How Could They Know? The Case of Healthy Gums

During my last dental exam, a month ago, I was told my gums were in excellent shape. Clearly better than my previous visit. The obvious difference between the two visits is that I now eat lots of fermented food. At the previous visit, my gums were in better shape than a few years ago. They suddenly improved when I started drinking a few tablespoons of flaxseed oil every day. Tyler Cowen is the poster child for that effect. After a lifetime of being told to brush and floss more — which I did, and which helped a little but not a lot — it now turns out, at least for me, that the secret of healthy gums is: 1. Eat fermented foods. 2. Consume omega-3. These two guidelines are not only a lot easier than frequent brushing and flossing but have a lot of other benefits, unlike brushing and flossing.

Dentistry is ancient and there are millions of dentists, but apparently the profession has never figured this out. This isn’t surprising — how could they figure it out? — but it is an example of a general truth about how things get better. (Or why they don’t get better — if only dentists and dental-school professors are allowed to do dental research.) In The Economy of Cities, Jane Jacobs makes this point. For a long time, Jacobs says, farming was a low-yield profession. Then crop rotation schemes, tractors, cheap fertilizer, high-yield seeds, and dozens of other labor-saving yield-increasing inventions came along. Farmers didn’t invent tractors. They didn’t invent any of the improvements. They were busy farming. Just as dentists are busy doing dentistry and dental-school professors are busy studying conventional ways of improving gum health.

Jacobs also writes about the sterility of large organizations — their inability to come up with new goods and services. On the face of it, large organizations, such as large companies, are powerful. Yes, they can be efficient but they can’t be creative, due to what Jacobs calls “the infertility of captive divisions of labor.” In a large organization, you get paid for doing X. You can’t start doing X+Y, where Y is helpful to another part of the company, because you don’t get paid for doing Y. A nutrition professor might become aware of the anti-inflammatory effects of flaxseed oil but wouldn’t study its effects on gum health. That’s not what nutrition professors do. So neither dentists nor dental-school professors nor nutrition professors could discover the effects I discovered. They were trapped by organizational lines, by divisions of labor, that I was free of.

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Hire a San Diego orthodontist for advanced dental procedures.

Joyce Cohen Gets Her Teeth Cleaned

A few months ago, Joyce Cohen, who writes The Hunt column for the NY Times Real Estate section, started drinking 2 tablespoons of flaxseed oil every day. She began after talking with me and because of stuff posted here. Yesterday she went to the dentist for the first time since she started drinking it.

“Jane the hygienist said my gums were in great shape — better than ever,” she wrote me. Meaning the best they’d ever been.

“What’s funny is you can’t FEEL good gums from inside your mouth, but I take her word for it.” The hygienist said that although she was scraping and scraping, there was no bleeding.

Joyce started with Spectrum Organic flaxseed oil without lignans but later switched to the oil with lignans. She despises the taste but finds it is most palatable mixed with yogurt.

My dental story. Tyler Cowen’s story.

Why Does Gum Disease Correlate With Heart Disease?

People who have heart disease are more likely to have gum problems. Why? According to an online health magazine from the University of Texas,

Medical researchers have two main theories to explain the link between gum disease and heart disease . . . One theory is that the bacteria from periodontal disease enter the blood stream and stick to the blood vessels, creating a thickening of the walls, which may end up clogging these vessels. The second theory is that the chemical by-products from gum disease cause the same clogging effect. The chemicals may come from the by-products of the bacteria or from the chemicals produced by the body’s own immune system.

A third possibility, not mentioned in the article, is that both gum disease and heart disease are caused by too much inflammation.

The three cases I described yesterday, in which high-omega-3 oils rapidly eliminated gum disease, convince me that the third possibility is correct. When you take 2 tablespoons/day flaxseed oil or 1 teaspoon/day fish oil, you are not killing the bacteria in your mouth. The bacteria remain as plentiful as ever. The difference is that your body is no longer overreacting to them. Plenty of evidence suggests that heart disease is caused by too much inflammation. This correlation is more evidence.

Why omega-3s reduce inflammation is known. The body requires omega-3 to build an anti-inflammatory signaling molecule. Not enough omega-3, not enough of this molecule, too much inflammation.

Omega-3 and Dental Health (still more)

The gum improvements produced by omega-3 fats can be easy to see:

1. About six months ago, my dentist noticed that my gums were in excellent shape (a healthy pink, not red), for the first time in memory. I had started taking 3-4 Tablespoons/day flaxseed oil a few months earlier. I hadn’t made other dietary changes nor had I started brushing or flossing my teeth more. I have slacked off the usual dental care (I floss less often) but my gums have remained in excellent shape, according to my dentist.

2. When Tyler Cowen (author of Discover Your Inner Economist) starting taking 2 Tablespoons/day flaxseed oil, his gums got much better within weeks. They improved so much surgery was canceled.

3. Catherine Shaffer, a Michigan writer, had the same experience with fish oil:

I bought a bottle of Carlson Laboratories [fish oil] and began taking the recommended dosage [1 teaspoon/day] . . . My gums have been chronically inflamed for as long as I can remember. They were reddish in color, had a tendency to bleed when poked, and have earned me many lectures on flossing from my dental hygenist. I have had to brush three times a day and floss twice to keep the inflammation down. However, as soon as I started taking the fish oil, my gums turned a pale pink, and I even though I have been very lazy about flossing, they have not been bleeding.

Maybe I should have called gingivitis (inflamed gums) the new scurvy. (Vitamin C cures scurvy in a few weeks.) Such fast big lasting improvements imply the flaxseed or fish oil supplied something important that was missing. Too much inflammation is a body-wide problem — many conditions end in -itis (e.g., arthritis) — so it is likely that the flaxseed or fish oil is having other benefits. Consistent with this idea, gum disease is correlated with several other health problems, including stroke, heart disease, and low-weight babies.

According to an online health-info source, echoing conventional wisdom:

Gingivitis is the most common and mildest form of oral/dental disease. According to the Food and Drug Administration, approximately 15 percent of adults between 21 and 50 years old, and 30 percent of adults over 50, have gum disease . . . The main cause of gingivitis is plaque . . . The best defense against gingivitis is brushing and flossing after meals, as well as professional cleaning by a dental hygienist every three to four months.

How fragile the conventional wisdom (“The main cause of gingivitis is plaque . . . The best defense . . . is brushing and flossing”) turns out to be. Eighty years ago, Weston Price, a Cleveland dentist, had the same doubts I do. In travels around the world, he saw many people with excellent teeth who never brushed them. They ate ancient diets, with far more omega-3 than modern food.

Omega-3 and Dental Health: Surgery Commuted

I started writing a follow-up to this Marginal Revolution post by Tyler Cowen before I knew of its existence:

January [2007] entodontist [= gum specialist]: “You’ll need surgery either right now, or within a few months. We cut open the gum, clean out the inflammation, and sew your mouth right back up. Only sometimes do we have to eliminate the tooth.”

July 5 [2007] entodontic surgeon, 10:31 a.m.: “We can cancel this morning’s surgery, it seems OK for now, just keep an eye on it.”

In June, Tyler posted about the benefits he derived from flaxseed oil (2 Tablespoons/day): “Very good for my heart, my brain, and my gums.” I asked him what was better. “Much better gums, for sure,” he replied. “The rest is harder to measure.” On July 4 I got around to asking for details. Tyler said that he had had bad gums for most of his life and that he noticed they were much better within a week or two of starting the flaxseed oil. He added

I have crooked wisdom teeth, never wore braces, and my mouth naturally produces lots of plaque. Put all together that means a significant problem with gum disease. I get cleanings every three months or so but still my gums have been much worse than average.

I too have crooked teeth and more plaque than average and I too found that flaxseed oil improved my gums; my dentist was the first to notice.

A recent experiment about omega-3 and dental health. A 1997 experiment. An amazing bowling video.