Dr. Michael Ruscio
When was the last time you spoke to your dentist about your gut health? If the answer is never, don’t worry. It’s unfortunately not a topic brought up in the dental office, even though it should be. When we think of gut health, we think of the usual —gas, indigestion, bloating. But all too often, gut health imbalances are “silent” and the only symptoms that show up are in the mouth. This is yet another way the mouth is a window into the health of the rest of the body.
In this article, we’ll discuss what you need to know about the mouth-gut connection, including how to know if you could have a gut health disturbance, what to discuss with your dentist, and how to take care of your mouth to optimize gut health.
Why Gut Health Matters
Gut health isn’t just about avoiding indigestion— it’s about caring for the over 100 trillion bacteria in your digestive system. These bacteria need to exist in a healthy balance for your body to function properly.
Your gut has been linked to many aspects of health, including mental health conditions, energy levels, weight, and even behavioral issues in children. Additionally, gut problems have been correlated with weight gain, nutrient malabsorption, high blood sugar and cholesterol, fatigue, and depression, just to name a few. More importantly, proper treatment of gut issues can improve mood, energy, metabolism, sleep, and skin.
The role of the gut microbiome is so deeply interwoven into your bodily functions, especially cognitive functions, that it’s often referred to as your ‘second brain’. For example, someone with a silent gut problem may experience no digestive symptoms, but instead insomnia, fatigue or depression. This is because the gut and the brain communicate in a two-way street, known as the gut-brain axis. When your gut microbiome is unbalanced and the harmful bacteria are overtaking the beneficial bacteria, your gut sends a signal to your brain that something’s wrong, which has been shown to cause stress, anxiety, depression, and other neurological issues.
Essentially — when your gut isn’t well, you aren’t well.
While improving one’s gut health is not a guaranteed to fix every problem, the data is compelling regarding the potential improvements you can experience when you improve your gut health.
Symptoms to Watch Out For
Your oral health is intimately related with your gut health; the mouth is the first section of the digestive tract, which runs from mouth to rectum which is why it’s important to understand what a gut health imbalance looks like in the mouth. So if you have a burning sensation in the mouth, dry mouth, or sore tongue, it might be a good idea to look more closely into your gut health.
Sometimes it’s hard to know if you have a problem in the gut, because some gut problems are ‘silent,’ meaning a digestive issue is present but it is not causing any digestive symptoms, it’s only causing symptoms in other parts of the body.
Fortunately, problems in the mouth can tip us off that a gut problem is present. A fascinating study found that the following symptoms were predictive of damage occurring in the stomach:
- A burning sensation in the mouth (aka burning mouth)
- Dry mouth
- Sore tongue
If these symptoms were present, there was a 60-98% association to stomach autoimmunity, known as anti-parietal cell autoimmunity (APCA).
What is APCA?
APCA is an autoimmune process wherein your immune system attacks and damages cells in your stomach lining, known as parietal cells. Parietal cells are important because they produce stomach acid, and stomach acid is crucial for healthy digestion.
More specifically, stomach acid is needed for:
- Absorption of vitamins and minerals
- Digestion of proteins
- Prevention of parasitic infection
- Prevention of bacterial and fungal overgrowths
This is why we often see chronic anemias and bacterial or fungal overgrowths in those with low stomach acid. Anemias are a major cause of fatigue and poor exercise tolerance. Bacterial and fungal overgrowths can manifest as a wide array of symptoms, including fatigue, weight gain, brain fog, gas, bloating, loose stool, constipation, skin problems, and depression.
So who is at risk for this APCA condition that damages their stomach lining and decreases their stomach acid production?
- Those with oral symptoms as listed above
- Those with anemias
- Those with thyroid autoimmunity, aka Hashimoto’s (20-40% of those with Hashimoto’s are affected by APCA)
- Those with any type of autoimmunity
It is also important to clarify that just because your risk is increased if the above are present, this doesn’t mean you will have this problem. So don’t be alarmed, but just understand it might be a good idea to check for this APCA. APCA can be easily checked with a blood test available from most major labs, and is known as anti-parietal cell antibodies test.
Why does treatment matter? Quelling stomach autoimmunity of APCA can preserve the health of your parietal cells and thus ensure you maintain the ability to produce adequate levels of stomach acid. Remember that stomach acid production is essential for healthy digestion. Also, if you maintain your ability to produce stomach acid, it will prevent the need to take supplemental digestive acid like betaine HCl.
What to Ask Your Dentist if You Suspect Gut Health Issues
If you are experiencing a burning sensation in the mouth, dry mouth or sore tongue talk to your dentist about these symptoms and rule out possible dental causes for these problems.
If not dental related and if seen along with thyroid autoimmunity, anemia, digestive symptoms, or any other autoimmune condition, consider getting screened with the APCA blood test. The APCA is a simple and quick blood test, similar to any other you’ve gotten with a doctor. This test is also reliable and a good way to detect gastric parietal cell antibodies in most patients. Your doctor may not be familiar with it because it’s not a commonly ordered marker. However, this test can be ordered direct to consumer labs by making an appointment with a LabCorp testing facility.
Find a healthcare provider who focuses on digestive health to assist you. Look for someone who is open-minded, but also conservative and practical. If your practitioner suspects APCA or other gut health disturbances, s/he can perform an evaluation for H. pylori and bacterial or fungal overgrowths.