Has it ever occurred to you that the overall picture of your dental health is really a reflection of your physical health? That's the premise of Dr. Steven Lin, a dentist who uses a holistic approach and who says less-than-stellar oral health results from issues in other parts of your body.
According to Lin, if people view their mouth as the "gatekeeper" of their gut and keep their microbiome balanced and healthy, the positive results will show themselves in a healthy mouth — teeth, gums and all — and a healthier body overall.
By all means, brush your teeth after meals and floss daily, but besides looking at your teeth and your microbiome, Lin suggests that the next thing to look at is the content of your kitchen cabinets and refrigerator or, more precisely, the foods you put in them and subsequently into your mouth. Maintaining a healthy diet that includes enough vitamin K2 will benefit your teeth and gums from the inside out.
In fact, using this approach with children could ensure they grow up without such issues and even develop naturally straight teeth. For adults, focusing on the gut first could mean never having to get fillings, not to mention other dental procedures many dentists and orthodontists insist on as a matter of course.
One of the biggest problems people have in regard to gum disease is that they're lacking in vitamin K2, aka menaquinone, which causes bleeding gums. Over time, it could mean the loss of gums and bone. But even if you begin supplying more K2 to your body, unfortunately, your gums and bone don't grow back.
Finding the key in vitamin K2 ended up changing Lin's approach to dentistry. In fact, Lin says it's all related to vitamin K2, both inside and outside your teeth. He shows how gun disease can be prevented and how it can be stopped in its tracks — if it's caught early enough — and why it's important to cure the cause, not just treat the symptoms.
What is periodontal disease?
Lin describes his bewilderment when some patients who cleaned their teeth faithfully nevertheless suffered worsening gum disease. He began wondering if the cause went beyond just plaque build-up on teeth. The bottom line is this:
"Gum disease (periodontal disease) is a long-term chronic disease. It's an inflammatory condition that often progresses without response to treatment. While small amounts of gum regeneration may be possible and surgical options are there, the broad answer is that it's irreversible."1
The term periodontium refers to two structures that comprise your gums: the cementum and the alveolar bone. Merriam-Webster2 describes the periodontal ligament (PDL) as the fibrous connective tissue layer that covers the cementum of a tooth and holds it in place in the jawbone. This is the area the disease attacks, and it occurs in stages:
- Mild periodontitis — Gingivitis or bleeding gums
- Moderate periodontitis — Loss of ligament attachment, pocketing or receding gums
- Severe periodontitis — Alveolar bone loss and deep gum pocketing
- Advanced periodontitis — Loose, mobile teeth and tooth loss
It's clear that people who experience the first stages of gum disease are given fair warning when their gums begin bleeding, usually while brushing their teeth. Over time, perhaps a shorter time for some than others, the disease results in lost teeth.
Your gingiva is the part of your gum around the base of your teeth, which is why the first signs of gum disease, such as redness, inflammation and often pain, is called gingivitis. But what many don't realize is that gum disease is inflammation-based, and vitamin K2 can make all the difference.
How K2 and vitamin D help your teeth, gums and more
More specifically, it signals a "loss of tolerance between your oral microbiome"3 and an unbalanced immune system. Bleeding gums are also connected to your vitamin D status. Vitamin K2 is a cofactor for vitamin D and calcium to support bone health, but it also helps reduce inflammation and the factors involved with gum disease by:
- Decreasing the production of inflammatory markers
- Regulating immune cells that cause inflammation
- Decreasing fibroblast cells
Vitamin K2 and vitamin D (along with calcium and magnesium) have a synergistic relationship. Calcium strengthens your bones and enhances overall skeletal health, but only works when it gets to the right place. Vitamin K2 directs calcium into the bone and prevents it from being deposited along blood vessel walls. According to Lin, K2 mediates gum inflammation two ways:
"It decreases fibroblasts known to fuel the gum disease process. In the healing process, fibroblasts act to form scar tissue. But in gum disease, their action is harmful and could advance the calcification of periodontal ligament — an early sign of gum disease.
It activates Matrix GLA protein: This Vitamin K2 dependent protein has been shown to prevent the calcification of the periodontal ligament. Many studies have shown that Vitamin K2 has the same anti-calcification effects around the body, including in the heart, kidneys and prostate."4
Matrix GLA protein, as explained in one study,5 is important because it inhibits calcification. To that end, there are other vital nutrients that work with K2 to promote oral health.
For example, human gingival fibroblasts (HGFs) are described in a Japanese study6 as the most abundant structural cell in periodontal tissue. Other research shows that HGFs may act as "accessory" immune cells7 that work to amplify immune responses to lipopolysaccharides,8 which are found in the outer membranes of infection-causing bacteria that cause inflammation and promote tissue destruction.
Another substance that quells inflammation is Coenzyme Q10, also known as CoQ10, which is produced in your body naturally. One study notes that CoQ10 "decreased oxidative DNA damage and tartrate-resistant acid-phosphatase-positive osteoclasts in the periodontal tissue"9 while suppressing inflammation.
The role vitamin K2 plays in your brain
Probably the most obvious way K2 makes such a difference in your oral health, then, is the way it works with vitamin D to help reduce all that inflammation and to regulate immune cells. In your brain, it may help prevent heart disease, cardiac embolism and stroke10 because matrix-GLA protein benefits both your brain and your heart.
Another way it expresses itself is through your central and peripheral nervous systems; it may even be an antioxidant in your brain, one study observes. Conversely, research shows how the drug warfarin can reduce vitamin K2 in your system:
"The relationship between vitamin K status and cognitive abilities needs to be further investigated. Notably, and despite the methodological challenges that such studies entail, it would be important to determine the long-term effect of warfarin therapy on cognitive abilities.
A potent anti-vitamin K agent, warfarin is widely prescribed for the prophylaxis and treatment of thromboembolic conditions … As individuals treated with warfarin are in a relative state of vitamin K deficiency, they could be at higher risk of cognitive problems based on the actions of vitamin K in the nervous system."11
Vitamin K2, working with K1, seems to enhance the effects of glutathione to prevent nerve cell death as well as brain damage.12 K2 also may be significant in its role of preventing neurodegenerative damage by preventing both oxidative stress and brain inflammation.13
Lin notes that low vitamin K2 appears to negatively influence incidences of Alzheimer's disease14and, overall, either eating adequate K2 or taking it in supplement form is important for preventing degenerative disease and promoting optimal brain function.15
One of the effects of being vitamin K2 deficient is that it produces the symptoms of vitamin D toxicity, which includes inappropriate calcification of soft tissues that can lead to atherosclerosis.16
Osteocalcin — Crucial in healing gum disease
Lin says the first order of business in halting gum disease is calming the immune system, and at the first sign of bleeding gums, your vitamin K2 intake should increase. This is because your ability to repair damage from gum disease is dependent on the release of vitamin K2-activated proteins.
That's where osteocalcin comes in. Osteocalcin17 is a protein hormone found in bone and dentin. Gum tissue releases it where there's inflammation and gum disease, particularly in postmenopausal women.18 In fact, it's crucial for your body's ability to heal gum disease.
If you're deficient in vitamin K2, your body may release osteocalcin, but it won't be active. Osteocalcin also increases your insulin sensitivity,19 so Type 2 diabetes and advanced gum disease are both associated with this protein. According to Lin:
"Vitamin K2 has a critical role in bone loss in both gum disease and osteoporosis. Vitamin K2 inhibits bone loss through resorption by inducing osteoclast apoptosis. The severity of bone loss in gum disease is worse in the presence of osteoporosis."20
Lin says that while further studies are needed, gum disease and vitamin K2 are linked because K2 is a central mediator in inflammation, immune regulation, matrix-GLA protein and osteocalcin. Anyone noticing bleeding gums or advanced stages of gum disease can consider taking vitamin K2 supplements, but also to begin eating more foods that will help supply it.
How to get more vitamin K2
Foods with significant amounts of vitamin K2 are rare, Lin adds, so you need to be intentional about it because you're probably not eating enough. It's important to know that how foods that contain K2 are treated and prepared because this makes a difference in the amount that is ultimately made available to your body.
With that in mind, Lin explains that if K2 is derived from animals, they must be pasture raised. Brie and Gouda cheese, for instance, are particularly high in K2, as is grass fed butter or ghee and organic, pastured eggs. Lin's partial list of K2-rich meats21 include:
- 2 to 2 oz. of pastured chicken, duck or goose liver pate
- 6 to 12 oz. of pastured chicken legs or thigh meat
- 2 to 3 slices of organic, grass fed beef or lamb liver
One reason you want to choose only pastured beef is because if cows are fed soy or grains, they won't get K1, which means they won't be able to convert it to K2. If cows eat "dead" hay that no longer has the proper nutrients, they may not produce K2-rich dairy products. In addition, Lin says:
"One dozen eggs a day from caged hens won't supply enough K2 for your daily requirement, whereas two to four eggs a day from pasture-raised hens may provide adequate K2 … Fermented foods also provide a different form of vitamin K2, however it needs to be cultured properly and then stored in a refrigerator, not pasteurized or contaminated. Today we eat far less fermented food rich in Vitamin K2."22
In the plant world, leafy greens are an excellent source of vitamin K1, and your choices come from more than just types of lettuce. They extend to turnip greens, mustard greens, collard greens, beet greens and, of course, spinach and kale.
Needless to say, though, organic greens are optimal choice, in light of information from the Environmental Working Group's 2019 Dirty Dozen23 list: The plant-based foods with the heaviest toxic load from pesticide overspray include spinach and kale in the No. 1 and No. 2 spots.
For vitamin K2, however,24 nattokinase (natto), which is fermented soy, is one vegetarian source of vitamin K2. Fermentation removes the disadvantages associated with eating raw or cooked soy. Other good sources of K2 include vegetables fermented at home using a starter culture of vitamin K2-producing bacteria.
If you think you may not be getting enough vitamin K2, besides eating grass fed raw dairy products, meat, eggs and fermented foods, supplementing is another option, but it should be menaquinone-7, or MK-7, a form of vitamin K2, which stays in your liver and helps support strong bones, but also helps reduce incidences of heart disease and cancer.25
I recommend getting around 150 micrograms (mcg) of vitamin K2 per day, although others recommend slightly more, such as 180 to 200 mcg per day.