January 15

Epidemic of cracked teeth

18  comments

I’m blogging from the waiting room of my dentist’s office in Boulder, Colorado thanks to my handy Verizon Broadband Access. MD and I are here for our annual maintenance; we come to Boulder because we love our dentist here. We always figure a reason to get back here so that we can put ourselves into her tender hands.
As MD was getting all her prelim stuff done, the dentist, Judy Timchula (who gets my highest recommendation) came out to chew the fat with me in the waiting room. She mentioned that she is seeing an epidemic of broken and cracked teeth. She said that when she started practice about 25 years ago she almost never saw this problem, and now she sees it all the time.
The patients who suffer these problems are almost always obese. Her theory is that they grind their teeth at night because they suffer from some degree of sleep apnea. I agree with her. Sleep apnea is a component of the insulin resistance syndrome, and can be significantly improved with a low-carb diet. The really nice thing is that a low-carb diet will improve the sleep apnea long before any substantial loss of weight occurs, so it is most likely a function of lowering insulin levels.
As per usual, someone has come along with a solution to this problem that only serves to create more problems via the law of unintended consequences. A dentist has developed a snore guard mouthpiece that dentists everywhere are making to put in people’s mouths who have this problem. Judy says that these patients are then prone to TMJ problems because of the way the device affects the jaw, they’re at risk for loosened teeth, infections, and a host of other problems.
The solution is simple. Follow a rigid low-carb diet and you will see sleep improvements almost immediately.


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  1. you may be right about low carbing and snoring. According to my girlfriend, who didnt have the fortune of meeting moi until I dropped the carbs , I almost never snore. My previous, pre-low carb gf’s weren’t so lucky, I apparently used to snore like a *&&^%$…
    Hi mrfreddy–
    I suspect that your new GF is lucky she came on the scene post low-carb.  Thanks for the snoring history.  I’m sure the low-carb diet has helped.  It helped moi as well (I used to grind my teeth).
    Cheers–
    MRE 

  2. Wow,It amazes me, really! Low carbing IS the true human diet and most civilized humans shun this.
    My question is, does snoring lead to cracked teeth? Or is it a combination of both, snoring and insulinemia. Or is grinding teeth a symptom of insulinemia? I have a sister who grinded her teeth throughout her childhood. I assume that she continues to grind her teeth. She is also diabetic but not obese. What is, if any, the relationship here.
    My aunt, who was the poster child of obesity, snored badly. It was really scary.I think that she was diabetic. I don’t remember. All of this probably ties together for my whole family.Don’t know what my point is here but I am sure that I will see some clear-cut hints with my family and insulinemia.
    Hi Mary–
    I think that many people with sleep apnea grind their teeth.  Sleep apnea is a byproduct of hyperinsulinemia, diabetes, and/or obesity.  The cracked teeth come from people gritting or grinding them during poor quality sleep.
    MRE 

  3. RE: sleep apnea
    Another frequently overlooked cause of sleep apnea is hypothyroidism (which is also underdiagnosed, as I found out the hard way). I did *not* have any of the commonly-listed risk factors for sleep apnea (obesity, mouth-breathing, snoring, etc.) so I figured that my sudden waking with long-lasting, violent coughing fits (annoying because it also woke my husband and was hard to get back to sleep) was due to allergies, post-nasal drip tickles, etc., and so did my former doctor. But I did have a lot of the hypothyroid symptoms and after finally finding the right doctor, was treated with thyroid hormones. Not only did most of my symptoms completely improve, but so did some things that I had not related to the hypothyroidism, such as the night-time coughing fits, and constant yawning & sleepiness whenever I read aloud to my 8 yo son, ever since he was a baby (this was strange because it didn’t happen with regular speech). Later I learned that sleep apnea *is* an often-overlooked symptom of hypothyroidism (due to weakened throat muscles that relax and close down during sleep, I guess).
    So much to learn … I feel like a medical detective sometimes.
    Cheers,
    Anna
    Hi Anna–
    Thanks for the interesting history.  Oftentimes thyroid problems are underdiagnosed.
    I’m glad you got your problem fixed.
    Cheers–
    MRE 

  4. Just a quick question. Can you elaborate on how the insulin resistant syndrome contributes to the teeth grinding? I am a psychotherapist in private and see alot of anxious, stressed patients with teeth ginding that resolves when they manage their life stressors better. But the stress management does not always work—so curious about the insulin resistant syndrome…
    thanks!
    Hi Rachel–
    I don’t know the mechanism behind hyperinsulinemia and sleep apnea–I don’t think anyone does, but it does exist.  But, when people have sleep apnea or even poor sleep quality they tend to grind their teeth.  I’m sure that people with acute and/or chronic stress have poor sleep quality, so they grind their teeth.  If you resolve their response to stress with psychotherapy, their sleep should improve, and the grinding should stop.  But if a component of their poor sleeping is being driven my a metabolic problem, that needs to be solved as well.
    Hope that answers your question.
    Best–
    MRE 

  5. Cracked teeth – I wonder do they have fluoride in the water there? I read in a book by christopher bryson called the fluoride deception that while fluoride does strengthen teeth it makes them brittle so they crack & break more easily. Does the same to bones as well.
    So if there is fluoride in the water & then coupled with the Sleep apnea problems then this would more than account for what the dentist is seeing.
    Hi Helen–
    I don’t know if the water here is fluoridated or not, but it doesn’t matter.  This is Boulder, and no one drinks city water.  They all drink bottled water.  So, it is certainly happening here in Boulder without the help of fluoride.

    Best–
    MRE

  6. Please give us some refs on this. I’ve been low-carbing for five years and was diagnosed with sleep apnea last Sep and am using CPAP.
    As far as I’ve heard, the connection between sleep apnea and obesity is unclear — hardly anybody’s apnea gets cured by weight loss, though improvement may occur, but a lot of people have become obese as our sleep deteriorated. My sleep problems go back more than 20 years, and I’ve had no sense that low-carbing has improved my sleep. At all.
    Hi Joanna–
    We’ve had multiple patients that were able to get off of their CPAP after a week or two on low-carb.  I don’t know what the connection is with insulin resistance and hyperinsulinemia, but as soon as the patients got their insulin levels under control (which doesn’t take long with a rigid low-carb diet) their sleep apnea improved markedly.  It takes very little weight (if any) before improvement is seen.  I don’t think the sleep apnea is a function of the obesity as much as it is a function of the hyperinsulinemia driving the obesity.

    If you are now on CPAP and you want to try this regimen, make sure to do it under your doctor’s supervision.
    Best–
    MRE 

  7. You should read Weston A. Price book written in the ’30 about diet and teeth quality. It’s an eye opener, the pictures are quite telling.
    Another point concerning cracked teeth, I read that the tooth enamel is the first calcium ion giver to neutralize acidic food and beverage. Continuous drinking of acid fizz (like colas) will probably weaken progressivly the teeth and a poor nutrition will then be unable to compensate.
    Hi Gallier2–
    I have read the Weston Price book; it’s most interesting.
    As to tooth enamel, alas, you could take everything I know about tooth enamel and write it on a postage stamp and still have enough room left over for the Lord’s Prayer.  So, I don’t know if it’s the first calcium ion donor or not.  Sorry.
    Cheers–
    MRE 

  8. With first, I meant first in chronological order, not in quantity of calcium ions.
    But I found this study with google which shows that the hardness of tooth enamel decreases with the exposure to Coca-Cola.
    Hi gallier2–
    Thanks for the link.  The study shows that Coca Cola causes a softening of the tooth enamel, but it takes a lot of time and is pretty much undone by saliva.
    Best–
    MRE 

  9. If you are now on CPAP and you want to try this regimen, make sure to do it under your doctor’s supervision.
    What regimen are you recommending? I’ve been on CPAP since early Oct 2006. I’ve been low-carbing for five years. All of my doctors know that I follow a steady low-carb diet.
    I didn’t grind my teeth and never had a snoring problem, only light intermittent snoring on my sleep study; I did stop breathing while asleep and was very tired all the time. My apnea rate was only moderate (150 arousals plus 31 awakenings in 8.4 hours), but I had serious oxygen desats.
    It’s impressive that your patients had such dramatic improvement so quickly. What did their follow-up sleep studies show?
    Hi Joanna–
    I’ve never done sleep studies on my patients.  Nor have I taken them off of their CPAP.  Their other physicians who started them did as they improved on their dietary regimens.
    In medicine there are no 100% deals.  What works for a lot of people won’t work for all.  In our experience, every patient we have seen who came in on CPAP got better and ended up discontinuing it.  That doesn’t mean that there aren’t patients out there who might not get rid of their sleep apnea.  We just never saw them.  Apparently, you are one.
    As to what we did…we put our patients on strict low-carb diets, restricting carbs to about 30 grams per day. 
    Best–
    MRE 

  10. Here’s a crazy theory about the teeth grinding. Maybe the folks that are obese/hyperinsulimic/insulin resistant/leptin resistant get so hungry in their sleep that all they do is dream about eating and chewing food!
    Hi Ned–
    Great theory; let’s write it up.
    Cheers–
    MRE 

  11. My sleep apnea went away when I quit eating wheat, at least the kind that would wake me up gasping. For me and many others, the high gluten wheat now all around us is very inflammatory and has many neg effects in our systems. We are well aware of insulins many important roles in how we function. Maybe, through lowering insulin levels and we help our sleep center in our brains to just function better. Every cell can function better when insulin is doing its job. So if this cell and his buddies are in the brain stem and are part of respiratory control… Maybe its the lowering of inflammation, as a result of lowered insulin, to allow our airways to be more open. Why wouldn’t it work everyone? Maybe insulin insensitivity isn’t their only reason for being inflamed. Maybe a certain individual is eating a pound of cheese a day and they’re sensitive to cheese, inflaming them like crazy. My point is that insulin is a general on the playing field of health. When we get rid of a bad general (ie: poor insulin management) and get a good one (ie: proper levels and sensitivity of our cells to insulin) we can have many, many positive health benefits. But even a great general can’t win a war single handedly.
    Low nutrient levels could be associated with soft enamel, as well as lowered pH from eating a lot of refined carbs and soda. We’re stressed, we’re nutrient deficient and we’re insulin resistant. We go to bed wound tighter than a drum and start chompin on our chompers. We have weak enamel cause we haven’t any or didn’t have any nutrients to build some good enamel and help with insulin. End result, we’re fat, have poor teeth and can’t sleep too well. So, in the immortal words of that famous philosopher Hulk Hogan “Say your prayers and take your vitamins” and I would add follow a Protein Power/ insulin friendly lifestyle. Amen and pass the sardines.
    Hi Robert–
    All excellent points and spot on.  Thanks for writing.
    Cheers–
    MRE 

  12. Dr Eades,
    Is doing strict low carbing made ineffective by taking insulin from an insulinemia point of view. I am strictly following Dr Bernstein’s diet guidelines for carbs, but I did not discover low carb as being positive for diabetics until after 10 years after diagnosis and started insulin (lots of insulin) at the same time as I started low-carb, a year ago. (I thought I was doing everything right but watched deterioration year after year until in desperation went looking for answers and discovered Dr Bernstein) I’m now finding it impossible to lose weight and my sleeping has definitely deteriorated, so back to my original question, does taking insulin negate low-carbing both weight wise and sleep wise. sigh…. if I had only found you all upon diagnosis, the establishment med system sure has a lot to answer for!
    Glenice
    Hi Glenice–
    You are in very good hands with Dr. Bernstein.  Too much insulin can negate the weight loss with low carb.  Insulin is a fat storage hormone.  If you have too much of it, you tend to store fat and prevent its release from the fat cell.  Dr. Bernstein typically recommends a fairly minimal amount of insulin, so if you are having trouble losing, you should check your dosages with him.
    Best–
    MRE 

  13. I have always suspected a connection between weight and sleeping problems. As my father got heavier his snoring got louder and now he wears a mask and O2 to bed for the sleep apnia. Also, before I got my now wife on the lowcarb she started snoring and I predicted it would stop if she lowcarbed with me and guess what… As soon as she lost a little weight the snoring stopped. Finally, A friend of mine says he never snored but his his wife has started complaining that he does now snore. Guess what changed… His weight has gone up about 20lbs over the last 2 years. I just figured that fat didn’t just collect around the belly, my dad has a fat neck, why couldn’t fat collect in your head somewhere and constrict breathing while you slept.
    As always, more proof that weight loss cures everything and lowcarb is the best way to do it.
    Thanks,
    Dave LaCivita
    Hi Dave–
    Weightloss solves a lot, but probably not everything.  There is some evidence that people with sleep apnea store fat in the neck area,
    Glad to hear that all the snoring in your marital bed has stopped. 
    Cheers–
    MRE 

  14. Mike,
    Great discussion – obese patients with cracked teeth, interesting. I appreciate the sleep apnea theory, but I can’t resist offering another possibility. My research into the root cause of acid reflux, documented in my book, Heartburn Cured, indicates that reducing carbohydrates can control GERD. Your own clinical experience supports this approach. Also, obese and elderly people suffer a much higher rate of GERD.
    I find it facinating that a new study published very recently in the Journal of the American Medical Association that looked at the medical records of more than 145,000 (people over 50) patients in England showed that taking heartburn drugs including Nexium, Prevacid and Prilosec for a year or more can raise the risk of a broken hip markedly. “The study raises questions about the safety of some of the most widely used and heavily promoted prescription drugs on the market, taken by millions of people.”
    “The researchers speculated that when these drugs reduce acid in the stomach, they also make it more difficult for the body to absorb bone-building calcium. That can lead to weaker bones and life threatening hip fractures.” The risk was 2 1/5 times greater compared to people not taking the drugs.
    My theory suggests that acid reflux is caused by ingesting more carbohydrates than our small intestine can absorb and that this act results in bacterial overgrowth and excess gas production that drives acid reflux. It stands to reason that those on high carb diets are more obese, more prone to reflux, more likely to take drugs like Nexium and more prone to osteoporosis and thus cracked teeth. Look at the sales figures for these drugs. They are in the billions of dollars (or Pounds) per year. The sales of just Nexium was 5.7 billion dollars last year!
    Hi Norm–
    Interesting theory about the cracked teeth and GERD.  I’m not sure there is a correlation between osteoporosis and cracked teeth.  If there is, I’d love to see the data.  If there is some weakening of the tooth structure due to lack of calcium absorption secondary to GERD drugs, there still must be some kind of mechanical stress to break the weakened teeth.  That’s where the sleep apnea and teeth grinding comes into the picture.
    Go Patriots!
    Cheers–
    MRE 

  15. Thank you Dr. Eades and those who wrote comments.
    I have been enjoying the past 3 years of fabulous sleep while low-carbing, but recently my sleep has deteriorated. I actually do dream that I am eating, and wake up grinding my teeth.
    I recently discovered these wonderful Finnish rye crackers that are very low in carbs. I’ve been eating two every day at lunch.
    Causation? Who knows. But I think I’ll skip the crackers for awhile and see what happens.
    Hi Karen–
    Keep us posted on what happens.  I’m curious.
    Cheers–
    MRE 

  16. Wow.
    After reading what everybody has to say, I have to conclude that making your life and your diet as simple as possible cures a lot of health problems. As I learn more and more about low carb and how many types of physical problems it alleviates, it seems strange that more people don’t try low carb first before going to their doctors for prescription drugs. I wish more people could be convinced it’s not a fad, but the way of eating that’s most natural to the human body. I will keep talking about it to friends and family no matter how frustrating it gets.
    Hi LC–
    Keep up the good work.
    Best–
    MRE 

  17. I’ve ground my teeth while sleeping my whole life, to the point that, according to my dentist, I have very little enamel left on cetain of my teeth. Even after 4 years of protein power this habit persists. My blood pressure has gone down to 110/60, my last cholesterol profile was great and I’ve experienced other benefits, yet still I grind away at night. So evidently factors other than carb consumption are involved.
    I’ve been reading your books and blogs for several years now and would like to thank you for your unceasing efforts in publicizing a philosophy of dietary sanity. You once stated on the blog that you knew some good doctors around the country, and even recommended one to a reader. Do you happen to know any in the Ann Arbor/Southeastern Michigan area? Maybe someone you trained, or met during your medical activities? One who shares your medical philosophy, of course. I ask this becaus I’ve been experiencing a few medical problems for a few years(poor sleep, brain fog,a high lipoprotein a level), and I’ve been through several doctors who constantly harangued me about the dangers of my saturated fat and red meat consumption. So either I ended up firing them, or they me. I feel like I need these nutrients to aid in my recovery. If you can possibly help here, I’d appreciate it greatly. Keep up the good work.
    Thanks, Norman
    Hi Norman–
    I always hate to recommend physicians whom  I don’t know really well because I’ve had some nasty surprises.  One of the speakers at the medical meeting at which MD and I lectured in Colorado Springs was a physician from West Bloomfield, MI, Dr. David Brownstein.  He was a most impressive lecturer and told me after my talk that he gave a lot of copies of Protein Power out in his practice.  I spent some time with him one night at dinner, and I think he would be an excellent choice for a Dr. who seems to be tremendously concerned with his patient’s well being.
    Here is his contact info:
    David Brownstein, M.D.
    5821 W. Maple Rd., Ste. 192
    West Bloomfield, MI  48322
    (248) 851-1600

    If you do choose to pay him a visit, please let me know how it goes.
    Best–
    MRE 

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