The one routine appointment you simply cannot afford to skip

Reduce your risk of countless conditions—from cancer to diabetes

Even with pandemic restrictions in place, I’m always preaching the importance of keeping up with routine healthcare—colonoscopies, dermatology exams, ultrasounds, EKGs, ECHOs… the list goes on.  After all, diseases didn’t go on vacation when COVID-19 came to town. And even one missed appointment could carry deadly consequences down the road.

But there is one routine check up that often gets overlooked… and it’s one that could prove lethal, if routinely missed: your dentist appointments.

In fact, putting your oral health on the back burner sets your whole body up for a domino line of disaster. So if you decided to dodge your routine dental visit this year, hopefully today’s conversation will convince you to reschedule in 2021…

Gum disease increases cancer risk

Let me be clear: Severe gum disease (periodontitis) raises your risk of both developing and eventually dying from cancer.

In a recent U.S. study of nearly 7,500 people, researchers divided subjects into three categories:

1.) Those with no or mild gum disease.

2.) Those with moderate gum disease.

3.) Those with severe gum disease.

Results showed that having severe gum disease raises the risk of cancer by nearly 25 percent.1

Specifically, subjects with severe gum disease faced a 24 percent higher risk of cancer in total, compared to subjects without periodontitis. And the risk jumped to 28 percent in subjects who had lost all of their teeth. But that’s not all…

With respect to lung cancer, specifically, severe gum disease more than doubled the risk—even in non-smokers. And unfortunately, the outlook wasn’t much better where colorectal cancer was concerned, either.

Results linked toothlessness (or complete or partial tooth loss attributed to injury, disease, or decay) with an 80 percent increase in risk of colorectal cancer—while severe gum disease raised risk by 50 percent overall. (The association was especially strong in subjects who had never smoked—among whom colorectal cancer risk increased more than two-fold among participants with severe periodontitis.)

Results also revealed a significant increase in pancreatic cancer risk with severe gum disease. And, sadly, the news only gets worse from there…

A direct route to GI tumors and death

Another recent study of 68,000 Finnish patients revealed similarly terrifying trends in cancer mortality. In this cohort, periodontitis was linked to a 33 percent increase in overall risk of cancer death—and more than double the risk of death among patients with pancreatic cancer specifically.2

Not only that, but research has identified the bacteria implicated in periodontitis within gastrointestinal (GI) tumors as well.3 (Yet another example of bacteria’s role in just about every imaginable biological process—but I’ll get back to that in just a moment.)

Plus, new research published this past summer told a similar tale: Data from the Nurses’ Health Study and the Health Professionals Follow-up Study showed a
42 percent increase in risk of esophageal cancer and a
52 percent increase in risk of gastric cancer with a history of periodontal disease.4

And while all of this might seem shocking… it really shouldn’t be. Poor oral health is linked to a seemingly endless array of crippling conditions. Heart disease… diabetes… premature birth… osteoporosis… even Alzheimer’s disease. The list goes on and on.

It actually makes perfect sense when you think about it. After all, gum disease is just another form of chronic inflammation. And as I’m always telling you, that’s the true root cause of all disease.

Fight back—with your toothbrush

The good news here is that defying these odds could be as easy as regular brushing. But while your dentist might be satisfied with brushing twice a day, research suggests that the magic number is closer to three.

Researchers recruited more than 160,000 subjects, all between the ages of 40 and 79 years, from the Korean National Health Insurance system. The goal was to examine the link between tooth brushing and two major cardiovascular killers: atrial fibrillation (the fancy term for irregular heartbeat) and heart failure.

After more than a decade of follow-up, the researchers found that subjects who brushed their teeth three or more times a day had a 10 percent lower risk of atrial fibrillation—and a 12 percent lower risk of heart failure.5

It’s also worth noting that these benefits were independent of a whole host of other factors—like age, sex, exercise habits, body mass index (BMI), and even comorbid conditions like high blood pressure.

Of course, this was an observational study. Which means it can’t prove that tooth brushing directly reduces heart risk—or the risk of any disease, for that matter. But there’s certainly a good case to be made for that conclusion.

And I must say… even I’m impressed by the difference just a little extra brushing made. So, keep your toothbrush and non-fluoride toothpaste handy… and brush after eating (or as often as you can)—at least three times a day.

That extra brushing may or may not help—but it certainly won’t hurt. Unfortunately, however, the same can’t be said for some other common oral hygiene routines…

The surprising risks of rinsing

By now, you know how I feel about antibacterial anything. Sure, these products may get rid of bad bacteria—but they also knock out the good bacteria, too. And no one has ever benefited from having fewer friendly flora.

Now, recent research suggests that this same principle applies to the bacteria in your mouth, too—in ways that you probably never would have imagined.

We all know how effective exercise is at lowering blood pressure, especially in the hours right after a workout. But what you may not know is that oral bacteria play an important chemical role in this process. And when you rinse your mouth with antibacterial mouthwash? Well, you may end up spitting this blood pressure benefit right down the bathroom sink.

Researchers recruited 23 healthy adults to run on a treadmill for 30 minutes, two separate times, followed by close monitoring for two hours afterward. During this time, the subjects rinsed with a liquid—either an antibacterial (chlorhexidine) mouthwash or a mint-flavored placebo—at 30, 60, and 90 minutes after exercising.

Results showed that when the subjects rinsed with the placebo mouthwash, their post-exercise systolic blood pressure dropped by 5.2 mmHg one hour after exercise. But when they used the antibacterial mouthwash, it only dropped by 2 mmHg in the same time frame.6

In other words, antibacterial mouthwash slashed the blood pressure-lowering effect of exercise by more than 60 percent in the first hour. And wiped it out completely after two hours.

Yes, it’s true that bad bacteria causes tooth decay. (More specifically, Streptococcus mutans—the same bug behind bad breath, plaque, and gum disease.) But antibacterial mouthwash clearly isn’t the best solution to this problem. However, a heaping helping of good bacteria just might be…

Fight bad bacteria with probiotics instead

Back in 2013, Italian researchers performed a systematic review of 23 randomized clinical trials. The goal was to see what role probiotics might play in reducing the risk of cavities.

These studies looked at a wide range of friendly flora—including Bifidobacterium longum, Lactobacillus rhamnosus, L. acidophilus, L. reuteri, and Saccharomyces cereviasae. And two-thirds of them found that probiotics were able to reduce levels of Streptococcus mutans in saliva—and put the brakes on plaque formation—in the short term.7

But there is a small caveat. The study authors note that you’d have to get regular doses of good bacteria—on top of brushing and flossing—to benefit from any additional protection.

So instead of that nightly swish of mouthwash, make sure you’re taking a high-quality probiotic every single day instead. You’ll want to look for one that features different strains of friendly flora—along with prebiotics, probiotics, and postbiotics. (Remember, when it comes to probiotics, more isn’t necessarily better. The key is diversity of strains over quantity.)

And be sure to double check your dental floss, too…

When dental floss turns deadly

I know it may be hard to believe, but it’s true: Even dental floss isn’t safe these days.

In fact, according to the latest research, simply flossing your teeth could substantially raise your body’s levels of something called polyfluoroalkyl substances (PFASs)—widespread chemicals with links to a long list of diseases, including cancer.

This study featured 180 women. And it showed that those who used Oral-B® Glide to floss their teeth had higher levels of a PFAS called perfluorohexanesulfonic acid (PFHxS) in their bodies compared to those who didn’t use the floss—by as much as 25 percent.8

This was the first study to link dental floss to higher toxic burdens of PFASs. And researchers found fluorine compounds in five other flosses, too. Which is quite concerning.

That’s because research has linked exposure to two forms of PFASs—perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS)—to kidney and testicular cancer, reduced semen quality, and ulcerative colitis in adults.

And in children—yes, children—the chemicals have ties to thyroid disease, immune dysfunction, and disruptions in sex and growth hormone levels.

That said, not all kinds of dental floss are to blame. This study found detectable PFHxS in Oral-B® Glide, as well as five other flosses (three of which were branded as Glide, and two generic products that cited Oral-B® Glide as a comparable product).

So obviously, brands matter. The Environmental Working Group (EWG) can serve as your guide to safer dental flosses. The good news is, you can find floss that’s made from organic silk and organic beeswax in most of your common shopping places, including Amazon. But when in doubt, you can always switch to a water pick.


  1. Michaud DS, et al. “Periodontal Disease Assessed Using Clinical Dental Measurements and Cancer Risk in the ARIC Study.” J Natl Cancer Inst. 2018 Aug 1;110(8):843-854.
  2. Heikkilä P, et al. Periodontitis and cancer mortality: Register‐based cohort study of 68,273 adults in 10‐year follow‐up. Int J Cancer. 2018 Jun 1;142(11):2244-2253.
  3. Nieminen M, et al. Treponema denticola chymotrypsin-like proteinase may contribute to orodigestive carcinogenesis through immunomodulation. Br J Cancer. 2018 Feb 6;118(3):428-434
  4. Chun-Han L, et al. Periodontal disease, tooth loss, and risk of oesophageal and gastric adenocarcinoma: a prospective study. Gut, 2020; gutjnl-2020-321949.
  5. Chang Y, et al. “Improved oral hygiene care is associated with decreased risk of occurrence for atrial fibrillation and heart failure: A nationwide population-based cohort study.” Eur J Prev Cardiol. 2019 Dec 1:2047487319886018.
  6. Cutler M, et al. Post-exercise hypotension and skeletal muscle oxygenation is regulated by nitrate-reducing activity of oral bacteria. Free Radical Biology and Medicine, 2019; 143: 252.
  7. Cagetti MG, et al. “The use of probiotic strains in caries prevention: A systematic review.” Nutrients. 2013 Jul 5;5(7):2530-50.
  8. Boronow KE, et al. “Serum concentrations of PFASs and exposure-related behaviors in African American and non-Hispanic white women.” J Expo Sci Environ Epidemiol. 2019 Mar;29(2):206-217.