A Holistic Way to Support Teeth & Gums
to Keep you Healthy for a Lifetime
Why Gum Disease is So Important
In this post we discuss a unique model of prevention, treatment and maintenance that you will not find anywhere else. In order to maintain oral health it’s important to understand how the mouth works and how it heals. We also discuss what to do before, during and after treatment to maintain and/or restore oral health.
We will focus on gum disease, because it is an inflammatory disease of the mouth that mirrors the inflammatory condition of the body as a whole. It is a two way, or bi-directional relationship. inflammation of the mouth mirrors and contributes to the inflammation of the body. Conversely, the inflammation of the body mirrors and contributes to the inflammation of the mouth.
In fact the signs and symptoms of gum disease are probably the best way to tell how inflamed your gums are. By looking in a mirror, do you see red or puffy gums around the necks of your teeth? It can also be diagnosed through images like x-rays and direct examination by your dentist of the gums and bone around your teeth.
Knowing if you have gum disease is important because it not only can save your teeth, but it can also save your health. Why? Because the bacteria that are associated with gum disease can leak into your bloodstream and infect the rest of your body.
Do your gums bleed when you brush or floss your teeth? Think about it. Every time your gums bleed, the bacteria in your mouth have access to your bloodstream, and therefore the rest of your body.
This is why gum disease is such an important topic and health concern. In no other disease including intestinal diseases do microbes of all types gain access to your body with such ease and with such consistency. It is truly an infectious disease that is working to weaken your immune system and organs 24/7, day after day, usually for decades before it starts to cause loose teeth. This is why early treatment and resolution of this disease is so significant and leads to better outcomes.
If you are interested in oral and systemic health, how to treat gum disease, and in preventive maintenance and holistic self care then read on!
Inflammation – The Silent Killer
Inflammation has been called ‘The Silent Killer’ as it is involved in the initiation and progression of almost all chronic disease states.
- Autoimmune conditions
- Heart Disease/Stroke
- Irritable Bowel/Food Sensitivities
There are numerous books and research papers discussing and proving that inflammation is a cofactor of virtually every disease known to man. But the most common and deadly inflammatory disease in the U.S.is heart disease. This is because more people die from heart disease in the U.S. than from any other disease as the graphic below shows:
This bears repeating; heart disease is the No. 1 cause of death both worldwide and in the United States, killing over 375,000 Americans each year. Here, inflammation in the blood vessels and heart is chronic, not acute. This leads to breakdown and disease, rather than stimulating a response and hopefully a recovery from an insult or infection. This is the difference between chronic and acute inflammation and disease states. Acute inflammation is usually short term and chronic inflammation is long term.
One of the manifestations of heart disease is pericarditis which is simply inflammation in and around the heart muscle and is thought to be caused by viral infection. In the age of Covid and spike proteins, it is especially important to keep inflammation down in your heart and your body as a whole.
“Prolonged inflammation can damage your body’s healthy cells and tissue, and weaken your immune system,” says Stephanie Maxson, senior clinical dietitian at the MD Anderson Integrative Medicine Center. “This weakened state can increase your risk of diseases like cancer.” Other causes of chronic inflammation can include obesity, smoking, stress, lack of exercise, exposure to secondhand smoke and diet choices.
Another condition to note here is fatigue, the most common and often the most elusive medical complaint in America! Chronic infection in the mouth leading to inflammation can drain your body’s resources 24/7. This is yet another reason to stay on track with your primary care health provider, your dentist, and possibly your cardiologist if you have any heart concerns.
The most prevalent disease in the mouth is periodontal disease or gum disease. Quite simply, gum disease results from inflammation of the gums around your teeth that goes unchecked or is not properly treated. Gum disease is actually quite common, affecting over 50% of the population at some point in their lives. The graphic below demonstrates:
Gum disease can be defined simply as inflammation around your teeth that results in the loss of the protective band of gum tissue and bone around your teeth, eventually resulting in infection and tooth loss.
How does this happen? Think of your gums as Saran Wrap or a protective wrap that protects and covers the bone beneath it. A good way of visualizing this is when a man wears a tie, it tightens the collar of your shirt around your neck just like your gums keep a tight attachment to your teeth. This is because your gums have a strong collagen attachment to your teeth, and therefore protects them and the bone underneath from bacteria and infection.
The gums in your mouth are essentially a barrier system just like your intestinal lining, your skin or your blood brain barrier. A barrier is meant to keep what inside in, and what’s outside out.
However, when there is gum disease, the bacteria associated with it inflames and punches microscopic holes in your gums in order to cause bleeding. This is how they produce food for themselves. These microbes, which include parasites and amoeba, want your gums to bleed so they can eat your red blood cells, one of their favorite foods.
When your gums bleed the natural protection provided by the barrier system of your gums has been violated. Because of this, the bacteria can actually follow the blood into your body. The reason they can do this is that these bacteria are usually motile, meaning they can move and sometimes move quite quickly. Sothey follow the blood because, for them, blood is food.
Again, this type of immune activity may go on 24/7. If you are suffering from fatigue that goes undiagnosed, have you looked into the condition of the ecosystem in your mouth: your oral microbiome? Remember that inflammation is bi-directional. Inflammation in the gut can affect inflammation in the mouth and vice versa. Gum disease is an infection caused by anaerobic bacteria, meaning the bacteria can live without oxygen. These types of bacteria hide in dark, warm and acidic environments. The gum pockets around your teeth is such an environment. Aerobic, or oxygen loving bacteria, are generally more friendly and less aggressive. They tend to have a more symbiotic relationship with our bodies.
As a whole, you want more aerobic (air-orbic) bacteria in your body than anaerobic bacteria and this balance between the two defines the microbiome of either your mouth or gut. If you have a lot of anaerobic bacteria your microbiome is unhealthy. If you have more aerobic bacteria then your microbiome is considered more healthy.
The microbes I find in the mouth associated with gum inflammation and gum disease are some of the most aggressive bacteria found in the body. Included in these microbes are Spirochetes and parasites. Once you know how these microbes function and feed on your body and/or tissue, you will not want to have them anywhere in your body.
Spirochetes are a common bacteria found in the pockets around your teeth and they are causative for gum disease. Here is a video showing spirochetes in action; how they move, aggregate, and how they feed on your gums:
How Gum Disease Affects Your Health
According to Harvard Medical School Publishing. people with gum disease (also known as periodontal disease) have two to three times the risk of having a heart attack, stroke, or other serious cardiovascular event.
Research also shows a connection between gum disease and:
- Rheumatoid Arthritis
- Autoimmune disorders, including lupus, Crohn’s disease, and scleroderma
- Poor pregnancy outcomes, including preterm birth and low birth weight
- Cancer – the highest risk being lung cancer and colorectal cancer.
More recent research shows other connections between gum disease and systemic disease:
The American Academy of Periodontology reported in 2021 that those with severe gum disease were at least three times more likely to experience COVID‐19 complications including death, ICU admission and the need for assisted ventilation.
The Alzheimer’s Society reported in October 2021 that people who had gum disease declined in memory ability six times faster than those who did not over the six-month follow-up period. The researchers concluded that gum disease is associated with an increase in cognitive decline in Alzheimer’s, possibly by mechanisms linked to the body’s inflammatory response.
Here is an interesting graphic from Dr Bae, our gum specialist. It shows the connection between gum disease and Autoimmune Diseases. And that it is bi-directional; meaning that gum disease can make your Autoimmune disease worse and that systemic inflammation can also make your gum disease worse.
Biomed J: 2019 Feb;42(1):27-35. doi: 10.1016/j.bj.2018.12.001. Epub 2019 Mar 2. Association between periodontal pathogens and systemic disease Fiona Q Bui 1, Cassio Luiz Coutinho Almeida-da-Silva 2, Brandon Huynh 1, Alston Trinh 1, Jessica Liu 1, Jacob Woodward 1, Homer Asadi 1, David M Ojcius 3
Oral DNA is the most well known saliva test and determines the amounts of 11 bacteria in the mouth that have been associated with and said to cause gum disease.
Another company that does saliva testing is Bristle. A sample of their report is below:
I like Bristle better because it tests not only for bacteria that causes gum disease but for bacteria that causes tooth decay/cavities. Another advantage of Bristle over Oral DNA is that it tests for over 30 bacteria rather than just 11. In addition, Bristle tests for healthy bacteria or the microbiome balance in the mouth, which offers options to work with in terms of probiotics.
The test Bristle does gives you good information about the status of your oral microbiome and risks you have of getting cavities or gum disease. They are also recommending more natural products and ways to rebalance the microbiome of the mouth besides traditional antibiotics and fluoride. They are aware of the dangers of overprescribing antibiotics, as they disturb and upset the microbiome balance of the gut. They also highlight natural and safer alternatives to treat gum disease and which supplements and nutrition to take.
The second way to tell if you have gum disease and probably the best way is to actually look at the condition of the gums around your teeth.
If you look in the mirror and see gums that are red and inflamed, or if they bleed when you brush or floss, this is a sign that you have inflamed gums and may have gum disease. Here is a picture of healthy gums. Notice the color is pink and the appearance is healthy.
When you look in a mirror do your gums look like this?
Or do you have gums that look more like this, where you have a band of red inflamed gums around your teeth?
If your gums look anything like the above picture, you most likely have some form of gum disease. Red, inflamed gums are one of the clearest signs of gum disease.
The problem with gum disease is that people think that red and even bleeding gums is just a fact of life. While this may be true at the time, it is still not desirable. It can and should be addressed and reversed.
The other thing about gum disease is that it doesn’t hurt until advanced stages. Swelling and infections around your teeth will loosen them. You can even lose your teeth if it goes unchecked for a long time.
The key to gum disease is to treat it early. This is as true of gum disease as it is for heart disease or any other condition in your body. Early treatment is always a good idea.
Part of the solution to gum disease is to understand what it is and how it manifests. As stated above, gum disease is caused by inflammation in the gums around your teeth. The inflammation is caused by certain microbes/bacteria that cause the body’s immune system to react to try and fight the bacteria under your gums. It’s this inflammation that can become chronic and cause the breakdown of your supportive bone around your teeth over time. Then the teeth may become loose, until there is danger of losing them.
So job #1 is to get rid of the bacteria that causes the inflammation and loss of bone around your teeth. Most dentists use antibiotics to try to kill the harmful bacteria that inflames the gums. Also cleanings are done to remove the buildup and tartar that creates a home for these bacteria to live in. However, can you be sure that all the harmful microbes are removed with antibiotic therapy or cleanings? What if there are resistant strains of bacteria like spirochetes or parasites that can’t be killed with most antibiotics?
If you think you may have gum disease, we recommend you see your dentist for routine evaluation, cleanings and possibly deep cleanings if necessary
In the meantime, there are things you can do to improve gum health and sometimes even heal the condition. You can find our recommendations below. Keep in mind that these recommendations are only meant to improve the situation and not cure the disease. For this you will still need dental treatment.
Dr O’s Recommendations
Dr O has designed a protocol to help people improve the microbiome and thus the health of the mouth. This will especially be appreciated by holistic-minded people who don’t want to take antibiotics. Dr O recommends the protocol below for around 80% of his patients.
Dr O’s Basic Home Care Protocol to keep you gums and mouth healthy:
- Brush your teeth with an herbal rinse or toothpaste of your choice.
- Use a ‘rubber tip’ to wipe along the gum line to remove the white film there called plaque. Do this on the outside and inside of the teeth. It’s actually called a Stimulator made by G.U.M and is available on Amazon.
- Pick up baking soda on the toothbrush and massage it along the gum, on the inside and outside of all your teeth, and then spit out. Use light pressure as baking soda is slightly abrasive.
- After using baking soda for 2-3 weeks, Dr O recommends you only use it 2-3 times a week, as baking soda is a salt and there is a chance it could raise blood pressure.
- Floss your teeth to further distribute the baking soda.
- As an alternative to flossing, you can use a Soft-Pick by GUM or The Doctor’s Brushpick at Amazon, Walmart or at your local pharmacy. You can also use the picks with a mixture of baking soda and a solution of 50% water and 50% hydrogen peroxide. The peroxide solution is also really good for cleaning your toothbrush, which you should replace every 3 months.
Here is a video demonstrating what Dr O recommends for most patients;
Why Is the Rubber Tip Important?
In my practice I give the rubber tip to every patient. It is that important. Not only does it remove the plaque along the gumline that causes gum disease, it also helps prevent gum recession. You can also find the rubber tip on Amazon by searching for Rubber Tip Gum Stimulator. It’s made by GUM. There’s one on Amazon Prime for $5.49.
Here is a video I did using a microscope to demonstrate how powerful and effective baking soda is in killing harmful bacteria in the mouth. I will let the video do the talking. I think after viewing you will see the benefits and incorporate baking soda into your home care.
You can find it on Amazon or at large health food stores.
Here is a picture of it. If you can’t find this brand they
Below, I list 3 scenarios of gum disease and what to do about them. As you read through the following scenarios keep in mind that your gums should be pink and resilient, should not bleed, and have attachment levels in the 1-3 mm range. This attachment level is referred to as ‘pockets’ and denotes how deep the gap is between the crest of your gums and where the gums attach to your teeth. The deeper the pocket, the bigger the gap, and the pocket is where the damaging bacteria hide and proliferate. .
Level #1: Slightly Red Gums
Fortunately, some simple home care can help to prevent and even reverse this kind of condition.
You may be in this category if:
- It has been awhile since you had a cleaning and your gums bleed
- Your pockets are in the 3-4 mm range
- Your dentist says you have gingivitis and may recommend deep cleanings
Dr. O’s Recommendations
- Take a picture with your smartphone to document and refer back to later
- Follow my Basic Home Care Protocol above for 3 months
- Go into your dentist for cleanings and routine care
- Have your pockets remeasured at your dentist upon recall
- Have your dentist or hygienist confirm if your gums are healing or not
I always recommend routine care, which includes regular teeth cleaning (prophys). Combining routine care with a daily routine to clean your teeth and gums will allow your gums to heal from inflammation. Often, with low level inflammation and gingivitis, when patients follow the above instructions there is total resolution of the condition.
Level #2: Red and Bleeding Gums
- Your gums bleed, look red and may be slightly ‘puffy’
- Your hygienist measures pocket depths of 3-6 millimeters
- Your dentist says that you have moderate gum disease
- Your dentist most certainly recommends deep cleanings.
Dr. O’s Recommendations
- Take a picture with your smartphone to document and refer back to later
- Follow my home care instructions above for 3 months minimum
- Go into your dentist for cleanings/deep cleanings and routine care
- Go to Target, Costco, or Walmart and buy a Waterpik or Irrigator of your choice
- Follow Instructions and consider adding antibacterial mouthwash
- Alternatively, you could follow one of the protocols I include in Attachment #2
If your pockets are in the 4-6 mm range, you will need deep cleanings. However, it will be better to lower the inflammation first so that the treatment has greater success when it is done.
When my patients follow the home care instructions for the waterpik below, they experience much improvement in bleeding and inflamed gums, and the pocketing improves to some degree. If 2/3rds of the pockets are improved when the deep cleanings are done, the result is just that much better. After you have deep cleanings and your gums have been re-evaluated, you may still want to do a laser procedure to heal the gums completely.
How will you know if you are better? One way is that you will see less red and more pink in your gums, and there will be less bleeding. The other way is when you go to your next cleaning the dentist and hygienist will report improvement in your pocket measurements.
Dr. O’s Protocol for level 2 gum disease:
If you have moderate gum disease, meaning 3-6 mm pockets, or even minor gum disease, with 3-4 mm pockets, the water pik should become your best friend.
Also, when you have red and bleeding gums that just don’t seem to resolve with routine home care or cleanings this should be your next step.
The recommendation when using waterpiks, however, is to always use a low setting or even the lowest setting so as to not apply too much pressure to your gums. In other words, let it do all the work.
Waterpik Protocol #1: A natural protocol using Grapefruit Seed Extract
- Fill the reservoir with water up to the designated level
- Use either sink or filtered water as you will not be swallowing it
- Add ¼ teaspoon of grapefruit seed extract into the 20 oz. reservoir
- Use as directed at a low setting
- You can adjust the amount of GSE according to taste
- You can also use a Xylitol mouth rinse or a Xylitol sweetener to cut the bitterness
Waterpik Protocol #2: Another natural protocol using Salt and Baking Soda
If your gums are relatively healthy and you have a waterpik you can use the following rinse:
- In a jar or cup pour about ¼ to ½ inch of your favorite salt with ½ to ¾ inch of baking soda and stir with at least 3-5 inches of clean water. Let it sit so the water becomes saturated. The excess salt will precipitate out. If there is still a lot of powder at the bottom, you can add more water until there is very little precipitate at the bottom.
- Dilute one part salt solution with 3-4 parts water for use with the waterpik. You can pour the excess salt solution into another jar to save for later, but make sure it’s closed.
- After you are done irrigating, pour the salt solution out and refill the well with water. Continue running water through the waterpik into the sink so that the water cleans all salt out of the tubing and internal components of the waterpik. If salt remains in the waterpik it will clog it up and it will no longer work.
Level #3: Puffy Gums and Visibly Stained Teeth
You may be in this category if:
- It has been years since you had a cleaning and your gums and teeth are sore
- Your hygienist measures pocket depths of 6 millimeters or greater
- Your dentist diagnoses you with advanced gum disease
- Your dentist recommends deep cleanings and a referral to a gum specialist
Dr. O’s Recommendations
- Take a picture with your smartphone to document and refer back to later
- You will need deep cleanings and most likely laser surgery to fix the damage.
- Go to Target, Costco, or Walmart and buy a Waterpik or Irrigator of your choice
- You should follow one of the protocols I include in Level 2 above.
Again, it will be best if you lower the inflammation, first so that the laser surgery has greater success when it is done. So, you will need to be on a home hygiene regimen, get deep cleanings done and re-evaluate the situation. You may also need to look at nutritional support and also look at what’s going on systemically that may be contributing to the breakdown of your gums and bone. For this you will need your physician’s help.
How will you know if you are better? Your gums will be more pink, not so red and inflamed. Your pockets will be back in the healthy range and your teeth will be more stable after your gums and bone have healed; you will not lose anymore.
A caveat: None of what I’m telling you above is a replacement for seeing a dentist regularly and having routine exams and cleanings. This in my opinion is a mistake and leads to more problems down the road. So don’t take my recommendations or advice as a way to skip seeing a dentist. It’s not.
How We Treat Gum Disease at Integrative Dentistry
The First Line of Defense – Home Care
Actually the most important thing you can do is keep your teeth and gums clean. For most people this means brushing, flossing and using a rubber tip daily. At Integrative Dentistry we replace your toothbrush and rubber tip every time you come in for a cleaning. (You may consider replacing your toothbrush even more often).
The purpose of using these tools is to remove the white film that collects along your gum line and between your teeth. This white film is called plaque and is the primary food source for bacteria in your mouth. Once bacteria colonizes plaque it will start to create inflammation in the gums and bone of your teeth. This is the precursor to red and bleeding gums and gum disease.
If you want to learn more about home care and the tools that matter you can ask during your next cleaning appointment. This is the right time to ask. Don’t be shy. It’s very important that you be doing this correctly. It makes all the difference in the world for your teeth and gums. In the meantime you can read more about these tools above.
The Second Line of Defense – Teeth Cleanings
Buildup of hard deposits attached to your teeth need to be removed periodically to keep your gums and bone healthy and disease free. This is why you go into the dental office for periodic cleanings or ‘prophys’ as they are called. This is short for ‘prophylaxis’, which means prevention. Stain and deposits are rough and house bacteria that release poisons that inflame your gums.
Think of a microscopic apartment complex where everyone parties 24/7. In order to clean up the mess, eventually you have to evict the squatters. Another analogy is barnacles on the bottom of a boat. If the barnacles are not periodically removed eventually you get moss, seaweed, and even small fish collecting and living in this newly formed ecosystem.
Plaque calcifies into hard deposits by absorbing minerals from your saliva. It’s plaque and hard deposits that cause inflammation and results in the breakdown of the gums and bone around your teeth.
Are Cleanings the Cure for Gum Disease
The first reason why cleanings and deep cleanings are sometimes not enough is that there are bacteria and parasite populations that are very aggressive and aren’t easily controlled by routine cleanings and home care. Some of these populations have survival strategies that allow them to hide in the biofilm/plaque and even in your own cells. One of these commonly found bacteria are spirochetes, as mentioned above. Here is a video showing how these offenders operate and where they live in your mouth.
Think of cleanings like doing tune ups for your car. Usually that’s enough. But sometimes the car just needs an overhaul or rebuild. That’s what the gum specialist is for.
The Third Line Defense – LANAP
LANAP stands for ‘Laser Assisted New Attachment Procedure.’ Dr Bae, who is our resident gum specialist, does not do traditional gum surgery. Instead he uses the Millennium Laser, to treat gum disease. The reason he uses lasers is that they encourage the attachment of healthy gum tissue to your teeth and help to regenerate the bone in your jaws without the pain and soreness associated with traditional gum surgery.
We have found that lasers are the best way to:
- Perform surgery on teeth, gums and bone in a non traumatic way
- Increase blood flow and stem cell activation to speed up the body’s healing response
- Restore the mouth’s natural barrier systems and proper function
- Control and kill harmful bacteria and restore the healthy microbiome of the mouth
To see how we use lasers to heal the gums and bone around your teeth, please watch the following video:
How to Tell if LANAP is Right for You
If you would like a second opinion on your diagnosis or to see if gum surgery is necessary in your case, you can call our office for a consultation with Dr Bae, our Integrative Periodontist.
Dr Bae is unusual as he looks at underlying conditions contributing to your gum issues before recommending treatment. Once he feels that you can benefit from treatment, he explains everything in ways that you can understand and get behind. The second difference with Dr Bae is that he only does laser gum surgery to address and heal gum disease.
So we have established, and research shows, that gum disease is an inflammatory disease that causes both tooth loss and affects your overall health.
In this report we have discussed how gum disease:
- Impacts your overall health
- Is caused by aggressive anaerobic bacteria around your gums
- Can improve with home care by using Dr O’s favorite tools and protocols
- Has 3 levels and how to deal with each one
- Takes the right treatment to heal and how to work with your local dentist
Future Topics on the holistic approach to gum care and gum treatment are:
- The Role of Probiotics
- Inflammatory Blood Markers
- Infection and Root Canals
If You are In or Near San Diego
We have a truly integrative approach to treating gum disease, because gum disease and its underlying causes are systemic in nature. It is not just a disease of the mouth. Our holistic approach includes unique and individualized home care instruction, gum treatments and the LANAP procedure using the Millenium Laser. Nutritional counseling with our staff nutritionist Victoria is also available.
If you live in or around San Diego, would like to become our patient to get help with your dental needs, or if you would like to see our specialist, Dr Bae to treat your gums, please call the office at 760-632-1304 or email us at [email protected].
For faster scheduling, please send current X-rays to the email above and fill out a New Patient History here: myholisticdentist.com/new-patient-intake-form/. We will follow up to schedule a time that is convenient for you.
Please note that we cannot give personalized advice to any patient who cannot be treated at the office. But if you send an email to the address above, we can offer suggestions about receiving help from local bio dentists. The holistic approach in supporting the body to heal is usually the best approach in our experience.
Carey O’Rielly DDS has been a practicing dentist for 35 years. He went to USC Dental School and Duke University for his undergraduate degree. He grew up in Laguna Beach and now lives in La Costa with his wife Victoria, who runs his office.
He began his career by owning and operating a network of six offices in the San Francisco Bay Area. Presently he owns a private holistic practice in North County San Diego’s Encinitas.
Dr. O started looking for solutions to his health challenges that resulted from the stress and environmental toxicity that built up over a ten year period running his dental network. He has dedicated himself to learning about oral systemic problems and how dentistry can affect your health. He has applied what he has learned over the last twenty years to ensure he, his staff and his patients are protected from the chemicals and toxic materials found in most dental offices. He has produced an environmentally friendly office that is also peaceful and calm.
He is an expert on dental materials having looked at hundreds of biocompatibility lab tests over the years. He has identified the most bio-friendly materials to use in his practice and which dental materials can be used to replace metal fillings and crowns, including BPA free and fluoride free ‘white’ fillings. He also uses metal-free Zirconia or ceramic implants and PRF (platelet-rich fibrin) grafting materials which come from the patient’s own blood.
Dr. O’Rielly teaches C.E. courses on the systemic effects of gum disease. He is an expert in using phase contrast microscopy for analyzing dental infections, where he shows patients what kind of microbes, i.e. bacteria, amoeba, and yeasts like candida are populating the mouth and affecting the body as a whole.
He has an educational blog and is writing a book on dental health called ‘Hidden Dental Infections: Healing Root Canals and Infected Teeth with the Erbium Laser’ where he discusses dental nutrition, toxic dental materials and the effects of old root canals on inflammation and overall health.