Tooth Loss, Dementia, & the Biological Terrain

missing teethIt wasn’t so long ago that most dentists scoffed at the notion that oral and systemic health are related. After all, they were trained – and still are largely trained – to be mouth mechanics, specialists at repairing problems in isolation, with little consideration for how that might affect the rest of the body.

Now, a week doesn’t go by without new research shedding even more light on the oral-systemic connection, particularly the link between gum disease and other inflammatory conditions, including heart disease, stroke, diabetes, arthritis, cancer, and Alzheimer’s.

Consider a study published earlier this year in the Journal of the American Geriatrics Society. Analyzing data from more than 1500 Japanese seniors, the authors found that

Tooth loss is associated with an increased risk of all-cause dementia and [Alzheimer’s disease] in the Japanese population.

Though you might think of tooth loss as something that goes right along with old age, it isn’t inevitable. Most tooth loss is the result of disease. And periodontal disease is extremely common among seniors. More than 70% of Americans age 65 or older have it – and nearly half of all adults over 30.

As gum disease progresses, it destroys both the soft tissues and the underlying bone that support the teeth. With bone loss, the teeth loosen in their sockets. Eventually, they fall out (if they’re not extracted first).

So it’s not that missing teeth cause problems like dementia. Rather, its the underlying disease process.

And that infection does not stay confined to the mouth. Pathogens travel through the circulation and can wreak havoc at sites far away from the mouth. (Oral bacteria have been found in the heart, for instance, and in knees.)

And if the biological terrain is polluted and disordered, related health problems become more likely.

This is why a preventive approach – not just against gum disease but all illness and dysfunction – is so crucial. A healthy, well-ordered terrain is your best insurance against chronic illness.

After all, it’s what dictates how illness develops or how health is sustained.

Learn more about the biological terrain

Image via NOttingham University Hospitals

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The Illusion of “Side Effects”

Some news items say so much all on their own.

pills in shape of USA

Almost one-third of new drugs approved by U.S. regulators over a decade ended up years later with warnings about unexpected, sometimes life-threatening side effects or complications, a new analysis found.

The results covered all 222 prescription drugs approved by the U.S. Food and Drug Administration from 2001 through 2010. The researchers looked at potential problems that cropped up during routine monitoring that’s done once a medicine is on the market. The 71 flagged drugs included top-sellers for treating depression, arthritis, infections and blood clots. Safety issues included risks for serious skin reactions, liver damage, cancer and even death.

“The large percentage of problems was a surprise,” and they included side effects not seen during the review process, said Dr. Joseph Ross, the study’s lead author and an associate professor of medicine and public health at Yale University.

Actually, we think the surprise would be drugs that had no unintended consequences.

As Dr. V sees it, the whole concept of “side effects” is a kind of illusion. Drugs have effects, full stop. Some of those effects are desirable; others, not so much. All of them are a result of the action of the drug.

Each year, thousands of Americans die from pharmaceutical drugs – and more than a million are “injured.” Some of cases are from abusing the drugs; some are from error; and a great many are, in fact, from taking medications exactly as prescribed.

While most safety concerns were not serious enough to prompt recalls, the findings raise questions about how thoroughly drugs are tested before approval, said drug safety expert Thomas Moore. But Ross said the results suggest that the FDA “is kind of doing a great job” at scrutinizing drugs after approval.

Oh, well, that’s a relief!

polypharmacy cartoonAnd if it doesn’t make you feel better, no doubt, they have a pill for that.

And that points to another problem with throwing drugs at disease: You easily wind up throwing yet more drugs at their unwelcome “side effects,” which have their own “side effects,” which can be treated with more drugs, ad infinitum.

According to the CDC, nearly 22% of Americans take 3 or more prescription drugs in the last month. Nearly 11% take 5 or more. Roughly three-quarters of all doctor visits involve drug therapy.

But while those drugs may do wonders at silencing painful or disturbing symptoms, they do absolutely nothing to treat what’s causing them. Meanwhile, their actions further pollute and disorder the biological terrain, deepening illness and giving rise to even more symptoms and new diagnoses. Oh, and more drugs.

And we wonder why health outcomes are so much worse here in the US than in other industrialized nations.

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Clash of the Health Polls

Central Valley mapThe Central Valley isn’t known for being all that healthy of a place. According to the latest rankings, most Valley communities rank in the bottom half of the list of 150 US cities – and most of those toward the bottom of that. (The one exception? Sacramento, which came in at a respectable 28th, just ahead of San Diego and Oakland.)

So we were a little surprised by a new “healthy eating” poll from the Gallup-Sharecare Well-Being Index. Of the 189 US communities included, here’s how the Valley towns fared:

  • #27 Visalia
  • #29 Fresno
  • #39 Modesto
  • #40 Stockton
  • #58 Bakersfield
  • #76 Sacramento

This is a region where nearly half of all adults are prediabetic, including more than 30% of young adults. This is a region with a food landscape that has been described as “designed for disease.”

This is a region of healthy eaters?!

It is if your poll consists of a single question: “Did you eat healthy all day yesterday?”

Self-reported data can be problematic. People lie to preserve their self-image. Or they forget. Or they give the answers they think their interviewer wants to hear. Or they don’t fully understand the question.

As we’ve noted before, “healthy” can be a tricky term sometimes. There’s plenty of rivaling opinion on just what that means. Without having some shared standard of what “healthy eating” entails, how can you make an accurate assessment?

A person who eats three homemade meals made with lots of fresh organic produce, sustainably raised meats and dairy as they choose, healthy fats, and no added sugars would probably say, “Yes, I ate healthy all day today.

But so might the person who ate mainly hyper-processed products, whether at home or on the go, that are marketed as “healthy” and “natural” but are anything but.

With this poll, there’s really no there there.

Image by Shannon1, via Wikimedia Commons

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To Freak Out or Not to Freak Out? Diet Soda Edition

There’s nothing quite like a Daily Mail headline to freak you out:

Daily Mail screenshot

Naturally, there were those who felt the need to respond.

Fortune screenshot

But while the article below it correctly points out the limitations of the study in question (more on this in a sec’), headlines like that can make it sound as if the research itself was bunk. And not a lot of people will read beyond that.

But we have to admit, that’s a sexier headline than “Study Shows Association Between Diet Soda Consumption, Stroke, and Dementia.”

And that’s all that the study in Stroke actually showed. Those who drank more diet soda showed a higher risk for the two conditions. It didn’t show that diet soda caused them. An observational study can’t show that.

There were other important limitations, too. For instance, the results came from an ethnically homogenous group. The researchers didn’t account for other sources of artificial sweeteners in the diet.

On top of that, the three-fold risk that the Mail shouted about? That was relative risk. The overall risk was still on the low side.

“Even if someone is three times as likely to develop stroke or dementia, it is by no means a certain fate,” [lead author Matthew] Pase said. “In our study, three percent of the people had a new stroke and five percent developed dementia, so we’re still talking about a small number of people developing either stroke or dementia.”

So go ahead and drink your diet soda?

Just as a single observational study can’t tell you that it’s harmful, it also can’t tell you that it’s perfectly benign.

soda aisleBut plenty of other research through the years suggests that it’s not something you want to drink a lot of. Some research has shown that regular consumption of diet soda reduces microbial diversity in the gut, which has significant implications for metabolic and mental health in particular. And we’ve known for years that it can damage teeth just as readily as the sugary stuff it’s meant to replace.

And then, of course, there are the familiar concerns with the artificial sweeteners themselves.

Interestingly, the authors published another paper recently that seems to have received much less attention, maybe because it confirms so much of what we already know.

This companion study, published in Alzheimer’s & Dementia, looked at the possible relationship between drinking sugary beverages and developing early signs of Alzheimer’s.

The researchers looked at people who consumed more than two sugary drinks a day of any type – soda, fruit juice, and other soft drinks – or more than three per week of soda alone. Among that “high intake” group, they found multiple signs of accelerated brain aging, including smaller overall brain volume, poorer episodic memory, and a shrunken hippocampus, all risk factors for early-stage Alzheimer’s disease. Researchers also found that higher intake of diet soda – at least one per day – was associated with smaller brain volume.

Again, we have association, not causation. But considering the wealth of research to date, both of these studies suggest yet more reason to make soda a sometime or never thing, not a habit.

Image by Mike Mozart, via Flickr

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The Causes of Illness & Degenerative Diseases, Part 1: The Basis for Holistic Biological Medicine

By Gary M. Verigin, DDS, CTN

Nearly all of the patients we see first come to our office because they’ve read online about certain dental materials and procedures that may be contributing to their medical symptoms or diagnosed conditions.

Here are some of the most common issues that lead them to our door:

table of health complaints

The National Cancer Institute Dictionary of Cancer Terms defines biomedicine as

a system in which medical doctors and other healthcare professionals (such as nurses, pharmacists, and therapists) treat symptoms and diseases using drugs, radiation, or surgery. Also called allopathic medicine, conventional medicine, mainstream medicine, orthodox medicine, and Western medicine.

Doctors have spent hundreds of thousands of dollars and countless hours, blood, sweat, and tears in learning, studying, and practicing their various specialties. I am convinced that each truly and dearly wants to help their patients heal.

physicianYet the medicine they rely on too often lands them short of their goal.

For instance, it’s a well-known fact that not all drugs are safe or effective. But the problem goes deeper. Larry Dossey has noted that much conventional medicine has never been evaluated by its own professed “gold standard,” the double-blind, placebo-controlled trial. More recent research has confirmed this. Sanjaya Kumar and David B. Nash put the matter bluntly in their 2011 book Demand Better!:

We could accurately say, “Half of what physicians do is wrong,” or “Less than 20 percent of what physicians do has solid research to support it.” Although these claims sound absurd, they are solidly supported by research that is largely agreed upon by experts. Yet these claims are rarely discussed publicly. It would be political suicide for our public leaders to admit these truths and risk being branded as reactionary or radical. Most Americans wouldn’t believe them anyway. Dozens of stakeholders are continuously jockeying to promote their vested interests, making it difficult for anyone to summarize a complex and nuanced body of research in a way that cuts through the partisan fog and satisfies everyone’s agendas. That, too, is part of the problem.

* * *

The plain fact is that many clinical decisions made by physicians appear to be arbitrary, uncertain and variable. Reams of research point to the same finding: physicians looking at the same thing will disagree with each other, or even with themselves, from 10 percent to 50 percent of the time during virtually every aspect of the medical-care process—from taking a medical history to doing a physical examination, reading a laboratory test, performing a pathological diagnosis and recommending a treatment. Physician judgment is highly variable.

Of course, none of those treatments are risk-free.

The Nutrition Institute of America funded an independent review of “government-approved” medicine that was published in 2006. Professors Gary Null and Dorothy Smith, along with doctors Carolyn Dean, Martin Feldman and Debora Rasio titled the report “Death by Medicine.”

The researchers found that America’s leading cause of death isn’t heart disease or cancer: its conventional medicine. They found that the iatrogenic death rate in the US (death caused by doctors and/or medical treatments) is 783,936 a year. That’s 84,059 more deaths than those caused by heart disease in 2001 and 230,865 more deaths than those caused by cancer.

drugsOver a decade, the scientists predict that iatrogenic deaths will total about 7.8 million, “more than all the casualties from all the wars fought by the US throughout its entire history,” a death rate equivalent to that caused by six jumbo jets falling out of the sky every day.

They also believe the numbers are actually much higher because most iatrogenic deaths aren’t reported as such: only 5 to 20% of iatrogenic deaths are reported for fear of lawsuits and because codes for reporting deaths due to drug side effects and other medical errors don’t even exist in many cases. The number of deaths due to conventional medicine may be 20 times higher than the numbers depicted here. [emphasis in the original]

The dominant paradigm in orthodox medicine has focused on the suppression of symptoms. If a patient has symptoms of inflammation, they’re prescribed an anti-inflammatory drug. If they have symptoms of depression or anxiety, they are given antidepressants or anti-anxiety meds.

Symptoms are thus mistaken for disease itself. In reality, they’re the natural consequence of the disease process. Meanwhile, all those drugs merely generate more illness. Instead of teaching patients a better way of living, doctors give drugs that suppress one constellation of symptoms and create another. This, of course, gets labeled as a different disease.

What has actually happened: The acute illness has been driven deeper.

Treating Clients, Not Patients

Read the Wikipedia entry on naturopathy, and you get a highly biased definition, full of allegations of “quackery.” The authors incorrectly and unfairly contrast naturopathic medicine with “evidence-based medicine” – a move you can only make by disregarding huge portions of the scientific literature.

Yet as Christine Fleetwood, ND, RPh, notes in an excellent recent article in the Townsend Letter (Feb/Mar 2017), “both conventional medicine and the public are catching on” to the virtues of naturopathic medicine.

The Mayo Clinic Staff says: Complementary and alternative medicine has never been more popular. Nearly 40 percent of adults report using complementary and alternative medicine, also called CAM for short. Doctors embracing, too, often combining them with mainstream medical therapies-spawning the term integrative medicine.

Fleetwood goes on to eloquently elaborate that this paradigm is constantly changing as treatments undergo further testing. It encompasses the best of orthodox medicine, as well as mind-body medicine, energy medicine, homeopathy, naturopathy and more, melding the modern with ancient healing systems.

Well now I really like the company Naturopathy has been placed. We’re with “ancient practices” – 3000 year old Ayurvedic medicine and possibly older Chinese medicine-both of which are heavily steeped in philosophy. The practitioner must understand the philosophy behind the medicine in order to implement the medicine. Conventional medicine on the other hand – despite being the dominant paradigm – has no philosophical backing or belief system.

Whether you call it CAM or integrative or functional or biological medicine, the approach is the same: You don’t address the disease; you address the underlying causes of disease. In doing so, both the individual seeking help and the practitioner engage in a team-oriented partnership.

This is why the individual is often referred to as a client rather than a patient. A patient is passive, wanting the practitioner to tell them what to do. The client is active, turning to the practitioner for information, advice, and treatment.

symbols of health and wellnessWhere a conventional medical appointment might last 10 minutes tops (the current average is around 8 minutes), a consultation with a biologically-based practitioner can last hours. The practitioner needs plenty of time to truly listen to a client’s concerns and respond to their questions in an open learning environment. The value they place on caring, helping relationships that promote a positive, caring atmosphere helps clients define their personal health and lifestyle objectives.

Putting the client at the center, practitioners can discuss the interrelationships of the client’s physical, emotional, mental, and spiritual well-being – not to mention the interactions of lifestyle, genetics, and environmental influences and how these can influence long-term health and complex, chronic diseases.

But there’s another form of biological therapy that differs significantly from the other modalities mentioned above. My approach is called Bioregulatory Dental Medicine. And to grasp its basics, we’ll need to first take a journey through the basic principles of bodily regulation toward a steady state known as homeostasis.

And that’s a journey we will begin in the next installment of this series…

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Some Thoughts on Consumer Genetic Testing

human genomeEarlier this month, the FDA announced that 23andMe could go ahead and market its genetic testing for 10 health conditions. Naturally, the company’s CEO got right to celebrating in the media.”

“My hope is that 23andMe, by being less and less regulated, will enable more people to open their eyes to science,” said Wojcicki on Wednesday at Fortune’s Most Powerful Women Next Gen conference in Laguna, Nigel. She added that providing her customers with information about their genes can empower them to take a more active role in making decisions about their health.

* * *

“People really thrive when they actually are empowered,” she said, adding that roughly 40% or 50% of 23andMe’s customers have been prompted to make changes to their lifestyle or health habits due to what they’ve learned about their genes.

Unfortunately for her, objective analysis suggests otherwise. As a literature review in the BMJ put it,

Expectations that communicating DNA based risk estimates changes behaviour is not supported by existing evidence. These results do not support use of genetic testing or the search for risk-conferring gene variants for common complex diseases on the basis that they motivate risk-reducing behaviour.

Oops.

Beyond that, there’s a simple truth that – for once – did not seem completely lost in the hoopla: Genes are not destiny. They are potential. Whether and how they express is largely a matter of environmental factors and forces – epigenetics – and their impact on the extracellular matrix, or biological terrain. For instance, the LA Times reported,

“It is important that people understand that genetic risk is just one piece of the bigger puzzle,” Jeffrey Shuren, director of the FDA’s Center for Devices and Radiological Health, said in the statement.

One of the major worries with direct-to-consumer testing is that customers could interpret results as definitive answers, said Brent Fogel, associate professor of neurology and human genetics and director of the UCLA Neurogenetics Clinic. In the clinical world, he said, genetic risk is used only occasionally as supportive evidence.

Similarly, over at Futurity,

ACMGG president and geneticist Michael Watson told Scientific American that the testing will confuse many consumers who won’t know how to quantitatively balance genetic risk against other factors such as environmental influences, lifestyle, and health status. He also argues that consumers will probably want follow-up testing in cases where doctors wouldn’t necessarily order it — and insurance companies won’t pay for it…

Anyhow, here’s something we consider far more empowering than the FDA’s news…

Image by Webridge, via Wikimedia Commons

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New & Improved Root Canals? Yeah, Right

removing infected pulpEven endodontists will tell you, if they’re being honest, that root canal disinfection isn’t always effective. They’ll tell you that about 25% of all root canals fail due to infection by pathogens left in the canal before it’s filled and sealed off.

Actually, latent infection is far more common than that, but let’s give them that “25%” for the moment – a number they seem to have high hopes of lowering with a new technology that was the subject of a paper published earlier this year in the Journal of Dental Research.

The device seems somewhat similar to early caries and oral cancer detection tools in that it uses fluorescence to “detect minute amounts of residual live bacteria in the root canal space. Indeed, during trials the team were able to successfully detect bacterial cells after just three minutes of testing.”

So saith the press release.

“The resilient nature of bacteria, combined with often complex root canal structures, make disinfection challenging, leading to a considerable number of persistent infections. This is one of the main causes of root canal treatment failures”, explained Professor Francesco Mannocci, Professor of Endodontics from the Dental Institute at King’s College London.

“SafeRoot will reduce the time for root canal completion and will increase the success rate of treatments by letting the dentist know when it’s safe to proceed with filling the tooth. This should produce fewer acute ‘flair-ups’ [sic] and failed root treatments, as any residual infection in the root canal will be identified,” said Professor Tim Watson from the Dental Institute.

There’s just one problem. Bacteria and other pathogens don’t confine themselves – or their toxic waste products – to the root canals themselves, the physical structures that house the living pulp of a tooth. They’re free to venture into the microscopic tubules that make up the dentin, the layer of tissue between the pulp and enamel. It’s been estimated that there are up to three miles of these tubules in every tooth.

dentinal tubulesThose dentinal tubules are the perfect hiding place for pathogens. There’s no way to thoroughly and permanently disinfect them. Ozone can provide a temporary fix, but in general, the bacteria will become active again within a year or so. Protocols to keep the biological terrain healthy and robust become more important than ever.

Those pathogens that remain in the tubules are what make root canal teeth ultimately so problematic. Their highly toxic waste products wreak havoc with the mitochondria in your cells and, ultimately, the terrain. Research has shown systemic illness developing out of these conditions, including cancer.

To learn more about the reality of root canals, why we don’t recommend them, and what you can do if you suspect root canal teeth may be affecting your overall health, start here.

Root canal image by BruceBlaus, via Wikimedia Commons

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