Half of us will have 2 chronic diseases by 55.

Every time I pick up a new health book, I do the same thing before I read a page of it. 

I flip to the index and look for “oral health.” It’s never there.

I used to think that was a curriculum problem, something missing from dental school, or medical school, or the way specialties get siloed off from each other.

I’ve realized it’s far, far worse.

It’s actually a research gap.

I realized this while reading a landmark 2019 paper about inflammation.

This paper maps out everything we know about systemic chronic inflammation—the researchers call it “SCI” for short. 

SCI is the slow-burn inflammation behind heart disease, cancer, diabetes, dementia.

I want every person reading this newsletter to know how much SCI you’re carrying, because it is a major factor in both how long you live and how well you live for every year you’re alive.

As I’m reading this paper, written by some of the world’s most-cited immunologists and aging research scientists, I think to myself…

Surely, the mouth—one of the top contributors of inflammation—will be mentioned!

After all, gum disease is a chronic infection—the most common one. Add up all the inflamed, ulcerated tissue around the teeth in a mouth with gum disease, and you’d get an open wound roughly the size of your palm.

That wound leaks bacteria and inflammatory signals into your bloodstream every day, every time you chew or brush.

And yet…the mouth isn’t mentioned once in all 179 references in the paper.

That is a gargantuan blind spot…

Imagine: every doctor who reads this paper (perhaps even yours) walks away with, what they believe, is a complete picture of chronic disease.

Meanwhile, a dentist can see it, measure it, and probe it in your mouth in under two minutes.

Neither the dentist nor the doctor in this scenario are aware of the mouth’s contribution to SCI.

This is dangerous, for everyone’s health outcomes, because you can’t fix inflammation while ignoring one of its biggest sources.

This is not good medicine, nor is it good dentistry either. 

This is the question I’ve spent the last few years trying to answer, and it’s the spine of the book I’m writing now…

I believe the mouth is the biggest, most unattributed contributor to systemic inflammation there is, and the paper’s own logic proves it.

And yet the authors never even look into it.

A drug trial gave more than 10,000 heart attack survivors a medication that did one thing—blocked a single inflammatory protein, IL-1β. Their cholesterol never moved. Their heart attacks, strokes, and cardiovascular deaths still dropped. That’s proof inflammation itself is a cause of heart disease, not just a bystander.

Diabetes and gum disease run in a real, mapped, two-way loop: high blood sugar damages the gums directly, and gum inflammation makes blood sugar harder to control. Treat the periodontal disease, and clinical trials show a real improvement in HbA1c.

And periodontal bacteria have been found physically embedded inside atherosclerotic plaque—organisms that started in a gum pocket, detected in an artery wal

Most people can tell you their cholesterol. Almost nobody can tell you their SCI status, and the implications of not knowing are bigger than most people realize. 

By age 55, more than 50% OF people are living with two or more chronic diseases, usually starting with something like diabetes. Most of that is preventable if it’s caught early.

The tool to check it is simple, cheap, and increasingly something your doctor will already order: a blood test called high-sensitivity CRP. If it’s high, you’re already on a path toward one or two more chronic conditions. Imagine the power of knowing this number early so you can do something about it. 

So, what to do next if you don’t want to be one of the 50% of people living with two chronic health conditions? 

Know your SCI number, and make sure your dentist and your physician both know it too.

1. Ask your physician for a high-sensitivity CRP test once a year. This one number tells you whether your body is quietly inflamed right now, before anything else shows up.
2. Print the CRP Letter and bring it to that appointment. It’s free: askthedentist.com/crp-oral-health and it helps close the loop between what your physician knows and what your dentist knows.
3. Make sure your dentist is looking for periodontal inflammation. That means pocket depths and bleeding points, not just cavities. A drill-fill-bill practice often isn’t trained to do this. If yours isn’t, ask for a referral to a periodontist.
4. Ask the real question at both offices. Does your physician know what’s happening in your mouth? Does your dentist know what’s happening in your blood? Most of the time, neither one does. You, your dentist and your physician need to be on the same page.

Inflamed gums aren’t a flossing problem. They’re an ecosystem problem.

If your gums are inflamed, the fix isn’t just “floss more.” You have to correct the oral microbiome dysbiosis underneath. The point is never to wipe out the bacteria in your mouth. It’s to feed the right ones so they can do their job. You’re tending an ecosystem, not sterilizing a wound.

Dysbiosis starts with how you eat and breathe.

• Refined carbs feed the pathogenic species directly.
• A dry mouth loses saliva’s buffering and protective proteins. Then the pH swings acidic, which is where the bad actors thrive.
• Mouth breathing, whether it comes from a blocked airway or from habit, dries the mouth out chronically. It’s not just a sleep issue.
• Constant snacking never gives your microbiome time without food to recover. If you’re hungry again right after a meal, the meal itself was wrong: too many refined carbs, not enough real fat or protein. You can’t out-brush or out-floss a bad diet.

Then change what you put in your mouth…

• Drop anything with essential oils from your toothpaste and mouthwash. Those ingredients are broad-spectrum. They can’t tell harmful bacteria from beneficial ones, so they knock down the very microbiome you’re trying to protect. (Link to what I use)
• Floss every day, no exceptions. It’s the one habit that physically breaks up the biofilm before it matures into something that causes trouble. (Link to what I use)
• Replace mouthwash with oil pulling, and use MCT oil, not coconut oil. Coconut oil’s lauric acid is broad-spectrum. It’s mouthwash in a nicer bottle. MCT oil works differently: it gets into the biofilm and loosens the matrix that houses the oral microbiome, resetting it without wiping out the whole population the way an antiseptic rinse does. (Link to what I use)
• Drink green tea every day. The EGCG in it interferes with the enzymes S. mutans uses to build the sticky biofilm that anchors it to your enamel. No foothold, no cavities from that pathway, and it does this without disrupting the oral microbiome. (Link to what I drink)
• Take vitamin D3 with K2. D3 is one of the most reliable ways I know to bring systemic inflammation down. K2 makes sure the calcium your body mobilizes ends up in your bones, not your arteries. (Link to what I take)
• Feed your nitric oxide bacteria. I built an entire toothpaste line around one molecule: nitric oxide, or NO. NO is how your body lowers inflammation and relaxes blood vessels. It’s a gas, so it’s gone almost as fast as your body makes it. Around age 40, our ability to produce it drops off a cliff, and I think that decline is a real, under-appreciated reason people start aging faster in their 40s. The bacteria that make NO possible live on your tongue. They turn dietary nitrate into nitrite, and your body finishes the job by turning nitrite into NO. Most toothpastes do it backwards by harming this delicate ecosystem in the mouth. (Link)

I hope this is the push you needed to find out what’s really going on in your body, starting with your mouth.

To your health,
Dr. B

P.S. If you only do one thing from this letter, print the CRP Letter and bring it to your next physician visit.

Citations:
Furman, D., Campisi, J., Verdin, E., et al. (2019). Chronic inflammation in the etiology of disease across the life span. Nature Medicine, 25(12), 1822–1832.
Ridker, P.M., et al. (2017). Antiinflammatory therapy with canakinumab for atherosclerotic disease. New England Journal of Medicine, 377, 1119–1131.