If you find you are doing everything you can for your teeth, brushing and flossing every day, and yet still having problems - then this post is for you. While it is well known that activities such as brushing and flossing affect the health of teeth, studies have also suggested that oral health may also be related to underlying imbalances in the body. These imbalances can be nutritional, metabolic, or environmental-related and addressing them is key to improving oral health. Given that dentistry is outside of the scope of Naturopathic medicine, this post will focus primarily on nutrition rather than common dental recommendations such as the type of toothbrush, flossing recommendations, etc.
What Are Periodontal Diseases?
Periodontal diseases include gingivitis and periodontitis. Gingivitis is the early stage of gum disease, characterized by inflammation, redness, swelling, and bleeding of the gums. If left untreated, gingivitis can progress to periodontitis, where the inflammation extends to the supporting tissues of the teeth. Periodontitis is more severe and can lead to tooth loss due to the destruction of the bone and connective tissue that hold the teeth in place.
Nutritional Causes of Periodontal Disease
There are several nutrients that play an essential role in preventing periodontal disease. For example, vitamin D deficiency has been shown to be a significant risk factor for the development of periodontal disease, with studies finding that low vitamin D levels are associated with higher oral inflammation and an increased risk of tooth loss (2023; 2001). One study found that tooth loss was two times more common in those who were not supplementing vitamin D compared to those who were supplementing. However, before supplementing vitamin D it is a good idea to talk to a health professional and get tested as high levels of vitamin D may also pose a risk to health.
Similarly, low levels of vitamin C have long been known to contribute to gum disease, including gingivitis. A study from 2012 found that individuals with lower vitamin C levels had a higher risk of developing periodontal disease (2012).
Omega-3 fatty acids also play a protective role against periodontal disease. Research has shown that individuals with a higher omega-3 to omega-6 ratio tend to experience less bone loss and gum inflammation. Supplementation with omega-3 has been found to improve outcomes in periodontal disease (2024).
Our clinic has a comprehensive panel that can look at all nutrients that have been found to be related to periodontal disease.
Minerals Related to Periodontal Disease
Data suggests that mineral imbalances may be other key contributors to periodontal disease. Calcium is critical for maintaining bone health, and low calcium levels have been shown to increase the risk of periodontal disease (2008).
Likewise, a proper balance of magnesium is essential for oral health. Studies have found that individuals with higher magnesium-to-calcium ratios have a reduced risk of tooth loss. Additionally, low magnesium levels are more common in those with periodontal disease, suggesting this nutrient may be related to gum health (2019).
Metabolic Factors and Periodontal Disease
Metabolic issues, particularly those related to blood sugar, play a significant role in the development of periodontal disease. High hemoglobin A1C (HbA1C) levels, which indicate poor blood sugar control, are associated with a tripling of the risk of periodontal disease (2023). This connection highlights the importance of controlling blood sugar for maintaining oral health.
In addition, elevated cholesterol levels have been linked to an increased risk of periodontal disease. A 2017 study found that individuals with high LDL cholesterol and low HDL cholesterol were more likely to develop gum disease (2017).
Immune-Related Factors in Periodontal Disease
The immune system plays a crucial role in defending against oral bacteria, but when this system is compromised, periodontal disease can worsen. For instance, neutrophils, a type of white blood cell, are the body’s primary defense against oral pathogens that lead to plaque buildup. A complete blood count (CBC) can screen for neutropenia, a condition where neutrophil levels are low, weakening the body's ability to fight off bacterial infections that contribute to gum disease.
Immunological disorders, genetic conditions, or nutritional deficiencies can all reduce neutrophil counts, thereby increasing the risk of periodontal disease. Proper immune function is essential to controlling inflammation and preventing the progression from gingivitis to periodontitis. Individuals with weakened immune responses may experience more rapid disease progression and tooth loss due to the body’s inability to fend off harmful bacteria.
We use a panel of testing that can check levels of immune cells and inflammation related to periodontal disease.
Environmental Toxins and Periodontal Disease
Environmental toxins also play a significant role in the development of periodontal disease. Lead exposure, for instance, has been shown to negatively impact oral health. A 2023 study revealed that individuals with higher lead levels are at increased risk for periodontal disease (2023).
Other Risk Factors for Periodontal Disease
Several other risk factors have been identified that can contribute to the development of periodontal disease. For example, a 2016 study found that gastroesophageal reflux disease (GERD) significantly increases the risk of tooth erosion due to exposure to stomach acids (2016). Additionally, lifestyle factors like stress, smoking, and alcohol consumption have been found to exacerbate gum disease.
Symptoms of Periodontal Disease
Common symptoms of periodontal disease include swollen gums, bleeding during brushing or flossing, persistent bad breath, and gum recession. In advanced stages, periodontal disease can cause loose teeth and significant discomfort.
Complications of Untreated Periodontal Disease
When periodontal disease is not properly managed, it can lead to severe complications, such as tooth loss. Chronic gum inflammation can also contribute to systemic conditions, including cardiovascular diseases, as bacteria from oral infections can enter the bloodstream.
Conclusion
Addressing periodontal disease involves identifying and correcting underlying nutritional, environmental, and metabolic imbalances. By conducting comprehensive testing, we can create personalized treatment plans that may include dietary changes, supplementation, and lifestyle adjustments. Proper management of these imbalances can significantly improve oral health and reduce the risk of disease progression.
Before initiating any treatment, it's crucial to first conduct comprehensive testing to identify any underlying imbalances. This testing helps ensure that the appropriate treatments are chosen and that the correct dosage is administered. Addressing a deficiency without proper diagnosis could lead to unintended side effects. When levels of certain nutrients are too high, this can also be harmful to health (eg. vitamin D).
At our clinic, we offer a thorough approach to identifying alternative causes of periodontal disease. Through a combination of blood testing, nutritional evaluations, and natural therapies, we aim to restore balance and promote lasting oral health.
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