There’s a concept in medicine called “iatrogenesis.” It’s the idea that medical interventions, even beneficial ones, can create unintended consequences. It’s not about whether a treatment works or is worth doing. It’s just acknowledging that when you work on one system, you inevitably affect others.
As long-time biological dentist Dr. Gary Verigin liked to say, there are no “side effects,” just effects. Some are desirable. Some are not.
Iatrogenesis is one of the factors that inspired biological dentistry in the first place. Decades ago, mindful dentists began to recognize that interventions like filling teeth with mercury and treating them with fluoride can have effects beyond their intended purpose. The mouth isn’t separate from the body, after all, nor is the body isolated from the mouth. What happens in one system ripples through the others, often in ways we don’t anticipate until we start looking closely.
We recently saw a great illustration of all this in a study just published in the International Dental Journal, which looked at the impact of bariatric surgery on oral health. To put it bluntly, researchers found that in the weeks after surgery, oral health took a real nose dive.
Even before surgery, obese patients showed higher levels of periodontal pathogens compared to lean controls. This isn’t so surprising, since other research has suggested that obesity and gum disease are linked. But after surgery, things intensified. There were more bacteria associated with decay. There were more associated with gum disease. There were more associated with bad breath.
All of these were, in the words of the researchers, “significantly more abundant.”
Why should this be? There are a few factors in play. For one, bariatric surgery patients often eat more often at shorter intervals. Some throw up more often for a time, bathing the teeth in gastric acid. The surgery itself triggers profound metabolic and nutritional changes that can affect the composition and flow of saliva. The oral microbiome – the complex community of bacteria that live in the mouth – shifts in response to all this.
The researchers found these same patterns in both human subjects and in mice with experimentally induced periodontitis.
But bariatric surgery is hardly unique in affecting the mouth, nor does every medical procedure necessarily have harmful effects. Rather, the takeaway is that dentists should be part of the larger health conversation – whether that’s involving bariatric surgery or extended fasting; chemo or high-dose supplementation; immune suppressing meds or acupuncture; hormone therapies or herbal protocols or a ketogenic diet. Even benign treatments can shift the oral environment in unexpected ways.
The mouth is never a bystander. It’s an active participant in your body’s ecosystem. If you were to do that extended fasting, for instance, salivary pH and flow could change. Osteoporosis medications can affect jaw bone health and healing. Herbs meant to help the body with chronic stress affect inflammatory pathways that also influence your gums and other periodontal tissues. Switching to a ketogenic diet changes what oral bacteria have to feed on. Antihistamines and antidepressants reduce salivary flow.
The potential for these kinds of “side effects” are exactly why it’s so important to monitor what’s happening in your mouth while you’re treating other conditions – and why you need to keep your biological dentist informed of any medical treatments or surgeries you and your physician may be planning, too.
Every choice you make for your health – conventional or holistic, medical or dietary, pharmaceutical or botanical – creates ripples. Recognizing them is key
