I promised more about your medical and your financial teams and how to choose them in this month’s column. However, a headline in an embargo briefing for this week’s Journal of The American Medical Association caught my attention.

It was about: you wash your face, fix your hair, brush your teeth for two minutes after flossing, which you do after a 20-second brushing of your teeth (at least that’s how you should be doing it, while you practice balancing on one foot). The headline triggered this memory of the importance of preventing gum disease.

First, let’s summarize this JAMA article and the concept that periodontal disease causes considerable inflammation in the rest of your body. That inflammation increases your risk of dying of strokes and developing inflammation in your brain, causing mental dysfunction, even if no formal stroke occurs.

Dr. Charlie Hennekens told me during an interview that inflammation isn’t a bad thing. In fact, it’s a really good thing. When your body is injured, inflammation is part of your immune response, that is, your body’s healing mechanisms (like white blood cells) rush to an injured area to help repair it. When you get an infection, inflammation caused by the bacteria or viruses calls forth your immune cells, which attack those nasty bacteria and viruses. And then your immune cells commit suicide so they don’t keep attacking and destroying your own cells or organs. So in these cases when you’re injured, we want your body to act that way.

The problem occurs when acute inflammation (as is the case when healing an injury, whether internal or external) turns to chronic inflammation, that is, the immune response doesn’t shut off, and the immune cells don’t commit suicide. And when all of those cells go into fight and can’t turn off, that’s where you get swelling, pain, compromised organs and systems, and many processes that cause or contribute to other diseases and conditions, including autoimmune diseases.

So what causes inflammation? All kinds of things, such as certain foods, smoking, stress, obesity, and especially low levels of chronic infections. And the most common of these in humans is periodontal disease.

You may not “feel” this kind of internal, chronic inflammation per se (though it can be manifested through pain and conditions like arthritis). But make no mistake: Chronic inflammation, because it’s so pervasive and is linked to many health problems, from heart disease to cancer, may just be the largest biological enemy you have. So as Hennekens reported in the 1980s and now is well established, inflammation is intimately involved in the pathogenesis of atherosclerosis and is reflected in your blood by high sensitivity C-reactive protein (hs-CRP).

Another new study sheds light on how the presence of Streptococcus mutans, a cavity-causing bacteria, may increase your risk of hemorrhagic stroke. Professional cleanings can reduce not only bacteria, but also harmful inflammation, which also may contribute to the risk of the other type of strokes (ischemic or those associate with decreased blood flow) and brain dysfunction.

As to the toothpaste, the study, “Randomized Trial of Plaque Identifying Toothpaste: Dental Plaque and Inflammation,” found that Plaque HD, a plaque identifying toothpaste, significantly reduced dental plaque in the mouth and inflammation throughout the entire body.

Because it was a small study for a small time period, it needs repeating and a much longer study period. Only 61 healthy subjects ages 19 to 44 were randomized to use either Plaque HD (n=31) or placebo (n=30) for 60 days. People who used Plaque HD significantly reduced dental plaque when compared with the placebo toothpaste and had a significantly reduced hs-CRP (a measure of inflammation in your body) when compared with the placebo toothpaste.

So the action steps from today’s column are:

• Floss and brush daily and see a dental professional regularly

• Try standing on one leg (right on even days, left on odd days) while flossing if you have a spotter or a place where you cannot fall

• Look for more data on Plaque HD toothpaste


Dr. Michael Roizen writes about wellness for the Cleveland Jewish News. He is chief wellness officer and chair of the Wellness Institute at Cleveland Clinic.

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