Leaky Gut, Periodontal Disease, & Chronic Disease

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Leaky gut, periodontal disease, and chronic disease are important stuff… but not very exciting topics. Whatever I can do to enliven and perk up this discussion might make it more exciting and relevant to you.

If I could prove to you that your gut could cause periodontal disease, would that stir you? Probably not.

However, if I suggested that an unhealthy gut (leaky gut) could not only undermine your health but also could kill you, would that get your attention?

It should!

70% of all deaths in the US are caused by chronic diseases. Since periodontal disease is one of the first signs of the development of chronic diseases, it follows that the treatment of both periodontal disease and an unhealthy gut might save your life.

Now that should capture your attention.

Gut Function 101

The “gut” starts with the mouth. From there, the tube that extends from the mouth to the anus is continuous and has several names. It is called the digestive tract, gastrointestinal (GI) tract, or the alimentary canal.

Interestingly, all of the tissues that line this tube are affected in similar ways. What happens in the small and large intestines will affect the mouth, and what damages the mouth will affect the tissues of the small and large intestines.

This tube is the stage from which chronic disease begins.

The outer layer of the tube in the intestines is made up of a single layer of epithelial cells, which is the barrier between what is inside the tube and the rest of your body. This healthy barrier selectively allows nutrients from the tube to enter the bloodstream to feed the body’s cells.

Between the hollow space inside the tube (called the lumen) and this protective epithelial barrier is a mucus layer. The mucus layer is protective and works with your immune system. It reduces gut inflammation by decreasing the interaction between the living bacteria in the lumen and the intestinal epithelial cells.

These living microbes on the surface of the mucous layer and floating in the lumen of the digestive tract outnumber all your human cells making up your total body.

There are approximately 30 trillion human cells that make you who you are. But there are about 38 trillion microbial cells living in your gut which are critical for your survival.

These healthy “bugs” make up your gut microbiome and affect your metabolism, nutrition, physiology, and immune function.

When the gut microbiome is disturbed and when unhealthy microbes overgrow, a wide number of chronic diseases can (and do) result.

What happens when the gut and oral microbiota are out of control?

Unhealthy bacteria and other junk in the gut could damage the epithelial barrier. If the healthy barrier became damaged, then toxic elements could leak into your bloodstream.

This is called a leaky gut (or increased intestinal permeability).

Toxic elements leaking into your circulation could cause chronic inflammation and chronic disease. Gum disease is just one of those chronic diseases that can develop once the gut becomes unhealthy.

However — and this is vitally important — once periodontal disease exists, then it provides another major entry point for toxic junk to move into your body… a “leaky periodontal pocket”.

Both a leaky gut and a leaky periodontal pocket can and must be treated to prevent and treat chronic disease.

Don’t believe me? Here’s a shortlist of just some of the systemic diseases that are directly linked to intestinal permeability and oral microbiome or gut microbiome dysbiosis:

  1. Inflammatory bowel disease (Crohn’s disease and ulcerative colitis)
  2. Irritable bowel syndrome
  3. Esophageal and colorectal cancers
  4. Allergies
  5. Respiratory and other infections
  6. Chronic and acute inflammation
  7. Metabolic diseases (diabetes, heart disease, and others)
  8. Alzheimer’s disease
  9. Autoimmune diseases, such as rheumatoid arthritis and Celiac disease

Current Research on Leaky Gut, Periodontitis, & Chronic Disease

Medical research uncovers new information each year that proves that the gut, its garden of bacteria, and the mouth are essential parts of the chronic disease puzzle.

Connecting these groundbreaking “medical dots” of knowledge will allow healthcare professionals to develop efficient and effective treatment plans. New protocols can now be created to treat periodontal disease and other chronic diseases that affect overall health and longevity.

I’m going to summarize some of the cutting-edge science that is getting the attention of astute medical doctors and dentists.

In 2015, one study pointed out that damage to the gut actually would decrease the body’s ability to maintain a healthy immune system leading to the development of various chronic diseases.

A published review in 2018 described how a leaky gut could cause multiple sclerosis as well as other chronic diseases.

In 2017, researchers demonstrated that inflammatory bowel disease could cause periodontal disease, which you know now is a form of chronic disease.

Then in 2017, several medical clinicians reviewed the evidence that periodontal disease contributes to a higher risk of atherosclerosis.

Investigators in 2017 published their double-blind study in which individuals significantly improved their leaky gut by taking a spore-based probiotic for only 30 days without even changing their unhealthy eating lifestyles.

Earlier in 2016, a group of doctors showed how periodontal disease is a disease of mitochondrial dysfunction within specific cells in the gum tissues (called gingival fibroblasts). Mitochondria within human cells function like batteries to make energy for each cell.

Back in 2012, a research team reported that vitamin K2 could fix damaged mitochondria in fruit flies.

Finally, in 2018, a review article described how vitamin K2 exits the liver and then travels throughout the body to assist in various biological functions including the prevention of mitochondrial dysfunction.

Future Areas of Research

Here is where connecting these “medical dots” can benefit you.

It becomes abundantly clear to me that there is a relationship between gut dysbiosis and many chronic diseases affecting the majority of US adults.

Specifically, it appears that unhealthy bacteria in the gut could lead to a leaky gut. Then, a leaky gut might weaken the body’s immune system and, finally, cause damage to mitochondria throughout the body.

Damaged mitochondria would cause organ systems to fail just like weakened batteries in a flashlight would cause the flashlight to dim and then go out. Ultimately, the path starting from a leaky gut, especially paired with otherwise poor oral health, could cause the development of various chronic diseases (including chronic periodontitis).

This new knowledge might offer additional treatment regimens for periodontal disease. As I see it, spore-based probiotics could improve the healthy balance of gut bacteria and repair a damaged gut. In addition, vitamin K2 might prevent and repair damaged mitochondria.

Based on the research papers I just summarized, I wanted to investigate a new treatment to possibly prevent and heal periodontal disease by fixing a damaged gut. So, Andrew Campbell MD, John Abernethy MD, and I wrote a protocol to study my theory.

We submitted our Periodontal Disease Clinical Study to the “Institutional Review Board” (IRB) on 5/31/18.

Our study was approved by the IRB and is currently in clinical trials. Microbiome Labs has sponsored our research, which is double-blinded and involves approximately 20 individuals with active periodontal disease. There are two groups — a control group that receives a placebo and an experimental group that receives the supplement.

Neither the investigators performing the study, nor the participants, know if they are part of the placebo or supplement group. Participants will take the placebo or the supplement daily for 6 weeks. The supplement consists of 5 spore-based probiotics and vitamin K2.

To determine the potential benefits of this supplement, we are measuring the depths of infected gum pockets, bleeding in these pockets, the health of the participants’ mitochondria, and the overall garden of microbes in the mouth at the start of the study.

At the end of the 6-week study, we will repeat these measurements.

I project that there will be a reduction in pocket depth and bleeding as well as an improvement in the health of the mitochondria and the balance of the mouth microbiome.

If our work demonstrates significant benefits, then other investigators could repeat and elaborate on my research study. There might be far-reaching inferences that could be considered if our results are positive.

I’m excited to see where this study might go and how it might help prevent and treat other chronic diseases.

What can you do to support a healthy digestive system and good oral health?

Much of your long-term health as a human being depends on maintaining a healthy gut. Fortunately, your oral microbiome is also aided by many of the same practices that assist your gut!

Some of the most beneficial include:

  1. Maintaining good oral hygiene via biofilm management (brushing, flossing to rid teeth of stubborn food particles, oil pulling, etc.).
  2. Avoid mouthwash, which knocks out bad and good oral bacteria and contributes to dry mouth, tooth decay, and bleeding gums over time.
  3. Keep an eye on your gum health with your dentist and/or periodontist. This goes from gingivitis to advancing periodontitis.
  4. Support your gut health with spore-based probiotics, a diet rich in probiotic foods and low in processed foods and simple carbohydrates.

To be continued once the study is completed…

Dr. Al is the top nutritional periodontist in the world. He still works regularly with clients via online/telemedicine consultations. To schedule an online consult with Dr. Al, click here.

12 References

  1. Raghupathi, W., & Raghupathi, V. (2018). An empirical study of chronic diseases in the United States: a visual analytics approach to public health. International journal of environmental research and public health, 15(3), 431. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5876976/
  2. Pickard, J. M., Zeng, M. Y., Caruso, R., & Núñez, G. (2017). Gut microbiota: Role in pathogen colonization, immune responses, and inflammatory disease. Immunological reviews, 279(1), 70-89. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5657496/
  3. Bischoff, S. C., Barbara, G., Buurman, W., Ockhuizen, T., Schulzke, J. D., Serino, M., … & Wells, J. M. (2014). Intestinal permeability–a new target for disease prevention and therapy. BMC gastroenterology, 14(1), 189. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4253991/
  4. Dominy, S. S., Lynch, C., Ermini, F., Benedyk, M., Marczyk, A., Konradi, A., … & Holsinger, L. J. (2019). Porphyromonas gingivalis in Alzheimer’s disease brains: Evidence for disease causation and treatment with small-molecule inhibitors. Science advances, 5(1), eaau3333. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357742/
  5. Pabst, O., da Cunha, A. P., & Weiner, H. L. (2015). Mechanisms of oral tolerance to soluble protein antigens. In Mucosal Immunology (pp. 831-848). Academic Press. Abstract: https://www.sciencedirect.com/science/article/pii/B9780124158474000410
  6. Buscarinu, M. C., Romano, S., Mechelli, R., Umeton, R. P., Ferraldeschi, M., Fornasiero, A., … & Loizzo, N. D. (2018). Intestinal permeability in relapsing-remitting multiple sclerosis. Neurotherapeutics, 15(1), 68-74. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5794695/
  7. Figueredo, C. M., Martins, A. P., Lira-Junior, R., Menegat, J. B., Carvalho, A. T., Fischer, R. G., & Gustafsson, A. (2017). Activity of inflammatory bowel disease influences the expression of cytokines in gingival tissue. Cytokine, 95, 1-6. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/28189042
  8. Bale, B. F., Doneen, A. L., & Vigerust, D. J. (2017). High-risk periodontal pathogens contribute to the pathogenesis of atherosclerosis. Postgraduate medical journal, 93(1098), 215-220. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5520251/
  9. McFarlin, B. K., Henning, A. L., Bowman, E. M., Gary, M. A., & Carbajal, K. M. (2017). Oral spore-based probiotic supplementation was associated with reduced incidence of post-prandial dietary endotoxin, triglycerides, and disease risk biomarkers. World journal of gastrointestinal pathophysiology, 8(3), 117. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5561432/
  10. Li, X., Wang, X., Zheng, M., & Luan, Q. X. (2016). Mitochondrial reactive oxygen species mediate the lipopolysaccharide-induced pro-inflammatory response in human gingival fibroblasts. Experimental cell research, 347(1), 212-221. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/27515000
  11. Vos, M., Esposito, G., Edirisinghe, J. N., Vilain, S., Haddad, D. M., Slabbaert, J. R., … & Morais, V. A. (2012). Vitamin K2 is a mitochondrial electron carrier that rescues pink1 deficiency. Science, 336(6086), 1306-1310. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/22582012
  12. Ivanova, D., Zhelev, Z., Getsov, P., Nikolova, B., Aoki, I., Higashi, T., & Bakalova, R. (2018). Vitamin K: redox-modulation, prevention of mitochondrial dysfunction and anticancer effect. Redox biology, 16, 352-358. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5953218/

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