Oral Health System
A systematic daily and weekly oral hygiene protocol grounded in the growing evidence linking oral health to cardiovascular disease, Alzheimer's risk, and systemic inflammation.
Oral health is dramatically underrated in longevity discussions. Chronic periodontal disease is now independently associated with cardiovascular disease, type 2 diabetes, adverse pregnancy outcomes, and — more recently — Alzheimer's disease (via Porphyromonas gingivalis pathogen translocation to the brain). Your mouth is a window into systemic health and a direct entry point for chronic inflammation.
Beginner
Goal: Eliminate the most common oral hygiene failures: inadequate brushing duration, skipping flossing, and acidic beverage habits.
Daily Minimum Protocol
Morning
- Brush teeth for 2 full minutes with a fluoride toothpaste (1000–1500 ppm fluoride)
- Brush your tongue — the majority of oral bacteria live there
- Spit, don't rinse — letting toothpaste residue stay on your teeth maximises fluoride uptake
Evening (most important session)
- Floss first, then brush — flossing removes the interdental plaque that brushing can't reach
- Brush for 2 minutes
- Use an alcohol-free fluoride mouthwash if desired (not a substitute for flossing)
Dietary Adjustments
- Limit acidic beverages (sparkling water, juice, soda) to meal times only — sipping them throughout the day keeps oral pH suppressed continuously
- Drink water after meals to neutralise pH
- Wait 30–60 minutes after eating acidic foods before brushing (acid-softened enamel is more vulnerable to abrasion)
Intermediary
Goal: Upgrade to evidence-backed tools, establish a professional cleaning schedule, and add targeted remineralisation.
Tool Upgrades
| Tool | Recommendation | Why |
|---|---|---|
| Electric toothbrush | Oscillating-rotating head (e.g. Oral-B iO or Pro 3) | Consistently outperforms manual brushing in plaque removal |
| Water flosser | Use before string flossing, not instead of it | Effective for pockets > 3 mm; reduces gingival inflammation |
| Tongue scraper | Stainless steel, use each morning | More effective than brushing at reducing VSC (bad breath compounds) |
| Interdental brushes | TePe or similar, sized to fit each gap | More effective than floss for patients with wider interdental spaces |
Professional Hygiene Schedule
- Every 6 months: Professional scale and polish with a dental hygienist
- Once a year: Full dental check with radiographs to catch early proximal caries
- If you have a history of periodontal disease: consider every 3–4 months
Remineralisation Protocol
If you experience sensitivity or have early white-spot lesions:
- Apply a high-fluoride toothpaste (5000 ppm, prescription-only in most countries) last thing at night
- Consider Tooth Mousse (CPP-ACP) or BioMin F for enhanced remineralisation
Advanced
Goal: Systematic monitoring of periodontal health markers, microbiome awareness, and minimising inflammatory load from oral sources.
Periodontal Monitoring
At your annual dental visit, request a full periodontal chart: probing depths at 6 sites per tooth, recorded and compared year on year. Probing depths > 3 mm indicate periodontal pockets; depths > 5 mm represent active disease requiring intervention.
Track over time:
- Bleeding on probing (BOP%) — target < 10%
- Number of sites with depth > 4 mm
- Gingival recession measurements
Oral Microbiome
The oral microbiome is increasingly understood as central to both local and systemic health. To support a healthy oral ecosystem:
- Avoid alcohol-based mouthwashes — they are non-selective biocides that reduce microbiome diversity
- Minimise antibiotic use where clinically safe — antibiotics profoundly disrupt the oral microbiome and the downstream nitric oxide pathway (oral bacteria reduce dietary nitrate to nitrite, a precursor to systemic NO)
- Consider probiotic lozenges containing Lactobacillus reuteri (some evidence for reducing gingival inflammation)
Systemic Connection Points
If you have elevated CRP (> 1 mg/L) on bloodwork with no obvious systemic cause, consider whether oral inflammation may be contributing. Treatment of periodontal disease has been shown in randomised controlled trials to reduce systemic inflammatory markers, including CRP and IL-6.
Request a salivary diagnostics panel if available in your area — tests now exist for pathogen-specific quantification of P. gingivalis, T. denticola, and T. forsythia (the "red complex" periodontal pathogens) which are most strongly linked to systemic disease.