May 20, 2017
We'll be exploring a new topic for us, all about how food and nutrients affect your gum health. It’s not often thought about, but our gums need certain nutrients from food in order to stay healthy. So, if you have been to your dentist recently and have been told you have bleeding gums or receding gums, or know someone who is dealing with that, listen in as we share what foods help, and which hurt your gums.
Kara: Welcome to Dishing Up Nutrition. I am Kara Carper, Licensed Nutritionist and host of today’s Dishing Up Nutrition. For the past 12 years we have talked about a variety of health issues and how each of these issues often relate to the food you have been eating. Today is a new topic for us! We'll be exploring how food and nutrients affect your gum health. Think about that for a second.... our gums need certain nutrients from food in order to stay healthy! So, if you have been to your dentist recently and have been told you have bleeding gums or receding gums – you know your gums need help. I'm sure you want to know what is causing the breakdown in your gums. You might be thinking, what should I eat? Is there a supplement I need to take? We will answer all of your questions today and more. 75% of Americans over the age of 35 have gum disease, so this is relevant to many of you listening!
I am pleased to welcome Jennifer Schmid to Dishing Up Nutrition to answer your questions. Jennifer will be the perfect person to interview today because she has knowledge in nutrition and dentistry. You have probably heard her voice before because she's been on past shows sharing her personal health transformation. She also teaches nutrition classes at Nutritional Weight & Wellness.
Jennifer, you have also been a licensed and certified dental assistant for 24 years, so I imagine you have seen a lot of teeth and gums, right?
Jennifer: Yes, I have certainly seen a lot of teeth and gums and I can’t believe it’s been 24 years. I don’t know where the time goes. In my 24 years of working in dental care, I've had a lot of different roles. I’ve worked chairside, I’ve done some administrative duties and I also managed an office and I’m also certified in IV sedation. I’ve worked in almost every dental specialty there is and right now I work with a periodontist and we treat patients with mild to severe periodontal disease and we also specialize in dental implants. You know the connection in the mouth and disease in the body has been researched and known for some time. I remember in the year 2000 when the U.S. Surgeon General said “The mouth is the mirror of health and disease in the body”. That was 17 years ago.
Kara: Wow. I had never heard that quote until I got it from you. Now, Jennifer, could you just talk about a few of the worst things you can eat or drink in regards to gum health?
Jennifer: The worst I would have to say is smoking and chewing tobacco, a lot of free radicals and toxins can damage the gum tissue. The next would be soda, we talk a lot about soda on this show, I would say especially Mountain Dew. In fact, I was at a dental seminar where I saw a screen shot that showed badly eroded and decayed teeth with inflamed gums. So both sides of the slide looked identical, you couldn’t tell them apart, so we had to guess which mouth somebody had used meth and which one had drank Mountain Dew. You couldn’t tell them apart. Which was extraordinary. So we know that regular Mountain Dew has more sugar than Coke, we know that in a 20 oz. bottle of Mountain Dew we have 19 tsp of sugar, versus with Coke it’s 17 tsp of sugar. But diet is almost worse because it has more acid. We know that regular soda and diet soda both contain phosphoric acid. Phosphoric acid damages bones because it takes minerals like calcium and magnesium away from the bones but it also does the same thing to the enamel on the teeth.
Also, sticky/sugary foods like gummy bears and fruit roll ups, are also very bad for the gums because they just stick and they get into those crevices in the teeth.
Kara: Sure, so the foods that a lot of kids are eating. They might have that as their snack or at school for lunch and then it’s just sitting on their teeth all day.
Jennifer: Also, things like cough drops, lozenges, and this may surprise some people, but nicotine lozenges. I had a patient a couple weeks ago, he gave up chewing tobacco which was great, but instead of putting the tobacco in his lip he replaced that with a nicotine lozenge and after a six month period of time he developed a lot of decay. Just in six months.
Another one would be coffee. Coffee is very acidic and can erode away the enamel, especially if someone is constantly sipping on coffee throughout the day. We all know that coffee stains teeth as well. I’m not telling people to give up their coffee, the best thing they can do is to drink it all in one sitting and not sip on it throughout the day. Then when you’re done with the coffee, rinse out the mouth with water, and then wait 20 minutes before brushing the teeth. You don’t want to brush in that acid and stain into the enamel.
Kara: Can I just ask you a quick question, back to the soda? Hopefully people heard everything you said in regards to soda, because I think a lot of our listeners are under the impression that diet soda is a better option, because it does not contain sugar. We know being in the nutrition field that it contains artificial sweeteners, but you’re saying that also regarding teeth it’s actually worth than regular soda.
Jennifer: It is, it’s got higher acid so it damages the teeth but also the bones. So if you’re concerned about your bone health, diet soda is worse for them as well.
Kara: A lot of our listeners, fortunately, have given up their soda, maybe they’ve given up regular or diet soda and I don’t think a lot of people have done meth. Can you talk about some other things that can damage gums?
Jennifer: Our long-time listeners know that we talk a lot about sugar on our show. Sugar feeds the bacteria and it makes plaque. So what is plaque? Plaque is a sticky colorless film, it’s an organized colony of multiple forms of bacteria that’s in everyone’s mouth, all the time. You can never completely eliminate the bacteria in your mouth, but you can keep them from destroying your teeth and gums. So plaque eats the same food we do and they specifically thrive on processed foods, sugar and acid. Which is no surprise right, so they love things like pasta, bread, muffins, cookies, soda. So these foods and beverages allow the bacteria to reproduce and turn into plaque quickly. Now the plaque will mix with saliva and when you’re not cleaning it off your teeth. When you’re not cleaning off your teeth that plaque is going to turn into tartar. Tartar is calcified or hardened plaque that attaches to enamel and it will get below the gum line. And at that point it can lead to periodontal disease because if bacteria is getting underneath the gum line, and bacteria loves that tartar, at that point you can’t mechanically brush that tartar off yourself.
Kara: Is this the stuff, when I got the dentist every six months and they get that little pick thing out? They’re getting the tartar that I couldn’t get off with my toothbrush?
Jennifer: That’s correct, that’s exactly what they’re removing.
Kara: So it’s normal to have some plaque, but I love the way you said that, “it’s eating the same foods we do.” So if we’re eating vegetables that’s probably not as much of a problem for that plaque buildup. If we’re eating proteins and healthy fats, probably not a problem. But it’s those sugars, those processed carbs that are turning into a lot of sugar and basically feeding that plaque.
Kara: We’re talking about the connection between what we eat and the health of our gums. As well as how the health of our gums effects our entire body. So it looks like we have a caller.
Caller: Yes, a lot of years ago I was reading a magazine before anybody had heard of it here that the Japanese have the longest lifespan in the world and they take Co-Q10 for their gums. They want their gums to hang onto their teeth because they get to be so old. And there’s another important consideration I found out that if you decide to take it, the ubiquinol form is about three times better absorbed than the regular stuff. So I only buy the regular stuff if it’s way, way cheaper, but how can I put that, let’s say you’re going to get five times more of the regular, then I’ll buy it, but if it’s only two times cheaper than … If it’s three to one, you just take more MG if you get the non- ubiquinol l because only a third is usable.
Jennifer: I’m not familiar with the non- ubiquinol.
Kara: The ubiquinol, I believe we sell both those types in our office, the regular co-enzyme 10 and the ubiquinol form. You know when I’m working with a client, when I suspect maybe they’ve had absorption issues, if anyone suspects not having great gut health or digestive health I would probably recommend the ubiquinol l form just to make sure that people are accessing it a little more easily without having to break it down as much. I do have some clients though that I know that the regular co-enzyme 10 works really well, that it’s relieving symptoms, it’s improving gum health. We’re going to talk a little bit more about CoQ-10 later in the show, we weren’t going to address the ubiqunol form so thank you for bringing that up. I would say you can’t go wrong with either one, try to get a real quality supplement and a soft gel form is always going to be best. Thanks for your call.
Before we went to break and took Pat’s call, Jennifer you were describing plaque and tartar and how plaque eats the same foods that we do, so those processed foods and sugar they’re going to be very problematic for increasing plaque and tartar and leading to higher risk of gum disease. But, when we talk about sugar and candy and soda and things like that, you’re not just talking about the white sugar we spoon into our morning coffee, right? I'm guessing you are talking about all the hidden sugar. One example that comes to mind for me is a typical lunch, I see a lot of my older clients eating a lunch like this, sometimes I think it’s because it’s easy and quick, and maybe they’re just cooking for themselves and they would have soup and crackers. Soup can be loaded with sugar. In fact, I saw a can of minestrone soup, that’s gonna be about two cups has 10 tsp of sugar! If you add in two saltine crackers, that’s another 4 tsp of sugar. That’s 14 tsp of sugar not including a beverage.
Jennifer: I think that’s going to be surprising to a lot of our listeners too. You wouldn’t think that salty crackers and soup would contain that much sugar. Plus, you know, many kids and adults are eating two cups of cereal for breakfast which has over 20 tsp of sugar! Not just talking about those sugar cereals like Cinnamon Toast Crunch and Frosted Flakes, but also Cheerios, Rice Krispies, Wheaties, Grape Nuts, and even Kashi! Dr. David Ludwig who wrote Always Hungry, says in his book, “If you eat a bowl of Corn Flakes with no sugar added, or if you eat a bowl of sugar with no Corn Flakes added, below the neck, the body is not going to know the difference.” And the tissues in the mouth and gums are not going to know the difference either!
Kara: Over half of Americans are eating about 60 tsp of sugar per day. That doesn’t account does not account for naturally occurring in fruits and vegetables – this is just added sugar. So, if someone is eating 60 tsp of sugar a day, what is happening to their gums?
Jennifer: When people eat sugar and the SAD (Standard American Diet) diet of processed carbohydrates, this feeds the bacteria causing plaque build-up. That will turn into tartar and it attaches to the teeth and also, when sugar and processed carbs feed bacteria, the bacteria can grow and enter into the bloodstream. So we all have blood vessels in our mouth and if you have periodontal disease that can lead to cracks and lesions in the blood vessels. The primary source of bacteria in the blood vessels comes from infected gums. We teach this in our Weight and Wellness class, in class five, the heart health class.
Kara: You’re right, we do. I’m just learning so much from you I never put it all together while I was teaching that class. So you’ve talked about things like Mountain Dew, smoking and sugar all cause more bacteria, which leads to red, swollen, puffy gum tissues, basically inflammation. What else causes gum recession and bone loss?
Kara: If you were listening before break, Jennifer mentioned an antioxidant that plays a role in healing gum disease. What is this nutrient that can help bleeding gums, inflamed gums and deep pockets? It’s called co-enzyme Q 10 and Pat was a caller who mentioned CoQ-10, people shorten the name and call it CoQ-10. As we get older our body produces less of this and we actually can become deficient. There are foods that contain CoQ-10, animal proteins like beef, pork, chicken, fish, however, I think it’s interesting that the highest amounts of CoQ-10, like the heart. Not a lot of people are buying and eating the heart these days, I don’t know anyone, so it’s going to be difficult getting enough CoQ-10 from food. As a nutritionist I typically recommend 200-400 mg as a supplement form of CoQ-10, and a soft gel form is very absorbable. We have this in our office. Jennifer, can you tell listeners the other reason that some people might be deficient in CoQ-10.
Jennifer: Sure, some other reasons are if you have a lot of free radicals or inflammation in your body. If you’ve got periodontal disease than you’ve got inflammation in your body. So that could be some other reasons on why you could be deficient.
Kara: Ok, so you know some people take cholesterol lowering medications and that naturally is going to deplete CoQ-10. Things like Zocor or Crestor are going to deplete CoQ-10, which we need for heart health. So if you’re on a statin lowering medication or cholesterol lowering medication, if you’re having side effects like leg cramps or leg pain or weakness we would also recommend 200-400 mg of CoQ-10.
Jennifer: I see a lot of patients that come into our office that are on statin medications that have periodontal disease so there’s a direct connection there.
Kara: We were talking about all the things that feed plaque and can cause eventually over time cause inflammation, maybe gum recession or bone loss. There were some other things you were talking about before the show though that could potentially cause those too?
Jennifer: Yes, and this may surprise you, but clenching and grinding can often destroy gums. People do this in their sleep and are not even aware they're doing it, but it can damage the gums. Clenching and grinding causes a lot of force on the teeth and can lead to recession and bone loss. You know, I’ve had patients come in and they’ve got good health and they say, I brush my teeth, I floss every day and I try not to have any sugar in my diet and I don’t understand why I have these deep pockets. Because when you come in to get your teeth cleaned, I’m sure most listeners know that those numbers measured around their teeth. And so, between one and three is good, fours are not too bad but five, six, seven and eight, you don’t want to be at those levels and they don’t understand and they’re embarrassed. So basically this clutching and grinding can cause those deep pockets. Another thing we look for when patients come in like that I come in, I ask them “Do you have sore or tired jaws in the morning?” Sometimes we can see wear patterns on their teeth as to where they’ve been grinding their teeth. Another thing we see is that when people are brushing their teeth it’s easy to just scrub back and forth and this is not good. You always want to use a soft bristle brush and instead of that sawing back and forth you want to brush your teeth in a sweeping motion. I’ll try to describe this over the radio, so just tilt your brush at a 45 degree angle. If you’re on the upper you’re going to kind of sweep down, sweep the debris down and away from the gum tissue. Same with if you’re on the lower, you’re going to kind of brush up.
Kara: Ok, I’ve been doing it wrong. I’m just going to admit. I thought you were supposed to do the opposite. I knew not to saw back and forth. This is so helpful!
Jennifer: We used to teach going in a circular motion but now we’re finding it’s more effective to go in the sweeping motion. Also, elective toothbrushes. The most important thing if using electric toothbrushes is never put pressure. Never put your own pressure, just let the brush do the work. There are some electric brushes on the market that may have an indicator like the Oral-B, which is great. So the brush will automatically stop so you know you’re brushing too hard.
And you know I have to talk about flossing, very important to floss, but proper flossing. We don’t want to saw down between the teeth or aggressive with the floss. We want to be very gentle and kind of hug the teeth with the floss with a C-shape fashion and then gently up and down removing that debris.
Kara: Wonderful tips, thank you so much. I have to say after you and I chatted in preparation for the show I have been on a mission to improve my own oral health, and my families, I think they’re kind of annoyed on Mother’s Day weekend I was talking about sugar and proper flossing and I think everyone was getting annoyed, but it’s important.
Jennifer: Well my familiar gets annoyed when I talk about nutrition so I understand what that’s like.
Kara: Fortunately I have never had a problem with clenching or grinding my teeth while sleeping. I have a lot of clients with this issue. Why does this happen? Why are so many people clenching and grinding their teeth during the night?
Jennifer: It's more common than you think, that someone is clenching and grinding their teeth at night because they have a magnesium deficiency. In fact, three out of four Americans are deficient in this mineral! I first started taking magnesium when I first came to Nutritional Weight & Wellness in 2012 and I took it more for Charlie-horses and leg cramps at night and also I was having trouble sleeping. I worked my way up to 800 mg of magnesium glycinate before bed to help my leg cramps go away so I could sleep better. At the time, I was also a clencher/grinder. I used to wear a night-guard and always woke up with sore jaws in the morning. Once I started taking the magnesium for my leg cramps, I realized I was waking up in the morning and my jaws were not sore anymore and I was able to stop using my night-guard because I had stopped grinding my teeth!
Kara: So you didn’t realize because you weren’t taking it for the grinding, you were talking the magnesium glycinate for something else but as a result the clenching and grinding went away.
Jennifer: That’s right. We know that it’s our magic mineral, it’s our relaxation mineral. That would make sense that it’s going to relax the muscles around the TMJ.
Kara: Definitely makes sense and I’m sure if people have TMJ, that diagnosis, magnesium would also be helpful.
Jennifer: Exactly, that's around the time when I started reading about magnesium and found that holistic and even some conventional dentists were recommending it. You know, night guards are expensive, especially if you get the custom ones made in a dental office. They run roughly around $600 and often not covered by insurance and some people go through two or three of these in a year because they grind right through that hard acrylic surface. It gets to be expensive.
Kara: As far as how much magnesium, you were taking 800 mg, but now you don’t need that much.
Jennifer: No, I’m only taking 400 mg of magnesium glycinate now and some people will need to start at a higher dose like I did, until your body starts to absorb it and then they can go down once they notice they’re not clenching or grinding. What’s great about magnesium glycinate is it shouldn’t cause lose stools like many other forms of magnesium, like magnesium citrate.
Kara: Yes, there are other absorbable forms, like you said the citrate, but we use that more if someone tends to be constipated. The glycinate really I think is the best for that relaxation that we would need in our jaws.
You know, when I was looking up information for the show today, I came across research that gum disease may be connected to memory loss, dementia and even Alzheimer's disease. Think about how close the mouth is to the brain. We've already talked about how bacteria in the mouth can cross the blood-brain barrier. Bacteria in the mouth could potentially get into the bloodstream and into the brain, causing inflammation in the brain. We know that dementia and Alzheimer's are caused by brain inflammation.
Jennifer: I also see first-hand how dangerous oral cancer is. Most people know when they go in to get their teeth cleaned the dentist comes in and they do that cancer screening, that oral cancer exam, it’s very important. Oral cancer is a type of cancer that can spread very quickly to the brain and we have seen this with some patients.
Kara: You've explained how bacteria in the gums can lead to disease just in general. But I’d like to specifically talk about how gum disease is related to Rheumatoid Arthritis (RA) and Fibromyalgia, which are both autoimmune conditions.
Kara: Welcome back to Dishing Up Nutrition. I’m Kara Carper, a licensed nutritionist and I’m really pleased to be here today with Jennifer Schmid who is a nutrition educator as well as a licensed and certified dental assistant. I’ve been interviewing her this morning about the connections between certain foods and gum health and the connection between poor gum health and disease states. We had a caller who did not stay on air but had a question over break in regards to something that’s been brought up a couple times today, the co-enzyme Q 10. The first caller Pat was talking about a certain form called ubiquinol and someone wanted to know the spelling and so I’m going to really quickly explain that the more common form of co-enzyme Q 10 is going to be ubiquinone that’s really what you’re going to see at most health food stores, that’s more common. The stronger form is ubiquinol. And the main difference is that the first version, the ubiquinone that’s going to be converted in the body to ubiquinol. So you know, if you don’t have absorption issues, you don’t have gum disease, heart disease, I really think it’d be fine to take the regular version. If you’re concerned at all about breaking things down in the body and absorbing than you may want to go with the stronger one, ubiquinol.
We were going to talk about autoimmune conditions and the connection with gum disease and autoimmune.
Jennifer: Bacteria can enter the bloodstream and cause inflammation, and even infections in joints and connective tissue and even organs. The reason we know there is this connection, is because doctors have been giving some patients antibiotics before dental surgeries and procedures for decades. Basically, cardiologists and orthopedic surgeons, those are the two types of doctors that prescribe them the most, they’re going to recommend pre-medication prior to treatment, anywhere from two years to life for patients. So people that have had joint replacements, like knee replacements, it really depends on the health of the patient, if they’ve got a compromised immune system or diabetes. So depending on if they are high risk than they need to be on the pre-medication longer. It’s really up to the surgeon. Some surgeons really just believe they want their patients to be on that antibiotic for life so they don’t risk an infection in the knee. I have seen a patient lose their knee replacement due to a bacterial infection because they didn’t pre-medicate. And for patients with an artificial heart valve, a history of infection endocarditis – and what that is is inflammation of the inner tissues of the heart – they would need to pre-medicate. Also heart patients who developed a problem in the heart valve. If patients were not to pre-medicate for this heart conditions it could lead to that ineffective endocarditis which could lead to damaged heart tissue and it could lead to blood clots that could lead to a stroke or a heart attack.
Kara: So when somebody is going in for a dental procedure they’re given antibiotics. I think a lot of people are just trusting their doctors, getting the antibiotics but maybe they didn’t know why. So I think that’s very helpful that you explained the importance of that.
Jennifer: And we try to screen patients, we ask them, “Have you had a joint replacement, have you been told to pre-medicate, do you have a heart condition that you may need to pre-medicate for?” And sometimes they’re just not aware or weren’t paying attention when the doctor explained that to them.
Kara: Right, so hopefully people are learning today from you what high-risk would mean for the pre-medication. I think listeners are making the connection that gum disease is linked to so many other health conditions. There is all the research but also your 24 years of clinical experience and all the examples you have seen are really powerful as well.
We're going to start talking about some nutritional solutions. But I have one more question that I hear about from many of my clients. They complain about having dry mouth. Is dry mouth a risk factor for other health issues? Why is it so common?
Jennifer: There's actually a medical term for dry mouth, it’s called xerostomia. Dry mouth can come from dehydration, certain medications, anti-depressants, blood pressure medications. Saliva does important things like washing bacteria off of teeth and it starts the process of digesting food in the mouth. When people have dry mouth, they can have alterations in their taste buds, speech difficulties, if you wear an appliance like a partial or a denture you can get a lot of sore spots because it’s rubbing on that dry tissue. Another important thing with saliva is that it starts the process of digestion in your mouth. So when people have dry mouth they have a hard time swallowing food. The average American chews only five to six times before swallowing! That’s too few. Some countries people chew their food 20 to 30 times which seems like an extreme amount, we want to chew our food really well to activate enzymes and let them work for us. I would challenge listeners to kind of count yourself, how many times are you chewing? I forget all the time and I have to remind myself, especially when I get in a hurry. We want to use those beautiful teeth to chew our food well.
Kara: I help clients with dry mouth figure out a solution to this uncomfortable problem. Now I have more tools in my toolbox thanks to you. We look at different factors like: is it from a medication and if so, is there a better medication or another alternative with fewer side effects? In fact I had a client two weeks ago that was complaining of dry mouth because of her allergies, she’s had terrible allergies for so long but it is a bad season as well. But she’s on these strong anti-histamines and has dry eyes, dry mouth. I told her about a product we carry that’s called D-Hist and it’s a natural anti-histamine that doesn’t have any side effects, no drowsiness, no drying. In fact that’s what got me off of taking Claritin years and years ago, it works really well. Then if people can get off those anti-histamines or other medications causing dry mouth, those symptoms will go away.
Jennifer: Our gum tissues also need water – like I mentioned – dehydration can be a cause for dry mouth. But sometimes dry mouth and other gum issues need fatty acids. Some examples of fatty acids that can lubricate these tissues are Omega-3 fish oil, GLA, those fatty acids work really well. Kara do you recommend these fatty acids for clients of yours that have dry mouth?
Kara: Definitely with dry eye, dry mouth, dry tissues in general, I would recommend three soft gels of the Omega-3 fish oil as well as three soft gels of the Omega-6, which is GLA. We’re coming up against the clock, is there a way you could summarize really quickly about the connection between gum health and heart disease. Maybe just even less than a minute.
Jennifer: I’ll just read what the American Academy of Periodontology states that several studies have shown that periodontal disease is associated with other disease in the body such as heart disease and research has indicated that periodontal disease increases the risk of heart disease. And scientists believe that inflammation caused by periodontal disease may be responsible for the association. So periodontal disease can also make existing heart conditions worse, like that infected endocarditis like I mentioned, it is caused by the bacteria that is coming from the mouth.
Kara: I wish we had more time to talk about that but I just hope that listeners are hearing that there’s a huge connection between periodontal disease, or gum disease, and heart disease. So really important to keep those teeth and gums clean. It’s time to wrap up the show and you’ve given up some great tips about how people can change their diets and how people can improve their gums, let’s just quickly recap some of those worst foods for gum health. Sugar and processed carbohydrates are going to lead to more plaque build-up, candy, cough drops and sticky, sugary foods like gummy bears and fruit roll-ups, that sugar is going to stick to the teeth. Beverages are soda, diet soda, juice, energy drinks and coffee.