Frequently Asked Questions about Oral Health

Why do I keep getting cavities even though I brush and floss?

Contrary to popular belief, cavity prevention is not only dictated by hygiene. Streptococcus mutans are the bacteria often responsible for tooth decay. Unfortunately, these bacteria cannot simply be cleaned away- this is because they colonise the mouth in levels based on saliva quality, competition (or lack thereof) from healthy probiotic bacteria, fuel supply and other systemic factors such as blood sugar control and digestion. Your diet matters too. Teeth are bones, and their structural integrity will affect their ability to withstand decay or cavity development. Your body’s ability to absorb and utilise the vitamins and minerals from your food (think vitamin D, K2, calcium) will affect the development of tooth decay and cavities - especially in states of deficiency. Intake of ultra processed, sugary foods are problematic in that they stick to the teeth, but also in that they displace healthier foods that provide more nutrients. I can help to untangle which factors are stopping you from overcoming gum disease and maintaining a healthy mouth. 

Why did my gum disease come back after treatment?

The answer may lie in the balance of your oral microbiome. You may have had a scale or root plane, or even a more invasive treatment such as gum flap surgery - only to find that the infection responsible for gum disease is back 6 months later. This is because the bacteria that create infection in gum disease do not necessarily go away even with the most thorough dental cleaning techniques. They are capable of recolonising the gum pockets within hours of physical removal. If nothing else changes - your diet, stress, blood sugar management, oral hygiene regime, gut health issues, nutritional deficiencies or inflammation levels - the environment in your mouth is ripe for reinfection. The research is clear: periodontal patients with pre-existing metabolic disease (diabetes or high blood pressure for example) have worse outcomes post-treatment. Dental outcomes can be improved by removing the obstacles listed above. This is where naturopathy shines.

Why do my gums bleed even though I floss every day?

Bleeding gums is a symptom of gingivitis - inflammation of the gums. Often there is a bacterial infection responsible behind the scenes. Sometimes flossing isn’t enough. Flossing does physically disturb the home that bacteria make for themselves (called biofilm) and can help to prevent the progression of gingivitis into gum disease. However a significant infection compounded by hormonal changes (such as pregnancy) or nutritional deficiencies such as vitamin C, or high levels of inflammation related to other health concerns - can make gingivitis a bit more complex to treat. Although flossing is a worthwhile thing to do, it simply can not address these other factors alone. I help to uncover the other causes of bleeding gums that flossing doesn’t touch.

Why does my bad breath keep coming back no matter what I do?

If nothing has worked, you just haven’t tried everything yet! Traditionally in natural medicine, bad breath was considered a sign of a detoxification issue rather than an oral hygiene issue. The mouth makes up the entrance to the digestive system. The digestive system (the gut) is a major detoxification pathway for the body. An overgrowth of bacteria in the gut can contribute to bad breath - and mouth wash can’t touch it! Constipation, dehydration, dietary choices, poor liver function, infections and other digestive issues could be to blame. If you’ve ruled out an infected tooth - it’s time to look deeper at the cause of chronic bad breath. I leave no stone unturned on the quest for fresh healthy breath. 

What is the connection between gut health and gum disease?

The gums technically form a part of the gut lining, which is the barrier between the outside world and your blood stream. The gums do not exist in isolation - they are physically connected to the gut - but they also are capable of delivering substances directly into the blood stream. Pharmaceutical and nutraceutical products are specially designed to dissolve in the mouth or be sprayed under the tongue for sublingual delivery into the blood. This is a two way street - inflammatory chemicals, toxins, undigested proteins, immune cells, vitamins and more - can reach the gums via the blood. We know that infection in the gut can initiate a cascade of inflammation that can affect far reaching parts of the body (via the blood) such as the brain but also the mouth. Diseased gums are highly inflamed. Old school naturopathic practitioners considered the gums to be a canary in the coal mine - reflecting to the surface of the body the deeper issues; infections, diabetes, heart disease, inflammatory bowel disease to name a few. 

How do hormones affect oral health?

Hormones act as messengers but they can also be a source of fuel for certain species of bacteria that are known to cause gum disease. In pregnancy, surging hormones can cause the gums to become more swollen, tender and bleed more easily due to higher blood flow. Pregnancy gingivitis is a common manifestation, but hormonal changes at other stages of life can affect the health of the mouth too. A reduction in oestrogen after menopause can reduce saliva flow, contributing to dry mouth or burning mouth. Hormone replacement therapies (HRT) including hormonal contraceptives can have their own effects on oral health - sometimes beneficial in menopause, but can be problematic at other times, depending on other systemic factors at play. Hormone levels are under tight regulation by the body - however in hormonal conditions (think PCOS/PMOS) or puberty, pregnancy and menopause, sometimes some extra support is needed so that your teeth and gums don’t pay the price.

More Frequently Asked Questions about Oral Health…

Can nutritional deficiencies cause tooth decay?

Nutritional deficiencies can contribute to tooth decay in a number of ways. Nutritional deficiencies can prevent the immune system and oral mucosa from maintaining a balanced oral microbiome. When in overgrowth, bacteria can cause tooth decay and dental caries or cavities. Weak tooth enamel that is lacking in minerals such as calcium will be more prone to breakdown, or developing “holes” in the teeth. Some women will experience tooth extractions following a baby - the body will direct crucial nutrients or minerals away from the mother’s own bones (including the teeth) in order to sustain the rapid bone growth required by the baby. Lastly, vitamins such as vitamin D3 and K2 help to regulate bone mineral density and calcium utilisation - deficiencies in these place people at higher risk of decay also. Many nutritional deficiencies can easily be tested for in routine blood testing - but the reference ranges can be deceiving, and your unique nutritional needs must be considered. The right supplement form and dosage can correct deficiencies within a weeks to months. Ask me how i know.

Can gum disease be reversed?

This depends on the stage of gum disease and whether bone loss has occurred. It was previously thought that bone did not regenerate once lost. Now there is evidence to suggest that the direction and depth of bone loss (vertical vs horizontal for example) determines whether there is any chance of regeneration.

The state of infection in gum disease can absolutely be reversed. Infected, purulent and bleeding tissues can be restored to a state of health. Healthy gum tissue is more successful at reattaching to bone. This is what occurs when gum pockets reduce in depth. A gum pocket with a depth of 6mm is absolutely capable of reducing to a healthy depth of 0-3mm with the right treatment. Read my story of reversing periodontitis (gum disease) here. The body is always trying to heal. I

What can a naturopath do that a dentist can't?

Dentist are highly skilled in the physical treatment of dental concerns. Most are not trained to identify or treat the other health issues that can make or break a person’s oral health. Consider insulin or blood sugar issues. This could be diagnosed Type II diabetes - or it could be unmanaged pre-diabetes (that has not yet even been identified by the client or their health practitioner) Dentists and periodontist know that blood sugar issues contribute to conditions such as gum disease - the research is clear in that. However, they are not trained or equipped to treat blood sugar issues or high insulin levels. This is where a naturopath can help - we are trained in the identification and treatment of blood sugar issues and can support dental patients to make sustainable diet and lifestyle change to reverse blood sugar issues. The flow on effect? Improved systemic health, reduced inflammatory burden on the gums, a healthier oral microbiome and a greater chance of long term success from expensive dental procedures. 

Can leaky gut cause dental problems?

Intestinal hyper-permeability (leaky gut) has now been implicated in just about all of the chronic inflammatory or metabolic diseases - Type II diabetes, Alzheimer’s dementia, cardiovascular disease, autoimmune diseases and fibromyalgia to name a few. We know that infection, inflammation or disease in the gut can initiate a cascade of inflammation that can affect far reaching parts of the body (via the blood) such as the brain but also the mouth. Diseased gums are highly inflamed and technically make up a part of the digestive tract too! We can also absorb pharmaceuticals and nutraceuticals sublingually through the oral mucosa and gums - think about your vitamin B12 spray, Strepsils, or dissolvable multivitamin chews. The tissue of the gums and mouth are semi-permeable, similar to the intestinal lining. We know that if the gut lining is ‘leaky’, the blood-brain barrier is likely ‘leaky’ too. So what about the gum lining - the gingiva? 

Why did I get pregnancy gingivitis?

Oestrogen and progesterone are two hormones that surge during pregnancy. One of their roles is to manage blood flow to the developing baby - but they also increase blood flow to other areas such as the gums. This can cause the gums to be more tender, swollen, vulnerable to inflammation and thus bleeding. Gingivitis is essentially just inflamed gingiva - in pregnancy, it is hormonally driven and is characterised by bleeding and sensitivity. 

What is the oral microbiome?

The oral microbiome is an umbrella term used to refer to the population of microbes (bacteria, fungi, parasites, viruses and yeasts) which colonise the oral cavity - the mouth. It is separate (but connected to) the microbiomes of the skin, gut, vagina and genitourinary tract. These microbes can be good (probiotic species such as the well known Lactobacillus species) bad (such as Entomoeba - parasitic amoebas that are often present in advanced gum disease) and some are neutral (or only become a problem when they’re growing out of control) Many microbes have now been causally linked to dental diseases such as tooth decay, caries, gum disease and bad breath. Naturopaths address the balance of the microbiome to resolve symptoms and manage disease progression by using natural substances; herbs, minerals, vitamins, special probiotic species and dietary supports.