How to Treat Periodontitis with Diet

“How to Treat Periodontitis with Diet” What’s the effect of nutrition
on periodontal disease? Periodontal disease is a
bacterial infection that results in inflammatory destruction of
the connective tissue and bone that supports the teeth, and is therefore one of the leading
causes of our teeth falling out. Like most infections though, how our
body responds may play a critical role. Yes, the presence of bacteria
is the primary cause, but a susceptible host is also
necessary for disease initiation. The standard explanation of periodontal
disease is the plaque theory: the buildup of plaque leads to
gingivitis, gum inflammation, which leads to periodontitis,
inflammation lower down beneath the gums.
But in some forms of periodontal disease plaque
doesn’t appear to play a critical role. Therefore, in the last few years,
there’s been more interest in the importance of systemic
health, our body’s response. In this respect, nutrition may
be of great importance since it’s been implicated in a number
of other inflammatory diseases, all of which carry elevated
periodontal disease risk. Traditionally, when we think of the
effects of nutrition on dental diseases, we’re only thinking about cavities. However, there’s been less research on
the role of diet in periodontal diseases. Well, if it’s about inflammation, one
would expect saturated fat-rich diets to make things worse,
increasing oxidative stress as well inflammation,
so we may want to cut down on saturated fat.
But, look, let’s not just speculate. I mean is there an association between
cholesterol levels and periodontitis? If not, it would be hard
to implicate saturated fat. But no, there does
appear to be a link. Those with high cholesterol do
appear to have up to double the risk. What about periodontal
conditions in vegetarians? A 100 vegetarians versus
non-vegetarians were studied, and those eating vegetarian did
have better periodontal conditions (less inflammation signs,
less periodontal damage, and better dental home care). However, it should be
considered that vegetarians may not just be avoiding meat, but are healthier in other ways,
like better dental home care. But do people who eat more
saturated fat get more periodontitis? Yes, about double the risk at
the highest levels of intake, and this study was in Japan
where they eat less than half the meat and dairy
compared to the US. The only way to know for sure, though,
is to do an interventional trial where you change people’s
diets and see what happens. In other words, you
have to put it to the test. And bone loss was indeed
magnified by a diet high in saturated fat
and cholesterol. But if you’re thinking, hmm…
that’s a weird-looking jaw, that’s because it was
a study done on rats. This is what I was looking for, though
the title kind of ruins the suspense. “A high-fiber, low-fat diet improves
periodontal disease markers” in terms of probing depth,
clinical attachment loss, and bleeding on probing—
all the standard measures. And, of course, eating a healthier diet,
body weight, blood sugar control, and systemic inflammation
improved as well. Ah, but that complicates things. Maybe their mouths got better just
because they lost so much weight? You can improve
periodontal disease with just bariatric surgery,
like stomach stapling. Well, after eight weeks on the diet,
they went back on their regular diet and so gained most
of that weight back, but the periodontal disease
improvements persisted, suggesting that it was more than just the weight
loss that lead to the improvements. They’re thinking maybe the high-fiber
diet altered their good gut flora, or maybe their oral flora?
What exactly was going on? Well, German researchers
took 20 women with mild to moderate chronic periodontitis, and for a year tried
to transition their diets towards more wholesome nutrition,
meaning more plant foods, more whole foods, more fresh foods,
trying to center their diets around vegetables and fruit,
whole grains, potatoes, and legumes—beans, split
peas, chickpeas and lentils. And after 12 months, the patients
showed a significant reduction of probing pocket depth,
gingival inflammation, and measured for the first time
decreased concentrations of inflammatory chemicals inside the
crevice between the tooth and gums, which are thought responsible
for the tissue destruction in periodontal disease, a
decrease by as much as 75%. And all the while, their oral
hygiene status didn’t change, suggesting it was
the diet that did it. But what was missing here?
A control group. But there’s never been any randomized,
double-blind, placebo-controlled trials of diet for periodontal disease
until now, which we’ll cover next.

  1. Thanks making this!! I had perfect teeth until around the time I got married. I changed my diet a bit when I got married (I baked more). I also went on the birth control pill so I wasn't sure if that changed my teeth too.

  2. What on earth is the reason that people who lost weight had improved dental health? He said it as if the weightloss itself caused less dental problems, not being connected to eating healthier. Or am I missing sth?

  3. Well I am on a high-fat ketogenic diet but I also follow fasting on different levels and my teeth and blood work are perfect by inflammatory markers are excellent and by the way I do not have high cholesterol 168 was my number and at 49 years old I am in excellent shape so it's not one-size-fits-all and fat is not the enemy people sugar is the enemy processed foods are the enemy

  4. Dr. Carolyn Dean has a little bit of anecdotal info regarding dental health and Mg.

    May 23, 2012

    A blog reader said he had high hopes that he would read a blog from me that resisted any mention of my favorite supplement, magnesium. Then he wanted to know if he really needed a magnesium supplement if he eats lots of green veggies. Well, I’m very sorry but the magnesium blog keeps chugging along fueled by constant input from magnesium fans. And yes, I think that everyone needs more magnesium in spite of a good diet. I know I do.

    One reader wrote: “Another disease you can add to your list that’s caused by magnesium deficiency is pseudogout (CPPD). I had calcium crystals in both knees, both ankles and my left wrist. Within three days of starting magnesium the pain in my left wrist started going away.” He said he found an article in Medical Hypotheses that reported Vitamin B1 (thiamine) needs sufficient magnesium to create thiamine pyrophosphate, but when magnesium is deficient calcium pyrophosphate is produced instead. He asked me to add this information to my website so it can help others regain their quality of life as he has.

    I think the following report is even more amazing. “I want to tell you a wonderful thing about Magnesium. I had pyorrhea and gingivitis for years. When I started taking magnesium the pyorrhea and gingivitis cleared up. Then I noticed my right front cuspid was thinner than the left but there was also a diagonal chip in the left cuspid. I began a regimen of brushing my teeth with magnesium and within 3 months the tooth had remineralized. Both teeth are fine and the right cuspid that was thinner is now normal. It truly is a miracle mineral. I told my dentist about it but really, he didn’t pay attention. Professionals think it’s some kind of idiocy. When will they wake up?”

    The type of magnesium to use on your toothbrush is magnesium oil. This is a supersaturated magnesium chloride (from sea water) in distilled water.

    I use LL’s Ancient Minerals Magnesium Oil because I know it’s safe without contaminants.

    Just put a few drops on a toothbrush and brush well.

    I use some of my regular, natural tooth paste; and spray some mag oil from a small spray bottle. One or two sprays will do.

    Some people use baking soda along with the mag oil.

    Some people floss first.

    Some dilute the oil if it’s too strong.

    Some also gargle with a few drops of magnesium oil in water for gingivitis.

    However, if you have mercury fillings, I would not use magnesium in the mouth. Magnesium pulls out toxic metals and could pull mercury into your mouth which you might then swallow.

    All in all, the results from using magnesium oil for dental hygiene are impressive.

    Another blog reader wrote that his mother is on a lot of medications but he got her taking magnesium. He said, “After her first dose she said that she later had a really good BM–and felt 10 years younger. WOW–that makes me feel it’s really worth it to remind her to take it—she’s almost 89 years old.

    Even multiple sclerosis can respond to magnesium. A blog reader wrote the following. “As an MS patient I was blown away to find that after only two days on magnesium citrate, several of my symptoms disappeared to the point that I am more of a functioning woman.”

    What about migraines? Here is a newly published article in the Journal of Neural Transmission. It’s called Why All Migraine Patients Should Be Treated With Magnesium. The lead author is Dr. A. Mauskop who runs the New York Headache Center and has written many papers on magnesium and migraines. I quoted him in my Magnesium Miracle book. You can read the abstract of his paper which he ends by saying “…the fact that magnesium deficiency may be present in up to half of migraine patients, and that routine blood tests are not indicative of magnesium status, empiric treatment with at least oral magnesium is warranted in all migraine sufferers.” That’s a pretty clear directive that you don’t often see in journal articles…usually they say, we need more funding to research this further!

    Carolyn Dean MD ND

  5. Literally am going to the dentist today to have a injured tooth extracted. Perfect timing thank you for giving me some hope that it doesn’t have to be downhill from here!

  6. Floss, floss, floss. Many cavities occur in between teeth where a tooth brush can’t get to. Not flossing is also is related to heart disease. Keep in between your teeth clean.

  7. I’m a dentist. I know a lot of vegans and vegetarians. My observations agree with the research discussed in this video.

  8. The problem with every study is that none cover a HEALTHY meat eating diet. They are all based around the standard first world diets. Of course restaurant burgers and fries are bad for you. Now try covering someone who has grass fed beef and a big pile of green veggies for dinner. That's the ultimate human diet right there.

    I have nothing against a plant based diet, but for me and many others, it makes us feel awful. Just adding small amounts of meat or eggs does wonders.

  9. As powerful as these studies are, I feel like I need studies like this to include high and low sugar and high and low acid.  Can we assume those are less important than saturated fat?  I feel like there were other stories to show sugar was related to teeth problem and I know that you have covered citrus as having caused problems with tooth enamel if you brush too close to eating it and you have covered how the artificial sweeteners mess with the microbiomes, so I guess I am looking for a way of reconciling the information.  Were the people in this study soda and artificial sweetener and sugar free, too or does the study stand on its own?

  10. Dr. G, I hate it when you say “which we’ll cover next”. The suspense is killing me! 😂😂 just kidding, thank you for your awesome work. Guess what: daily dozen for two months and my cholesterol is down 40 units. Thank you so much!!

  11. I got really exited about this video because I originally had planned to make my dentistry diploma thesis about this topic 😀 Thank you for sparking my academic interest in medicinal nutrition.

  12. I am glad the doctor is doing more informational videos on dental problems. This is a major cause of problems in many folks. Plus, the high cost of dental care in the USA makes these videos by Dr Greger even more important imo.

  13. I'm 24 and was told I have periodontis when I was 22. Any further suggestions would be great. I'm a fairly healthy individual but I probably could have flossed more during college /:

  14. Are there any studies on the affects of eating a lot of fruit in the diet? I am developing very sensitive teeth, and my dentist keeps telling me it's from an acidic diet (eating fruit). I don't eat refined sugar in my daily diet. I eat about 2-3 serving of whole fruit per day (no smoothies).
    I do rinse my mouth out with water directly after eating fruit, but this doesn't seem to be helping much.

  15. im 66 had this problem a long time, i have been vegan for 2yrs, 8mths ago i had an attack of this disease, i awoke one morning with loose skin in my mouth, during research i discovered ,s,l,s [sodium laurel sulfate ] which is used for creating froth in tooth paste, i found a tooth paste which is s,l,s free, and ;bingo; my mouth is not totally cured , but there is a marked difference, my disappointment is not ever being told by a dentist that s,l,s can have a detrimental reaction on my gums,

  16. Dentistry is the next profession to just get blown to smithereens. Let's scrape all this stuff off and have you put toxins down into this portal constantly to keep badies away. Wow, that is so dumb, yet it's still SOP everywhere. Learning about the microbiome has not metastasized yet.

  17. Uuhhhh. Ehhhhhh. Uhhhhhhhhh. Ehhhhhhh. Uhhhhhhh ehhhhhhhh. Uuhhhhhhhhh. Ehhhhhhhhh.
    You know what I’m talking about uhhhhhhhh. Ehhhhhhhh.

  18. I know this is anecdotal…I started a 12 daily dozen style, whole-food, planet-based diet 3 years ago. It has done wonders for my weight & energy. I make sure to supplement B12, Omega 3, D, Zinc & Magnesium. I'm almost 40 and I'm now in the best shape of my entire life. However, 1.5 years after starting my new diet I developed periodontal disease…basically I'm suffering from bone loss and gum recession. I have great oral hygiene habits and have never had a problem in the past. I believe the diet is causing this. I won't stop my diet however, because so far the other benefits have been great for me. I've done some reading online and it appears other planet based dieters have had similar issues. What I don't get is that I'm very careful with my diet…I follow the daily dozen religiously. Any advice anyone?

  19. I have periodontal disease so it's going to be interesting to see what part 2 is like. I have noticed since going vegan, I've had much less issues with it though.

  20. I had gingivitis for 20 years Dentist couldn’t improve it – went vegan and became more alkaline my sweat didn’t sting my eyes anymore and no more bleeding gums!!! Others I have converted to vegan have had the same result

  21. Many indigenous tribes found around the world never used or had toothbrush/floss/paste ect.. yet perfect set of teeth. Explain? Those who say you need to brush/floss are full of it.

  22. Please make a video on what kinds of breads to eat. Also, huge thank you for making these videos Dr. Greger. I'm honestly really grateful.

  23. I have been on a WFPB diet for just over a year and had a dentist visit this month. I was shocked at the lowering in measurements from hearing 7s and 8s to mostly 0s.
    I had been told by my dentist that it is incurable and that I could only slow it down but eventually would lose my teeth. Dentists are so unaware of diet benefits.

  24. awesome video, I hope we can have more on tooth health from dr greger, if you want to help your teeth for a good oral hygiene regiment then using a range of tools is important, a decent tooth powder is great and a all natural toothpaste also E.O.s can be good, salt water rinse after eating, you can get some awesome products for your oral health

  25. When i took on a vegan diet a year ago, i had shocking problems with inflamation abcesses pockets, my dentist said i was to just live with it and visit him every 3 months,well after 3 months of eating vegan every problem went away!! And lots of other things did too!! I see him once a year for a clean now, I never expected that to happen, its wonderfull!!!😊

  26. Dr Greger – you should change your title. It is misleading. It should say how to "help prevent" instead of treat. I'm a dentist and we see patients with periodontal disease- lots of calculus stuck to the roots of their teeth and bone loss. The treatment, which every dentist and hygienist in the world knows, is to scale the calculus off. So you can't "treat" by saying follow this video, the calculus will come off. This video talks about treatment. Misleading. You should title it something else. I'm disappointed in you Dr. Greger. Don't help uneducated people misunderstand the basics of dentistry.

  27. While you are trying to give dental advice to people, you should mention that people should floss to clean the sides of the teeth where the toothbrush cannot reach. Either give complete dental advice and real advice on actual treatment of perio, or stay in your lane. I don't want my patients to believe they can treat perio themselves with diet. Diet won't be physically removing hardened calculus stuck to the teeth below the gums. The title of this video is truly misleading and disappointing

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