Why Grok Didn’t Have to Floss but You Do
Today’s article is a guest post by Dr. Mark Burhenne, the #1 bestselling author of The 8-Hour Sleep Paradox. As an authority on dental health, he is also on a mission to help shift the conversation about sleep from quantity to quality as the foundation for primal living. As a member of the American Academy of Dental Sleep Medicine, Dr. Burhenne blogs about the mouth-body connection on his website, AsktheDentist.com. Today, he addresses some of the most pressings topics surrounding oral health from an ancestral health perspective, which , if you think about it, can be summed up with the following question: If Grok didn’t floss his teeth, why should I, especially when I’m living a primal lifestyle?
Here we go:
What happens in your mouth affects the rest of your body, which is why your oral health is an essential part of primal living.
There’s no bypassing the mouth. And if you don’t take care of what’s inside of it, you could have more to worry about than just cavities and fillings. Today, our mouths can be a source of many problems that ail us—like poor sleep quality and poor microbiome health. But even more seriously, studies have shown that bad bacteria in the mouth can contribute to cardiovascular disease, dementia, preterm labor, pancreatic cancer, diabetes, and more.
Poor oral health has effects downstream in the body. And poor systemic health in the rest of the body can show up in the mouth—it’s a two-way street.
Obviously, Grok was not aware of this, but he didn’t have to worry about this mouth-body connection. Why? His diet matched his biology, his lifestyle was more suitably adapted to his surroundings, and, as a result, he didn’t have to deal with the onslaught of negative epigenetic influences that we do today.
But let me back up a bit. This story begins when Grok was an infant.
From the moment Grok was born, he was breastfed. Baby Grok sucked on a fleshy (not plastic) nipple, which helped develop a perfect swallow and tongue reflex. There was no transition from sippy cups to soft baby food—he went from mother’s milk to unrefined, unprocessed foods, which had the toughness necessary to stimulate proper jaw development. A well-developed jaw meant his airway had plenty of room at the back of the throat to stay wide open even during the muscle collapse in deep stages of sleep, allowing him to get as much HGH (human growth hormone) as possible each night. HGH bolstered the immune system, warded off disease, and allowed Grok to be his best and brightest each day. His diet was rich in organ meats and bone marrow (Vitamin K2), which also promoted proper development of the lower third of the face, allowing for straight teeth and a wide airway for uninterrupted sleep. Baby Grok was also born vaginally, which exposed him to a host of beneficial bacteria, establishing a robust oral microbiome.
By comparison, modern humans are exposed to sippy cups, pacifiers, plastic nipples, and soft processed foods starting from birth. As a result, the lower third of the face is underdeveloped in most of the population, leading to snoring, sleep-disordered breathing, and sleep apnea even in people who are young and in shape. For modern people, braces are so common they’re nearly a rite of passage, but rarely do we stop to think that those crowded teeth are a result of a jaw that never got to grow to its full size thanks to a childhood diet of applesauce and crackers. Modern humans are also more likely to be born by C-section—a medical necessity in our modern world, but with consequences to the microbiome.
The result? Modern humans suffer from gum disease and cavities at high rates of 60% and 90%, respectively. Instead of addressing the root cause, we scrape away at the problem by brushing and flossing. But brushing and flossing don’t come without a consequence—every time we brush, we create a bacteremia (bacteria in the blood, which is normally sterile). Bacteremia appears within 60 seconds and lasts for at least 20 minutes, which shows just how connected the mouth is to the rest of the body. But those bacteria are quite different from what they used to be during Grok’s day—because of our modern diet, the biofilm is thicker, so there’s less exposure of the teeth to oxygen and saliva, changing the makeup of bacteria in the mouth. The oxygen-hating bacteria (anaerobes) have become much more dominant in the mouth, changing the makeup of our oral microbiome.
To make matters worse, many people use antibiotic mouthwashes on a daily basis. This is like using a nuclear bomb in the mouth—killing off both good and bad bacteria and causing them to grow back in the wrong ratio, making the oral environment even more dysbiotic.
Cavities, crooked teeth, poor sleep, and chronic disease are seen as normal in the modern world, whereas in Grok’s, they were rare.
What Happens in the Mouth Happens in the Body
Like I said earlier, oral infection, especially gum disease, may affect the course and the manner of the development of many systemic diseases, such as breast cancer, pneumonia, diabetes, and even low birth weight and preterm delivery.
The most well-known mouth-body connection is the one between gum disease and heart disease, including several studies that show a relationship between gum disease and stroke. A common bug in the mouth that causes gum disease is also found in the endothelial cells in the walls of hardened arteries. It’s clear that inflammation in the mouth isn’t contained—it spreads to the rest of the body. And 70-90% of people living in the US have some sort of inflammation in the mouth.
Pneumonia can result from infection by anaerobic bacteria. Dental plaque and calculus are the source of these bacteria, more likely in patients with periodontal disease. Such patients harbor a large number of bacteria below the gum line where oxygen is less prevalent. Studies have shown that people with respiratory disease have significantly higher oral hygiene issues than people without respiratory disease.
Periodontal disease is also seen as an early complication of diabetes. So much so that a dentist can detect undiagnosed diabetes and even early prediabetic conditions just by performing an oral exam.
Given all these correlations, it shouldn’t come as a complete surprise that gum disease has been regarded as a stronger indicator of total mortality risk than coronary artery disease.
So it’s time to control the environment and not the bacteria—something Grok did every day of his life, just by living his life in a way that matched his evolutionary biology.
So here’s how to optimize your moth-body health the primal way.
Diet is most important
Thankfully, the primal way of eating helps to optimize oral health by protecting teeth from acid attacks and promoting good oral microbiome health. Proper nutrition allows the pulp to heal the tooth from the inside and it nourishes the oral microbiome, allowing the tooth to be healed from the outside. This dual front optimization allows the tooth to continually renew itself.
If you’re able to breastfeed your children, do so
Afterwards, go straight to foods with substance, like sugar snap peas and salmon jerky, which promote proper development of the lower third of the face and airway.
Keep your kids away from sippy cups and pacifiers
Transition kids directly to a stainless steel cup, like Caveman Cups.
See the right dentist
See a dentist who is concerned with facial development, or trained in Orthotropics (I recommend finding an orthodontist here.)
Get enough Vitamin K2
This nurtient helps both kids and adults. In kids, Vitamin K2 promotes straight teeth and proper development, and in adults, it keeps teeth strong, promotes remineralization of the teeth, and prevents heart disease. The modern diet is devoid of Vitamin K2 in large part because our animals are no longer pasture-raised and we no longer consume organ meats.
Throw away your mouthwash
If you’re worried about bad breath, suck on oral probiotic lozenges and get a tongue scraper. Eating the proper foods and taking a probiotic will address the root cause of bad breath.
Floss
For those of you who can truly say you are eating like Grok 100% of the time, then theoretically, you wouldn’t have any need to floss. But we are so removed from our ancestral diets that it is impossible to eat as our ancestors did. In a perfect world, we’d be eating a diet that nurtures the biofilm, instead of eating a diet that alters it to the point where we have to remove it daily to prevent disease. Eating a diet that requires the scrubbing of the teeth afterwards is a perfect example of how we have drifted from the harmonious matching of diet to health.
So even though flossing may not seem like the best fix for this mismatch between our diet today and our evolutionary origins, it’s certainly become a necessity of our modern lifestyle. So don’t stop!
Dr. Mark Burhenne
Why Weight Loss Doesn’t Promise Happiness
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Wow, this is fascinating! I knew oral health was connected to overall health, but this takes it to a whole new level. I breast fed my kids for a long time but was totally guilty of using sippy cups for a long time. I just had a dentist appointment yesterday and I’m happy to report my teeth are in great shape. I do floss regularly but don’t use mouthwash. I also feel that oil pulling has been very helpful.
Hi Elizabeth! I, too, have been doing oil pulling. I’ve been doing it for about a year and a half now, and at my last 2 dentist appointments I had NO TARTAR on my teeth at all!
I give half the credit for this to my primal/paleo diet (no added sugars/candies, no breads/pastries, no grains), which leaves so much less simple carb stuff in my mouth. But the oil pulling keeps my mouth so much cleaner and healthier than ever before, that I think that is a big part of it, too. My dentist is very much in favor of the practice, and explained that the oil interacts with the lipids in bacterial cell walls to grab and pull them away from teeth very effectively.
I was delighted to see on this dentist’s website that the dietary patterns I practice help with remineralization, and DON’T cause demineralization! Good information!
Thanks, Elizabeth! I like how your dentist explains the mechanism behind the benefits of oil pulling. Glad you liked the article about remineralization.
And there’s so much more coming out about the oral-systemic connection! Stay tuned. I’ll also be talking more about oil pulling on my blog.
So interesting! I’ve never heard of probiotic lozenges. I’m going to give them a try.
Great resource. I’m surprised that there is no mention of how to brush. However, there is lots of info on Burhenne’s website, which is full of other good stuff.
My mouth is doing mighty fine (probably because I do the standard brush twice a day and floss in addition to primal eating). But perhaps a tongue scraper could be of use in special circumstances. Good article.
Hello,
I want to say I have been living with your dietary and physical fitness logic for a little over three months and I feel great, as Rogan says, “this is just how I eat now” so thanks for existing. That being said, this post leaves me with a burning question: Although I agree with your logic for the most part here, you don’t address the fact that our life expectancy is nearly three times that of “Grok” and I doubt he had great teeth when he died at just 35. I think it is dangerous to make a direct comparison in this case between modern man and Grok. Agree, disagree, thoughts?
Saying that Grok’s life expectancy was 35 isn’t really meaningful. It reflects the high death rate in childbirth of the child and mother. I’m sure someone can give citations for this – hunters and gatherers of all ages generally have good mouths, even elderly hunters and gatherers, unless they are corrupted by “civilization.”
It certainly isn’t just us old coots who have bad mouths. Little kids do too. Primal has helped my mouth.
The maximum life expectancy for humans has been steady for as long as there’s been humans. Our higher life expectancy is mostly due to less children dying and better sanitation. So if you were healthy you’d live to be around 70. Many of our country’s founding father lived to be 70 or 80 even though the average life expectancy was 40 in their time. So why did they live so long? Most of them were pretty well off. So they had better diets, better medicine, and less dangerous work.
Let’s say you had two villages. In the first village, the adults all live to be 80 years old. However, half the children die at age 3. So that means the average life expectancy is 41.5 year old (80 + 3 divided by 2 = 41.5) However you either lived to be 80 or you died at 3. So the average doesn’t actually exist.
Now the next village, the adults all live to be 80, but only 1 in 10 die at age three. Their life expectancy is 72 (80 x 9 + 3 divided by 10). But once again you either die at three or 80.
So the idea that our ancestors all died at 35 is just pure bunk.
Great question – according to one study (http://www.pnas.org/content/111/3/954) it looks like ancient hunter gatherers in North Africa had a lower rate of cavities (51.2% for the hunter-gatherers vs. 90% for modern types).
Life expectancy improvements in modern times can largely be attributed to improvements in medicine, widespread decreases in violent behavior, as well as the notable decline in smoking. I think dental health is important, but vastly less so than these other factors.
I don’t think Dr. Burhenne is suggesting we adopt an entirely paleo approach to dental health, after all he still encourages brushing and flossing; however I believe he makes good points about the importance of diet, habits, and early childcare in oral hygiene.
I agree, Paul. Some of the conclusions drawn in this article appear to be based purely on speculation. There were undoubtedly plenty of “Groks” who lost their teeth at an early age due to poor oral hygiene, heredity, breakage, disease, etc., regardless of what they ate. Grok and his children probably went hungry a lot and ate anything that would fill their stomachs, nutritious or not.
The advantage modern man has is the ability and the means to properly care for his teeth–regardless of what he eats. (A Primal diet doesn’t guarantee good teeth.) That many people don’t take proper care of their teeth is a personal decision and has little to do with evolution,
Those “Groks” you mention would have had little in the way of sugar or carbs in their diet, and therefore probably had little decay. Non-nutritious food was not then what it is now… Breakage would probably have been common, what with violence and using teeth as tools. Probably the real issue with oral health in Paleolithic times was periodic starvation, during bad seasons.
I think what you’re saying is a great point. I’m happy to report that many of my patients in their nineties have all of their teeth and those teeth are functioning well. So, I think our genetic potential (or our blueprint) for our teeth’s longevity, if all goes well and if we take care of ourselves, is to have teeth that function many years past the lifespan of Grok.
It’s great to see that there are primal doctors out there who are dedicated to getting to the root of our problems, rather than continuing down the rabbit hole of prescribing palliative care that doesn’t address the real issues. Thanks, Dr. Burhenne!
I’ve heard that there was a connection between oral health and heart disease, but I didn’t realize it extended to a whole host of other diseases, too. Geez. Scary stuff. I’ll make sure to keep eschewing SAD foods for primal ones (along with brushing and flossing, of course).
Dr. Burhenne, what are your thoughts about periodic oil pulling for oral hygiene?
See his website.
Interesting point about breast feeding and jaw development. I honestly had never heard that one before. Another case for breastfeeding (if possible).
I remember Denise Minger talking about how she helped heal her teeth (in part) from K2 supplementation after being a vegetarian for years. I imagine it should probably just be one of those “essential supplements” most people should take. Although, if I can start getting enough offal or natto in my diet, then I can skip out. It’s just that neither is really my cup of tea.
One of my patients came in yesterday—a Japanese physician—and we started talking about Vitamin K2. She grew up eating natto every day. She and her family still eat it and like the taste of natto. I think it’s an acquired taste and worth trying to make it one! I’m still working on it…
Weston Price really was ahead of the curve. He was a dentist turned nutritionist due to his observation poor dental health due to the grain and sugar based Western diet. He supported his theory by studying cultures sustained on local indigenous foods and their near perfect mouth structure. Grok did not use waxed string to clean his teeth but would bet he used fish bones, long thorns or some other tool to get at the last bit of his meal.
I’m very impressed by Weston Price and proud that he was a dentist as well as way ahead of his time.
I started using Evora oral probiotics about 4 months ago. Last week I saw my dental hygenist and she told me my teeth had less tartar and my gums looked great. About $12/month for the probiotics and well worth it I believe.
I’m interested in primal/paleo eating mainly becasue I’m diabetic and have dairy and grain allergy symptoms.
My question today since we’re talking about teeth is if the primal diet is healthy for teeth why would we have dogs with plaque, etc?
Because dogs are eating kibble, I’d guess. I’d be curious to know if a dog who is fed a raw food diet would also have plaque.
Are you talking about dogs eating their “version” of paleo (which is, I don’t really know, meat and organs with occasional lightly cooked [simulating partial animal digestion] vegetables), or dogs that eat processed human-made dog food?
My dogs are raw fed. Three of them. One (Chloe) was fed kibble for a few years before I learnt of the prey model raw diet. One that was probably on kibble for a couple years before we rescued him. And one that was a stray for a majority before we rescued her.
My raw fed dogs get muscle meat (80%), organs (10%), bones (10%) with a lot of variety: beef, duck, whole sardines, turkey necks, duck necks, whole eggs with shells, elk, venison, rabbit etc.
Chloe has some plaque that’s hardened, but the other two not so much. We give them beef ribs every now and again and that has done an amazing job of reducing 80% of the plaque. We will start brushing their teeth once a day with an enzymatic toothpaste till the plaque (hopefully) completely disappears and then we’ll stop the brushing to see how their teeth looks after a few weeks.
Just as with human food, there’s a lot of junky dog food out there. We feed our dental therapy dog a grain-free diet and supplement with pasture-raised freeze dried meat and organ meat treats. Orijen is a great brand.
Dogs are very prone to gum disease. They are the animal model for periodontal disease in humans. Our rescue dog came to us riddled with severe periodontal disease and had several teeth extracted.
What a helpful post! I brush twice a day, floss daily, and just started tongue scrapping as an Aryuvedic practice, but could you say something about toothpaste? Also, we have an reverse osmosis water system, which I appreciate for removing contaminants, but I wonder about the beneficial minerals it removes. Any thoughts?
Toothpaste is a big topic! Check my website for some of my articles about toothpaste. As for reverse osmosis, I’m not worried about removal of minerals from water as we get minerals from many other sources. I do take a liquid mineral supplement, but remember, if you don’t want to ingest fluoride, reverse osmosis doesn’t remove it, only distillation does.
This connection appears to be a reverse case of cause and effect. People who tend to take better care of their teeth also take better general care of themselves, exercise more, eat better, smoke less, aren’t overweight, lower incidence of diabetes, etc. As an aside, I saw an equivalent study that “connected” people who wear expensive clothes with various health attributes. Fat smokers who have diabetes don’t spend much money on their wardrobe.
My dad retired from teaching dentistry, so this was an area of interest to him. Many studies “linked” oral health problems to other health issues, but none ever established causation. Just like eating meat is “linked” to cancer, which we know isn’t really the case.
http://www.heart.org/HEARTORG/HealthyLiving/Dental-Health-and-Heart-Health_UCM_459358_Article.jsp
Its possible that gum disease or infections that aren’t being treated could possibly result in a blood clot in fairly close proximity to the brain/heart.
This has been an area of interest to me as well, having suffered an ischemic stroke just last month while being in fairly good health. No cause was found and I’ve almost fully recovered from it. A bit interesting to get to see pictures of your brain and watch your heart actually pumping blood on a tv screen.
More interesting is the hospital food. Basically a big tray full of sugar. For breakfast I got french toast with blueberry syrup, a couple of nasty breakfast sausages, fruit juice, fat free milk, a cut up orange and a biscuit with fake honey and fake butter. Lunch was pasta chicken soup (all pasta), white bread with one slice of turkey and fake fat free mayo, more fruit juice, more fat free milk and another quartered orange. I was told “You aren’t eating much…”
My hospital experiences have been the same except that since I have (controlled) diabetes, I got nasty artificially sweetened foods instead of sugary ones.
I do agree with you that people who tend to take care of their teeth also take better general care of themselves, eat better, exercise, etc. and that in general is always the case. However, gum disease is causative of systemic disease, the mechanisms of which are discussed here: http://cmr.asm.org/content/13/4/547.full In regards to your stroke, I’m sorry to hear, and the hospital food experience is unfortunately all too common. How do they expect you to recover with an inflammatory sugar-laden diet? Have you gotten a sleep study to investigate the possibility of SDB (sleep-disordered breathing)?
I always felt that my teeth health was directly related to my health. When I was feeling awesome, I didn’t have sensitive teeth and when I became sick again, my teeth started hurting once more. I just don’t know how to get to this awesome state again, unfortunately.
Is oral micro biome easy to transfer between person to person? Because my husband does not floss more than once a month and he never has any cavities while I floss everyday and I always have cavities. So, if he has better micro biome than me, how is it that I manage to not “contaminate” his?
I would love to hear if anyone has found a vit D3 plus K2 supplement for kiddos. I take one myself but each dosage is 5000 IU which would be too high for a child. I can only find kids D3 without the k2. We do, however, at a lot of farm fresh free-range eggs. Would this give my daughter enough vitamin K2? She eats about 5 a week.
They do make d3 in liquid form with K2. Search on Amazon and you will find some. Vitamin D toxicity is a symptom of K2 deficiency. So technically, if you take enough K2, vitamin d toxicity is a nonissue. Thus, megadosing on vitamin d3(50,000 IU/day) is possible.
I have always heard that mouth health reflects what is going on in the body, but I appreciate the different (primal) perspective on this.
Great piece, thank you. It also gives me great anxiety. I’ve always had a hate/ignore relationship with my teeth: top and bottom don’t touch, which leads to great build up of plaque, missing a tooth and have a peg on the top, so not that attractive. But I do need to floss. I know I do. I’ll get a tongue scraper too after reading this.
Great article, thanks! Would love to hear more of your thoughts on other dental practices/procedures, e.g. wisdom tooth removal, braces/retainers, etc. (advice for/against them?)
Wow, I learned so much from this! I have to say, in my own primal n=1 experiment, I’m doing pretty well on my dental health. I used to get multiple cavities per year. Since going primal 4 years ago, I have had ZERO cavities.
I feel like that’s not a coincidence!
You just summed up the whole article! Keep up the good work!
I’ve written a couple of articles on toothpaste, providing links to your website. I’ve been content with using baking soda, a pinch of sea salt, and oil of peppermint for my toothpaste/tooth powder. I found a stainless container with holes in the top that can be closed when not in use. It keeps the baking soda clean and dry as it tends to sit on the bathroom counter. It also prevents one from pouring too much out. An empty spice jar would work just as well. Do you think this is adequate for tooth brushing? I’ve heard about oil pulling, but it seems like a lot of trouble. I’ll revisit the idea on your website, though. The original source for this information was from elsewhere and a bit confusing. I appreciate all of your helpful information.
Great article! General medicine/dentistry mostly ignores the nutrition/facial growth/dental health relationship but the facts are there. As previously mentioned, Weston A Price is the pioneer when it comes to that science and his book Nutrition and Physical Degeneration has plenty of data that supports the ideas expressed in this article. In the 30’s he already knew about the link between the teeth health and potential major disease issues. At the time he was against root canal procedures because he believed that it created a nice breeding ground for bacteria to adapt to the host system and proliferate without being visible to the immune system until it grew strong enough to wreak havoc in the body once it left its nest. Root canal was a very lucrative procedure versus extraction so you can guess why you haven’t heard of Dr Price and why almost every dentist will recommend the said procedure. The WAPF (Weston A Price Foundation) recommends fermented cod liver oil and butter oil as a supplement for general health, especiallty teeth and bone health and have documented cases of self healing cavities with proper diet and supplementation. They promote a diet similar to P.B. high in saturated fat and low in PUFAs, lots of veggies, fermented foods but include grains and beans stressing they must be properly prepared, meaning correctly sprouted and cooked and often fermented. Pasture fed butter oil has a very high amount of K2, which Dr Price had named X-Factor back then when the vitamin was not known of the scientific community, along with fish oil it makes for a hell a supplement mix!
Tongue scraping : the benefits are incredible! Outstanding difference in my morning breath when i scrape before going to bed. If I am to skip dental care for any reason I will take 20 seconds and do that, it already changes a whole lot. For a few bucks it’s a must.
The impact of underdeveloped cranial structure can be incredibly great. I suggest you look deeper into this if you have crowded teeth, small jaw, difficulty breathing from the nose or sleep apnea. The issue arises when the body grows if the nutrition is too poor the facial bones will not grow to their full potential, but the cartilage does. This one ends up squeezed into an undersized cranial structure, blocking airways and creating pressures. One can have back or neck issues just because their body instinctively adopts a posture where the head is off center, forward, to allow better airflow to the lungs. This is one example of how it can create issues that would not seem related. Sounds far fetched but this has been fully documented.
Xylitol is not primal but in small doses it has been proved to help balance mouth bacteria and prevent cavities for decades. It’s mainstream for oral health mostly in European countries. It is a natural substance though they mostly extract it from hard woods and your our bodies actually produces some as well. I also like it to cheat without taking carbs, especially in drinks but as with all polyalcohols if you take it in great quantities and are not used to it may cause bloating or other types of intestinal distress, not great. At least it doesn’t taste horrid like most fake sweeteners it’s more like fresh (cool) sugar, like minty.
I’m thinking that oral microbiome issues are behind any cases of caries and periodontal disease. In my experience, brushing and flossing were probably akin to trimming back brush and mowing weeds when what I needed was a nuke to take everything out and start from scratch. Once I went through an intensive period of killing everything off with ozone, this horrible carifree rinse which is essentially bleach but more expensive and then a low carb diet, I was finally able to turn things around and get decay under control. I maintain with the usual brushing and flossing plus a steady stream of xylitol and green tea.
This article is a good reminder to get back to vitamin K2. I went off of it while pregnant since I have a couple of MTHFR SNPs and had a couple of miscarriages. I’m unsure of it’s compatibility with conditions when blood thinning may be in order. ??
On the kid front, I feel really conflicted about feeding tough foods to babies and toddlers. I know it’s important to proper bone development but my mama instincts would lead me to chew or tear apart bits for baby to eat (which I don’t because of my broken microbiome!). So I cook or chop my 1 yr old’s food in a way to prevent choking. I think it takes a little time to work up to things like jerky and raw veggies.
There are some pretty cool sippy cup alternatives these days like munchkin miracle 360 trainer and wow cup which allow babies to figure out drinking from a regular cup without dumping water everywhere.
My kids learned how to drink out of shot glasses. They’re small and can handle being dropped. They never had a sippy cup.
All my shot glasses had little handles on them which were perfect for their little hands.
Worked great until my daughter was about 14 months old and picked it up with her mouth and downed the water in it, without using her hands. I gave her a metal cup after that.
Hey Mark,
Thanks for bringing me such a new concept. It never come to my mind that the oral health can affect so much….I’ve shared this with my family.
Great post!