 Experimentally, if you have people stop brushing their teeth, plaque starts to build up, and within a few days the gum starts to get inflamed. You can't see anything yet, but if you take a biopsy of the gum line, you can see the inflammation starting to spread. And within a few weeks, overt gingivitis becomes apparent, where your gums can get red, swollen, and bleed easily. And if you don't do anything about it, you can develop periodontal disease, where the inflammation creeps down into the supporting structures of the tooth of bone and ligaments, setting you up for tooth loss. Okay, but how do we get along for millions of years without brushing? Yad dental disease is almost universal these days, but thousands of years before the invention of the toothbrush, there are skulls with perfect teeth. Now you can say, yeah, but that was also thousands of years before the invention of candy bars, and you don't know until you put it to the test. Okay, yeah, but where are you going to find people to not only stop brushing, but also to forego eating process junk? Security guards, that's how you do it. It's one of these survivor-type TV shows, where people are forced to live under stone age conditions, so no toothbrushes, toothpaste, dental floss, toothpicks, or other oral hygiene products for a month. Now, I mean, they could use a twig or something, but they're pretty much on their own. But no candy bars either, right? They're going for about 4,000 BC, so lots of whole grains, with supplemental salt, herbs, honey, milk, and meat, and then they could go out and pick berries and see what they could catch. So what happened? With no oral hygiene, their plaque built up, but their gums got healthier. This is measuring B.O.P., bleeding on probing, whether or not your gums bled when poked with a dental tool, a measure of gingivitis, and in almost every case, they got better. Here are before and after pictures. Yeah, lots of plaque build up, but actually healthier gums. How is that possible? Well, many of the more disease-causing bacteria seem to have disappeared from their mouths. They suggest this could be from the lack of refined sugars, but they were eating honey, so it wasn't a sugar-free diet. Ah, but what they were eating was lots of whole grains and berries, rich in antioxidant-fided nutrients with anti-inflammatory properties. So maybe it was a combination of sugar intake restriction combined with the intake of really healthy foods. Thus, all those experimental studies where people stop brushing and their gums inevitably get inflamed may only be applicable for people eating lots of processed foods, fruits and sugar, and low in anti-inflammatory whole plant foods. What about the role of nutrition in periodontal health? Gingivitis can lead to periodontitis, an inflammatory disease of the supporting tissues of the teeth, which if untreated, can lead to the progressive loss of the bone that holds the teeth in place. Now part of the development of periodontal disease may involve oxidative stress, so not only do we need to reduce our intake of pro-inflammatory foods like refined carbs and saturated fats, but it would help if we sought out foods that are antioxidant rich. So is there an association between dietary vitamin C intake, for example, with periodontitis? Apparently so, with increasing risk of periodontitis associated with lower levels of vitamin C intake. But you don't know until you put it to the test to figure out what effect vitamin C depletion and supplementation would have on periodontal health. They basically locked everyone up for three months so they can provide controlled amounts of vitamin C, and measures of gum inflammation were directly related to their vitamin C status. On about one orange worth of vitamin C, their gums improved, but then down to 5 mg a day they got worse, but then on 10 oranges worth a day they got better, and then worse again went back down to 5. Pretty convincing, though 5 mg a day is like scurvy level. I mean, we know that your gums start bleeding, your teeth can fall out when you have scurvy, but that doesn't mean taking extra helps. And indeed, 1,500 mg of vitamin C a day did not seem to help prevent gingivitis, and even 2,000 a day failed to help periodontitis sufferers. Maybe vitamin C is just too weak of an antioxidant? Okay, what about lycopene, the powerful antioxidant pigment that makes tomatoes red? It worked, but that was from injecting the stuff directly into the gum pocket with a syringe. So, work if you just eat it. Let's find out a randomized placebo-controlled clinical trial on the efficacy of lycopene in the treatment of gingivitis. Two weeks of less than a single tomato a day's worth of lycopene versus placebo for two weeks, both along with a standard dental treatment, which helped a 10% to 20% reduction in gingivitis in the placebo group, but nearly 30% improvement within just one week in the lycopene group. And this was just like the amount of lycopene found in a teaspoon and a half of tomato paste a day—totally doable. Okay, so tomatoes may help with gingivitis. What about periodontitis? Another randomized double-blonde, civil-controlled trial again, treated with usual dental cleaning plus, either that one tomato a day's worth of lycopene or placebo for two months. And significant improvements in plaque gingivitis and bleeding, though not pro-pocket depth and clinical attachment. You can see the difference. See how much better their gums look? They conclude that supplementation with lycopene seems to have augmented the healing sequence of inflamed gingival tissues. Okay, but that was with a whole tomato's worth a day. How about half a tomato's worth, or just three quarters of a teaspoon of tomato paste worth of lycopene a day? It didn't work. No difference. So it looks like you have to go the whole tomato.