat any sugar as it is pretty hard to brush her teeth, I have actually been called "cruel" for this. Every one of her peers is given sweets and fruit juices. I had no sugar as a small kid and didn't have any cavities until I discovered fizzy drinks at university.

November 12, 2012
2:11 pm
heather
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I've had a lifetime of dental problems (9 cavities in 5th grade) - I've had fillings fall out and have had fillings replaced. Cavities as a child (constant). In my thirties it was root canals and crowns (no my dental hygiene was never great but I tried). It was cracked and broken teeth which I blamed on my nighttime grinding. They couldn't drill without breaking the tooth. It didn't matter how much I brushed and flossed at this point. It came to a screeching halt when I went Primal. And my "dental hygiene" is actually worse now. I use my WaterPik and occasionally brush with whitening toothpaste because I'm a coffee drinker. That's it. It was a 180 degree turn around for me.

November 12, 2012
2:14 pm
heather
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Oh yes, I did go through the numbers games at the dentist. They were pretty bad. 2 weeks of faithful brushing and flossing (I HATED FLOSSING!) kept me from the deep gum cleaning. Little did I know...

November 14, 2012
1:03 pm
Marilyn
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@ Cyclops: I saw something like that, too, but can't find it now. As I remember, the illustration was about the pH of the mouth -- when the mouth is too acidic, minerals flow out of the teeth, but when the mouth is more basic, minerals flow into the teeth and the teeth can actually remineralize somewhat. A paleo diet, by reducing food for acid-generating bacteria, probably automatically adjusts the pH of the mouth.

November 14, 2012
2:46 pm
Marilyn
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JS, thanks for the info on the Tom's strawberry flavored toothpaste. Sounds good. I'll check it out next time I'm at the health food store.

November 15, 2012
7:23 pm
Elenor
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What is y'all's take on Xylitol toothpaste (and chewing gum)? My dentist was pleased when I said I was using it. (Spry in the brand I use -- they have a nice peppermint, and cinnamon, and I forget what-all else.) As I understand it, the Xylitol starves the bacteria so they can't dig holes in your teeth.

November 16, 2012
9:24 am
usrbin
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Another interesting read on the topic can be found here:

http://www.agd.org/publications/articles/?ArtID=9892

The article is a bit of a long read. But it details the acid theory vs the proteolysis-chelation theory of dental caries. The articles puts forth the notion that we may have been going down the wrong path of how dental caries are formed due to a dominant (and unproven) theory. In my mind, there is also a certain parallel with dominant (and unproven) nutritional theories that drive research and policies.

November 18, 2012
7:26 pm
Grafvitnir
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Being a periodontist and having eaten a paleo diet for almost three years I had to add this:

http://www.ncbi.nlm.nih.gov/pubmed/19405829

http://www.zora.uzh.ch/25306/2/Baumgartner_Impact

to the reference list 🙂

November 18, 2012
8:25 pm
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pam:

Y axis is the total pocket depth in excess of 2mm/tooth.  You can look at the chart to see the original data.

I'm not sure that receded gums ever grow back, but I'm open to correction here.

eddie, Mike B:

Exactly.  CRP is C-Reactive Protein, an approximate measure of systemic inflammation.

neal:

That's one reason I'm skeptical that our post-chimpanzee ancestors ate a highly frugivorous diet…as I point out in this article, their tooth enamel simply wasn't built to withstand the acids and sugars.  And the experience of many modern raw vegans underscores this point.

heather:

I'm glad things have improved for you!  Thanks for sharing.

Marilyn:

"Health food" stores usually carry a selection of non-traditional toothpastes, many of which are sorbitol-free…particularly those intended for kids.

Elenor:

Apparently xylitol is non-fermentable, so plaque bacteria can''t use it as a food source.  There are also some anti-streptococcal effects specific to xylitol: Wikipedia footnotes this book as a source (particularly see p. 204).

usrbin:

That's very interesting!  I'm not really qualified to judge it, but it seems like the upshot is: simple sugars, particularly sucrose, indeed cause tooth decay, though by a different mechanism (inhibition of the hormone that controls dentinal fluid flow).

Grafvitnir:

That's a great reference: thank you for linking it!  

(The second link is a PDF version of the first)

 

I'm finally caught up.  Thanks, everyone, for sharing your experiences...and please continue to do so!

JS

November 23, 2012
10:35 am
Marilyn
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Elenor, I just bought some Spry online. When I got it and discovered that in addition to xylitol it also has sorbitol, I tossed it. In my mouth, that would be kind of like putting water on a fire to put it out, and at the same time, putting on some gasoline. It's a real challenge to find products that have xylitol that don't also have a bunch of other junk. I even suspect any plain xylitol sugar that doesn't specify "birch." Not because I'm worried that much about corn -- by the time it's been processed into xylitol, it probably doesn't make much difference -- but from what I've read, most of the corn xylitol comes from China, and has been known to be laced with sorbitol, since sorbitol is much cheaper.

November 23, 2012
8:14 pm
Morris
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My experience is even more dramatic. After decades of perio disease and tooth loss (pockets in range of 4-8mm) and following dentist’s instructions a sudden flare (bone loss, implants falling out) caused me to finally look into root causes. I had changed my diet to a more “heart healthy” one on my doctor’s recommendation and within 3 months sudden worsening happened. So I reversed my diet (i.e. fewer grains, legumes, meals/day) and in a couple of months there was a detectable improvement. So I kept going in that direction and backed into the “paleo” diet. Now 2 and half years later improvements continue albeit at a slow pace. Some interesting things I found: improvements in lower back & neck pain, aging biomarkers too numerous to list. The key thing is that the change came mostly from reduced production of plaque not from brushing. I floss once a week as a test for gum sensitivity. Diet change was not the only intervention. I was initially concerned about the high fat content but my total cholesterol has now declined to near normal (212ng/dc) from a high of 350.

November 25, 2012
6:41 pm
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Marilyn:

I don't chew gum myself, but health food stores will usually have several different types of xylitol toothpaste.  I just got some Kiss My Face berry flavor (yes, the kids' stuff), and it's sweetened with xylitol and a touch of stevia.

Morris:

That's how most of us got here: "I'm eating exactly what I'm supposed to eat, why do I feel worse and worse?"  

Your experience is consonant with the idea that periodontal inflammation is symptomatic of systemic inflammation.  I'm glad you're seeing improvements!  

And yes, I also find that many signs of "aging" are really signs of poor diet.

JS

November 25, 2012
9:19 pm
Marilyn
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Thanks again, JS. "Kid stuff" tooth paste sweetened with xylitol and stevia sounds worth checking into! I just bought some "kid stuff" mints sweetened only with xylitol, BUT the last several ingredients are artificial coloring. Another item to cross off my list. . . .

November 28, 2012
5:59 pm
dana pallessen
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your readers might like to read "cure tooth decay, by ramiel nagel. it is right in line with what you have said about tooth health as well as more exyensive in other areas. he also believes the natural way of eating is the right way.

December 4, 2012
11:38 am
pam
Guest

ok. sorry didn't see the caption.

ok i'd report back if i have success growing back my gum.

i really dont' want to loose my teeth!

December 10, 2012
10:55 am
Tim Lundeen
Guest

I've had bad tartar and plaque as long as I can remember, eating paleo didn't really change anything. The kelp variety Ascophyllum Nodosum (avaiable as capsules from Nature's Way, or bulk from Maine Sea Vegetables) helps a lot with tartar buildup, I take 1T/day in bone broth with a little salt.

What's made a tremendous difference is upping my fermented skate liver oil from 1/2-tsp/day to 2 tsp/day. This basically increases Vitamin A to about 9,000 IU and D to 4,500IU, plus additional quinones, K2, etc. I've also started using Mark Manhart's Calcium-Zinc toothbrush moistened with some of his oral calcium-zinc solution to brush in the evening before bed. The combination is amazing -- no plaque, no tartar buildup, my teeth feel shiny and smooth all day. So I expect to get an excellent report on my next cleaning (just to confirm), and then to just stop going to the dentist.

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