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Healthy Mouth = Healthy Body

The mouth is a window into the health of the body. It can show signs of nutritional deficiencies or general infection.  The mouth is filled with countless bacteria, some linked to tooth decay and periodontal (gum) disease. Researchers have found that periodontitis (the advanced form of periodontal disease that can cause tooth loss) is linked with other health problems, such as cardiovascular disease, stroke and bacterial pneumonia.  Likewise, pregnant women with periodontitis may be at increased risk of delivering preterm and/or low-birth-weight infants.

Topics

  • Dentistry for Overall Health
  • Inflammation and Overall Health
  • Healthy Lifestyle and Healthy Mouth
  • Gingivitis
  • Beginning Periodontal disease
  • Advanced Periodontal disease
  • Periodontal disease and pregnancy
  • Periodontal disease and heart disease
  • Periodontal disease and arthritis
  • Periodontal disease and diabetes DONE
  • Metal free dentistry
  • Nickel free dentistry
  • Vitamin D and decay
  • Probiotic
  • Vitamin C
  • Vitamin D
  • Vitamin K
  • Vitamin B
  • Iron
  • Periodontal disease and Rheumatoid Arthritis
  • Importance of teeth for overall health
your immune system

Your Immune System, Chronic Inflammation and Autoimmune Conditions:  What it is and how is it related to our mouth?

What is an autoimmune related condition? Allergies, asthma, Rheumatoid Arthritis, Lupus, Psoriasis, Celiac Disease, Thyroid disease, Type 1 Diabetes, Inflammatory Bowel Disorder, Multiple sclerosis (MS) and Periodontal (Gum) Disease  are all autoimmune conditions, and at their roots they are connected by one central biochemical process: an overworked immune system response also known as systemic inflammation that results in a body attacking its own tissues.

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What is chronic inflammation and how does it lead to autoimmune disorders?

Inflammation is characterized as acute or chronic.  Acute inflammation is a normal and short-live physiologic response to injury, irritation, or infection that typically lasts minutes to days.  The physiologic processes responsible for acute inflammation lead to redness, swelling, heat, and pain at the affected site.

Chronic inflammation is a long-term physiologic response that lasts weeks or even years.  Chronic inflammation can be caused by environmental toxins, a microbial or viral infection, poor nutrition, stress, and processes related to aging.  Chronic inflammation is activated when the mechanisms of acute fail to stop infection or heal an injury.  Prolonged inflammation can generate a series of destructive reactions that damage cells, eventually leading to the clinical symptoms of disease.  Chronic inflammation occurs when the body’s immune system fails to maintain homeostasis.  Autoimmune conditions can develop when chronic inflammation remains in place and untreated.

Our Mouth and its relation to Chronic Inflammation: Periodontal Disease is a Chronic Inflammatory condition

Taking good care of your teeth and gums is not only about preventing cavities or bad breath.  The mouth is a window into the body.  The mouth can show signs of total body inflammation or distress.  Some of the most common manifestations of inflammation in a mouth are gingivitis and periodontal disease.

What is Periodontal Disease?

The term “periodontal” means “around the tooth.”  Periodontal disease (also known as periodontitis and gum disease) is a common inflammatory condition that affects the supporting and surrounding soft tissues of the tooth, eventually affecting the jawbone itself in the disease’s most advanced stages.

Periodontal disease is most often preceded by gingivitis which is a bacterial infection of the gum tissue.  A bacterial infection affects the gums when the toxins contained in plaque begin to irritate and inflame the gum tissues.  Once this bacterial infection colonizes in the gum pockets between the teeth, it becomes much more difficult to remove and treat.  Periodontal disease is a progressive condition that eventually leads to the destruction of the connective tissue and jawbone.  If left untreated, it can cause shifting teeth, loose teeth, and eventually tooth loss.

Check out this video:

perio chart graphic

Periodontal (Gum) Disease is a Chronic Inflammatory Condition

Periodontal Disease is a Chronic Inflammatory Condition.  Medical doctors consider gum disease an inflammatory condition that results in bone loss and eventually tooth loss.  Research has shown that periodontal disease is related to other inflammatory conditions such as rheumatoid arthritis, celiac disease, thyroid disease, heart disease, atherosclerosis, type I diabetes, and Alzheimer’s.

Periodontal disease is a form of chronic inflammation in the mouth that causes bone loss to occur.  Bone loss causes gums to recede and pockets to form between the teeth and gums.  These pockets trap tartar, plaque, and other debris that can lead to infection and abscesses.  Advanced gum disease is a leading cause of tooth loss in adults.

Gingivitis is an Acute Inflammatory Condition

Gingivitis is an acute inflammatory condition without bone loss and is caused by bacteria that live in bacterial biofilms, known as plaque.  Plaque is a sticky, colorless film that forms constantly on the teeth and tissues in the mouth.  The bacteria in plaque irritate the gums causing them to become red, tender, and more likely to bleed.  Gingivitis can be reversed if plaque is removed before it builds up.  Plaque can be removed by brushing twice a day, daily flossing, and having your teeth cleaned regularly in the dental office.  If gingivitis progresses, it can become periodontitis.

Do you have bleeding gums?  You have gingivitis and may be at risk for developing Periodontal Disease?

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Best Solutions for bleeding gums:

  • Get professional cleanings twice a year. This is the only way to remove plaque below your gum line that a toothbrush cannot reach
  • Eat a diet rich in omega-3 fatty acids, the kind found in fatty fish (herring, salmon, sardines, trout, tuna,) fish oil, and flaxseed. Those types of foods will help reduce inflamed and bleeding gums
  • Make sure you do not have periodontal disease.  If you do, you will need treatment for your gums.
  • Avoid stress as is has been linked to having bleeding gums
  • Take Vitamin C  and E at optimal levels to reduce risks or symptoms of active Periodontal disease
  • Drink water throughout the day to prevent dry mouth. Dry mouth leads to a reduction in salivary flow and causes an increase in odor-producing bacteria that can lead to bleeding gums
  • Use sugarless gum after meals. It has Xylitol, which can reduce bacteria and stimulate salivary flow, which helps to decrease bleeding gums.
  • Brush your tongue daily as it accumulates multiple bacteria that can lead to bleeding gums.
  • Brush twice a day
  • Use mouthwash approved by American Dental Association (ADA)
  • Floss Daily. Do not worry about your gums bleeding at first, this is quite common. After a few days of flossing, the bleeding gums should stop as your gums become healthier.
  • Take Probiotics
  • Swishing your mouth with coconut oil may be a more effective and a safer alternative to chemical mouthwashes, according to new research.  A study has proven for the first time that the oral use of coconut oil is effective in reducing plaque related to gingivitis, and Periodontal disease; a common form of inflammation in the gum tissue of the mouth that occurs in response to bacterial biofilms (known as plaque) adhering to the surfaces of the teeth and which can lead to more serious oral condition known as periodontal disease

How does coconut oil pulling work?

First, coconut oil is a well-known antimicrobial agent and may have direct antibacterial properties due to its lauric acid content. Second, oil pulling results in the emulsification of coconut oil which greatly increases its surface area and once formed on the surface of the teeth reduces plaque adhesion and bacterial aggregation.  According to the study, coconut oil produces a soap-like substance when the saliva mixes with the oil (a process known as saponification). This is also why coconut is used in soap-making.  According to the study, “The soaps produced with coconut oil can lather well and have an increased cleansing action. Lauric acid in coconut oil can easily react with sodium hydroxide in saliva during oil pulling to form sodium laureate, the main constituent of soap which might be responsible for the cleansing action and decreased plaque accumulation.”

oil pulling wellness post

Periodontal Disease and its connection to overall health

Research studies have shown that there is a strong association between periodontal disease and other chronic conditions such as diabetes, heart disease, pregnancy complications and respiratory disease.

Periodontal disease is characterized by chronic inflammation of the gum tissue, periodontal infection below the gum line and a presence of disease-causing bacteria in the oral region.  Halting the progression of periodontal disease and maintaining excellent standards of oral hygiene will not only reduce the risk of gum disease and bone loss, but also reduce the chances of developing other serious illnesses. Periodontal disease is the leading cause of tooth loss among adults in the developed world and should always be promptly treated.

Treatment for Periodontal Disease

The most common treatment for periodontal disease is Scaling and Root Planing.

In order to preserve the health of the gum tissue, the bacteria and calculus (tartar) which initially caused the infection, must be removed.  The gum pockets will be cleaned and treated with antibiotics as necessary to help alleviate the infection.  A prescription mouthwash may be incorporated into daily cleaning routines.

The goal of treating gum disease is to remove bacterial biofilms and promote reattachment of healthy gums to teeth.  Treatment of gum disease helps eliminate swelling, reduces infection, and stops bone loss.  Treatment for active periodontal disease consists of two appointments; one side of the mouth is addressed at each appointment.  Anesthetic is administered to ensure patient comfort.  A special ultrasonic instrument is used to remove bacteria beneath the gums and smooth the root of the tooth to help prevent bacteria from adhering to the tooth again.

toothache and inflammation

Causes of Periodontal Disease

Periodontal disease, which is also known as gum disease and periodontitis, is a progressive disease which, if left untreated, may result in tooth loss. Gum disease begins with the inflammation and irritation of the gingival tissues which surround and support the teeth.  The cause of this inflammation is the toxins found in plaque which cause an ongoing bacterial infection.

The bacterial infection colonizes in the gingival tissue and deep pockets form between the teeth and gums.  If treated promptly by a Periodontist, the effects of mild inflammation (known as gingivitis) are completely reversible.  However, if the bacterial infection is allowed to progress, periodontal disease begins to destroy the gums and the underlying jawbone, promoting tooth loss.  In some cases, the bacteria from this infection can travel to other areas of the body via the bloodstream.

covering mouth bad breath

How do I know if I have gum disease? Symptoms of gum disease include:

  • Bad breath that won’t go away
  • Red or swollen gums
  • Tender or bleeding gums
  • Painful chewing
  • Loose teeth
  • Sensitive teeth
  • Receding gums or longer appearing teeth

Gum Disease Risk Factors

The main cause of periodontal (gum) disease is plaque, but other factors affect the health of your gums.  

  • Age:  Studies indicate that older people have the highest rates of periodontal disease. Data from the Centers for Disease Control and Prevention indicates that over 70% of Americans 65 and older have periodontitis.
  • Smoking/Tobacco Use: Tobacco use is linked with many serious illnesses such as cancer, lung disease and heart disease, as well as numerous other health problems. Tobacco users also are at increased risk for periodontal disease. Studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.
  • Genetics: Research has indicated that some people may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be more likely to develop periodontal disease. Identifying these people with a genetic test before they even show signs of the disease and getting them into early intervention treatment may help them keep their teeth for a lifetime.
  • Stress: Stress is linked to many serious conditions such as hypertension, cancer, and numerous other health problems. Stress also is a risk factor for periodontal disease. Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal diseases.
  • Medications: Some drugs, such as oral contraceptives, antidepressants, and certain heart medicines, can affect your oral health. Just as you notify your pharmacist and other health care providers of all medicines you are taking and any changes in your overall health, you should also inform your dental care provider.
  • Clenching or Grinding Your Teeth: This can put excess force on the supporting tissues of the teeth and could speed up the rate at which these periodontal tissues are destroyed.

Other Systemic Diseases

Other systemic diseases that interfere with the body’s inflammatory system may worsen the condition of the gums. These include cardiovascular disease, diabetes, and rheumatoid arthritis.

Poor Nutrition and Obesity: 

A diet low in important nutrients can compromise the body’s immune system and make it harder for the body to fight off infection. Since periodontal disease begins as an infection, poor nutrition can worsen the condition of your gums.  In addition, research has shown that obesity may increase the risk of periodontal disease.

Taking care of overall health will help to keep Periodontal disease in remission. Periodontal disease is a serious condition that can warn dentists that Active Inflammation is happening which may not be limited to the mouth and your dental provider may refer you for a medical exam.

Dental providers may suggest additional lifestyle changes that may dramatically impact your overall health by decreasing overall Inflammation.

  • Stop smoking or Vaping. Tobacco use is a significant risk factor for development of periodontitis and increasing Overall Systemic Inflammation
  • Maintain a well-balanced diet. Eat foods rich with antioxidant properties, such as Vitamin E and Vitamin C.  Vitamin E-containing foods include vegetable oils, nuts, green leafy vegetables.  Vitamin C-containing foods include citrus fruits, broccoli and can help your body repair damaged tissue and to decrease Inflammation.
  • Eat a diet rich in omega-3 fatty acids, the kinds found in fatty fish (herring, salmon, sardines, trout, tuna,) fish oil, and flaxseed
  • Avoid eating processed foods.
  • Stop eating foods high in simple sugars, such as fructose.
  • Stop drinking soda or energy drinks
  • Take probiotics with multiple strains of beneficial bacteria
  • Take Vitamin C daily
  • Take Vitamin D daily
  • Eliminate any food that you may be sensitive to and it potentially creates inflammation in you, such as dairy or gluten containing  
  • Exercise regularly — it’s a natural anti-inflammatory.
  • Practice deep relaxation like yoga, deep breathing, biofeedback, or massage, because stress worsens the immune response.
  • Sleep at least 7-8 hours each night

Below are pictures showing connection of Periodontal disease to overall Health and stages of Progression of Periodontal Disease:

Periodontal Disease and Overall Health
stages of perio
perio x ray 1
perio xray

Periodontal Disease and Overall Health Problems

Periodontal Disease and Rheumatoid Arthritis:

Researchers continue to find strong links between periodontitis (gum disease) and rheumatoid arthritis (RA). In one study, people with RA were eight times more likely to get periodontitis than people without RA.  Another study found that people who had gum disease were more than twice as likely to develop RA as people without gum disease. What these and other studies suggest is a complicated, two- way relationship: RA may lead to gum disease.

hands stiff and painful

How Might RA Cause Periodontitis?

Periodontitis is a type of infection and inflammation that destroys the structures supporting your teeth. Symptoms of periodontitis include loose teeth and gums that are red, swollen, and bleed easily.  There’s no one-size-fits-all approach to treating RA. It’s important to work closely with your physician.  Periodontitis develops when the plaque that normally forms on your teeth spreads below your gum line. Plaque is a sticky film made up of bacteria, mucus, and food particles. The plaque build up between your teeth and gums causes the symptoms of periodontitis.

How Might Periodontitis Trigger RA?

Doctors think that RA is caused by a combination of the genes you’re born with and events in your life that trigger those genes to become active. Periodontitis may be one of those triggers.   Here are reasons why researchers think periodontitis may trigger RA:

  • The cells from your body’s defense system (immune system) that invade your mouth when you have periodontitis are similar to the cells that invade your joints when you have RA.
  • A specific bacteria is present when you have periodontitis and has been found to cause cell changes that can trigger an autoimmune reaction like RA. Periodontitis that begins early in life has been linked to diabetes, which is also an autoimmune disease.
diabetes and periodonal disease

DIABETES AND PERIODONTAL DISEASE. Tightly connected

Diabetic patients are more likely to develop periodontal disease which in turn can increase blood sugar and diabetic complications.  People with diabetes are more likely to have periodontal disease than people without diabetes, probably because people with diabetes are more susceptible to having overall chronic inflammation.  In fact, periodontal disease is often considered a complication of diabetes, as a result of chronic inflammation. Those people who don’t have their diabetes under control are especially at risk.  Research has suggested that the relationship between diabetes and periodontal disease goes both ways – periodontal disease may make it more difficult for people who have diabetes to control their blood sugar.  Severe periodontal disease can increase blood sugar, contributing to increased periods of time when the body functions with a high blood sugar. This puts people with diabetes at increased risk for diabetic complications.

What about Vitamin Deficiency and its signs in the mouth?

Vitamin B deficiencies are one of the most common deficiencies that can affect the mouth and teeth.  A common oral effect of vitamin B deficiency is a burning sensation in the mouth, especially on the tongue. People with this deficiency can also have trouble swallowing. The tongue may feel swollen. The tissue of the inner cheeks can be pale and may break apart easily and slough off.  B-vitamin deficiencies also can lead to anemia (too few red blood cells). Severe B12 deficiency can cause neurological problems such as numb or tingling limbs.  A deficiency in folic acid can also make your mouth feel like it’s burning. As with B12, a severe deficiency in folic acid can lead to numb or tingling limbs. Folic acid is crucial to fetal development as well. Not having enough of this vitamin during early pregnancy can increase the risk of having a baby with neural tube defects. These are defects of the brain, spinal cord or both.  Vitamin B deficiency also may increase your risk of:

  • Angular cheilitis — A painful inflammation and cracking in the corners of the mouth.  It usually is related to a fungal infection.
  • Recurrent aphthous stomatitis — Also known as recurring canker sores. Anemia, which can occur because of vitamin B deficiency, can increase your risk of these sores.
  • Chronic oral mucosal candidiasis — A fungal infection in the mouth. The Candida albicans fungus is found naturally in the mouth. It does not normally cause problems. However, poor nutrition or poor absorption of vitamins makes you more susceptible.

Atrophic glossitis — A condition that causes the taste buds to break down, making the tongue look “bald.” This condition affects the sense of taste. It can occur with a severe vitamin deficiency.

healthy food fish

Here are common Sources of B vitamins:

  • Thiamin (B1) — Pork, whole and enriched grains, legumes, nuts, dried beans
  • Riboflavin (B2) — Milk and milk products, eggs, liver, almonds, shellfish
  • Niacin (B3) — Protein-rich foods, meat, liver, poultry, fish, whole grains, peanuts
  • Pyroxidine (Vitamin B6) — Meat, poultry, fish, leafy green vegetables, bananas, whole grains, legumes, nuts, fruits
  • Cobalamin (B12) — Fish, meat, poultry, milk and milk products, eggs, fortified cereals
  • Folic acid (also called folate) — Leafy green vegetables, orange juice, legumes, broccoli, asparagus, fortified cereals, nuts
healthy food Iron

Iron

The effects of iron deficiency are similar to those of vitamin B deficiency:

  • Burning sensation in the mouth and tongue
  • Fungal infections in the mouth
  • Tongue redness and swelling
  • Sores and pale tissue in the mouth
  • Iron deficiency can be caused by a poor diet or by intestinal problems that reduce iron absorption. It also can result from regular blood loss, such as from heavy menstrual periods or internal bleeding. Iron deficiency can cause anemia.

Good sources of iron include:

  • Lean meat
  • Leafy green vegetables
  • Beans
  • Shellfish
  • Whole-grain bread
  • People with significant iron deficiency may have to take iron supplements.
healthy food tomatoes

Vitamin C

Vitamin C is also called ascorbic acid. This vitamin is needed to make collagen, the main building block for many tissues. This deficiency can lead to gums that bleed easily. Gingivitis, the earliest stage of gum disease, also can cause gums to bleed easily. Vitamin C deficiency may also cause fatigue and easy bruising.  Smoking depletes vitamin C in the body, so smokers need extra amounts of this vitamin.

Good sources of vitamin C include:

  • Citrus fruits
  • Dark green vegetables
  • Tomatoes
  • Strawberries
  • Peppers
  • Cantaloupe
healthy food sweet potato

Vitamin A

Vitamin A helps skin cells grow and maintain themselves. A lack of vitamin A can lead to delayed healing in the mouth.  Vitamin A can be stored in body fat, so high-dose supplements are not recommended. They can cause side effects such as joint pain, headache, diarrhea, fatigue, vomiting and liver damage.

Good sources of vitamin A include:

  • Fortified milk
  • Liver (chicken, beef)
  • Leafy green vegetables
  • Orange and yellow fruits and vegetables (such as apricots, cantaloupe, pumpkin, sweet potatoes and carrots)

Vitamin D

healthy food egg

Vitamin D works with calcium to maintain bone quality and strength. Deficiencies of this vitamin can lead to brittle bones. In the mouth, vitamin D deficiency can increase the risk of jaw fracture and periodontal disease. A deficiency early in life could affect the formation of teeth.  Sometimes people with kidney disease also have vitamin D deficiency.

The body will make its own vitamin D if it is exposed to sunlight for several minutes two or three times a week.

The vitamin is also found in:

  • Fish liver oils and fish
  • Fortified milk and milk products
  • Egg yolk
  • Some cereals
healthy food sprouts

Vitamin K

Vitamin K deficiency can affect the mouth. Normally, vitamin K is made by bacteria in your intestines. A vitamin K deficiency may be caused by liver disease, long-term antibiotic use or other disease(s). Poor diet is seldom the cause.  Vitamin K helps to make proteins that allow the blood to clot. A deficiency of vitamin K may cause easy bruising and slow healing.

People with vitamin K deficiency may have excessive bleeding after a tooth is extracted, or even after a tooth cleaning.

However, it also is found in foods, including:

  • Brussels sprouts
  • Green leafy vegetables
  • Broccoli
  • Eggs
  • Beef
antibiotics banner

Antibiotics / Probiotics / Dental and Overall Health.

How can antibiotics affect dental health? 

As many as 70 million Americans suffer from the digestive disorder, Gum disease, allergies, frequent colds. In many cases, it is difficult to connect indications directly with the digestive system, but that is where up to 80 % of the immune system lives.

Why is the gut so powerful? It is not the gut itself but rather its microbiome. The microbiome really operates as an organ; only it is not made of tissues in your body it is made up of trillions of microorganisms. The microbiome is our own body’s ecosystem and imbalance leads to a compromised immune system and for us, dental professionals, higher rates of Periodontal disease.

Check out this video:

Most patients are already severely deficient in probiotics. Most patients have low amounts of friendly bacteria due to it being destroyed by antibiotics in our food and prescribed ones, use of hand sanitizer and pesticides in our food, fluoride use, and chlorine in our water. Due to our daily environment, most people should be taking probiotics daily to avoid the over reactive immune system. For our patients with Periodontal disease or aggressive recurrent decay, probiotics are even more important than anything else we traditionally suggest, such as Listerine or Act Mouthwash.

Antibiotics can be life saving. Even when necessary, they dramatically alter gastrointestinal flora—the zoo of friendly and not-so-friendly bacteria that live in your gut and your mouth. Our mouth and GI are full of millions of bacteria; Did you know that by changing GI and Mouth biodiversity, we change inflammation markers in our GI and mouth?

Clostridium difficile (C. diff) commonly lives in the intestines, where it usually does little harm. When you take antibiotics, however, it may overgrow. This bacterium releases a powerful toxin that causes the lining of the colon to become inflamed and bleed. This, in turn, leads to horrible watery, often bloody diarrhea, which results in dehydration. The abdomen swells and is painful.

Probiotics help restore gut ecology during or after antibiotic treatment. They provide assistance through promoting cell receptor competition, encouraging healthy competition for nutrients, inhibiting the adherence of pathogens to the mucosal membrane, lowering colonic pH (a more acidic environment favoring the growth of nonpathogenic species), stimulation of immunity, and producing disease-reducing antimicrobial substances.

probiotics are best

Which Probiotics Are Best? Can probiotics help to improve dental health?

Though Saccharomyces boulardii is the best studied of probiotics for the treatment of GI side effects? Many common Lactobacillus strains are also effective. Probiotic formulas using multiple strains are more than twice as effective as single strain products.

Medical doctors typically prescribe a probiotic blend of Saccharomyces boulardii, Lactobacillus rhamnosus, Bifidobacterium bifidum, and Bifidobacterium breve. To be effective, very high doses of at least 15 billion units are necessary several times daily.

There is concern that gastric acid kills probiotics when taken orally. This is true, which is why large dosages are necessary and why they are best taken with food. A tougher strain, Lactobacillus sporogenes, also called Bacillus coagulans, is somewhat antibiotic-resistant and is also able to tolerate the acidity of the gastric environment, assuring that more probiotic bacteria reach the intestines.

Antibiotics, Periodontal Disease, Caries, Bad Breath- all lead to the shift of good versus bad bacteria in our mouth.

When bad bacteria is present and good bacteria is missing, patients have GI problems, uncontrolled Periodontal disease, caries or bad breath.

Here is a summary from a government site about Periodontal disease:

  • Probiotics are living microorganisms, principally bacteria that are safe for human consumption and have beneficial effects on human health.
  • Probiotic therapy is being considered for application in oral health due to the emergence of antibiotic-resistant bacteria.
  • Probiotics incorporated into dairy products neutralize acidic conditions in the mouth and interfere with cariogenic bacteria.
  • Patients with periodontal disease who used chewing gum or lozenges containing probiotics saw their periodontal status improve.
  • Probiotics in gargling solutions or gum inhibit the production of volatile sulfur compounds that contribute to bad breath.
probiotics found

Besides supplements, where can probiotics be found?

  • Fermented foods are naturally loaded with probiotics and are a must in any healthy diet. Some of the most beneficial probiotic foods include:
  • Kefir, a fermented dairy product
  • Sauerkraut, fermented cabbage (or other vegetables)
  • Kimchi, the Korean version of sauerkraut
  • Coconut kefir
  • Natto, Japanese fermented soybeans (provided that it is made traditionally with non- genetically modified soy.)
  • Beet and carrot kvass
  • Miso
  • Kombucha
  • Sauerrüben (lacto-fermented turnips) Fermented pickles
  • If you’re planning to buy commercially produced fermented foods, make sure that they haven’t been pasteurized – the pasteurization process does not differentiate between good and bad bacteria. It kills all of them and you’ll be left with a product that has no probiotic properties whatsoever.

What is a good probiotic and how to choose the best probiotic supplement?

Selecting a probiotic supplement can be overwhelming no thanks to the staggering number of brands available on the market. The following guidelines should make it easier for you to choose the supplement that will better meet your particular needs.

Here are some of the criteria a quality probiotic supplement should meet:

Look for those things in your probiotic:

  • The supplement should contain at least the three bacteria superstars.
  • The expiration date should be clearly stated on the packaging as they should be alive
  • The bacteria should be protected. They should be in a capsule and protected from stomach acid.  The supplement should contain at least the following three bacteria superstars:  
  1. Lactobacillus acidophilus or L.acidophilus – This is the most important strain of the Lactobacillus species and can be naturally found in the mouth, intestine and vagina.  These bacteria produce vitamin K and lactase. They also promote nutrient absorption and facilitate the digestion of dairy products.  
  2. Bifidobacterium longum or B.longum – These bacteria are commonly found in the digestive tract of adults where they produce anti-inflammatory substances that protect the gut’s lining.  These probiotics keep toxins and pathogens out of the gut.  
  3. Bifidobacterium bifidum or B.bifidum – Found in both the small and large intestines, these bacteria are necessary for optimal digestion.  If you can find a supplement that also contains two or three other strains (such as Lactobacillus rhamnosus, Lactobacillus bulgaricus, Lactobacillus plantarum, Lactobacillus casei, and Bifidobacterium breve), that would be even better.
  • The expiration date should be clearly stated on the packaging. For probiotics to improve your health they need to be alive when you ingest them. While this may sound obvious, keep in mind that if you purchase a product without a stated expiration date, you have no way of knowing if or how many of the healthy bacteria are still alive.  The expiration date of a probiotic product is determined based on formulation and stability tests. It informs you that bacteria in the supplement will remain alive and potent—at the levels indicated on the label—until that specified expiration date.
  • The bacteria should be protected. Did you know that stomach acid kills many of the good bacteria that enters your digestive tract?
Once they’ve left your stomach, about 80% of the remaining live bacterial cells will die before reaching your intestine?
Although several probiotic supplements claim to contain billions of active organisms per capsule, many of them actually deliver as little as 15 to 25% of live bacterial cells to your gut? To ensure that almost all the probiotics reach your intestine alive, choose a product that is microencapsulated. Microencapsulation encloses each fragile live bacteria in a lipid medium to protect them against oxygen, light, stomach acids and bile. What this implies is that this process promotes the survival of our bacterial allies not only on the shelf but through the harsh digestive milieu. In fact, research shows that if probiotics are microencapsulated, practically all of them will survive in the stomach. That’s because the lipid matrix surrounding the bacteria will only begin to dissolve in areas of the intestine where the pH is alkaline pH and not in the acidic environment of the stomach.

So, to get the most “bang for your buck”, select a product that contains various strains instead of focusing only on the number of CFUs. This being said, each capsule should contain at least 2 billion organisms from each strain so that you can reap the health benefits of each strain.

So how many CFUs should you look for in a probiotic?

At least 10 billion CFUs per serving (or 4 billion CFUs if microencapsulated).

What about yogurt? Doesn’t it contain probiotics?

Although many commercial yogurts claim to be made with active cultures, it is unlikely that you will benefit from these products. That’s because the milk used to make yogurt is usually pasteurized and often contains antibiotics. Some yogurt companies pasteurize their product after the cultures are added.  Adding sweeteners and flavors may reduce the probiotic properties of any live organism still present in the product.

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