By now, most of us know that gum disease is linked with heart disease. But if that’s not enough to get your attention, how about this—new evidence shows that if you have gum disease, you may be more likely to get serious autoimmune diseases and cancer.

Did that get your attention? If you want to be healthy, act now to keep your mouth and gums in good shape. Important: It’s more than just brushing and flossing.


Most of us are aware that the “good” bacteria in our guts, sometimes called the “gut microbiome,” play a key role in health. But there’s growing evidence that the “mouth microbiome” is extremely important, too. The mouth has billions of “good” bacteria that support digestion and oral health. But when infection-causing oral bacteria take over, causing gum disease, there’s an increased risk for even more serious conditions…

  • Heart disease and stroke. Many studies have found a link between gum disease and an increased risk for heart disease and stroke. One reason is that gum infection causes body-wide inflammation that can contribute to these diseases.
  • Type 2 diabetes. While gum disease hasn’t been shown to cause diabetes, people with diabetes tend to have more gum disease—which in turn can raise blood sugar, making diabetes worse.
  • Rheumatoid arthritis. Researchers at Johns Hopkins University School of Medicine in Baltimore have found that a particular bacterium that causes chronic gum disease can trigger an autoimmune response that is linked to rheumatoid arthritis. The same pathogenic bacteria was found in mouths and diseased joints.
  • Pancreatic cancer. At NYU Langone Medical Center in New York City, investigators have found that the same bacterium associated with rheumatoid arthritis is also linked with increased risk for pancreatic cancer. Participants in the study who had this bacterium in their mouths were 50% more likely to develop pancreatic cancer than those who did not.

Whether you have a chronic illness or want to avoid one, taking care of your mouth is essential. Here’s how…

If you’re generally healthy and want to prevent gum disease….

You already know the basics—limit sugary foods, don’t smoke, do brush after every meal, and floss at least once a day. More tips…

  • Floss every night. It’s fine to floss more frequently, such as after every meal, but if you can manage only the once-a-day minimum, make sure you do it at the end of the day. Here’s why: When you sleep, saliva production is at its lowest, enabling bacteria and plaque to get a stronghold on those little bits of food stuck between your teeth.
  • Eat plants. Vegetarians are less prone to gum disease than meat-eaters, in part because their diets are less inflammatory. Even if you eat meat, make sure you eat a primarily plant-based diet rich in vegetables, fruits, whole grains, legumes, nuts and seeds.
  • Manage stress and get enough sleep. Stress interferes with saliva production and changes the bacteria in your mouth. Plus, being well-rested and calm helps your immune system stay strong enough to protect against gum disease.
  • Watch out for excessive alcohol. Moderate drinking isn’t a problem, but people who are “alcohol dependent” are much more likely to have lots of gum disease–causing bacteria in their mouths.
  • See your dentist twice a year for cleaning or more often if you’re prone to excessive plaque buildup. (You already knew this, and yet one-third of Americans don’t even see their dentists annually.)

If you’re starting to show signs of gum disease….

Gingivitis is the earliest, mildest form of gum disease. It’s marked by gums that are red, swollen and bleed easily (“pink toothbrush syndrome”). If this is happening to you, do all of the above and try a little extra dental TLC…

  • Use a water pick—with added hydrogen peroxide. (Follow the instructions on your product for where to add it). Using a water pick with water alone will clean between your teeth, but with added hyrogen peroxide, you’ll kill “bad” bacteria. (Yes, you’ll also kill some “good” bacteria, but it’s like pruning a garden—getting rid of the “bad” bacteria will help the “good” ones reestablish themselves.) I recommend doing this daily for two or three months or until gingivitis is resolved, then dropping down to once or twice a week for maintenance.
  • Rinse your mouth with warm saltwater when needed. Saltwater rinse helps reduce inflammation and kills bacteria. But use this remedy only for flare-ups—daily use can damage teeth.
  • Try oil pulling. This Ayurvedic practice involves swishing your mouth with a spoonful or so of coconut oil or another plant oil for several minutes and then spitting it out (click on the link above for details). Although there isn’t much scientific proof that it works, my clinical experience is that it is effective at preventing, and even reversing, gingivitis.
  • See your dentist and follow the above recommendations, but if your dentist recommends it or your gingivitis doesn’t get better, make an appointment with a periodontist. Unchecked, gingivitis can proceed to periodontitis, a more serious condition. Advanced periodontitis may require surgery.

If you have dry mouth…

To thrive, the healthful bacteria in your mouth need saliva, which keeps your teeth and gums moist and healthy and helps to wash away “bad” bacteria before they can get established. The good bacteria, it turns out, are more resistant to being washed away by saliva than the bad bacteria.

But many medications—including prescription drugs for high blood pressure (diuretics) and depression and over-the-counter drugs for allergies (antihistamines)—inhibit saliva production. So can some medical conditions such as diabetes. If you take a medication or have a condition that causes dry mouth, drink plenty of water throughout the day. You may also want to look for a chewable probiotic, which will help release saliva even as it helps improves digestive health.


In my work as an integrative medicine specialist, I treat many people with autoimmune diseases, including rheumatoid arthritis, ankylosing spondylitis (a type of arthritis that mainly affects the spine), psoriatic arthritis, lupus and Sjögren’s syndrome. My primary approach is to repair the gut, rebuilding the gut “microbiome” with diet and enzymes, probiotics and other supplements. If you have periodontal disease, it can have a negative effect on the gut biome.

In my experience, when my patients improve the microbiomes in their mouths, it helps them manage their diseases. So I always insist that at the outset of my treatment, my patients first see their dentists and then possibly periodontists for evaluation and possible treatment—even if they don’t have obvious evidence of gum disease. The truth is, everyone with gum disease should take steps to treat it because it could be triggering system-wide inflammation.

To learn more, see the “Bottom Line Guide to Surprising Ways to Keep Your Teeth and Gums Healthy.”

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