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Keeping a Healthy Smile

In my practice, there are two sorts of mechanical problems that can wreak havoc on good health. Theoretically, we have mechanical solutions for both of these problems, but the statistics don't lie and don't vary from what I've seen. These are two problems that severely compromise the quality of health at any age, they are just more likely with advancing age.

One is breaking a hip, and its adverse consequences are well known: the risk of death in some studies doubles in the twelve months following an injury, particularly in women in this study. The mortality rate is even higher in men, in this study at a rate three times that of an age-matched population. Osteoporosis develops later in most men, which may explain the difference. For women, osteoporosis starts to develop when estrogen levels decline in the peri-menopausal years. The only therapy I have seen restore bone in my practice is a combination of diet, supplements, and post-menopausal hormone replacement therapy.

The second mechanical problem of concern is that of tooth loss and dental health in general. We think of the health of our mouths as pertaining largely to dental hygiene and the work of our dentist, but the health of both teeth and gums correspond directly with our nutrition even more than our hygiene habits. To quote from a recent review on the topic,

Because having 20 teeth is considered necessary for functional dentition and chewing with removable dentures is at least 30% to 40% less efficient than chewing with natural teeth, persons with extensive or complete tooth loss are more likely to substitute easier-to-chew foods...

More chewable foods include soft sandwiches, cereals, soups (can be great nutrition!) and potatoes. Foods that disappear off a dental patient's plate include meat, particularly meat on the bone, salads, nuts, and fresh foods, both vegetables and fruits. Sweet foods are prioritized over savory and nutrition sorely suffers.

Securing Dental Health

In a brand new study, researchers have found a remarkable protective effect of estrogen on the health of bones, teeth, and gums in post-menopausal women. Women treated for osteoporosis with estrogen or estrogen and a progestin, in combination with calcium and vitamin D, were found to have greater attachment of their teeth, reflecting better health of jaw bones, gums and the teeth themselves. The treated group had about half the incidence of periodontal disease found in the untreated group. 

I would clarify several points for women who want to jump on this bandwagon:

  • Post menopausal estrogen therapy should be applied to the skin, safer than taken orally.
  • The safest "progestin" is bio-identical progesterone. Progestins such as "Provera" increase the risk of breast cancer.
  • Hormone levels should be monitored, and, in my opinion: estrogen metabolism should be evaluated and optimized.
  • Supplemental vitamin D should be accompanied by vitamin K2, either in abundant fermented foods or actual vitamin K2 as MK7, at 100-200 mcg daily.
  • The other benefits of the therapy are improved health of your brain (mood and cognition), breasts (less breast cancer), bowels (less colon cancer), sleep and bones in general. 
  • The main adverse considerations are the cost and nuisance of the treatment.
  • Another adverse consideration is that most doctors and consumers of mass media will assume you're giving yourself breast cancer by taking this treatment. You lower your risk with estrogen and progesterone. Risk is indeed increased with estrogen and a progestin, which has hogged the media spotlight!

I suppose that the corollary for male consideration would be optimal vitamin D and K2, adequate dietary calcium, and adequate--but not too high--levels of estradiol. 

I know my hair is graying, and skin will wrinkle, but I would certainly love to keep all my teeth healthy for as long as possible!