According to functional medicine, the gut is at the center of autoimmune disease — and a growing body of scientific research backs this up.
As we look at the gut as a key factor behind many autoimmune diseases, including Hashimoto’s, we need to consider all parts of the gut — including the stomach, the intestines, and the mouth. So when we have an infection in the mouth, even a minor one, or something else that disrupts the oral microbiome (the community of microorganisms found naturally in the mouth), this has the potential to trigger autoimmune disease.
Our teeth, gums, tongue, and throat are so important to our overall health, and this is especially true for people with Hashimoto’s, who are particularly vulnerable to infections. For us, dental procedures, infections, and fillings (just to name a few), could ignite an autoimmune disease!
Could an unknown or unaddressed dental issue have triggered your thyroid condition?
I recommend thinking about your dental timeline to see if you can trace any decline in your health, to a dental procedure. In the meantime, let’s look at some of the potential dental triggers of Hashimoto’s and how you might address them, so that you can experience complete healing.
In this article, we’ll discuss:
- How different oral health issues can trigger thyroid problems
- How dental procedures can be problematic for those with Hashimoto’s
- How and why you should eliminate your exposure to fluoride
- Recommendations for better oral care at home
The Surprising Link(s) Between Oral Health and Disease
You might be surprised to learn how much your oral health can influence your thyroid — and overall — health. Most people with Hashimoto’s have some degree of intestinal permeability, and because the mouth is part of the GI tract, they are more prone to oral health issues, including gum disease, dry mouth, cavities, inflammation, and infection.
New research shows that our oral health may play a bigger role in our gut health than we ever would have guessed.
The gut and the mouth have the most significant microbiomes (communities of microbes like bacteria, fungi and viruses) in the body — the mouth alone may contain over 770 species of bacteria! The connection between the gut and oral microbiomes is referred to as the oral-gut microbiome axis.
Recent research suggests that disease can be passed via microbes from mouth to gut. But what’s maybe more surprising is that microbes previously believed to colonize only in the mouth have been found in other organs, including those related to the gut, but also even beyond to other organs like the pancreas and brain. As such, some researchers now believe that oral microbes could be linked to various diseases including arthritis, Alzheimer’s, cardiovascular disease, and IBS.
When oral microbiota goes into the gut, it changes the gut biome, and we know that changes in the gut flora are linked to problems like Inflammatory Bowel Disease (IBD) and leaky gut, which is a trigger for autoimmune thyroid disease.
Oral health issues of all kinds can trigger autoimmunity. Now we’ll discuss some common dental triggers of Hashimoto’s, and how to start feeling better.
Trigger #1: Infections and Inflammation in the Mouth
There are several potential causes of inflammation in the mouth — all of which will need to be resolved before you can recover fully from Hashimoto’s.
Impacted teeth (teeth that may grow at an angle because they are stuck under the gums) can create inflammation around the root of other teeth and can lead to gingival inflammation, periodontitis, and tooth decay. If you’ve been eating a “modern” diet containing flour, sugar, and processed vegetable fats, developing tooth decay is more likely, and adopting a more ancestral diet (such as the Paleo diet or the diet promoted by Dr. Weston A. Price) may help with preventing new-onset tooth decay.
Dr. Price, a dentist who did most of his work through the 1920s and 30s, was one of the first people who connected nutrition with tooth decay. After studying indigenous populations around the world, he discovered that, when populations who were used to their traditional diet started to eat “modern” (refined/processed) foods, the health of their teeth, and their overall health, declined. He concluded that tooth problems were not genetic, but instead that ancestral diets led to well-formed jaws/teeth, whereas processed diets led to dental problems like crowded teeth, smaller jaws, and tooth decay. He also noted that diseases like heart disease and cancer were absent in these populations.
This led him to recommend dietary guidelines based on those ancestral diets, which included unprocessed foods, bone broths, pasture-fed animals, soaked or sprouted grains, and whole-fat animal products.
Dr. Steven Lin, author of Dental Diet, also promotes Paleo-style eating for healthier teeth.
Mouth Bacteria and Dental Infections
Hidden in any part of the body can lead to gut dysfunction and trigger autoimmune disease — and any time there is an imbalance of bacteria in the mouth, there is the possibility of infection. Examples of common oral health issues that can cause infection include abscesses and gingivitis.
A dental abscess is a collection of bacteria usually present in the gums (surrounding the teeth). An abscess usually looks like a boil on the surface of the gums, and is very painful. The bacteria from the abscess can stimulate our immune systems and drain into the gut, leading to digestive symptoms.
We can often prevent dental infections through the use of oral self-care, but in many cases, the infections will need additional interventions from the dentist, such as antibiotics, draining, or even surgical intervention.
Symptoms may include dental abscess, jaw pain, and/or headaches.
Recommended Treatment Plan
If you have not had a dental X-ray or dental exam in over a year, or currently suspect that you may have any dental issues, be sure to make an appointment with your dentist ASAP. Some dental infections may be “silent” and only a dental exam will reveal their presence — this means that even if you don’t have obvious signs or symptoms of a dental infection, it’s a good idea to get an exam if it has been over a year.
Trigger #2: Periodontitis
Periodontitis is inflammation of the gums, a disease which can lead to gum recession, as well as bone and tooth loss, if not addressed. This inflammation is connected to dental dysbiosis or an imbalance of bacteria in the mouth.
Periodontitis is caused partly by the bacteria P. gingivalis, which can trigger infections in other parts of the body.
I consider periodontitis to be its own category, and do not group it with the inflammation category listed above; and interestingly, studies have correlated it with Hashimoto’s.
Periodontitis can be worsened by — the very substance added to our water and toothpaste that is meant to prevent tooth decay! (More on fluoride further on in this article.)
Symptoms may include bleeding gums (especially with brushing or flossing), puffy gums, receding gums, plaque buildup on teeth, loose teeth, bone loss in the jaw, and bad breath.
Pathogens in our mouths that cause periodontitis have been suggested to contribute to rheumatoid arthritis and Hashimoto’s by activating an inflammatory response.
Recommended Treatment Plan
The conventional dental approach to periodontitis may involve scaling and root planing, where the roots of the teeth are scraped and cleared out to allow for better gum reattachment, surgery, and gum grafts, as well as utilizing the antibiotic doxycycline to restore a better bacterial balance. Doxycycline penetrates the gums seven to 20 times more effectively than other drugs, which means it can get to those deeper gingival crevices where pathogens can hide.
While previous research implicated that oral bacteria triggers periodontitis, I was excited to learn that Dr. Mark Bonner, a Doctor of Dental Surgery out of Quebec, Canada, has found that most cases of periodontitis are caused by two parasitic infections of the gums: Entamoeba gingivalis and Trichomonas tenax (sorry if it’s gross, I just get so excited about new root causes). In one study, Dr. Bonner and his researchers found Entamoeba gingivalis in 69 percent of diseased gingival pockets, whereas it was absent in healthy gum tissue.
This bug is transferred from person to person through kissing and may also be present in dogs, cats, and horses. The parasite Trichomonas tenax may be found in another 5 to 20 percent of periodontitis cases and is also found in people, cats, and dogs.
Dr. Bonner has created a protocol that involves the use of pharmaceuticals (antiparasitics, antifungals, antibiotics) and advanced dental cleaning methods and testing of the periodontal pockets to ensure eradication of Entamoeba gingivalis and Trichomonas tenax, and a return of healthy gum flora. He reports that this method is a cure for periodontitis and has trained over six hundred dentists on the method. For more information on Dr. Bonner’s protocol and additional dental guidance, I recommend his book To Kiss or Not To Kiss.
While Dr. Bonner has trained over 600 dentists worldwide on his protocol, the majority of these dentists are in France and in French-speaking parts of Canada. He does host some seminars in English, and dentists in the US are beginning to take notice as well.
Overall, I’ve noticed reduced gum inflammation in Hashimoto’s patients after using gut balancing herbal protocols (such as the ones in my book Hashimoto’s Protocol) and prescription antiprotozoal agents, such as metronidazole (Flagyl) and Nitazoxanide (Alinia), which have activity against amoeba. However, herbs and prescription medications without the dental cleaning methods may not be able to penetrate the gingival pockets deeply enough to get to all the organisms.
Another consideration is that this amoeba is passed through person-to-person kissing, so you may also want to make sure your kissing partners are treated accordingly.
Check out my full article on for more information.
Trigger #3: Dental Procedures
Dental procedures, like tooth extractions and root canals, can lead to less-than-obvious infections which must be resolved if you want to feel completely better.
Tooth Extraction (Leading to Cavitation)
When you have a tooth extracted, there is a risk of cavitation (a hole in the jaw). A cavitation can collect bacteria while open, and then as the jaw heals over it, bacteria can get trapped inside, which ultimately leads to infection.
Root canals are dental procedures that are done when the root, or inside of the tooth, becomes infected. During this procedure, the tooth is cleaned out and the nerves and insides of the tooth are removed, but the root and tooth are left in the mouth — essentially leaving a “dead tooth.” A dead tooth can harbor infections, and when the nerve of the tooth is removed, we are less likely to sense them.
Symptoms may include deep jaw pain, sensitivity to hot and cold, headaches, and/or migraines.
Recommended Treatment Plan
For a cavitation as caused by tooth extraction: If your symptoms started post wisdom tooth removal, you may want to work with a biological dentist to rule out this type of infection. (To find a biological dentist in your area, visit the International Academy of Oral Medicine & Toxicology’s website for a listing.) The cavitation can be drained and cleaned out by this type of dental professional.
For root canals: If your symptoms began after a root canal procedure, the affected area may need to be cleaned out surgically by a dental specialist, or you may need to have the tooth removed. Unfortunately, these infections are more likely to be inaccessible to antibiotics.
Trigger #4: Amalgam Fillings
Amalgam fillings, or “silver” fillings, contain 50 percent of mercury by weight. They also contain small amounts of silver, tin, copper, and zinc. Amalgams are a major source of mercury exposure in the general population, accounting for two-thirds of human mercury exposure.
Every time a person chews, mercury vapor is released from the fillings.
Most human mercury exposure comes from mercury vapor outgassing from dental amalgam fillings, which is released at an approximate rate of two to 28 micrograms per facet surface per day. Some 70 to 80 percent of this may be absorbed into the body.
We know that all people with Hashimoto’s have a genetic predisposition for the autoimmune disease, and many have sensitivities too. Some people with Hashimoto’s have greater sensitivities and reactivity to metals than others.
For people with Hashimoto’s, mercury can be especially problematic, as it affects T4 to T3 conversion, and causes increases in thyroglobulin antibodies. Research shows that mercury from amalgam fillings accumulates in thyroid tissue, and that mercury levels in the body correspond with the number of fillings a person has had.
Many of my clients report mercury toxicity as a root cause. Symptoms of mercury toxicity may include digestive issues, joint pain, fatigue, brain fog/trouble concentrating, and hair loss. Many of the symptoms related to mercury exposure overlap with those seen in Hashimoto’s. (Read about how Carrie’s dental procedure triggered her Hashimoto’s.)
Recommended Treatment Plan
If you have Hashimoto’s and amalgam fillings, I encourage you to get the MELISA (Memory Lymphocyte Immunostimulation Assay) test. This test can detect hypersensitivity to metals and environmental toxins, and help you determine whether removing your fillings should be a priority.
If you do need your amalgam fillings removed, it’s critical that you have them removed safely. When done improperly, the process can cause you to breathe in additional, possibly large doses of mercury vapor — a big problem if you have the MTHFR gene mutation and intestinal permeability (an excess of mercury exposure all at once can overburden your detox pathways).
Many of my clients have reported an onset or increase in Hashimoto’s symptoms after improper amalgam removal. Proper precautions for safe removal of dental amalgams (to prevent the absorption of mercury vapor into your body) include the use of:
- A Pre-Procedure Assessment: Lab tests can ensure fitness for the procedure and include a complete blood count (CBC), a comprehensive metabolic panel (CMP) and a renal function-glomerular filtration rate (GFR) test.
- The use of rubber dams, oxygen masks and skin covers (for you).
- Extra suction to help evacuate the vapors away from you
For best results, before undertaking the removal of dental fillings, I recommend building up your resilience by completing my Fundamental Protocols, the Liver Support Protocol, the Adrenal Balancing Protocol, and the Gut Balancing Protocol, before getting amalgam fillings replaced. (You can find more information about these protocols in my book, Hashimoto’s Protocol.)
The success of removing amalgam fillings is highly dependent on your body’s ability to clear toxins. Most people with Hashimoto’s already have a toxic backlog, and as the body’s primary detox organs are the liver, skin, and gut, the Fundamental Protocols will give your detox capabilities extra support. The protocols can also be done afterwards.
Please check out my full article on dental amalgams for more information.
Trigger # 5: Incompatible Dental Materials
Fillings, onlays, bridges, braces, plastic aligners (like Invisalign), and other types of materials used for dental work, may trigger an immune response in some individuals. This is a sign that the materials used may be incompatible with your own unique biochemical makeup.
Even “tooth-colored fillings,” referred to as dental composites, can be an issue for some people who may be sensitive. Some composites contain BPA, a known thyroid toxin, which can be released from dental materials and potentially cause symptoms to develop.
What’s important here is that you become familiar with your dental timeline — if you have any of these dental devices, can you trace the onset of your symptoms back to the introduction of any of the materials or dental alignment tools mentioned above?
Recommended Treatment Plan
If you want to determine if you are sensitive to the chemicals and materials in your dental work, I recommend seeking out a biological dentist; the International Association of Biological Dentistry and Medicine (IABDM)’s website has a directory of biological dentists.
With the exception of Invisalign, it may not be feasible to remove materials used in dental work. It may also not be entirely necessary. Before going to extreme measures, I recommend that you introduce protocols into your life that can boost your detox abilities and substance tolerance.
It’s also important that you — and anyone else with an autoimmune condition — start working with a biological dentist to get tested for biocompatibility. Going to a biological dentist will help ensure that any future dental work will be done using only the safest materials for your distinct biochemistry.
Trigger #6: Dental X-Rays
There is evidence that radiation is linked to thyroid cancer — at least for dental professionals who are around X-ray machines consistently, as they are the ones who have been sampled in the current research. Many dentists say that the amount of radiation that patients are exposed to from dental X-rays is too small to be concerned about. However, professionals also have an obligation to follow certain standards of patient care, and minimize exposure to radiation.
And since thyroid-related health conditions can leave us more vulnerable to any type of toxin, even small amounts of radiation could put us at risk, so it’s wise to limit exposure to all radiation.
Recommended Treatment Plan
For this potential trigger, it’s not so much about a treatment plan, but a strategy for minimizing your exposure in the future.
Here are two things you can do:
- Get digital X-rays rather than film x-rays because they are safer overall, and emit less radiation.
Trigger #7: Fluoride
Fluoride is derived from fluorine, an element in the periodic table that does not occur in the elemental state in nature, as it is a highly reactive, toxic gas. Like some other trace minerals, including , this is present in compound form in our natural environment, and even in our bodies — but only in tiny amounts.
Unfortunately, many adults are exposed to fluoride in excessive amounts, and this can affect the thyroid. In fact, fluoride was prescribed to treat hyperthyroidism up until the 1950s because of its thyroid-suppressing activity.
Most adults in fluoridated communities are ingesting between 1.6 and 6.6 mg of fluoride per day from water, which is more than enough to suppress thyroid function. Fluoride may act as a trigger in inducing thyroid cell death and inflammation, and may lead to the development of thyroiditis (inflammation of the thyroid), including autoimmune thyroiditis.
Additionally, research shows that fluoride toxicity increases with each generation. This means that if your mother had fluoride toxicity, it is likely that you will be more susceptible, and your children even more so, and so on.
Fluoride is commonly used in dental treatments.
Acute oral exposure to high levels of fluoride may cause nausea, vomiting, abdominal pain, diarrhea, drowsiness, headaches, polyuria (excessive urination) and polydipsia (excessive thirst), coma, convulsions, cardiac arrest, and even death.
Chronic excessive intake of fluoride has been linked to many diseases such as osteoporosis, arthritis, cancer, infertility, brain damage, Alzheimer’s, autoimmune thyroid disease, DNA damage, gastrointestinal irritation, kidney dysfunction, calcification of teeth (known as dental fluorosis), and much more.
To remove fluoride from our lives, we need to know where to find it, and you’ll probably be surprised by some of the sources aside from dental treatments: certain medications, supplements, bottled beverages, teas (especially the red and black varieties), canned food items, chewing tobacco, toothpaste, and water (in fluoridated communities) can all contain fluoride.
Recommended Treatment Plan
Some people have reported improvement in thyroid symptoms and thyroid function tests following removing fluoride from their lifestyle.
You can only remove fluoride from water by distilling it, using reverse osmosis filtration systems, or using activated alumina defluoridation filters. Most other filters do not remove fluoride.
One of the most convenient and cost-effective reverse osmosis water filters out there is AquaTru’s countertop filter. I have one in my bathroom that I use on a daily basis! It’s super easy to set up (no plumber required!), and I feel better knowing that I’m brushing my teeth and washing my hands with purified water. This is also a great option for apartments or other places where you can’t adjust the plumbing. Plus, the wonderful people at AquaTru have been so generous to offer my readers a discount!
Another option is having a plumber or handyman install an under-the-sink reverse osmosis unit. These typically cost around $200 and provide a consistent, daily source of water without fluoride. I recommend that you use the fluoride-free water for cooking and drinking, for your pets, and for your family.
I also recommend products from Clearly Filtered to remove fluoride. They produce a variety of filtration systems, including water pitchers, shower heads, and under-the-sink filters, that are able to remove up to 99 percent of fluoride from water.
It should be noted that boiling water concentrates the fluoride instead of getting rid of it, while freezing water does not affect the concentration of fluoride. Bottled water isn’t a safe go-to either, since some contain fluoride (see Fluoridealert.orgfor more information).
If installing your own filter isn’t an option, water delivery services will deliver fluoride-free water to your home or office.
If you want to get more involved, join the Fluoride Action Network, an advocacy organization dedicated to broadening the awareness of fluoride toxicity.
In addition to removing fluoride from your day-to-day life, supplements can help you recover from long-term fluoride use. A recent study done in rats has shown that taurine, a major constituent of bile, can partially alleviate thyroid dysfunction caused by fluoride! Rootcology Liver & Gallbladder Support contains taurine and other bile-boosting ingredients.
Another study in mice showed that the amino acid GABA may also have a protective effect on the thyroid.
Please take a moment to review my article on fluoride and your thyroid for more information on this topic.
I suggest trying oral care products from companies that steer away from artificial and toxic ingredients like fluoride, and instead, focus on remineralizing teeth. I recently discovered Akamai’s Complete Oral Care Kit, and have been really happy with the results! It contains a fulvic mineral complex to remineralize teeth and support healthy gums.
Wellnesse whitening toothpaste also contains hydroxyapatite, a naturally-occurring mineral and main component of tooth enamel, which both strengthens teeth and prevents cavities without fluoride.
Getting Better Dental Care
I’ve mentioned the term “biological dentistry” here a few times, and I want to give you a better understanding of what this is exactly, because I truly believe it to be a safer way to maintain a healthy mouth — something we’ve established is important to your overall health — especially if you have Hashimoto’s or another autoimmune disease.
Biological dentistry is a branch of dentistry that looks at the connection between oral care and the health status of the rest of the body. While most traditional dentists focus only on “rescue care” rather than prevention, biological dentists try to prevent health problems that may originate from exposure to certain procedures and materials.
Biological dentists have advanced training in using biocompatible materials in dental procedures, and in the removal of amalgam fillings.
To find a biological dentist in your area, visit the International Academy of Oral Medicine & Toxicology’s website for a listing. If you find a dentist in your area, I suggest you call and “interview” the biological dentist in advance of scheduling an appointment. Here are the questions you should ask:
- Do you use a thyroid shield for X-rays?
- Do you use a rubber dam for removing mercury fillings?
- Do you perform the MELISA test?
What You Can Do at Home: Recommended Self-Care Steps for Better Dental Health
Of course, one of the most vital factors in maintaining healthy gums, teeth, and mouths is our own self-care practices. Some consistent, focused effort here can minimize the need for invasive dental work (anything beyond a cleaning) and reduce inflammation.
Let’s look at a few strategies you can implement on an ongoing basis that will help improve and maintain oral health.
Create an Alkaline Environment
Dental cavities are related to the pH of our mouth (which allows for specific bacterial species to proliferate if kept acidic), as well as the nutrition we take in. Cutting back on sweets, soda, tea, and coffee, and following any of my Root Cause-approved diets, can help reduce the level of acidity in the mouth.
You can also try brushing your teeth with baking soda for one week to help create an alkaline environment in the mouth, making it more difficult for pathogenic bacteria to survive.
Use a Proper Tooth-Brushing Method
Many of us are not familiar with proper brushing techniques. While brushing your teeth, aim at the gum line, as that’s where most pathogenic bacteria live. You can do this by angling your toothbrush up to reach the upper teeth, and angling it down to reach the lower teeth.
The most helpful way to brush is through applying gentle pressure and a jiggling motion — and a Waterpik sonic toothbrush can do the work for you. Flossing is also an important daily habit to start, as this will help to dislodge food particles (aka, food for the pathogenic bacteria).
Eliminate Pathogenic Mouth Bacteria
Eliminating pathogenic mouth bacteria can be challenging as the mouth bacteria form biofilms, also known as dental plaques, that protect them from the usual methods of removal.
My Root Cause Basic Dental Protocol (detailed in Hashimoto’s Protocol) recommends taking an inventory of your mouth to check for receding gums, dark spots, painful teeth, plaque buildup, and loose teeth. It also recommends some of the following tools and strategies that may help eliminate bacteria:
- Cranberry juice: Cranberry juice has been found to have anti-adhesion properties which prevent the attachment of the bacteria to our body’s surfaces, and may also help to dissolve the protective coats that store the bacteria.
After implementing these strategies and tools, check the progress of your dental health regularly over time, and try to note your symptoms. I also recommend getting evaluated for sinus infections.
I recommend trying and continuing with some of the self-care steps I’ve introduced here. Please review chapter 11 of my Hashimoto’s Protocol book for a more detailed overview of the Root Cause Basic Dental Protocol.
I hope that this article has helped you understand how easily your oral and overall health can be compromised… even when you think you are doing something positive like going to the dentist!
Of course I am not discouraging you away from dental visits, but I do think it’s important to take a second look at everything to do with your oral health when it comes to autoimmune diseases like Hashimoto’s, and take precautions when it comes to dental procedures, dental care at home, and dental products.
Supporting your oral health through diet, oral probiotics, pathogenic treatments, and other natural approaches to oral hygiene, as well as stepping away from traditional treatments like fluoride, is so important to your healing.
When it comes to the health of the thyroid, it is important to consider all root causes, even the ones in the mouth… after all, your mouth is the gateway to the rest of your body, and that is a very precious thing!
Have any of the triggers outlined here sparked an “aha” moment for you? Have you addressed a dental trigger and noticed that it helped resolve Hashimoto’s symptoms, or just made you feel better in general?
To learn more about the root causes of Hashimoto’s and how you can approach thyroid healing both naturally and sustainably, I’ve compiled years of research, personal experience and clinical outcomes into my books, Hashimoto’s: The Root Cause, Hashimoto’s Protocol, and Hashimoto’s Food Pharmacology: Nutrition Protocols and Healing Recipes to Take Charge of Your Thyroid Health.
As always, I wish you well on your journey toward better health!
P.S. For continued updates and interaction, please become a part of our Facebook community and sign up for my newsletter to have helpful information delivered right to your email inbox. You’ll also receive occasional updates about new research, resources, giveaways, and more!
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Originally published in June 2017, this article has been revised and updated for accuracy and thoroughness.
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