THE “TEETH” IN DISEASE?

READERS SUMMARY:


1. HOW SCIENCE PRESENTS A CURVEBALL YOU DID NOT SEE COMING?

2. HOW YOUR MOUTH MIGHT BE THE KEY TO DIABETES, OBESITY AND INFLAMMATION?

3. IS THERE A HYPOTHALAMIC PAROTID AXIS?

4. IS THE PAROTID GLAND THE MOUTH’S PANCREAS?

 

Most of you may not know that before I was a neurosurgeonb I was a dentist and oral and maxillofacial surgeon.  Many people know that Weston  A. Price was a dentist too, who was ostracized from organized dentistry for many political reasons.  Much of his accomplishments have been largely under appreciated ,because he was painted as an “renegade” by the American Dental Association and by organized dentistry.  Most dental students never learn a thing about him or his work as a result.  The paleo community knows about Weston A. Price largely, because of his foundation and people like Sally Fallon and the newer generation of young bucks, like future PHd, Chris Masterjohn.  When I went to dental school at UCONN, my classmates and I never learned a thing about Weston A Price.  We never were told about his work or his books.  In the last 25 years, my education has evolved from dentistry to oral surgery, then to neurosurgery, and now to evolutionary molecular biology and it hopefully it will end in Optimal longevity.

 

My background is different, and kind of gives me a unique view point into medicine, surgery, and aging.  Unlike many other paleo practitioners,  I look at health and disease a bit differently.  If you have read my QUILT, you know that levee one is the top of the heap.  The cellular terroir determines all things in biologic terms for the future’s of our cells.  Lately, there has been a lot of “discussion”  in the blogosphere about macronutrient theories of obesity and the role of carbohydrates, and most of you know that my views on the situation are different then some of these paleo luminaries.  Instead of drawing a line in the sand on macro-nutrients,  I have chosen to look at the problem through the optic of how our brain accounts for electrons from our food, and how it responds to those signals via the hormonal signals from our hypothalamus in our brain.  The main hormone that determines how we partition electrons is leptin as I have laid in my quilt and many of my blogs.  Today, we are going to talk about an area that has never been tapped in our community–How might diabetes and obesity begin when we view the problem through an “old” scientific finding that has been largely ignored since it was discovered in 1968.

 

I’d like to introduce you to John Leonora, Ph.D in endocrinology.  He was a medical/dental researcher who like, Weston A. Price,  was largely ignored by most of organized dentistry and medicine.  He toiled at Loma Linda Universi,ty and he recently died in February of 2006.  I first heard his name in 1986, when I was a first year dental student at UCONN during a class on the origin of dental caries.  Back then, I heard a presentation on a new theory of dental caries based upon a lecture that Dr. Leonora gave in 1983.  I became reacquainted with some more of his work from some of my current patients who are 7th Day Adventists and one of my former dental school classmates, Dr. John Sorrentino recently.  My 7th Day Adventist friends turned me back on to his work in 2006 and I largely ignored this information again after I read it.  I think I never fully grasped the implications of it, honestly.   I compiled the articles he wrote, and in 2006,  put them in a file cabinet under the tab called the “oralhypothalamus”.  Then in October 2011, my old buddy Dr. Sorrentino, from UCONNm, sent me an article in a general dentistry magazine to read.  As soon as I saw the name,  John Leonora,  lightening struck my own memories.  It was time to synthesize what I remembered from those articles in 2006 and the 1986 talk, and what I now know and write something cogent for you to consider.

 

Dr. Leonora had some new theories about how dental caries (tooth decay) were caused.  He rejected the dogma I was taught in dental school that the acid from bacteria caused demineralization of enamel and dentin in teeth to cause dental decay.  He took it much further.  He postulated that that dental caries was caused not by bacteria,  but caused by inflammation that was due to hypothalamic interruption of hormones that controlled avascular structures in teeth and other endocrine organs.  He believed that the parotid gland in our mouth acted just like our pancreas does in our gut.  He believed that the parotid gland indirectly controlled the metabolism of avascular structures like dentin, enamel, and the islets of Langerhans that control insulin release in the pancreas.  This axis essentially helped the brain sense the initial carbohydrate breakdown in the mouth, and relayed that data to our parotid gland and pancreas to formulate the brain/gut axis response hormonally to this energy substrate.  This is why salivation and insulin secretion can often occur before a sugary meal is even eaten.  Leptin receptors are also now known to exist in the mouth, gingiva, and on taste receptors.

 

In 1986,  as a first year “dumb ass” dental student, I had no idea how brilliant this man was then.  Moreover,  how incredibly ignorant the rest of the dentistry and medicine was to his findings that began in the late sixties.  Today, I now know about the tremendous accomplishments of Weston A Price, so it comes as no surprise that another dental researcher findings are finding the light of day today.  Dr. Leonora found that rats fed a high cariogenic diet (high sucrose diet) had the flow of dentinal fluids completely reversed in their teeth.  This reversal of dentinal fluid caused the teeth to become susceptible to decay because it fostered an inflammatory terroir in the tooth.  In 1978, he wrote about the systemic role of trace elements in glucose metabolism (Magnesium and Zinc). Remember, from the Gnolls blog post we spoke about how the loss of intracellular magnesium was the first biochemical step in developing diabetes, but not the first quantum effect that causes it.  Dr. Leonora found the exact same thing in the hypothalamic parotid axis too. I don’t think this is a coincidence either.  Prior to this in 1975, he wrote about the effects of carbohydrates on the hypothalamic parotid gland endocrine axis and how it mimicked the endocrine and exocrine pancreatic physiology.  He followed this line of research up with working out how the parotid gland also had dual endocrine and exocrine function like the pancreas.  He showed in the earlier 1980’s that dental caries was largely influenced by hormonal fluctuations and not from bacterial acid production to cause disease but from hormonal changes due to a foods carbohydrate load.  This hypothesis was largely rejected at the time.  Even today,  most dentists and physicians are ignorant of this mans work.  I knew about it because I listened to his 1983 talk on this at UCONN medical library and my professor pretty much shot it down after I asked him about it.  He was quick to point out citing the “accepted research at the time in the literature.”  I totally forgot about it until recently.

 

Mainline scientific theories may have long lifespans, but are inevitably overturned as accumulating evidence renders them obsolete and brings alternative theories to the fore. This happened in physics in 1905 with the advent of the theory or relativity, and it happened 150 years ago in biology, when many diseases did not spontaneously generate but whose etiologies became explainable when germs and viruses become known. It has now happened again today in molecular biology with ROS and antioxidants effects on mitochondria as well.  Dr. Leonora’s work was pretty shocking for the early 1980’s scientific community, and I failed to realize its significance until recently as well. My knowledge back then was fairly limited.  Today, I am a bit more well rounded and I think his work merits some further attention.

 

When such a major scientific change in paradigm happens, there is usually a period of significant and often bitter controversy between scientists seeking to hold on to the theories of the older paradigm, and those espousing the newer one. The recent disputes on obesity from Taubes, Guyenet, and Harris come to mind.  Often, this is followed gradually by changes in basic thinking patterns and a subsequent long period of fertile discovery. That fertile ground takes many shapes.  Today’s post is planting some more of those seeds for you to think about.

 

It appears that obesity and diabetes development “might begin” in the oral cavity.  We know that carbohydrates are first broken down by salivary gland amylase.  αamylase breaks down long-chain carbohydrates.  Most human amylases tend to be alpha amylases.  Both the parotid gland and pancreas share this physiology.  It appears the endocrine function of the parotid gland’s acinar cells respond to a releasing hormone of hypothalamus. This ability is only found in the human parotid gland.  If the human parotid gland is removed, the hypothalamic parotid axis ceases to work on dentinal flow. Oral inflammation occurs and sets the stage for disease propagation.  It appears that this axis is coupled to lingual leptin receptors, and possibly to parotid gherlin levels.  This releasing hormone signal from the brain releases a parotid specific hormone that directly effects the flow of fluid in dentin and helps forms teeth and to calcify and re-calcify decayed teeth (with Vitamin K2)  to keep them in optimal health.  When the process is broken down, dentinal fluid reverses towards the apex of the tooth, and we absorb things from the oral cavity we should not and it causes an inflammatory response.  This is precisely how inflammation enters the tooth and jaw to cause inflammation.  It also helps explain why diseased teeth show apical abscesses as the inflammation become chronic.  It also appears to be the mode of action in how we absorb heavy metals from amalgams and metal dental framework.  It further sheds light on why bad periodontal and dental health correlates well with cardiac risk and elevated cardiac CRP and diabetes.  It appears the oral cavity is the initial sensory sensor for foods for the hypothalamus as well.

 

This parotid signaling system is how the brain readies the “avascular parts” of the gut for the onslaught of carbohydrates that will eventually hit the duodenum.  The Islets do not have a direct blood supply. They have a portal blood supply much like that of the pituitary gland. It readies the avascular Islets of Langerhans of the pancreas to further deal with a carbohydrate load.  It seems to somehow effect the islets portal blood supply and its gene regulation even before the carbohydrates hit the duodenum to signal the pancreas to action.  There is research ongoing to see if the parotid gland somehow is involved in the biphasic release of insulin.  It also appears that Dr. Leonora discoveries should have illuminated some light on the significance of the hypothalamic parotid gland endocrine axis as it relates not only to dental care, but also to endocrine pancreatic function and the possible development of diabetes and obesity.  Sadly this curious finding remains largely unknown by even the most learned neurobiologists and clinicians.  I hope this changes soon, because it might just uncover more information to help us help people restore their health.

 

 

 

CITES:

1.  http://www.sciencedirect.com/science/article/pii/S1568163703000667

2.  Biological Significance of Glutamate Signaling during Digestion of Food through the Gut-Brain Axis, Akihiko Kitamura, Tomokazu Tsurugizawa, Kunio Torii, Nutritional Physiology Fundamental Research Group, Frontier Research Laboratories, Institute for Innovation, Ajinomoto Co., Inc., Kawasaki, Japan   Digestion 2011;83 (Suppl. 1):37-43 (DOI: 10.1159/000323407)

3.  http://www.nature.com/oby/journal/v8/n3/full/oby200024a.html

4.  http://jme.endocrinology-journals.org/content/34/2/353.full   (salivary leptin)

5.  http://onlinelibrary.wiley.com/doi/10.1111/j.1601-0825.2011.01820.x/abstract  (leptin’s effects on dentin stem cells)

6.  http://www.springerlink.com/content/x482348327311k50/  (leptin and oral cancer)

7.  http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijds/vol6n1/leptin.xml  (leptin receptors on gingiva)

8.  Groschl M, Rauh M, Wagner R, Neuhuber W, Metzla M, Tamguney G, et al. Leptin in human saliva. J Clin Endocrinol Metab.2000; 86: 5234-9.

9.  Ken Southward, DDS, FAGD, “The systemic theory of dental caries.”  Featured in General Dentistry, September/October 2011. Pg. 367-373.  (http://www.agd.org/publications/articles/?ArtID=9892)

10. Chaussain-Miller C, Fioretti F, Goldberg M, Menashi S. The role of matrix metalloproteinases (MMPs) in human caries. J Dent Res 2006;85(1): 22-32.

11.  Schatz A, Martin JJ, Schatz V. The chelation and proteolysis-chelation theories of dental caries: Their origin, evolution and philosophy. NY State Dent J 1972;38(5):285-295.

12.  Kato MT, Leite AL, Hannas AR, Buzalaf MA. Gels containing MMP inhibitors prevent dental erosion in situ. J Dent Res 2010;89(5):468-72. Epub March 3, 2010.

13. Requejo R, Chouchani ET, Hurd TR, Menger KE, Hampton MB, Murphy MP. Measuring mitochondrial protein thiol redox state. Methods Enzymol 2010;474:123-147. Epub June 20, 2010.

14. Leonora J, Tieche JM, Steinman RR. Further evidence for a hypothalamus-parotid gland endocrine axis in the rat. Arch Oral Biol 1993;38(10): 911-916.

15. Leonora J, Tjaderhane L, Tieche JM. Effect of dietary carbamyl phosphate on dentine apposition in rat molars. Arch Oral Biol 2002;47(2): 147-153.

16.  Leloup C, Tourrel-Cuzin C, Magnan C, Karaca M, Castel J, Carneiro L, Colombani AL, Ktorza A, Casteilla L, Penicaud L. Mitochondrial reactive oxygen species are obligatory signals for glucose-induced insulin secretion. Diabetes 2009;58(3):673-681. Epub December 10, 2008.

17.  Stowe DF, Camara AKS. Mitochondrial reactive oxygen species production in excitable cells: Modulators of mitochondrial and cell function. Antioxid Redox Signal 2009;11(6):1373-1414.

 

18. Potula R, Hawkins BJ, Cenna JM, Fan S, Dykstra H, Ramirez SH, Morsey B, Brodie MR, Persidsky Y. Methamphetamine causes mitrochondrial oxidative damage in human T lymphocytes leading to functional impairment. J Immunol 2010;185(5):2867-2876. Epub July 28, 2010.

 

Comments

  1. Hi Dr. Kruse.

    I have been having some problems with my oral health, even though i have been eating paleo for 2 years: ie almost no grains (occasional rice), no processed food, lots of meat and vegetables and daily fruit, and virtually no dairy except for occasional cheese. It may be that i have gotten into a rut with my food choices because i am concerned that i may be vitamin deficient. i know for a fact that i am iron deficient as i was diagnosed by a hemotologist, and in april my hemoglobin was 13, but my ferritin was less than zero. the anemia is probably from heavy periods, although for the past year i have cut down on flow my taking aleve.

    my gums are receding at a quick pace and my tongue is sore. two days ago after reading your post on paleo supplements, i decided to take a multivitamin. the next morning my tongue was much less sore. i don't know if it was a coincidence or not.

    do you have any advice for me re: my recceding gums? my gums don't bleed when i brush and floss. my dentist says x-rays show i have bone loss in my jaw. i had a graft down on the lower front teeth to act as a patch to hold them in place.

    thanks for any insights you might have.

  2. This post is actually pretty timely for me. Since starting hard core Paleo and Leptin reset I have had a tartar build up like I have never had before. I just went to my dentist for a cleaning and started asking about why that might occur and he asked me what had I changed. I said diet and he immediately asked if I was doing Atkins. He said he had never seen anything in the literature but he noticed when Atkins first gained popularity that he had a rash of people who hadnt had tatar problems all of a sudden start. I googled it and found several different forum post on the subject but never a explanation that I found plausible. Any ideas?

  3. @V. I think the signs you have clearly point to a deficiency of some sort. The biggest concern i have is your strong history of bone loss and periodontal disease. This points to hyperactive oral matrix metalloproteinases. You need to change toothpaste to one loaded with eccg (green tea extract) and increase you levels of green tea too. I think you need to consider B vitamin testing for the tongue issues and i also think you likely may need mineral replacement. If you decide to do this without testing you can but you will need a shotgun approach to cover all bases. You need to add Krill oil with hyaluronic acid twice a day, high dose vitamin k2, complex b vitamins three times a day, magnesium malate, and high dose vitamin C. The fact that your iron is low and ferritin low on a paleo diet tells me you likely have heavy periods and you are a poor absorber of iron. Vitamin c will allow you to absorb much better. You need 10-16 grams of C a day. You may also have a B12 issue in your gut as the cause of the iron problem and the tongue issue. You need lots of folic acid and b12 but really testing is key. Replacing hcl in the stomach often helps to with betaine hcl tabs. Something is wrong and your mouth is a big clinical sign something is radically amiss. I hope you take my advice and get tested. You dont have to lose your teeth! One more point…..if your tongue burns this can be due to a change in hormones especially estrogen which really affects the posterior taste buds for bitter tastes. I see this alot in perimenopausal women and those coming off bcps. Its also fairly common in menopause.

  4. @CM. This one has an answer and is a feature of an upcoming blog. Excessive tartar build up is caused by a lack of osteocalcin in the saliva. You can correct this by taking high dose vitamin K2 supplements or increasing intake of foods loaded with it. It also tends to walk hand and hand with good serum vitamin D levels and adequate mg and calcium levels but seen with HDLs below 45. The most common cause is a gut dysbiosis cause.

  5. Another great post Dr K! I now understand why I had my 1st cavity in 38 years! Inflamation! now almost over 1 year of being primal/paleo – I'm looking fwd to getting a thumbs up from my dentist and no more cavities!

  6. thanks for you detailed reply. i will definitely get tested. i forgot to mention one thing. i go through times where i bruise easily. i figure it may be the anemia. a had a big bruise on my thigh, but i wasn't overly concerned thinking i just bumped into something. then i got a bruise on my flu shot site! so another troubling symptom that for now i'm chalking up to the anemia.

  7. another mind-tweaking post that I do not fully understand but will give me food for thoughts for days! Your comparison of the parotid gland with the pancreas in its endo/exocrine duality is very interesting. I have noticed a more salivated mouth after following Paleo/Leptin Rx than before, where my mouth is quite dry and then drooling when I'm about to eat. Great article

  8. Thanks Doc.

  9. while we're on the topic of mouth/oral cavity. I've read Resveratrol is better assimilated into the body via absorption in the mouth rather than through the GI (pills). Do you recommend this method? I've tried just opening a capsule and putting it in my mouth sublingually for a few min.

  10. when you say high doses of vit K for lack of osteocalcin in the saliva, how high are you talking?

  11. @V, re bruising: I may be jumping the gun here but if you check the site and the good doc's personal experiences, you'll see that easy bruising is a BIG sign of vit K2 deficiency. I also noticed my wife stopped bruising (it was way too easy for her during normal activities) after we went hi-dose K2 + D3 when we first went paleo (30 mg MK-4 K2 and 10k IU D3 supplementation for 4 months or so).

  12. Laney- i've come across bruising and K2 deficiency as well- what brand do you use? what dose does your wife take, and is she still taking the same dose? Is that vitamin fat soluble, meaning it could build up to toxic doses in the body if i take too much?

  13. @ dan. Im a fan of sublingual resveratrol

  14. @ Dan H Im a fan of sublingual resveratrol

  15. K2 is an absolute paleo must. Its not in our food supply and it needs to be highly supplemented. It makes me angry tomread what others think is optimal. Listen to a clinician who tests for it. No one gets enough.

  16. zeusandhera says:

    I read that people's oral health improved dramatically after using an "oil pulling" protocol (swishing around coconut,sesame or olive oil in your mouth for 20 minutes a day). If true, would the fats or other elements in these oils have any effect on the hypothalamus/parotid dynamics? Have you ever heard of oil pulling or know of studies that support or condemn it?

  17. Jack – don't know if you recommend brands but maybe you could do so for sublingual resveratrol and K2-MK-4 please? I don't live in the US so have to order in. Thanks.

  18. @Toni The email you sent really is about the hormonal regulation of fat cells in your belly. They are all controlled by hormones. This is why when you are trying to get to optimal you really need to test to see where you are. You can do it without testing but you will take much longer to get there. To answer you directly read on. The rate of release of free fatty acids from adipose tissue is affected by many hormones that influence either the rate of esterification or the rate of lipolysis. Insulin inhibits the release of free fatty acids from adipose tissue, which is followed by a fall in circulating plasma free fatty acids. It enhances lipogensis and synthesis of acyl-glycerol and increases the oxidation of glucose to carbon dioxide via the pentose phosphate pathway. All of these effects are dependent on the presence of glucose and can be explained, to a large extent, on the basis of the ability of insulin to enhance the uptake of glucose into adipose cells via the GLUT 4 transporter.

  19. @V, if I may comment and ask a couple of question about your gingival recession and bone loss. Do you grind/brux your teeth. Has your dentist mentioned you may be grinding? Any TMJ pain, or discomfort in your facial muscles? Any hot and cold sensitivities with your teeth. You mentioned burning tongue, What type of toothpaste do you use?

  20. Anna Adamson says:

    So what would make the parotid gland swell and what could be done to counteract that swelling? My husband is type 2 diabetic and one parotid gland has been swelling and causing discomfort during flights.

    • @Anna in a Diabetic the most likely answer is a sialolith. A salivary stone caused by mineral deficiencies in cells and loss of the nutrients in the saliva and there is forms a chemical reaction to form a stone and cause blockage. The short answers is loss of intracellular nutrients…….Low K2, low D3, bad osteocalcin function, low intracellular Mg levels causing loss of Calcium into the saliva ………this perfect storm causes a stone to form. When he flies the cabin is pressurized. This increases intraoral pressure at the stoma of the parotid gland by the upper molars and salivary flow slows because his duct is partially blocked by the sialolith. That is my best hypothesis of why it happens.

  21. Dr K, I also have noticed hypersalivation since starting your LR protocol six weeks ago. Is this a good thing or not? My teeth are in pretty good shape, btw. I am taking plenty of supplements, B complex, K2, Mg, etc. I am an undermethylator, but I have never had this problem before. Will it go away? Green tea makes it worse.

    • @Kitty this is a great sign. Green Tea has ECCG in it and it is a very stimulatory chemical to salivation. ECCG also is a potent blocker matrix metalloproteinases. These protect teeth and cartilage and the periodontal ligaments. This will keep your teeth looking and working well and is a marker of health. The more saliva the better. It is a sign of health. I don't think you want it to go away. Ask any patient who has the opposite problem (xerostomia) how it can be.

  22. @v: I had written the dose, 30mg, brand is VRP ultra-K2, taken as 2x 15mg pills, together with 10000IU of D3 again from VRP. always with food as both are fat soluble and this brand has them in capsule form. After 4 months we are down to half the K2 and same on D. But as Jack says the prudent move is to test for both.

  23. @v again:what we did is take K2 in split doses due to the reduced half-life, D3 in the morning with breakfast.

  24. i have recession and bone loss pretty evenly throughout my mouth. wouldn't grinding just affect the molars? my husband never mentioned me grinding me teeth at night and i don't have tmj pain or discomfort in my facial muscles. i do have hot/cold sensitivities because of gum recession- it is a symptom, not a cause. i use prevident- a perscription toothpast with high flouride content. i usually disinfect my toothbrush with listerine before i put on the toothpaste. i used to use sonicare, but now that i found out brushing with too much force is a leading cause of gum recession, i use a cute children's toothbrush and try to brush carefully.

    my ears perked up about quick tartar build-up because i seem to have that as well- which might be another indication of k2 deficiency.

    is there a blood test to see if one is deficient in vitamin k? i think that i can use my menstrual flow as a way to gage if k2 mk4 supplementation is working for me. tell me what you think: if after supplementing with k2 mk4 at 30 mg for 2 months my flow lessens and i don't get any questionable bruises, i can be confident that vitamin k deficiency was the source of my easy bruising/heavy periods/anemia.

    if i continue to have heavy periods even with k2 supplementation, than i will have to assume that the cause of my heavy periods is from another source- like not having enough of a thyroid hormone because my ferritin is too low. there are so many possible causes that i will try to investigate this by adding one new supplement at a time instead of many at once.

    i forgot to mention that when i start bruising, i also start to lose concentration- that is why i forgot to mention it. :P i recently ran my first red light and i have trouble in others ways, like making correct change. so my thinking is affected. that is my i am going nuts on the internet trying to find a solution. i don't want to deteriorate to the point that i can't use my brain to figure out this problem.

  25. PS i went to amazon and saw they have the carlson's and thorne k2 for sale- but it didn't say there whether it was k2 mk4 or another kind of mk. does carlson's and thorne only make the k2 mk4 version??? i read that k2 mk7 can build up in the body to toxic doses and the bulk of positive research for k2 is associated with the mk4 kind, so i want to make sure that when i buy carlson's or thorne, that that's the kind i am getting.

  26. now looking at the comments sections at amazon, one customer wrote that thorne k2 is the mk4 kind, and i'm assuming so is the carlson's, since dr. kruse recommends it. but according to wikipedia, mk4 is written out as "menaquinone", while carlson's k2 is "menaterenone". why the discrepancy?

    • @V Vitamin K2 homologs (menaquinones) are characterized by the number of isoprenoid residues comprising the side chain. Menaquinones are abbreviated MK-n, where n represents the number of isoprenoid side chains. Thus, menaquinone-4 abbreviated MK-4, has 4 isoprene residues in the side chain. Bacteria can produce a range of vitamin K2 forms, including the conversion of K1 to K2 by bacteria in the small intestines. No known toxicity exists for vitamins K1 and K2.
      Three synthetic types of vitamin K are known: vitamins K3, K4, and K5. Although the natural K1 and K2 forms are nontoxic, the synthetic form K3 (menadione) has shown toxicity.[1

      • @V Carlson's comes in 5 mg pills. One a day wont make you toxic. Vitamin K2 is in the top three vitamin/supplements missing from our biologic platform. Ten years ago Dr. Holick championed how badly we were deficient in Vitamin D3. Today I am telling my readers we are woefully deficient in Vitamin K2. This is playing a role in why heart disease is the number one killer in men and women. We eat to die in the Western world.

  27. This is very interesting. I am currently working on reversing DM2/NIDependent and following a (paleo plus selective-dairy minus starches) diet. For the past four months I have been struggling with a mouth infection, can't seem to get to the bottom of it. Have removed foods to which i seem to have developed sudden intolerances (including cinnamon, to my dismay!), but the inflammation has not gone away (now mostly inside cheeks and the corner of the jaw where the mandible body meets the ramus). It's inception roughly followed a 2-3 month period of daily diarrhea directly related to a course of TCM targeting spleen/pancreas/kidney function. When I stopped the TCM (traditional chinese medicine), constipation replaced the diarrhea, and the inflammation abated somewhat but continued.

    I was thinking my gut needs healing and have been focussing on kefir/yogurt/probiotics in addition to mag malate and dandelion+milk thistle for recently developed constipation. So far, little improvement to oral inflammation. Also doing your leptin reset, with all of the positive indicators but no weight loss as yet.

    I am at a loss as to what to try next in regards to my mouth…but the posting above has got me wondering about other connections.

    • Joi I see this a lot in my patients who have multiple systems that are in need of optimization. I think the mouth is as valuable diagnostically as a paleo physician as looking into the eyes are for a neurosurgeon. We can gain a lot of insight to basic physiology if we are open to the meaning of the symptoms. With your problem I would seriously consider oral rinses with a mix of pure green tea, melted coconut oil, turmeric, cumin, and relatively high doses of K2 and Magnesium malate. I also think oral swishes and sublingual contact really helps stimulate this parotid hypothalamic axis. Please keep us informed.

  28. V, another contributing factor to loss of supporting structure (gums and bone) is your bite. The way your teeth come together. Occlusal wear due to grinding is seen every, not just the molars. I agree that temp sensitivity is a symptom not a cause, therefor something is happening that you are continually sensitive to cold. Otherwise the sensitive areas become less noticeable as time goes on. And If I may recommend using Gel Kam for your temp sensitivity and Prevident for prevention of caries, especially on root surface that are exposed.

  29. joi, how were you treating your daily diarrhea? i would think you were losing lots of nutrients/electrolytes because of the diarrhea and that was the cause of your mouth problems. i hope you are not seeing that practitoner of chinese medicine anymore. zhong yao conglei meiyou bangzhu guo wo.

    dr. kruse, you said i should be taking high does k2mk4- do you think 5mg is high enough? i was thinking 30 like the other poster mentioned.

  30. thanks for your suggestion fara. maybe i can try wearing some kind of mouth guard at night and see if it helps. it couldn't hurt, right? what treatments are their for teeth grinding.

  31. Dr. Kruse, I too am experiencing hypersalivation since I went no-wheat one month ago and low carb a little earlier than that. I didn't know it is a healthy sign. I'm curious about the need for K2. I'm currently taking Warfarin to thin my blood since having a heart ablation in early February 2011. I hope to get off the Warfarin in November when I have my next checkup. Wouldn't K2 make my blood thicker? I've already increased the Warfarin dosage since I started low carb and have been eating so many vegetables…broccoli, cabbage, etc.

    • @ Deanna you can not take K2 when you are on coumadin. The goal should be to get your doc to change you to another blood thinner like Pradaxa or a combo of aspirin and lovenox. Coumadin depletes vitamin K and causes more arterial calcification, and less intraoral and salivary K2 for optimal oral health. There is a ton we can learn about what is going on in us by a simple oral exam.

  32. V, a night guard will not be sufficient. If you are interested, look for a neuromuscular dentist in your area. A removable orthotics is needed to correct your bite. Your bite create a whole host of issues, that a simple night guard will not address. obviously follow Dr. kruse's advice on testings but your perio issue may have a mechanical factor as well.

  33. Anna Adamson says:

    So if he has a sialolith is there any remedy to dissolve it or would it need physical removal? Is there any point in supplementing with Mg, D3, & K2 to prevent more from developing? We got nowhere with the specialist he went to see last month …he just said "your cholesterol is good but you should take a dose of Lipitor to be on the safe side" WTF!!!

  34. By the way, I have to tell you how much we appreciate your time and knowledge.

  35. Wow. Reading this makes me very happy that I quit my addiction to chewing tobacco.

  36. Thanks for a very timely blogpost – for me!

    I've had a quite restricted diet for the last 8 months (candida + elimination after being diagnosed with hashimoto's for about 1,5 years ago). After that went completely gluten free (got sinusitis, edemas and cubital tunnel syndrome from re-introducing flour in the challenge of the elimination diet…). I now follow a paleo-/Primal blueprint-inspired diet and got my gut working again thanks to my holistic oriented MD. I drink 4-8 cups of green tea each day. No juice, seldom milk, usually only water and wine occasionally.

    I brush& floss 1-2 times a day. The last year with a fluoride free tooth paste.

    After first starting calcium supplements and second starting trying out milk in my diet again I noticed

    – some cramping in my feet (which I ignored even though I knew it was a sign of a slight magnesium deficiency)

    – headaches

    – aching jaw

    – a higher level of stress-/lower stress tolerance

    – receding gums(!!!)

    – weaker and more discolored enamel

    – freezing teeth

    – less tartar (used to have a lot) build up

    I started googeling – and realized at one of the main minerals for enamel is: magnesium. Main source of magnesium in the western diet is whole grains… and that stress and headaches and muscle soreness (the jaw-problem) all ties together with magnesium. In a diet such as mine it's quite difficult to reach enough magnesium unless eating a lot of nuts and seeds? Which I don't. So I started supplementing and so far my symptoms (except for the receding gums – yet) are improving.

    I supplement with 2-6 pills (2 in summer, up to 6 in winter) of Now foods 1000IU D3/45mcg K2 – which is necessary to keep my d3 level at about 100nmol (if I remember correctly). And I added 2x 400mg mixed magnesium (Magnesium Caps, Now Foods) after experiencing the symptoms. I've never (so far) tested low in serum magnesium, but I've not been tested after re-introducing milk. My b12 is above middle (Norwegian standard), but my iron levels stay quite low even though I supplement and have negligible periods.

    My theory is that the increased ratio of calcium in my diet may have increased the problem as calcium is an antagonist (?) for magnesium. My regime seems to be working in so far that my enamel has stopped getting browner. My gums have stopped receding, but I don't see any growth.

    I'd really appreciate any thoughts or suggestions regarding this. And how to get my gums back, if possible. ;)

    • @Selma I am no fan of Calcium supplementation and have never really been. The real issue for me is low vitamin D levels and low K2 action. This is translated into oral health and tells us a ton about the environment of the gut too. Periodontal disease is a great warning symptom for those who pay attn to it. I think the moves you're making are good. I would move away from a fluoridated toothpaste and consider using a lot more polyphenols in your diet. I swish and swallow a lot of green and black tea for this reason.

  37. Some more facts:

    The norwegian gowernment does not supplement water with fluoride.

    I've (after noticing the symptoms) started rinsing with a fluoride solution after brushing and I sometimes brush with baking powder (to reduce the discoloration).

    • @Selma When the diet is optimal it has amazing effects upon the oral health and especially the tooth coloration. The change in tartar build up however is one of the most amazing findings I have seen.

  38. Dr. Kruse,

    I'm 43, female, and have chronic periodontal disease that led to gum recession/bone loss already in my early 30s as inflammation was probably present in my late 20s but as we know there are no symptoms or signs besides deep pockets and tartar. Low carb, wheat-free since 2008, had treatment for gum disease in 2007 after my dentist sent me to a hygienist as he wasn't able to make a difference anymore with cleanings. After treatment the pockets got smaller which meant that the gums receded (a lot at the front teeth) and for a while the situation was under control, but in the last 10 months I had many gum infections and one threatens to kill a tooth from underneath.

    After losing weight on low-carb, my T3 went down a lot. Could that cause the infections indirectly/the body is not able to deal with the anaerobic bacteria in the pockets anymore? I understand that gum disease is linked to gut dysbiosis and after I took another course of antibiotics a couple of months ago I'm sure that I don't have any good gut flora to speak of (constipation, check)

    What is the best course of action to save the teeth and the bone that I have? I asked about the amalgam fillings and the doctor said that they release negative ions so there are not bad per se.

    Besides taking K2, D3, Mg, vit C, eating bone soups, drinking green tea (that stains my teeth) what else can be done? Do probiotics help at all with gut dysbiosis and implicitly with immune response/Tregs?

    I have to say that I do find chocolate highly rewarding and the excess weight that I lost was due to bingeing on chocolate treats (stress led to addictive behaviour). Excess sugar might be the cause to my teeth/gum problems, maybe because of the parotid gland that you talk about. My mother has T2DM and I also suffer from some symptoms associated with PCOS although doctors didn't think I had it, testosterone was not elevated.

    The question is then how much refined sugar is too much. Should it be off limits for me?

  39. Could periodontal disease be thought of as a result of the inflammation of the avascular systems, or are there bigger isssues (or too many others) that should be taken into account?

    • @casey periodontal disease is a disease of the ligament around the tooth and it does have a vascular supply albeit not a great one. The major issues with perio disease are anaerobic bacteria due to an altered oral immunity from the changes in saliva, cell mediated immunity, and the complement system. All are involved. Most people with perio disease have Vitamin D levels below 35 and also have a low dietary source of K2 (by osteocalcin level testing) The best way to treat it is to go ketogenic paleo diet and use a ton of polyphenols in your mouth to block the MMP's that cause the ligament breakdown.

  40. Hello Dr. Kruse, I read that glycerin prevents tooth remineralization–what do you think? Thanks for all your writings, I am slowly making my way through them.

    • @algts glycerine is an interesting chemical for the mouth. It can be made from lard or tallow or from industrial biodiesel by products. When it is made from animal products, nasty stuff like lye, is used to get it. Same thing is used when soap is made from it. Here is my take. I know of no studies that say glycerine is good or bad for teeth. I do know it is in many toothpastes. But considering how it is made most commonly I would pass on it. Moreover, it is sticky and this gives it a substantivity to bond to the glycocalyx of the tooth from microbiota. This is not a good thing. It also has a sweet taste, but I dont believe it is cariogenic. All that being said, I am not a supporter of glycerin for mouth health.

  41. Thank you for replying. I had been taking Coq10, vit D and K2 for a long while with no change, maybe the doses of K are not high enough; tartar is deposited very quickly too (in a couple of months it is visible) It is very frustrating and scary.

    Do the polyphenols get into the deep pockets?

    @ Selma

    your gums are not going to grow back as once there is bone loss it is irreversible.

  42. @ Lumi. Polyphenols do get deep in pockets if you swish and swirl before you swallow. I used to believe that alveolar bone loss was irreversible after gingival recession or perio ligament loss. I no longer do. There is some literature and anecdotal reports that if you make lifestyle changes chronically it can come back when your hormonally optimal again with good habits.

  43. Off topic, but what are some recommendations for people who work at night? I know you basically said that they are screwed and need to stop, and I agree, but some people are so obstinate that they will never change even though it is killing them. So what would you do? Something with melatonin perhaps?

    Thanks in advance. I'm not getting my hopes up!

    • @Stabby There is a lot to do…….but I base it on testing. I use melatonin, DHEA and progesterone to right the ship of shift work. Sleep and metabolism are firmly coupled. The lower light levels the more severe the coupling effect. This is why so many people gain weight in the winter. The other issue you wont like since your a PHD guy. I am a believer in carb winters to match our biology. Few carbs are available to most animals in winter outside of the tropics. If your Vitamin D is optimal and you are exercising regularly in the winter during your shifted schedule you could eat more carbs………but my rule is the lower the light level or the more shifted your work schedule the less carbs one can afford to tolerate. Again…….I know the raccoon in you does not want to hear that. But I firmly believe it to be very accurate.

  44. Hi Dr. K.,

    I'm scheduled to have double jaw surgery at the beginning of December and I'd like to continue on this diet. Unfortunately, I'm told I will be on a liquid diet for 6 weeks post-op. Is there a method for me to remain on this diet? I have zero desire to be drinking Ensure and milkshakes which is what my doctor has told me many of his patients eat. Also, any supplements to help with the healing processes?

    Thank you!

    • @JTK37 You need to be rinsing with green tea daily before the double jaw. YOu also need to start supplementing with arginine and ornathine 2000 mgs pre op and post op for wound healing. I also push resveratrol for bone healing cases (like this) because resveratrol stimulates BMP-2. I aslo love the stress co factors pre op and post op……Mg, alpha lipoic acid, Ubiquinol, 10-15 grams of Vitamin C. As for what I would have you eating……my paleo shakes I eat on my surgery days. Raw eggs, Nutiva coconut manna or Tropical Traditions coconut cream with heavy cream, cocoa, cinnamon, ginger, blueberries. nutmeg, unsweetened coconut flakes……..sometimes I add pumpkin, bacon grease or coconut milk for a change up. Sounds gross till ya try it. I put 4-6 eggs in and mix it in a commercial blender with ice. It is amazing. If you need more protein which you might…….add whey. Post op its worth it.

  45. stabby- what about looking into the sperti vitamin d lamp that dr. holick recommends? i have one, but one time one of my moles got a little burned using it. nothing serious according to the dermatologist, but it freaked me out, so i stopped using it. now i want to get back into using it, but make sure my moles are covered. it also comes with special googles you have to wear so you don't fry your eyeballs.

  46. @Jack What do you think about Fluoride someone already mentioned using something with heavy fluoride earlier.

    I watched this video on Dr. Mercola's Website…pretty anti Fluoride…is this at all right or does it sound like bull to you?

  47. Cú Chul says:

    is there any good article or source on treating arthritis by paleo eating & exercise?

  48. Thanks, Doc. I was actually asking for someone else, I would never work at night in a million years. Of course that means it's even worse because whereas PHD is like 400-600 cals worth of carbs, most people can't keep it under 1000 or so. Hrmf. Oh well, do what you can, right?

  49. Laurie Herscher says:

    Hi Jack,

    This is fascinating–in Radiation Oncology, we are taught that radiotherapy to the parotid increases risk of dental caries. I always explained it to patients that there is something about saliva that protects teeth–but I didn't know what or how. Thanks! Laurie

  50. @Jack and @Lumi

    Thanks for your answers.

    I know that dental bone loss is considered irreversible. But I will choose to try anyway – because it won't harm. ;) I might be the one exception.

    Regarding fluoride I was using it as a quick fix for hardening the enamel since I panicked. There is little doubt about the harmful effects of fluoride once it gets into the body, but it's also quite certain that it hardens enamel. So when I get this under control I'll get off the fluoride mouthwash again.

    (A strange side effect that I attribute to the magnesium supplements is that I now see emerging lunulas (the white crescent on the nailbed) on a couple of fingers again. Like many hypos I only had lunulas on the thumbnails until now. )

  51. Dr. Kruse-

    Any connection that you see with staining of the teeth? My hygienist almost didn't believe me when I told her that I don't smoke! We blamed it on my green tea drinking but this doesn't even really seem plausible given how much staining occurs even after just 3 months. And I really only drink 1-2 cups of greet tea per day…no coffee.

    It's also interesting to hear about the accounts of tartar build-up. I used to get very excessive tartar build-up but the problem has since gone away. I'm very far from perfect health currently, however, my Vit D levels are now optimized whereas they were <30 during the time when I was getting excessive tartar build-up. Perhaps that was the missing piece.

    Thanks as always for the info.

    • @Dru the staining on your teeth is die to the composition of the glycocalyx on your teeth. That tells me you have some bad bacterial in your mouth so I would recommend swishing with a lot of green tea and really supplementing with K2 and D3 . The glycocalyx of tartar is formed from MMP's in the mouth. Green tea, black tea, and krill oil help destroy that over time. Use them until it goes away. This is a early sign that you likely have a low HDL and a bit of a leaky gut too.

  52. Also, can you expand on why you don't like calcium supplementation?

    Ever since going dairy-free I've been supplementing with 1000mg calcium citrate. Bad idea?

    • @Dru We get enough Calcium in our SAD and in most diets. The real problem is the lack of intracellular Magnesium, lack of K2 telling that calcium where to go and what to do in what tissues. If you have a low D just replacing the D3 will fix the calcium issue. I dont like Calcium unless one has an eating disorder

  53. I just started with K2 supplementation 100mcg/day. Though my osteocalcin levels are fine.

    I had low Total Chol and HDL for many years which I think can be attributed to HCG usage as part of my TRT therapy. Since discontinuing HCG my Total Chol and HDL have greatly improved.

    Definitely yes on the leaky guy. But again, the tartar build-up hasn't been an issue for at least a year or two. The staining has gotten worse, however.

    • @Dru. I have seen quite a few people completely drop their

    • @Dru. I have seen a few guys drop their HDL with HCG and i have seen some women get it too on the HCG diet. We know it modulates the hypothalamus but i still have not figured out if the effect is due to CETP or the leaky gut of a low T level. Very tough due to confounding variables. It needs to be studied but it never will be.

  54. @Q. This article is co authored by my classmate that stimulated this blog…….read on

    Guess who the co-leader is?

     

     

    Website http://www.nescent.org/

    direct link

    http://www.nescent.org/science/awards_summary.php

     

     

    EVOLUTION OF HUMAN TEETH AND JAWS: IMPLICATIONS FOR DENTISTRY AND ORTHODONTICS

    PI(s): Peter Ungar (University of Arkansas)

    John Sorrentino (John A. Sorrentino, DMD, FAGD)

    Jerome Rose (University of Arkansas Main Campus (Fayetteville,AR))

    Start Date: 25-Oct-2011

    Keywords: human evolution, disease, education, evolutionary theory

    Dental caries, periodontal disease, hypoplasia, malocclusion, and impaction pose serious challenges for dentists, orthodontists, and oral surgeons. But paleontologists and bioarcheologists have found these dentognathic pathologies to be rare in traditional foragers, early human populations, and our fossil hominin forebears. The proposed NESCent Catalysis meeting will bring together evolutionary biologists, paleopathologists, biomechanists, dental researchers, food scientists, and clinicians to explore the idea that many of our dental and orthodontic problems relate to a discordance between the chemical and physical properties of our foods today and those to which our teeth and jaws evolved. The meeting will be organized around four themes: 1) evolution of the human dentognathic complex; 2) an historical perspective on dentognathic pathologies; 3) food and the oral environment; and 4) approaches to integrating evolutionary theory and clinical practice. Experts will review the "state of the science" for each theme, with time for discussion and planning of future collaborative research. Participants will be selected to represent a broad range of research and clinical interests, a diversity of backgrounds, and a variety of career stages, from emerging scientists to well-established scholars. The goal of this meeting is to catalyze the development of Evolutionary Dentistry, a discipline focused on the oral environments of our ancestors, and how an improved understanding of them can inform clinical dental and orthodontic practice.

    http://www.nescent.org/science/awards_summary.php

  55. Paleo dentistry is now born…….we need to get this twittered all over the place and all over the net and on FB.

  56. Dr. Kruse, how do you filter your green tea to remove the flouride?

    • @Martha I had an industrial filter company make me one after I told them what I was looking for. They had one for an industrial use and they made me a bunch of smaller one to fit my home system.

  57. Dr. Kruse,

    Could a proper diet and good supplementation possibly reverse the formation of bone spurs caused by pronated walking? Maybe? Hopefully?

    Susan

  58. Dr. Kruse, How do you feel about pure titanium dental implants? I've had continuous herpes eruptions for 3 yrs (starting 4 days after implants). Suspecting both titanium for immunosuppression, or the rare possibility of infection from the cadaver bone graft.

    Dr. David Dennison, of the Rochester Mayo Clinic, has raised this issue, but it seems few dentists are biting:

    http://www.nextbio.com/b/search/article.nb?id=201

    • @MimiDiet One thing we do know from studies — placing a long titanium or metal pin down through the middle of a bone to stabilize it is linked with a much higher increase in the amount of metal found in the bloodstream. Chromium seems to have the highest levels reported for these intramedullary nails. Intramedullary titanium nails also increase the amount of titanium found in blood samples, but not as much as chromium. Evidently, the large surface area of the intramedullary nail exposes the bone to more titanium, thus the higher levels of serum (blood) metal. As a spine surgeon I used to never worry about this topic……now I do. I think the jury is still out on this but it is an area I am monitoring.

      David G. Dennison, MD. Distal Radius Fractures and Titanium Volar Plates: Should We Take the Plates Out? In The Journal of Hand Surgery. January 2010. Vol. 35A. No. 1. Pp. 141-143.

  59. (Oral herpes)

  60. Dr. Kruse, the folks that built our water filter at home say they have no idea how they would make a filter that can take the fluoride out of green tea. Are there any hints you can give us as to how your's got made? Maybe your use of the word "industrial" is key here. I would appreciate any help, thank you! P.S. I have been reading your work here for a while, learning so much. Thank you.

    • @Martha We contact our company and we were told they built a filter for an industrial company that treats all its city water to remove the fluoride for their product and we got their scrap sheets that were cut for our small home filters. That is all I know.

  61. Thank you Dr. Kruse! I will forward this info to the filter company, see if it rings any bells for them.

  62. How much vitamin K2 should I be taking to heal receding gums? Along with Green tea is there any other advice?

  63. Cole Proctor says:

    Jack

    I have not read all of your site …yet. But as a long term health fanatic, I have followed the slow and reluctant changes in the medical, science, diet and health communities over many years. And I'll have to say you have jumped to the head of the class in your unique approach and dedicated inspirational style. I suspect you have sold your Ferrari and found a new and admirable purpose.

    Despite being a healthy 6'3", 175 lb athletic 73 year old, who has been low carb since Atkins/Eades days, a short run at Mediterranean, now primal/paleo and wheat free for several years, I have developed an annoying case of Burning Mouth Syndrome. Since most medical sites classify BMS as one of those mystery syndromes that seems to have no cause and no cure…live with…it will go away…maybe. Some anecdotal remedies like ALA, various rinses, etc have had no

    affect. Several dentist/doctors have seen nothing and had no answers.

    Seems a malady with burning in the name might indicate inflammation.

    Have had a couple root canals. Take zero prescriptions, many vits/supps, had my last cold 14 years ago.

    Hoping your dentist/neuro background might have clues.

    Last lab:

    TC 228

    HDL 80

    LDL 136

    TG 61

    CRP 1.2

    Vit D 49

    • @Cole Proctor Pretty miserable syndrome to get. This syndrome has a lot of correlative etiologies but no causative ones……but one I think you need to look into is the high levels of inflammation you have. If that is HS CRP 1.2 is up there for me. It tells me that you have a serious underlying issue potentially cooking. I would first look at getting in to see an anti aging doc to get tested. Second I would worry about your gut and B vitamins. You might be taking them but you may not be absorbing them and this could be an issue. A proxy for this would be a B12 level below 1000. Another issue……your D levels is too low for my blood and that tells me immune system is not optimal……then we need to worry about viral infections as a source of this issue……SO I would have you up D3 big time with your Vitamin K2 levels……if you B 12 is low I would go to IM injections of B vitamins over Oral ones. I also would put you on high dose fish oil and krill oil and make you start swishing three times a day a with coconut oil and green tea . You need to start drinking a lot of green tea with this condition as well. Those are my thoughts…….and no I dont have the Ferrari any longer. LOL

  64. Jack: thanks for the quick response. I am increasing the D3,K2,fish/krill,B etc. Doing the swishes and drinking the green tea/coconut. Still looking for a good anti-age Dr with an open mind…they are a little rare. Thinking of doing a few lab tests on my own. Not sure if that was HS CRP…just says CRP 1.2. within limits of 0-4.9. Always learning, tweaking, and experimenting…another 40-50 years I'll have it all figured out. I gather you may have sold the Ferrari, but did not buy the Vegan. I live in the mountains, and have not missed a sunrise in years…spectacular.

    • @Cole I am in the process of becoming very minimalistic in my life. If you are accessing the power of the light at sunrise and sunset in the mountains daily your path to optimal is a being laid down in fine fashion. I am envious of this for sure. Merry Xmas.

  65. I was so excited to see you had a post about teeth. That is one of my biggest health concerns at this time. I've read some of Weston Price's book and other things I could find based on it before.

    Growing up I never had any cavities until I was 17. Then I had 3 small ones. I had them filled. I've never had insurance as an adult so after those fillings and the removal of my wisdom teeth I wasn't able to go to the dentist for almost 10 years. When I was 23 one of my fillings came out and I knew I was getting a cavity in the same place as before, but there wasn't much I could do about it. Sadly, at that time I was a vegan. I was a vegetarian/vegan from about 22-27. I started reading MDA about 1 1/2 years ago and switched from veg to Primal. i didn't last long on primal as carbs were hard to get rid of especially since I had been high carb eating veg for awhile. I've also always had a major sweet tooth my entire life. Sugar and pop have always been my addictions. 2 yrs ago I went to the dentist again and they found 20 cavities! I still have no money or insurance to get them fixed which is how I found out about Dr. Price.

    Finally this past July/August I went Paleo for the 3rd time and this time it stuck. I have been Paleo since Aug. I've had a couple slip ups, but nothing too major. I started your Leptin Reset yesterday as well.

    My question is about cavities. In the comments I see a lot about bone loss in the jaw and receding gums. The dentist was shocked that with so many cavities my gums are actually not that bad. I think there were only two spots that were starting to be a problem. I was wondering about your opinion on whether cavities can actually be healed with nutrition or whether I absolutely have to get them filled? Dr. Price's findings would imply them healing themselves, but it seems he did most of his actual "experiments" with children. I would think that healing children's teeth would be much easier than an adults. So, I'm worried it wouldn't work for me (I'm 28). At this point I don't have any money to get any fillings.. so it's not really an option, but I'm just worried about having to pull teeth if I can't get them to heal some on their own.

    • @Erica you need to use high dose Vitamin K2, A and D3 to help recalcify your teeth. The use of green and black tea swishing and swallowing also is a huge benefit. It the teeth are in that bad a shape you should consider going to a free local clinic or the local dental school to get a check up at least. Pulling your teeth is definitely not paleo……..you need to act to stop it.

  66. @Jack: Thanks for the quick reply. I have been working on the D3 for the last few months. I recently ran out of K2, but I was taking it as well. When I went paleo I switched to drinking green and black tea and water exclusively. I've always drank tea. I'll try to swish around more now. Vitamin A is def an issue I think. I have KP (Keratosis Pilaris) on my arms and light Fordyce Spots on my upper lip. From my understanding it is caused by a problem utilizing vitamin A. Which my guess may be related to some type of gluten sensitivity/celiac. Though no one in my family has been diagnosed celiac and I don't have stomach issues with gluten I think I still may be sensitive and have other issues besides gastric ones.

    On my mom and her side of the family has some issues I think may be related to gluten. Almost all of the women have had their gallbladder removed. I'm hoping to fix myself so this doesn't happen to me. A lot have hypothyroidism. My mother also has had horrible teeth issues her entire life. Lastly, stomach and/or colon cancer.. though that is often mainly in the men of the family.

    I would really love to avoid all of these issues as best I can. I'm very poor at this moment so I can only do the best I can at this time. I don't imagine I will be for the rest of my life so I will definitely be getting testing done as soon as I can afford it. Until then I can only guess and go by symptoms.

    I don't want to pull my teeth either. Amazingly, even with this many cavities I don't often have pain unless I eat something with a lot of sugar.

    I'm not sure I see much of a point in going to the dentist at this time as they will only tell me I have a ton of cavities and tell me it will cost $5,000+ to fix them.. like before. I can't do anything about it right now and I would like to try to heal them on my own if I can.

    Do you think Cod Liver Oil would be the best option for Vitamin A or a supplement just with vitamin A? Also, I have quit gluten and am doing your Leptin Reset. Eating CO in hopes of helping my stomach as I assume with a problem using Vit A that would imply a leaky gut of some kind. I'm worried about how high I should go with Vit A as I'm confused about Vit A toxicity. CW seems to say that it can happen easily, while WAP seems to imply we used to use/eat much higher levels of Vit A. Any advice on what you mean by "high dose" Vit A?

    • @ERica you could use cod liver oil……but foods high in Vitamin A on a primal diet are my favorite

      By high dose I was refering to supplements. Some take 10000 to 25000 IU a day. I prefer food sources like offal. And even grass fed offal is cheap

  67. At least they're not saying reduce the sugar just because of decay…

    http://www.calgaryherald.com/health/sweet+tooth+R

    "A growing body of scientific evidence shows that the fructose "can trigger processes that lead to liver toxicity and a host of other chronic diseases," Lustig and his colleagues say. "If international bodies are truly concerned about public health, they must consider limiting fructose — and its main delivery vehicles, the added sugars HFCS and sucrose — which pose dangers to individuals and to society as a whole," they say."

  68. Dr K- I've read that the combination of high vitamin butter oil and cod liver oil creates K2. What's your opinion? Do you think being on the Leptin reset diet, taking a vitamin butter oil/clo blend (eg. Green pastures) and drinking and swishing green tea is enough to remineralise a cavity?

  69. claudia rowe says:

    Dr Kruse. I have three teeth that must be replaced and the dentist insists that titanium is the only option, save a plastic denture. I have a number of autoimmune conditions inc. MS and, having read this blog, have gone from not being able to wait for the procedure to be to having a slightish freakout.

    My teeth are slowly falling out from lupus (I'm told) and likely the MS (I'm supposing).

    What's your view? Titanium or plastic?

  70. Patty Cakes says:

    Dr. K I am slowly working my way through your blogs. I find some of the best tidbits in the comments and I learn so much from each and every one of them! I love the leptin reset now just five weeks into it. Been ice-packing myself in the mornings as well and I am not a lover of cold but anything is worth great health. I'm 53 so time is of the essence.

    I have recently been diagnosed with a dentigerous cyst that formed out of an unerupted wisdom tooth. I'm told surgery is the only way to handle this. There is absolutely no pain in my jaw at all. I'm wondering if getting my D levels up (about to get tested after 10000iu/day for 5 months) with K2 supplementation if this cyst will miraculously disintegrate? Or are there other things I need to do along with diet?

    • @Patty is it an OKC cyst? Most likely……..you have options with OKC's I used to be aggressive with them but i think that was because i was a young cutter then

      Treatment options:

      Wide (local) surgical excision. my first choice back then……..

      Marsupialization – the surgical opening of the (OKC) cavity and a creation of a marsupial-like pouch, so that the cavity is in contact with the outside for an extended period, e.g. three months. Very conservative option.

      Curettage (simple excision & scrape-out of cavity).

      Simple excision. if it is a simple lesion but no tall our of it is with a wisdom tooth.

      Carnoy's solution – usually used in conjunction with excision. Stuff stinks.

      Enucleation and cryotherapy never did this………

  71. Patty Cakes says:

    Thanks for your speedy reply! I've seen two dentists and neither one mentioned OKC so I'm not sure. But based on your response it looks like surgery is the only way to get this to disappear before it grows and causes more problems. I most likely will not look for a "young cutter". LOL. I'm told to get the last two wisdom teeth removed at the same time. The marsupial pouch sounds like a nightmare….I think I'll opt out of that one.

    So plan A is to get that Vit D level up to at least 80, continue K2 supplementation during this time and then go for the surgery since it looks like it won't disintegrate.

    Thanks again for you help on this topic and all the others!

  72. Dr. Kruse,

    I've been doing the Leptin RX for just over a week and I can go on and on about how incredible I feel. Complete 180! I just finished listening to your podcast on askbryan.com. Excellent stuff! I was shocked when you arrived at the part about teeth. So fascinating that a root canal can alter your brain chem.

    After coming here and reading this article I'm really concerned, because I'm pretty sure I need a root canal. One year ago, a couple of 4-year-old fillings fell out (interestingly about the time I started gaining weight again) and I haven't gone to the dentist to correct the damage – for lack of funds. BAD, I know.

    It's become pretty uncomfortable lately and I know I need to go get it taken care of immediately.

    Are there any alternatives to getting a root canal? Is there anything I can ask my dentist to do to lessen the negative effects of the procedure?

    Thanks for everything!

    • @Hila there are but it depends upon dentist. If youre dentist is dialed into your desires I think they will work with you. Dentistry can do some amazing things these days

  73. In case you are able to get her to go along with this, post the location: I'm confident you can find lots of Y!A users who'd like to read her stuff.

  74. Bridgette says:

    Dr. Kruse – Fascinating read. I have always felt like my dental health was a much bigger part of my overall health status than most seem to think.

    I’ve posted in other spots about my current dental predicament. After reading this blog post I have a few more questions though. My vitamin D levels are decent (70), but I’m still supplementing hoping to improve them even more and I will be getting the osteocalcin test next week. You mention supplementing Mg and it’s one of those supps I’ve never tolerated. I’ve tried every form (citrate, malate, etc). I get lower back pain which I assume is kidney related and end up with black, tarry stools. Any ideas why this happens? Other suggestions on getting in the Mg?

    In the last few days while increasing my seafood intake I’m noticing a lot more clenching of my jaw and grinding of my teeth. Could this be a result of an intolerance to seafood?!?! I’ve been eating a lot of sardines and canned salmon, so I’m wondering if it’s more of a histamine reaction. I’m going to have some fresh, wild salmon tonight to see if it makes a difference, but I’m almost positive it’s related to the seafood in some way. I’m getting quite a bit of pain in my temples and jaw leading to headaches.

  75. Bridgette says:

    Thanks Dr. Kruse. Any thoughts on why I can’t tolerate supplementing w/ Mg?

  76. Bridgette says:

    I had a Genova NutraEval test done that showed I was low, but not the Exatest RBC. I’m going in for bloodwork next week and will add the RBC. Have you ever used the NutraEval? Thoughts on it?

  77. Hi Dr. Kruse,

    Could you please recommend a plan of attack to address the following issues? My health seems to be deteriorating quickly lately, and this post makes me believe that everything is related.

    Current age: 31. Ate a typical SAD diet until about a year ago where I dropped carbs.

    Age 16: Started getting bad cystic acne, still have it today but more in control.
    Age 19: IBS like symptoms begin
    Age 27: Gums start receding and continue for about a year. Black triangles at all teeth. Bone loss seems to have stopped or slowed since then
    Age 28: Gallbladder removed due to gall stones
    Age 29: During a physical, noticed that my blood glucose numbers looked high, though the doc said they were fine. Fasting blood glucose = 105. Ran an a1c test about 6 months ago and it’s at 5.5.
    Age 30: Dentist suspected 8 ?!? cavities in molars. Saw another dentist for a second opinion who agreed, had these all filled
    Age 31: Tired of feeling crappy, started reading more on health. Ran a vitamin D test, and it came out to 18 !!! Well under. Doc prescribed 50,000 IU once a week for 8 weeks, then once a month for 3 months.
    Age 31: Also, started working out at the gym. This greatly helped my IBS – I went from terrible to not bad at all.

    I’m starting to believe that this all started from excessive carb and sugar consumption.

    What I’m doing now: Vitamin D supplement (50,000IU weekly), Fish oil (600mg DHA), no carbs or sugars.

    What tests or strategy would you suggest to research my current conditions? ( pre-diabetes, acne, etc ). I’m trying to find the right link to this puzzle. Ugh!!!

    • @Andrew you have a leaky gut for sure. Check out my blog called the leaky gut Rx…….it will help you big time. YOu also need to eat an AI paleo diet.

  78. ^

    Oh, and just to add, even though I have pre-diabetic numbers, I am nowhere near obese. I’m around 5’9 160

  79. Hi Dr. Kruse, thanks again for all of the info you provide here. I left another question regarding familial hyperlipidemia on another blog. Been reading the site for days now and I love it. I am glad I read here because I am scheduled to have a benign parotid tumor removed at the end of april. My gut tells me to wait and leave it alone. It is 1.5 cm, and has been there for at least three years. The ENT says it can turn cancerous and is pushing to go forward. Also, not a fan of the scar and potential damage to the facial nerve.

    Weight and sleep problems became problematic for me after a trial of bupenorphine for back pain seven years ago. I took it because it was supposedly non addictive. Yeah right. I know you mention opaites and pain issues in cold therapy and I’d love to know your thoughts on how this messes up the mind. Thanks again. J

  80. Hi Dr. K – Wondering if I can ask you to go back to your dentistry days and give me some insight here. I had several mercury amalgams removed in the last few years and nearly all of those teeth cause me problems off and on.

    I’ve had a few different opinions given from dentists – all holistic/biologic, BTW – and am just not sure what direction to take. X-rays look fine, but I will randomly (every few months) get pain from hot or cold foods or even chewing. It may last a few weeks and then goes away and as I said above it comes and goes in different teeth even.

    One tooth has a cap and I’m finding it’s sensitive at the gum line when I floss – even starting to bleed a very tiny amount. Short of just extracting the teeth, I’m not sure what to do. One dentist believes it’s a bite problem and it will all improve with a retainer.

    Is there anything “concrete” I can look at/do to try to figure out what’s going on since x-rays are all good? No one has suggested any other kind of testing. I just started vitamin K2 drops – 15 gm/day and I also began oil pulling in the AM with sesame oil.

    Thanks so much for any input!

    • @BJK77 I think you should have heavy metal screenings done……if they are negative then do not worry about the fillings. Sensitivity at the crown margin is a sign of leakage and a bad margin. Get that fixed by a new dentist who specializes in porcelain crowns. Usually a prosthodontist does them. I think K2 is a great idea and I think making sure your D level is good too.

  81. Hi Dr K, thank you for all you do. I am studying your blog and podcasts trying to keep up with the treasures you are dishing out. I was recently reading up on Co Q 10 and it seems to be effective in restoring receding gums when applied topically. Have you heard of this? Any reason you can think of why i shouldn’t try an n-1 on it? Also i have started applying mag gel on my cheeks and chin- targetting the jaw beneath the skin.
    Heading for optimal in every area and paying it forward with joy.

  82. Hi Dr. Kruse,
    This is a fascinating and pertinent post. I live in the Middle East, and my friend has been diagnosed with ‘chronic non-specific parotid sialadenitis’, which includes painful swelling behind her ears and on her face. It’s something she’s dealt with since childhood, but now she’s 28 and it’s been getting worse. She’s visited five doctors over the last year, and taken three courses of antibiotics (way over-prescribed here), all without success. She’s had imaging done, but no stones or tumors showed up, though she’s been advised she should have surgery anyway (also over-prescribed here). Needless to say, she would like to avoid surgery if possible.

    Would you recommend a ketogenic diet? Supplements? Do you have any references that she could take to doctors here to encourage them to explore the nutritional aspects of her condition?
    Thank you so much for your time and efforts!

    • @Sarah The first thing she needs to do is stop eating all grains and eating PUFA’s that means go to amazon and down load The Paleo Solution by Robb Wolf or The Primal Blueprint by Mark Sisson and instituting the diet. She then need to increase her vitamin K2 intake.

  83. Lisa B Ball says:

    I have Lyme. It’s now creating dental issues. Had a cracked tooth that was refilled and then capped. Within 2 weeks, the nerve started to die. I had it extracted. @ weeks later the same tooth on the opposite side cracked. It also has an amalgam filling; doesn’t hurt, but is inflamed. What should I do??? I’m not opposed to another extraction. Haven’t seen my dentist yet. Thanks, Lisa B in Memphis :)

  84. Teller Coates says:

    First of all, thank you for your generosity. I genuinely recognize how you are paying it forward.

    We may need a paid consult, but for now, I came to Paleo when my teeth starting falling out, along with periodontal disease. I had one extraction so that I could at least chew without pain on one side of my mouth, but on the other side is another tooth that is extremely loose and it is painful to chew on that side.

    I have supplemented with D3 and K2, but I wonder if it is too late? My dental student intern said that my gums are the only thing holding it in and that it can never regenerate, that my diet most likely caused it (alcohol and tobacco). Should I have it extracted and concentrate on the remaining teeth, or can this sort of extreme case be fixed with diet?

    Thank you so much for everything, regardless…I now respect the circadian rhythms and plan to CT this winter.

  85. @JS great blog here to give you a perspective on dental decay.
    http://www.sorrentinodental.com/Blog.html?entry=why-teeth-decay-i

  86. Hi Dr K. I’m re-reading blogs and marrying them up with the newest BG 9 info. My children (ages 7 and 11) both had cavities semi-regularly prior to us going paleo/epi-paleo. As you know, we now totally obey natural light cycles/circadian rhythms, are cold in winter, eat according to your Rx. I have been working hard on my children’s guts and also supplementing them with D3 and K2 (the LEF combo), as well as having them eat butter, offal, bone broths, pro/prebiotics etc. It seems that this should re-establish their dental health, too. Does that sound right? Also, I’ve told the school dental clinic that I do NOT want xrays or flouride treatment for my children (nor do I want sealants)… just teeth cleaning. They’re not happy. Your thoughts? Thanks!! Lauren

  87. PS forgot to add, the kids get Mg every evening too.

  88. It’s the dentists who aren’t happy (my kids are fine)… I seem to be telling a lot of docs lately to deal with their discomfort! :)

Trackbacks

  1. […] This nerve controls the entire GI tract down to the transverse mesocolon.  It also monitors the hypothalamic parotid axis in the mouth that monitors carbohydrate contents in food in the mouth. This signal is an early […]

  2. […] directing calcium ion homeostasis in bone, dentin and the arteries of our body.  Remember in the teeth blog we spoke of the hypothalamic pituitary axis and how it controlled flow in the dentinal tubules used […]

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