Let’s talk about teeth, Baby! Let’s talk about K2 and D3. (If you share my love of 90’s hip hop, you certainly recognize the beat to these lyrics that just may someday be the Dr. Mindy remix of the old Salt n Pepa favorite).

The modern food system. It makes a lot of food, but that mass produced food is depleted of so many important nutrients. Let’s chat about one of the most common and unrecognized nutrient deficiencies in modern humans. Vitamin K2.

Many of us think about how key nutrients in our diet affect our overall health. It’s unfortunate, but much of the traditional dietary and dental advice is based on old assumptions made from a place with insufficient understanding or regard for the “big” picture. Conventional dental nutritional advice simply tells us, “Don’t eat sugar” and “Calcium is the most important nutrient for strong teeth and bones, so drink a lot of milk.”. Period. That’s all, folks. With all that has been discovered and studied and proven over the last century, this common advice barely scratches the surface. I’ll try to keep this fascinating, so put on your party pants and get ready for a wild ride into tooth, bone, and even cardiac health.

Though still overshadowed by more well-known calcium and vitamin D3, it is vitamin K2 that is most responsible for preventing, and even reversing, dental cavities. Outside of oral health, the benefits go far beyond this into bone, cardiac, and systemic health.

Don’t get me wrong, Calcium and D3 are critical factors. Calcium is the mineral that is the actual building block of our teeth and bones. D3 is the fat-soluble vitamin that facilitates the absorption of calcium that we consume, making it available for our body’s needs.

Supplementation of calcium and D3 has thus been the go-to for prevention of osteoporosis, which is conventionally associated with calcium deficiency. Interestingly, the increased focus on supplementation of calcium and D3 alone has correlated with an increase in prevalence of athlerosclerotic heart disease, often with limited true increase in bone density and dental health. While many studies have reported this trend of increased arterial plaques, heart attacks, and strokes with supplementation with calcium alone, the biggest alarm sounded when the prestigious British Medical Journal published these findings in April of 2011. Old news dies hard, though, because over a decade later I still have numerous patients supplementing with calcium alone, or calcium with only D3, for osteoporosis prevention.

It is essential to understand that calcium ingested and absorbed, with the help of D3, does not effectively get to our teeth and bones without the presence of the third essential member of the trio, the fat-soluble vitamin K2. Calcium is no doubt the lead singer of this band, but it is way off pitch when it goes solo. It requires BOTH of its background dancers- D3 and K2- to put on a good show.

An analogy that I often use with patients is that of trucking cargo to a jobsite. Calcium is the cargo. D3 is the truck that allows transport of the cargo (allows it to absorb into our bloodstream). K2 is the GPS to make sure that it gets to its proper destination. Without the GPS, the cargo ends up at the wrong jobsite (soft tissues) and sometimes just gets left on the side of the road (the walls of arteries and veins).

Vitamin K2 is responsible for activating Osteocalcin, a very important protein that draws calcium from our bloodstream into our teeth and bones. There, our bone-building osteoblasts and tooth-building odontoblasts can use it as a matrix to lay down new bone and dentin tooth structure.

K2 is also responsible for the activation of another key protein, matrix gla protein (MGP), which is responsible for removing excess calcium accumulating in soft tissues such as arteries, veins, and ligaments. In one of the more routine xrays taken in dentistry to evaluate the teeth and jaws, we will occasionally see calcification of a small ligament that runs from our skull to our throat. In my exams, the presence of this calcification brings about conversation of possible correlation with insufficient K2 levels.

K1, phylloquinone, is most well known for clotting. We get this straight from its plant sources when we eat our leafy greens.

K2, menaquinone, is the activator for important calcium directing proteins and therefore essential in tooth and bone health. Unlike animals, we humans are unable to synthesize this one in our digestive system, so we must get it from food sources.

As compared to the simple plant-derived nature of K1, vitamin K2 is derived from a more complex bacterial pathway.

The most common dietary sources of K2 are from grass-fed and pastured animal products.

With their gut microbiome, animals have a unique ability to synthesize K2 from the K1 they obtain from grass. We humans do not have this super power. The meat (particularly organ meat, such as liver), egg yolks, and full fat cheese/butter/cream/milk from these grass-fed animals is an ideal way to obtain dietary K2. It is important to note that the same foods sourced from their grain-fed counterparts do not have an appreciable amount of vitamin K2.

An amazing vegetarian source of vitamin K2 is natto, due to a specific strain of bacteria used in its fermentation process. Variable amounts of K2 can also be found in naturally fermented sauerkraut, kimchi, and other fermented veggies.

Vitamin K2 supplementation is a great idea, and a friendly option for diets of all kinds- carnivores, omnivores, vegetarians, and vegans alike. You’ll find 2 varieties of K2 in supplements. Supplemental MK7 is the preferred natural form sourced from natto. Supplemental MK4, less desirable with lower bioavailability, is a synthetic form from a plant extract. A standard good daily dose of MK7 supplement is 90 to 120 mcg, just once a day. Some of my favorite MK7 supplements are shown below.

• I love Jarrow. They use the MK7 form. Gelcaps are small and easy to swallow, with 90 mcg per capsule. They also have a good D3 supplement, the same small gelcaps.
• SBR Nutrition D3 and K2 drops. Clean ingredients with the MK7 form, as well as MCT oil carrier. This is about the most convenient dosage. Just a few drops. Drop it straight under the tongue for fast absorption, or add it to a bit of food or drink. K2 content is 25 mcg per drop, so 3 to 5 drops are a great dose. Great for adults and kids alike!

Please be sure that you are getting sufficient D3 from these or other supplements, or from plenty of summer sunlight exposure, as both of these vitamins are necessary for proper calcium utilization. It is important to note that K2 and D3 are fat-soluble vitamins, so you need good, healthy fats in your diet to absorb and reap the benefits. Examples of healthy fats are olive oil, coconut oil, avocado oil, grass-fed butter and cream, avocados, etc. The discussion of healthy vs unhealthy fats is a rabbithole that I can’t fit into this post, but safe to just say that there is a lot of old misinformation, brought to us by studies funded and manipulated decades ago by the food industry, that is still commonplace in mainstream beliefs and recommendations.

My dental school education regarding dietary dental health didn’t get much past the basics of less sugar more calcium but, thanks to some prodding from a functional medicine MD friend of mine years ago, I tip-toed… and then dove head first… into an amazing journey of post-graduate education into a true nutritional understanding of not only oral health, but whole body health. I started where many people have. A thick book published way back in 1939, full of black and white pictures and loads of information, by a Cleveland dentist who has been called “the Isaac Newton of nutrition”. Dr. Weston Price left his practice in 1925 to travel the world in search of the cause behind the epidemic that he was seeing in his patients- rampant tooth decay and physical degeneration, including malformed dental arches with severely crowded teeth and altered facial structure.

His travels and studies were focused around indigenous populations who were still eating their traditional diets and living their traditional lifestyles, all with perfect jaw/facial structure and no tooth decay or gum disease. At the time of Price’s travels, many of these populations were beginning to trade with the western world and be “modernized” to highly processed and industrialized foods. In this unique time, he was able to observe not only the perfect physical and dental health of populations eating their traditional diets of unprocessed plants and animals, but was also able to see the effects in subsequent generations and siblings as the population moved from traditional diets to the processed white flour and nutrient depleted foods of western civilization.

Left side vs right side photos show the differences he was seeing in the same indigenous populations. He would see these dramatic changes in the older generation still maintaining traditional diets vs the younger generation eating the processed foods traded with western civilization. He even saw dramatic differences in older siblings, who were conceived and began life when their parents were still sustaining completely with traditional diets, vs younger siblings, who were conceived and born after their parents had introduced nutrient depleted foods from trade and lifestyle changes from trade and colonization with modern society. Pretty alarming, no??!

He also did laboratory studies of nutrients in traditional vs modern foods at the time, in order to study nutrient content. He found that the traditional foods were chock full of vitamins and minerals, while the processed modern counterparts were severely deficient. While most of these vitamins and minerals that he found were already known and named compounds, there was a particular nutrient whose presence he found to be a critical factor in the presence or absence of tooth decay and alterations of development of the jaws and face. He named this unidentified nutrient “Activator X”, and he found it to be particularly high in the butter from grassfed cows, especially during rapid growing seasons when the grass was at its greenest. Upon return from his travels, he even went so far as to prove that he could slow down, stop, and in some cases reverse the progression of dental decay in a group of US children, simply by giving them daily doses of butter very high in its “Activator X” content. Spoiler alert: Activator X has now been identified as Vitamin K2. With all that we now know about the mechanism of action of Vitamin K2, this makes a lot of sense.

Sufficient K2 is important for all ages and groups: kids, tweens, teens, young adults, middle-agers, the elderly, and prospective and expecting mothers/fathers.

In her book Vitamin K2 and the Calcium Paradox, Dr. Kate Rheaume-Bleue goes into great detail about the workings of K2 in various body systems.

Some conditions that can be associated with vitamin K2 deficiency:

• Narrow, crowded dental arch
• Dental cavities
• Osteoporosis
• Atherosclerosis
• Wrinkles
• Kidney disease
• Fertility issues

It is very important to realize that K2 is by no means the only root cause behind any of these things. The human body is a complex beast, and there are many ducks that need to be in a row for all systems to continue to run efficiently on all cylinders. Nutrition plays a critically important role, along with sleep, breathing, and movement.

Vitamin K2 and The Calcium Paradox by Dr. Kate Rheaume-Bleue, an extremely knowledgeable naturopath, is an amazing resource for a deep dive into the understanding of the working of Vitamin K2 in all of its many workings in overall health. This comes with my highest recommendation

Dr. Weston Price’s book, Nutrition and Physical Degeneration, is an eye-opening read. This is a great place to start a health journey. An important aspect of understanding health is to understand the true health of humans with traditional diets and lifestyles. We have to look at history for this, and it very quickly shows us how our modern processed and nutrient-void food system is literally breaking us down. We are a resilient species, so we are adapting, but the cost to health has been substantial.

Dr. Steven Lin is a dentist out of Australia who had a similar eye-opening and profession-enhancing experience to me after he read Dr. Weston Price’s book. He now dedicates a great deal of his time to study of and educating others in nutritional impacts on oral and overall health. He has written a book, The Dental Diet, and he is also a great one to follow on Instagram.

Multiple studies and journal articles have been published over the last 20 or so years that support all of these findings regarding the benefits of vitamin K2. That being said, we’re still waiting for some big sexy publications to get this important knowledge into the mainstream. If you know much about science, you know that funding for research is critical. The truth of the matter is that this funding often comes from big industry….pharmaceutical companies and industrialized food, to name the biggies. Studies are only funded if they will bring a conclusion to turn profit for the funding source. While health improvements may be astounding, simple dietary changes to natural whole foods to achieve these improvements don’t make money for anyone, so the funding for this research unfortunately is lacking.

Some studies and journal articles that you can start by looking into arethe October 2008 issue of the Journal of Thrombosis and Haemostasis, and the January 2006 issue of the Journal of Agricultural and Food Chemistry.

And others!

https://pmc.ncbi.nlm.nih.gov/articles/PMC6413124/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6413124/