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How Natural Medicine Can Improve Oral Health

Pohala Clinic PC Blog How Natural Medicine Can Improve Oral Health
natural medicine for oral health

Why Does Oral Health Matter?

Oral health is incredibly important for not only having a healthy mouth but also a healthy body. When the mouth is not healthy, bacteria and other pathogens can enter the bloodstream through the gums, creating inflammation both locally in the mouth as well as systemically. Having a clean mouth not only improves oral health but also metabolic health as well! 

What is Periodontitis?

Periodontitis is an inflammatory condition affecting the periodontium (gums); which includes tissues such as the gingiva, periodontal ligaments, cementum, and bone. It is estimated that roughly 42.2% of adults older than 30 years old in the United States have some form of periodontitis, with 7.8% having severe periodontitis and 34.4% having non-severe periodontitis.1 Things that can predispose people to periodontitis include smoking, poor oral hygiene, diabetes mellitus, cardiovascular disease, and pregnancy. Symptoms of periodontitis may include gum inflammation, pain, redness, swelling, changes in texture, bleeding, calculus build up, increased tooth mobility, shifting of teeth, and, eventually, tooth loss.2 

Standard of Care Treatments

Standard of care treatments may include cleaning, scaling, and root planning, as well as educating patients on proper oral hygiene practices (including brushing 2-3x daily, flossing 1x daily, rinsing with mouthwash, smoking cessation, and routine professional cleanings).2  In more severe cases, other therapies may be used including antibiotics, pocket reduction surgery, as well as gingival / bone grafts.3 The number one toothpaste type that is generally recommended by dentists and periodontists for periodontal disease is called stannous fluoride, which has been shown to be generally more effective than standard sodium fluoride in the treatment of periodontitis.4

Pros and Cons of Fluoride

Fluoridation seems to be very effective at reducing the rate of dental carries and helping to calcify enamel. Stannous fluoride has also been shown to reduce bacterial growth in those with periodontal infections. 4 However, fluoride may cause dental fluorosis, as well as neurological, endocrinological, and nephrological toxicity.5,6 However, fluoride is still recommended by the American Dental Association and is considered generally safe to use for the promotion of optimal oral health.7 

Adjunctive Treatment Options to Consider

Theobromine based Toothpaste: Theobromine, the active ingredient of cocoa, has been shown to mineralize carious lesions at rates more or comparable to sodium fluoride.8 It is thought that this is due to theobromine’s ability to increase the activity of osteoprotegerin, which helps to increase osteoblast activity and therefore, tooth enamel remineralization.9,10 Icariin (the active ingredient in Horny Goat Weed) has also been shown to increase osteoprotegerin signaling and thus, bone remineralization.11,12,13 Essential Oil (including thymol, eucalyptol, and menthol)  based mouthwashes have also showed promise in the treatment of periodontal disease by reducing calculi and gingival inflammation.14,15 

Who Might Benefit?

Theobromine based toothpaste is great for people with or without periodontitis trying to improve their oral health. There are both fluoridated and non-fluoridated theobromine products available on the market. Although fluoride is a great way to improve enamel remineralization, theobromine-based toothpaste may be an effective alternative for those who decide to stay fluoride free; or may be a great addition to those already using fluoride products in their oral hygiene practices. Herbal medicines that work by increasing osteoprotegerin may also be a great adjunctive treatment alongside a well implemented oral hygiene regiment.  

Let’s Improve Oral Health Together

If you’re ready to explore how naturopathic medicine can support oral health, we’re here to assist you. Schedule a visit with a Pohala Clinic provider to take the first step.

You can also learn more about Dr. Alex M Cullen ND, MCR, who utilizes clinical training and clinical research experience to support patients with bone health, including oral health.

 

 

Work Cited:

  1. “Periodontal Disease in Adults (Age 30 or Older)| Data & Statistics | National Institute of Dental and Craniofacial Research.” Accessed June 14, 2025. https://www.nidcr.nih.gov/research/data-statistics/periodontal-disease/adults.
  2. Gasner, Noah S., and Ryan S. Schure. “Periodontal Disease.” In StatPearls. Treasure Island (FL): StatPearls Publishing, 2025. http://www.ncbi.nlm.nih.gov/books/NBK554590/.
  3. Boehm, Tobias K., and Clara S. Kim. “Overview of Periodontal Surgical Procedures.” In StatPearls. Treasure Island (FL): StatPearls Publishing, 2025. http://www.ncbi.nlm.nih.gov/books/NBK599507/.
  4. Clark-Perry, Danielle, and Liran Levin. “Comparison of New Formulas of Stannous Fluoride Toothpastes with Other Commercially Available Fluoridated Toothpastes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials.” International Dental Journal 70, no. 6 (December 8, 2020): 418–26. https://doi.org/10.1111/idj.12588.
  5. Aoun, Antoine, Farah Darwiche, Sibelle Al Hayek, and Jacqueline Doumit. “The Fluoride Debate: The Pros and Cons of Fluoridation.” Preventive Nutrition and Food Science 23, no. 3 (September 2018): 171–80. https://doi.org/10.3746/pnf.2018.23.3.171.
  6. Cunningham, Jasmyn E. A., Hugh McCague, Ashley J. Malin, David Flora, and Christine Till. “Fluoride Exposure and Duration and Quality of Sleep in a Canadian Population-Based Sample.” Environmental Health 20, no. 1 (February 18, 2021): 16. https://doi.org/10.1186/s12940-021-00700-7.
  7. “Fluoride: Topical and Systemic Supplements.” Accessed July 28, 2025. https://www.ada.org/resources/ada-library/oral-health-topics/fluoride-topical-and-systemic-supplements.
  8. “Efficacy of Theobromine and Sodium Fluoride Solutions for Remineralization of Initial Enamel Caries Lesions.” ResearchGate, December 17, 2024. https://doi.org/10.18502/fid.v18i10.6134.
  9. Zhang, Mengjuan, Haifeng Zhang, Lu Jia, Yi Zhang, Runwen Qin, Shihua Xu, and Yingwu Mei. “Health Benefits and Mechanisms of Theobromine.” Journal of Functional Foods 115 (April 1, 2024): 106126. https://doi.org/10.1016/j.jff.2024.106126.
  10. Clough, Bret H., Joni Ylostalo, Elizabeth Browder, Eoin P. McNeill, Thomas J. Bartosh, H. Ralph Rawls, Tetsuo Nakamoto, and Carl A. Gregory. “Theobromine Upregulates Osteogenesis by Human Mesenchymal Stem Cells in Vitro and Accelerates Bone Development in Rats.” Calcified Tissue International 100, no. 3 (March 2017): 298–310. https://doi.org/10.1007/s00223-016-0215-6.
  11. Wisanwattana, Wisanee, Kanjana Wongkrajang, Dong-yi Cao, Xiao-ke Shi, Zhong-hui Zhang, Zong-yuan Zhou, Fu Li, et al. “Inhibition of Phosphodiesterase 5 Promotes the Aromatase-Mediated Estrogen Biosynthesis in Osteoblastic Cells by Activation of cGMP/PKG/SHP2 Pathway.” Frontiers in Endocrinology 12 (March 12, 2021). https://doi.org/10.3389/fendo.2021.636784.
  12. Wang, Wei, Dan-Fang Sun, Zhe Dong, and Wen-Lu Zhang. “Icariin Suppresses Osteogenic Differentiation and Promotes Bone Regeneration in Porphyromonas Gingivalis-Infected Conditions through EphA2-RhoA Signaling Pathway.” International Immunopharmacology 143 (December 25, 2024): 113302. https://doi.org/10.1016/j.intimp.2024.113302.
  13. Zheng, Dong, Songlin Peng, Shu-Hua Yang, Zeng-Wu Shao, Cao Yang, Yong Feng, Wei Wu, and Wan-Xin Zhen. “The Beneficial Effect of Icariin on Bone Is Diminished in Osteoprotegerin-Deficient Mice.” Bone 51, no. 1 (July 1, 2012): 85–92. https://doi.org/10.1016/j.bone.2012.04.006.
  14. Haas, Alex Nogueira, Tassiane Panta Wagner, Francisco Wilker Mustafa Gomes Muniz, Tiago Fiorini, Juliano Cavagni, and Roger Keller Celeste. “Essential Oils-Containing Mouthwashes for Gingivitis and Plaque: Meta-Analyses and Meta-Regression.” Journal of Dentistry 55 (December 1, 2016): 7–15. https://doi.org/10.1016/j.jdent.2016.09.001.
  15. McGrath, Colman, Janet Clarkson, Ann-Marie Glenny, Laurence J. Walsh, and Fang Hua. “Effectiveness of Mouthwashes in Managing Oral Diseases and Conditions: Do They Have a Role?” International Dental Journal, The role of mouthwash as part of routine oral care, 73 (November 1, 2023): S69–73. https://doi.org/10.1016/j.identj.2023.08.014.
Author
De. Alex Cullen, Naturopath Alex Cullen ND Doctorate of Naturopathic Medicine (ND) Master’s of Science in Clinical Research (MCR) Bachelor’s of Science Major: Wellness and Alternative Medicine (WAM) with a minor in Chemistry

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