Pregnancy Gingivitis: Failure to Look for the Cause

A few days ago, I learned from a Crest ad that a large fraction of pregnant women, such as half, suffer from gingivitis (inflamed gums). It’s called pregnancy gingivitis. The ad recommended better dental hygiene, such as brushing your teeth more.

Thirty years from now will people think how could they [meaning us] have been that stupid? Faced with pregnancy gingivitis, they brushed their teeth more? Pregnancy gingivitis is supposedly due to “hormones” that increase during pregnancy. In other words, a health expert actually thinks — or claims to think — that pregnancy gingivitis has a different explanation than other gingivitis. Yet he doesn’t know what causes other gingivitis. For example, here is what Mayo Clinic experts say causes gingivitis. This makes no sense. But it is worse than most nonsense, since fetal health is at stake.

Several years ago, I greatly increased my flaxseed intake because I discovered it improved my balance. My gums suddenly went from red (inflamed) to pink (not inflamed), no doubt because flaxseed has lots of omega-3, which is anti-inflammatory. Gingivitis is — usually? always? — caused by too little omega-3.

My theory: pregnancy gingivitis happens because pregnant women need more omega-3 than usual. A growing brain needs lots of omega-3.  If this theory turns out to be true, the gums of pregnant women should be monitored to make sure they are getting enough omega-3. Nowadays pregnant women are given omega-3 to take but there is no test to make sure it is enough. That pregnancy gingivitis is common suggests it often isn’t enough. Actually, everyone’s gums should be checked to make sure they are getting enough omega-3.

Better Balance and Gums From Flaxseed Oil

When I took flaxseed oil capsules for reasons connected with the Shangri-La Diet, I noticed, to my surprise, that my balance improved. The next time I saw my dentist, he told me that my gums were much better. A reader of this blog named Chuck Currie has noticed the same things.

I ran across a reference to your book again which led me to your website. And, like I said, from there to Mark Sisson and all the rest.

I had already ran across information about flax oil and cholesterol and heart health. So I started taking two tablespoons a day [of flaxseed oil] – morning and night. I noticed my balance improvement while doing yoga, but thought it was due to practice. After reading several paleo blogs, I switched to fish oil – one table spoon a day in the morning. Then after reading some other studies regarding possible negative effects of over-consumption of fish oil, I stopped that also.

During this time I really became a strict paleo/primal eater and exerciser. No carbs other than leafy greens and non-starchy vegs. No more chronic cardio. Stopped swimming due to shoulder issues. Started using kettlebells and body weight tabata exercise. Went back and forth on supplementation. My weight dropped to below 120. [He’s 5 feet 8 inches tall.]

I was getting totally confused on what was legit and what was BS. Sure I lost weight, but I must have looked sick because people were asking if I was all right. I think they thought I had cancer or AIDS. I felt great though. No more 2 o’clock naps and I slept great. Then I read Kurt Harris’s 2.0 blog and that set me straight – and straight back to your blog.

It made me think, OK what works on the individual level, not the hypothesis level. I had also noticed that my balance had deteriorated (I thought it was because I stopped doing yoga) and my gums were bleeding again – I had forgotten that they had stopped bleeding. [After he switched from flaxseed oil to fish oil, his balance slowly got worse.] Sort of back to basics. Sun, lots of it, or D3 – 10,000 units (I am sitting in the sun as I type this on my iPhone). Omega 3 – your posts about flax oil made sense – [sudden release of short-chain omega-3 causes] slow release [of long-chain omega-3] – and is more sustainable than cold water fish and fish oil. Magnesium at night for better sleep and muscle cramps. (when I first went full paleo, I suffered from terrible leg cramps during the night until I found magnesium). And extra butter – beyond cooking with it.

I tested the flax/balance question by continuing to not practice yoga or any other balancing exercises and [measure my balance] just using my ability to wash my feet in the shower without leaning against the wall – which had been my normal habit before my first improvement and then again when it went away. After about a week – perfect balance – both washing and drying my feet. Also, no gum bleeding. So as some would say, “the shit works”.

[He added later:] I can definitely say, with a high degree of confidence, that my balance is not as good when taking fish oil as it is when taking flax oil. Fish oil does provide a small improvement over not supplementing any omega-3. But the big improvement comes with flax oil.

Flaxseed Lowers Blood Pressure

A new study found that ground flaxseed powerfully lowers blood pressure:

A patient population with peripheral artery disease (PAD) was selected as ideal to benefit from dietary flaxseed. . . . Patients received 30g of milled flaxseed (or placebo) each day over 6 months. [I eat  50 g/day — Seth] . . . No significant adverse events were associated with flaxseed ingestion. . . . SBP in the placebo group increased by ~3 mmHg and DBP remained the same over the experimental period. However, SBP levels were ~10 mmHg lower (P<0.04) and DBP was ~8 mmHg lower (P<0.004) in the flax group compared to placebo. In the flaxseed group, patients with a SBP <140 mmHg at baseline did not receive an anti-hypertensive effect but patients who entered the trial with a SBP > 140 mmHg at baseline obtained a sustained and significant 15 and 7 mmHg reduction in SBP and DBP, respectively, during the six months. . . . one of the most potent anti-hypertensive effects ever observed by a dietary intervention.

This supports my belief that we can improve our overall health by trying to improve our brains (which are more sensitive than the rest of the body). I have blogged about flaxseed oil many times. I became interested in it when I noticed it improved my balance. Balance measurements showed that the optimal dose  (2-4 T/day) was higher than flaxseed oil manufacturers suggested.  Then I and others noticed that taking this amount of flaxseed oil produced big improvements in gum health. Tyler Cowen, for example, no longer needed gum surgery. Go home, said the surgeon.

Thanks to Grace Liu.

My Dental Exam: Good Gums

A week ago I had my teeth cleaned. So dirty! said the dental hygienist. This wasn’t surprising. Because I am in China a lot, I get my teeth cleaned only twice per year. Long ago they got dirty so fast my dentist insisted on four cleanings per year. “But aren’t my gums okay?” I asked the hygienist. They felt okay. Not tender. They did’t bleed when I flossed (which wasn’t often). No, she said. You have pockets of 5 (= 5 mm depth). There is bleeding. Indeed, when I washed out my mouth with water at the end, there was some blood.

Yesterday I had my teeth examined. The hygienist was wrong. Almost all my pockets were 2’s, with a few 3s. That’s very good and a vast improvement from the 4s and 5s I had before I became a big fan of flaxseed oil. My gums improved exactly when I started drinking flaxseed oil, no doubt because the omega-3 in flaxseed oil reduces inflammation. My gums were fine in spite of all the plaque — which is supposed to make gums bad. Apparently the hygienist was so devoted to her theory (lots of plaque = bad gums) that she failed to see an exception she stared at for 30 minutes.

There is a well-established correlation between gum disease and heart disease (more gum disease, more heart disease), probably because both are caused by inflammation. So good gums is very good news — it shows I am doing a good job of reducing inflammation throughout my body. These results also support two of my pet theories:

1. Studying what foods make the brain work best is a good way to improve overall health. I started studying flaxseed oil, and how much to take, because I discovered by accident that it improved my balance. Experiments (what is the effect of flaxseed oil on my balance?) soon showed the optimum amount/day was more than flaxseed oil makers recommended! Before I started eating lots of butter, the optimum for me was about 3 tablespoons/day. After I started eating lots of butter, the optimum seems to have gone down to 2 tablespoons/day. Gum improvement seems to be easy to notice at about 1 tablespoon/day.

2. Our health care system fails to get the simplest things right. Omega-3 is not a mysterious nutrient. It has been shown to improve health in thousands of studies. It is well-known that it is anti-inflammatory. It is also well-known that too much inflammation is a major problem. Even so, our health care system has failed to grasp that a large fraction of the population eats too little omega-3 and this has an easy fix. Other examples of failure to get the simplest things right include gastroenterologists not realizing that digestive problems may be caused by food, dermatologists not realizing that acne may be caused by food, and everyone not realizing that cutting off part of the immune system (tonsillectomies) is a terrible idea.

What other simple things does our health care system get wrong?

Flaxseed Oil and Gum Disease: Still More Success

The following comment was left a few days ago:

I was doing SLD using flax seed oil for two weeks before my last dental appointment.  My pockets that were 4’s and 5″s magically changed to 2’s and 3″s.  I had my dentist print both the reports because I was so grateful that they stopped talking about some really painful sounding root work.  My brushing and flossing were totally unchanged.  I was expecting the result because of what I’ve read on the blog, but nothing this good.  I am convinced that taking flax=reduction in gum inflammation, at the very least. [emphasis added]

Take that, “decline effect” (big experimental effects, when the experiment is repeated, get smaller)!

The  commenter sent me the records of the two cleanings. At the pre-flaxseed-oil cleaning (April 28, 2011), he had 24 sites (13 teeth) with pockets of depth 4 or 5. At the cleaning after he started flaxseed oil (July 28, 2011), he had no sites with pockets of depth 4 or 5.

You can find many similar reports here.

Flaxseed Oil Heals Bleeding Gums, Again

In response to this post, which went up three months ago, a reader named Tara has just written:

I started taking 2 TB of flax oil daily about four days ago and now my gums are barely bleeding at all after I brush and floss. My gums were red, swollen and would bleed after I brushed and flossed and are now pink and healthy looking.

I’ve had this problem for years and I could not understand why it would keep happening even though I was consistent with my dental routine. I take the berry flavored Barlean’s flax oil mainly because it tastes good and so I look forward to taking it- if it was gross I would not be consistent with taking it.

Anyhow, thanks for the information! I wish dentists would look into this but they probably won’t so I’m glad that you do.

I agree about the Barlean’s, by the way. Their Omega Swirl flaxseed oil does taste good. The Omega Swirl webpage does not list healthy gums as one of its benefits. Instead it lists a bunch of benefits, such as “Heart Health” that are nearly impossible to verify.

Someone recently told me something fascinating about flaxseed oil: It made it much easier to kneel on the floor.  Before he started taking it, his knees would hurt after a few seconds. Now they don’t. I don’t remember my knees hurting quickly but I consume 66 g/day of ground flaxseed (= about 2 T flaxseed oil) and can kneel without pain for minutes.

The tiny fact reflected in Tara’s comment — an easily-available supplement (flaxseed oil) quickly cures a common problem (bleeding gums) but hardly anyone knows this — is  a devastating comment on our health care system.

1. Dentists haven’t managed to figure this out. Flaxseed oil is not an obscure supplement. Dentists are not making money giving people much worse advice (“floss regularly”).

2. Nutrition professors haven’t managed to figure this out. Omega-3 is not an obscure nutrient. Nevertheless, the 2010 USDA Dietary Guidelines says omega-3 fats are “essential” but says nothing about how much you need. Inflammation is believed to be the cause of many diseases, including heart disease. By getting this one thing  (minimum omega-3 intake you need to be healthy) right, the USDA could do a world of good. Instead they tell people to eat less animal fat (“consume less than 10 percent of calories from saturated fatty acids”).

To be fair, professional researchers are starting to figure this out.  A 2010 study of 9000 people found that “participants in the middle and upper third for omega-3 fatty acid consumption were between 23 percent and 30 percent less likely to have gum disease than those who consumed the least amount of omega-3 fatty acids.” With the right dose, I believe gum disease becomes 100% less likely. But at least they noticed a connection.


Flaxseed Oil Cures Bleeding Gums in Three Days

I am pleased by these results:

After a possibly overzealous dentist told me I need a gum graft [which may cost $3000], my husband encouraged me to start taking flaxseed oil. A few people online have reported that flaxseed oil dramatically improved their gum health, and we figured it was worth a shot.

My initial dose of flaxseed oil was two tablespoons a day, and my gums stopped bleeding and hurting within three days. This is pretty huge for me, because my gums have been bleeding since I was in junior high. [Emphasis added.] At the same time, I added using a Sonicare toothbrush and flossing a little more vigorously. Considering that I had tried these things in the past without the flaxseed oil and they only made me bleed more, I feel like the flaxseed oil is the difference maker.

I have subsequently reduced my flaxseed oil dose to one tablespoon, which I feel is more appropriate for a woman my size. I haven’t gained any weight from the flaxseed oil, which was a bit of a surprise. Taking it in the morning seems to help curb my appetite by at least the 130 calories it consumes.

The online reports she mentions are from this blog. A recap: Because of the Shangri-La Diet, one evening I took four or five flaxseed oil capsules. The next morning, I was surprised to notice that putting on my shoes standing up, which I’d done hundreds of times, was much easier than usual. This suggested that the flaxseed oil had improved my balance. I started to carefully measure my balance and varied my flaxseed oil intake. My measurements showed that variations in amount of flaxseed oil really did affect my balance. They also suggested the best dose. My balance improved up to a dose of 3 tablespoons/day of flaxseed oil. So the best dose was about 3 tablespoons per day. I blogged about this.

Tyler Cowen, inspired by my results, started taking 2 tablespoons/day. A month later, he no longer needed gum surgery. Knowing nothing about my flaxseed oil intake or Tyler Cowen’s results, my dentist told me my gums were in excellent shape, better than ever. My sister’s gums showed similar improvement. Tucker Max noticed his gums stopped bleeding after he started taking flaxseed oil. He’d had bleeding gums most of his adult life. Nothing else had helped. He also found training injuries healed faster. When he stopped drinking flaxseed oil, his gums soon got worse. Carl Willat noticed dramatic gum improvement. Joyce Cohen had excellent results (her gums were “in great shape — better than ever”). Tim Beneke and Jack Rusher had similar results. Gary Wolf, on the other hand, didn’t like the mental effects. A recent epidemiological study found a weak correlation between inflamed gums and omega-3 intake.

What have I learned? Above all, that such a pattern of results is possible. These results suggest there was/is a big hole in the usual nutritional ideas. Tyler Cowen, me, my sister, etc., were eating a conventionally “good diet” yet there was a lot of room for improvement, both in brain function and overall inflammation level. (I’m sure flaxseed oil heals gums because it reduces inflammation.) And improvement wasn’t hard — there was a simple fix. In other words, omega-3 deficiency is very common. The conventional deficiency diseases, such as scurvy and pellagra, were/are rare. They appeared only under extreme conditions with very limited diets (e.g., prison, long sea voyage). Yet just as scurvy and pellagra are easily cured, there is a simple cure for omega-3 deficiency: about 2 tablespoons/day of flaxseed oil. (Perhaps ground flaxseed is an even better source.)

Other facts support the idea of widespread omega-3 deficiency. When gums are very red, and bleed very easily, it’s called gingivitis. According to this article, ” estimates of the general prevalence of adult gingivitis vary from approximately 50 to 100%”. Heart disease is common. There’s plenty of evidence that heart disease is caused by inflammation (gated). For example, it’s well-known that inflamed gums correlate with heart disease. Statins may reduce heart disease — to the mild extent they do — because they reduce inflammation.

I also learned that psychology can help improve general health (too much inflammation causes all sorts of problems, as Tucker Max’s experience suggests). My background in experimental psychology made it easy for me to measure balance.  I also found other mental tests were sensitive to flaxseed oil. These mental tests were like an animal model in the sense that they made helpful experiments (e.g., different doses) much easier. My friend Kenneth Carpenter, in his book about the discovery of Vitamin C (gated), stressed the importance of an animal model of scurvy. Once the best dose of flaxseed oil (for me) was known, it turned out to be easy to take a dose that produced dramatic improvement (in others).

The idea that psychology and self-experimentation can improve overall health is new. I presented my flaxseed oil results at a meeting of the Psychonomic Society a few years ago. After my talk, one member of the audience, a professor of psychology at Illinois State University, angrily complained that my talk was “pop culture” — not even pop psychology — and said I shouldn’t have been allowed to speak. He thought I had made elementary mistakes.

Flaxseed oil better than fish oil. Bad results of flaxseed oil.

Root Planing Cancelled

My friend Carl Willat writes:

Last June I went to the dentist for a checkup and cleaning, fully expecting my gums to be in great shape since I had been diligently using my Braun Oral B electric toothbrush.  To my surprise and disappointment the hygienist told me the pockets had actually become deeper and that she was seeing bleeding in many places, to the point where she was recommending I have my roots planed, a painful and expensive procedure I had undergone once before many years ago. So of course I went home and started taking the flax seed oil and ground flax seed [“a couple of tablespoons a day of oil, plus random amounts of ground flax seed”] as you had recommended.  I also started using a Sonicare toothbrush at that point so it’s hard to figure out the degree to which either variable might be responsible, but today she said my gums were much better, and had hardly bled at all during the measurement of the pockets. All talk of root planing was forgotten.

According to this, root planing costs $400-$1600. After Tyler Cowen started drinking flaxseed oil (2 T/day), he no longer needed gum surgery.

It is hard to get well-preserved flaxseed oil in Beijing (it goes bad at room temperature) so I now take 66 g/day ground flaxseed instead of 2 T/day flaxseed oil. I add it to yogurt twice/day. I don’t know if ground flaxseed is healthier or less healthy than flaxseed oil but it is much less trouble. Preservation is no problem (flaxseeds can be stored at room temperature) and ground flaxseed requires zero willpower to eat with yogurt. I had to push myself a little to drink the oil.

Periodontitis and Omega-3

A few years ago, after I started taking about 3 tablespoons/day of flaxseed oil, my dentist told me my gums were much healthier. They were less red, more pink. Friends and blog readers who took flaxseed oil in similar amounts noticed the same thing. Tyler Cowen’s gums improved so much he no longer needed gum surgery.

An epidemiological study in the November Journal of the American Dietetic Association reports correlations between omega-3 intake and periodontitis (an extreme form of inflamed gums). The more omega-3, the less periodontitis. I’m sure that sufficient omega-3 intake cures periodontitis so this study has methodological interest for me. One interesting point is that the study reached a correct conclusion — contrary to the nihilism of John Ioannidis. Another is that the correlations were weak. The risk of periodontitis was only 20% lower in the group (quintile?) with the highest omega-3 intake. Although there were 9000 subjects, there was no significant correlation with linolenic acid, the form of omega-3 found in flaxseed oil.

Thanks to Sean Curley.

Omega-3 and Dental Health (revisited)

A few years ago I learned that flaxseed oil improved my gums and other people’s — especially Tyler Cowen’s. A few months ago I went to Beijing for two months. Toward the end of the visit my gums would bleed when I’d use a toothpick. Yet I was drinking 3 tablespoons of flaxseed oil every day, just like in Berkeley. Continue reading “Omega-3 and Dental Health (revisited)”

More about the Effects of Flaxseed Oil

Commenting on an earlier post, Jack Rusher reports:

Like Anonymous, I’m an MMA [Mixed Martial Arts] enthusiast. My experience with 3 T/day of flaxseed oil have been more or less identical to his. Before: high doses of NSAIDs [non-steroidal anti-inflammatory drugs] just to survive training, constant soreness and fatigue, etc. After: no joint pain at all, complete discontinuation of NSAIDs, lower frequency and severity of injury.
Dental results: my hygienist made strong comments regarding the improvement of my gums on my first post-flax visit, attributing it to changes in my oral care behavior . . . of which there were none.

How Could They Know? The Case of Healthy Gums

During my last dental exam, a month ago, I was told my gums were in excellent shape. Clearly better than my previous visit. The obvious difference between the two visits is that I now eat lots of fermented food. At the previous visit, my gums were in better shape than a few years ago. They suddenly improved when I started drinking a few tablespoons of flaxseed oil every day. Tyler Cowen is the poster child for that effect. After a lifetime of being told to brush and floss more — which I did, and which helped a little but not a lot — it now turns out, at least for me, that the secret of healthy gums is: 1. Eat fermented foods. 2. Consume omega-3. These two guidelines are not only a lot easier than frequent brushing and flossing but have a lot of other benefits, unlike brushing and flossing.

Dentistry is ancient and there are millions of dentists, but apparently the profession has never figured this out. This isn’t surprising — how could they figure it out? — but it is an example of a general truth about how things get better. (Or why they don’t get better — if only dentists and dental-school professors are allowed to do dental research.) In The Economy of Cities, Jane Jacobs makes this point. For a long time, Jacobs says, farming was a low-yield profession. Then crop rotation schemes, tractors, cheap fertilizer, high-yield seeds, and dozens of other labor-saving yield-increasing inventions came along. Farmers didn’t invent tractors. They didn’t invent any of the improvements. They were busy farming. Just as dentists are busy doing dentistry and dental-school professors are busy studying conventional ways of improving gum health.

Jacobs also writes about the sterility of large organizations — their inability to come up with new goods and services. On the face of it, large organizations, such as large companies, are powerful. Yes, they can be efficient but they can’t be creative, due to what Jacobs calls “the infertility of captive divisions of labor.” In a large organization, you get paid for doing X. You can’t start doing X+Y, where Y is helpful to another part of the company, because you don’t get paid for doing Y. A nutrition professor might become aware of the anti-inflammatory effects of flaxseed oil but wouldn’t study its effects on gum health. That’s not what nutrition professors do. So neither dentists nor dental-school professors nor nutrition professors could discover the effects I discovered. They were trapped by organizational lines, by divisions of labor, that I was free of.


Hire a San Diego orthodontist for advanced dental procedures.

Omega-3: What Happens When You Stop?

Tucker Max wrote again, with new data:

I started taking two tablespoons of flax seed oil about a month after reading this post by you [about Tyler Cowen’s dental experience] (sometime around the beginning of August, I think). I decided to try it because I have had bleeding gums for about as long as I can remember. This has always confused me, because I don’t have any cavities and have otherwise good dental health. I would always ask my dentists about this, and they would always tell me I didn’t floss enough, but even when I would floss regularly, the bleeding wouldn’t totally stop. After about a week or so of two tablespoons of flax seed oil a day, I had virtually no gum bleeding. I didn’t change anything else.

Then, about two weeks ago, my girlfriend pointed something out to me: I was not taking pain relievers anymore. I train in amateur mixed martial arts (MMA), which is a very intense, full contact combat sport that combines boxing, muay thai, brazilian jiu-jitsu, and wrestling. For as long as I’ve been training in it, I have had to deal with muscle soreness and pain in my joints, and to deal with it, I would take 4-6 ibuprofen before training. But, for about the past three months, I wasn’t in enough pain to need it. I didn’t really think about it at first, just chalking it up to getting tougher. But that doesn’t make sense–I’ve been training in MMA for well over a year, and the only thing I have done differently in the past three months is start taking flax seed oil. I wasn’t 100% sure that the flax seed oil was making the difference, but considering the effect it has on inflammation–which is what ibuprofen is for–it made sense.

That was when I sent you the emails you posted. One of your commenters accused me of falling victim to the placebo effect, so I decided to test it. I stopped taking flaxseed oil on November 5th. At the time, my gums were not bleeding, I had no joint pain or soreness of any significance, and I felt great overall.

As I write this it’s November 15th. My gums have bled heavily when I brushed this week, especially the past few days, and I have intense pain in both shoulders, soreness in my left elbow, and my knees are throbbing. I had intended to go two weeks without taking any flaxseed oil, but I am stopping the experiment now because this is all the proof I need.

One more interesting fact: I took four tablespoons a few hours ago, instead of the regular two, thinking that maybe I could load up and it might help me get back to normal quickly. The pain is pretty much the same, and I just brushed and my gums bled, so obviously the flaxseed oil takes more than a few hours to affect those problems. But–and I haven’t measured this with reaction tests like you do–I feel considerably more mentally alert right now. I don’t know if I felt like this before, and maybe I didn’t notice it because it came on slowly, or maybe I need four tablespoons at once to see a difference, but I really do feel the difference.

Omega-3 and Dental Health (even more)

Tucker Max wrote again:

I started taking the flaxseed oil when I saw your post about Tyler Cowen not having to get gum surgery because he was taking it. I have had bleeding gums etc for most of my adult life, and nothing has ever made them better so I tried flaxseed oil. Worked great.

Tyler’s experience. My experience. Joyce Cohen’s. Tim Beneke’s.

Joyce Cohen Gets Her Teeth Cleaned

A few months ago, Joyce Cohen, who writes The Hunt column for the NY Times Real Estate section, started drinking 2 tablespoons of flaxseed oil every day. She began after talking with me and because of stuff posted here. Yesterday she went to the dentist for the first time since she started drinking it.

“Jane the hygienist said my gums were in great shape — better than ever,” she wrote me. Meaning the best they’d ever been.

“What’s funny is you can’t FEEL good gums from inside your mouth, but I take her word for it.” The hygienist said that although she was scraping and scraping, there was no bleeding.

Joyce started with Spectrum Organic flaxseed oil without lignans but later switched to the oil with lignans. She despises the taste but finds it is most palatable mixed with yogurt.

My dental story. Tyler Cowen’s story.

Why Does Gum Disease Correlate With Heart Disease?

People who have heart disease are more likely to have gum problems. Why? According to an online health magazine from the University of Texas,

Medical researchers have two main theories to explain the link between gum disease and heart disease . . . One theory is that the bacteria from periodontal disease enter the blood stream and stick to the blood vessels, creating a thickening of the walls, which may end up clogging these vessels. The second theory is that the chemical by-products from gum disease cause the same clogging effect. The chemicals may come from the by-products of the bacteria or from the chemicals produced by the body’s own immune system.

A third possibility, not mentioned in the article, is that both gum disease and heart disease are caused by too much inflammation.

The three cases I described yesterday, in which high-omega-3 oils rapidly eliminated gum disease, convince me that the third possibility is correct. When you take 2 tablespoons/day flaxseed oil or 1 teaspoon/day fish oil, you are not killing the bacteria in your mouth. The bacteria remain as plentiful as ever. The difference is that your body is no longer overreacting to them. Plenty of evidence suggests that heart disease is caused by too much inflammation. This correlation is more evidence.

Why omega-3s reduce inflammation is known. The body requires omega-3 to build an anti-inflammatory signaling molecule. Not enough omega-3, not enough of this molecule, too much inflammation.

Omega-3 and Dental Health (still more)

The gum improvements produced by omega-3 fats can be easy to see:

1. About six months ago, my dentist noticed that my gums were in excellent shape (a healthy pink, not red), for the first time in memory. I had started taking 3-4 Tablespoons/day flaxseed oil a few months earlier. I hadn’t made other dietary changes nor had I started brushing or flossing my teeth more. I have slacked off the usual dental care (I floss less often) but my gums have remained in excellent shape, according to my dentist.

2. When Tyler Cowen (author of Discover Your Inner Economist) starting taking 2 Tablespoons/day flaxseed oil, his gums got much better within weeks. They improved so much surgery was canceled.

3. Catherine Shaffer, a Michigan writer, had the same experience with fish oil:

I bought a bottle of Carlson Laboratories [fish oil] and began taking the recommended dosage [1 teaspoon/day] . . . My gums have been chronically inflamed for as long as I can remember. They were reddish in color, had a tendency to bleed when poked, and have earned me many lectures on flossing from my dental hygenist. I have had to brush three times a day and floss twice to keep the inflammation down. However, as soon as I started taking the fish oil, my gums turned a pale pink, and I even though I have been very lazy about flossing, they have not been bleeding.

Maybe I should have called gingivitis (inflamed gums) the new scurvy. (Vitamin C cures scurvy in a few weeks.) Such fast big lasting improvements imply the flaxseed or fish oil supplied something important that was missing. Too much inflammation is a body-wide problem — many conditions end in -itis (e.g., arthritis) — so it is likely that the flaxseed or fish oil is having other benefits. Consistent with this idea, gum disease is correlated with several other health problems, including stroke, heart disease, and low-weight babies.

According to an online health-info source, echoing conventional wisdom:

Gingivitis is the most common and mildest form of oral/dental disease. According to the Food and Drug Administration, approximately 15 percent of adults between 21 and 50 years old, and 30 percent of adults over 50, have gum disease . . . The main cause of gingivitis is plaque . . . The best defense against gingivitis is brushing and flossing after meals, as well as professional cleaning by a dental hygienist every three to four months.

How fragile the conventional wisdom (“The main cause of gingivitis is plaque . . . The best defense . . . is brushing and flossing”) turns out to be. Eighty years ago, Weston Price, a Cleveland dentist, had the same doubts I do. In travels around the world, he saw many people with excellent teeth who never brushed them. They ate ancient diets, with far more omega-3 than modern food.

Omega-3 and Dental Health: Surgery Commuted

I started writing a follow-up to this Marginal Revolution post by Tyler Cowen before I knew of its existence:

January [2007] entodontist [= gum specialist]: “You’ll need surgery either right now, or within a few months. We cut open the gum, clean out the inflammation, and sew your mouth right back up. Only sometimes do we have to eliminate the tooth.”

July 5 [2007] entodontic surgeon, 10:31 a.m.: “We can cancel this morning’s surgery, it seems OK for now, just keep an eye on it.”

In June, Tyler posted about the benefits he derived from flaxseed oil (2 Tablespoons/day): “Very good for my heart, my brain, and my gums.” I asked him what was better. “Much better gums, for sure,” he replied. “The rest is harder to measure.” On July 4 I got around to asking for details. Tyler said that he had had bad gums for most of his life and that he noticed they were much better within a week or two of starting the flaxseed oil. He added

I have crooked wisdom teeth, never wore braces, and my mouth naturally produces lots of plaque. Put all together that means a significant problem with gum disease. I get cleanings every three months or so but still my gums have been much worse than average.

I too have crooked teeth and more plaque than average and I too found that flaxseed oil improved my gums; my dentist was the first to notice.

A recent experiment about omega-3 and dental health. A 1997 experiment. An amazing bowling video.

Omega-3 and Dental Health (part 2 of 2)

I looked at my gums this morning. I had never seen them so pink (that is, non-red). They looked just like the picture of healthy gums at the dentist. As I explained yesterday, my gums are in good shape because I am drinking 4 tablespoons/day of flaxseed oil, which contains a lot of omega-3.

Meta-analyses of the effects of omega-3 have had trouble finding an effect. A meta-analysis about mood found a barely-reliable effect and concluded “the evidence available provides little support for the use of n–3 PUFAs to improve depressed mood.” (They should have said “a little support.”) A meta-analysis about heart disease concluded “Long chain and shorter chain omega 3 fats do not have a clear effect on total mortality, combined cardiovascular events, or cancer.” The effect on total mortality was close to significant and there was evidence of heterogeneity (i.e., studies varied) so their results were not completely negative, as the authors noted in response to comments. The effect is just weak, apparently.

In other words, after combining many experiments, each experiment with dozens or hundreds of subjects, meta-analyses can barely see an effect of omega-3. Yet I found a perfectly clear effect with one subject? An effect I wasn’t even looking for? That seems discrepant, and worth trying to explain.

My explanation is this: What I had in my favor and all those other studies did not were the benefits of self-experimentation. In particular,

1. The effect on balance was so clear that I used it to find the best dose. I found that 3 tablespoons/day was better than 2 tablespoons/day and even at 3 T/day there was an effect of time of day. So I went to 4 T/day. It seemed no better than 3/T day, so I stopped there. Conventional studies have not been able to do anything like this.

2. The effect on balance was so clear that I could use it for quality control. If I happened to buy a bad bottle of flaxseed oil I would have noticed — the results would not have been consistent, starting from when I started the new bottle. (I have gone through about six bottles.) Previous studies have had little or no quality control. If half their omega-3 went bad, they would have had no way of knowing.

3. I was strongly motivated to take the flaxseed oil. I know it is beneficial. This is not the case in any double-blind experiment when treatment is compared to placebo. In such experiments, every subject has reason to doubt that taking the pill will make a difference.

4. Dosage in nutrition, as in these mood and heart disease studies, has been built around avoiding failure — for example, what dose will avoid heart disease? Whereas I was looking for the optimum. My brain does not fail in any obvious way if I don’t have enough omega-3; it just functions worse. The amounts needed to avoid obvious failure are probably (a) different for different parts of the body and (b) less than optimal. For example, the amount of omega-3 needed to avoid dementia may be 1 T/day whereas the amount needed to avoid heart disease may be 2 T/day. The optimal amount, the amount needed for best performance, is likely to be greater than all of these failure thresholds. It is a better target.

Something else in my favor, not related to self-experimentation is that I studied the effect of omega-3 on my balance — how long before I lost my balance, a measure that can have many values. In contrast, most omega-3 research has involved binary measures like mortality or heart attacks. Someone either dies or does not die, for example. Binary measures tell you less than many-valued measures.

Given these advantages, it makes sense that I could find a much clearer effect.

Omega-3 and Dental Health (part 1 of 2)

Today I had my teeth cleaned and was told my gums were in excellent shape, better than ever before. They were less inflamed than usual. “What causes inflammation?” I asked. “Tartar,” I was told. I haven’t changed my cleaning habits. The only thing I have deliberately changed since my last cleaning is how much flaxseed oil I drink. At the time of my previous cleaning I was drinking about 1 tablespoon/day; now I drink 4 tablespoons/day. The person who commented about my gums doesn’t know about my omega-3 intake.

Omega-3 is believed to be anti-inflammatory, so it is quite plausible that the change in my omega-3 intake is what improved my gums. There have been a few studies of omega-3 and gum inflammation but none found impressive results. Weston Price emphasized that dental health and overall health go together. Lots of research connects gum disease and heart disease. The importance of omega-3s was first realized because of their effect on heart disease.

This research means better gums is very good news — for which I thank SLD-forum posters, who sparked my interest in omega-3.