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Eight years ago, I told you something that made a lot of people raise their eyebrows:
The mouthwash sitting on your bathroom counter could be raising your blood pressure.
Back then, many people thought it sounded far-fetched. A few colleagues in dentistry and medicine dismissed it outright.
I stood firm because the science made sense. I’d seen the early research, I knew how the oral microbiome worked, and I trusted that more evidence would follow—and it has.
Since then, more research has piled up—and one landmark study really drove it home.
In 2019, a three-year trial looked at people who used mouthwash twice a day. The results were staggering:
- 49% higher risk of developing diabetes
- Almost double the risk of high blood pressure
All from killing off bacteria in the mouth!
Here’s what’s going on:
Half of the nitric oxide your body makes—the molecule that keeps your blood vessels relaxed and flexible—comes from the back of your tongue.
Certain oral bacteria take the nitrates from your food and turn them into nitrites, which is step one in making nitric oxide.
Antibacterial mouthwash wipes them out.
No bacteria → no nitric oxide → blood vessels can’t expand → blood pressure goes up.
(Nitric oxide isn’t the only molecule that declines with age. Research shows C15:0 levels drop too, affecting cell resilience and metabolic health. That’s why I take Fatty15 daily.)
Now for the good news: you can reverse this, simply by supporting that nitric oxide pathway—and even lower blood pressure. (A clinical trial found that simply scraping your tongue daily improved nitric oxide production and measurably lowered blood pressure.)
So what does this mean for you? If you are trying to improve insulin sensitivity, are prediabetic, or already dealing with high blood pressure, the next steps are simple:
- Scrape your tongue every day
- Feed the right bacteria with Fygg Functional Mints
- Brush with a toothpaste that protects your oral microbiome—like Fygg
- Eat nitrate-rich vegetables like beets, celery, and leafy greens
These aren’t just dental habits. They’re cardiovascular and metabolic habits.
Here’s why I’m so fired up right now:
This month, two different MDs have talked about how oral health impacts their patients’ brain and heart health, one one of the largest health podcasts in the U.S.
Dr. David Perlmutter—one of the most respected neurologists in the world—calls nitric oxide “a missing link” in both cardiovascular and brain health.
Dr. Jermey London—a board certified cardiothoracic surgeon—when asked, “if you wanted to fast track someone’s path to heart disease, the #1 killer in the world for both men and women, how would you design their day?” responded, “don’t brush your teeth and don’t floss.”
Wow. I love it when medicine talks dental!
We’ve been talking about this for years, and now it’s hitting the mainstream conversation—in this case, on a top five health podcast!
And you’re part of why that’s happening. Every time you share one of my posts, forward one of these emails, or just keep the conversation going, you’re pushing the oral–systemic connection into the mainstream.
If you want to see this collaboration between dentists and MDs in action, here’s where to start:
- Listen to Dhru’s episode with Dr. Perlmutter: Overlooked and Shockingly Simple Tools to Assess and Mitigate the Risk of Alzheimer’s Disease
- Listen to Dhru’s episode with Dr. Jeremy London: The Daily Habits That Quietly Lead to Heart Disease (And How to Stop Them)
- Download my CRP Letter to get your dentist and your doctors talking to each other and working together for you
- Join the waitlist for my Functional Dentist CE course—open to all healthcare providers who want to join this movement. Hit reply and my team will get you set up.
Because your mouth isn’t separate from your body. It’s the front door to everything else.
-Dr. B
P.S. I’ll be going in-depth on the mouth-brain and mouth-heart connection in my upcoming book with Penguin Life. What questions do you have? What’s been missing in the conversations you’ve had with your dentist, doctor, or even your friends? Reply to this email and let me know. Your questions might shape what makes it into print.
Know someone who would appreciate this information?
Forward it to them & tell them to sign up for future emails here.
References & Further Reading
Bondonno, C. P., et al. (2015). Antibacterial mouthwash blunts oral nitrate reduction and increases blood pressure in treated hypertensive men and women. Free Radical Biology and Medicine, 94, 36–46.
Joshipura, K. J., et al. (2017). Antiseptic mouthwash use and pre-diabetes/diabetes among overweight/obese adults: A cross-sectional study. Nitric Oxide, 71, 14–20.
Kapil, V., et al. (2013). Human inhibition of oral bacteria reduces the nitrate-nitrite-nitric oxide pathway, blood pressure, and exercise performance. Nitric Oxide, 26(4), 197–206.
Burhenne, M. (2018). Why I Never Recommend Mouthwash. Ask the Dentist.
Burhenne, M. (2019). The Oral Microbiome: What It Is and Why It’s So Important. Ask the Dentist.
Burhenne, M. (2020). Tongue Scraping: Benefits for Oral and Overall Health. Ask the Dentist.
Burhenne, M. (Podcast, 2021). How the Oral Microbiome Impacts Your Whole Body. Ask the Dentist Podcast, Episode 3.
Petersen, C., et al. (2021). The role of oral bacteria in cardiovascular disease. Journal of Oral Microbiology, 13(1), 1887690.
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