Stress, formaldehyde, smoking, and pain hypersensitivity in teeth or other body parts.

Tying up loose ends into a bow.

Jul 20, 2023

Stress, smoking, and smog are all health hazards for the related reason of increased formaldehyde levels. We make formaldehyde endogenously when under stress, and it is produced in smoke and is found in bad air or in odors from new car smell, or new carpet or new vinyl shower curtains. Volatile chemicals off-gas from plastic products and molds can add another air-borne hazard. Formaldehyde also has a few dietary sources - aged fruit juice is a source after it has been bottled for a while. Aging increases formaldehyde content. That might not be enough to affect adults but it might add up for an infant or toddler who is smaller proportionally and may be given juice regularly.

Baby crib mattresses were found to be a source of volatile (gaseous) chemicals that increased risk of unexplainable crib deaths (besides vaccine history). A doctor in Australia designed a crib mattress cover that prevents release of volatile chemicals from the mattress and it worked - fewer dead babies and they didn’t end up with flat skulls like US infants who were put only on their “Back to sleep”. - never allowed to sleep on their bellies, the infants often got deformed skulls and then ended up in little plastic football helmets to try to get the skull to grow in a more normal shape.

Formaldehyde needs methyl folate to be broken down into a safer chemical. Excess formaldehyde can leave someone with too little methyl folate and formaldehyde levels may increase due to lack of methyl folate. Lack of methyl folate as it is used up then also reduces methylation cycles and can lead to lower energy levels for the person and increased risk of DNA changes, epigenetic or other gene changes in the cell nucleus which may be cancer promoting.

In the tooth pulp or gumline or elsewhere in the body, formaldehyde and other stress produced chemicals, add to inflammatory signaling which increases TRP channel expression. Then more TRP channels causes more reactivity to ‘pain’ signals.

Smoking, smog, and stress are increasing pain signaling because they are hurting us and we should stop hurting ourselves with them - says our body. Our body will get louder as the negative chemicals increase. “Stop hurting ourselves.” “PLEASE stop hurting ourselves!” “PLEASE STOP hurting ourselves!” “PLEASE STOP HURTING OURSELVES!” …. “OKAY, YOU ASKED FOR IT, WE HAVE CHRONIC DEGENERATION NOW! MAYBE NOW YOU WILL LISTEN TO US!”

Our cells want more methyl folate and methylation cycles to function normally, and to not have oxidative waste chemicals in excess. Lactic acid is a waste chemical that is increased when energy metabolism shifts away from the Citric Acid Cycle and to fermentation of sugar, fats or glutamate.

Mitochondrial support nutrients and antioxidants like vitamin C and alpha lipoic acid would be helpful in addition to methyl folate. Nrf2 promoters also help reduce inflammation and promote clean up within the body.

Formaldehyde negatively effects proteins, which then may change their signaling in a way that leads to more TRP expression on cell membranes.

“Formaldehyde is a well known cross-linking agent that can inactivate, stabilize, or immobilize proteins.” (Metz, et al., 2004)

“Tissue damage and its downstream consequences are experimentally assayed by formaldehyde application, which indiscriminately modifies proteins and is presumed to cause pain through broadly acting mechanisms. Here we show that formaldehyde activates the ion channel TRPA1 and that TRPA1-deficient mice exhibit dramatically reduced formaldehyde-induced pain responses.” (Macpherson, et al., 2007)

The increased expression of TRPA1 channels seen in teeth with cavities is trying to tell us to stop chewing so hard on that fragile cavity-ridden tooth and stop drinking ice water with that cavity-ridden tooth while ‘we/your caring body cells’, try to repair the demineralization enough to protect the inner tooth pulp from daily painful stimuli which wouldn’t have been painful on a tooth without cavities.

The general inflammation of the gumlines during extreme stress or volatile chemical exposure (smokers/people in smog or working in a brand-new office building) would have a similar mechanism of action - more TRPA1 channels but more spread throughout the inflamed body and gumline, not just in a tooth with cavities.

The way to reduce an excess number of TRP channels is to reduce your stress load, increase repair pathways, and keep that up for a few years. The excess in TRP channels can gradually reduce back to a more normal level of sensitivity. But some increased sensitivity may remain or return as soon as stress levels or smoking/bad air increases again. Flair-ups in symptoms can then be common and also be confusing as to what is going on in the body.

Another oxidative stress chemical we produce which activates TRPA1 channels was found to be the aldehyde 4-HNE - levels of it might be increased by emotional or physical stressors on the body. Whether fearful, anxious, angry, or grieving - emotional stress can cause similar symptoms of increased inflammation as working a physical job for eight hours, having a strenuous workout at the gym, or inhaling smog, smoke, or stale musty smoke odors in an apartment with the lingering effects of having smoked regularly indoors. Third-hand smoke is also a health negative.

“Similar to TRPA1 agonists cinnamaldehyde and acrolein, 4-HNE is an α,β-unsaturated aldehyde and is produced by lipid peroxidation in cells during oxidative stress. Considered to be the compound primarily responsible for the pathological effects of oxidative stress, 4-HNE can bind to cysteine, histidine, and lysine residues in proteins via Michael addition reaction (Uchida, 2003). We find 4-HNE to be a potent activator of TRPA1, with an EC₅₀ of 13 μm (Fig. 1B and data not shown). This is physiologically relevant, because oxidative stress is thought to cause accumulation of HNE at 10 μm to 5 mm in membranes (Uchida, 2003).” (Macpherson, et al., 2007)

Our body probably doesn’t want formaldehyde to enter the tooth pulp through a cavity, as it would be a neurotoxin within the Central Nervous System and can cause neurodegeneration.

“Formaldehyde is an environmental pollutant that is also generated in substantial amounts in the human body during normal metabolism. This aldehyde is a well-established neurotoxin that affects memory, learning, and behavior. In addition, in several pathological conditions, including Alzheimer's disease, an increase in the expression of formaldehyde-generating enzymes and elevated levels of formaldehyde in brain have been reported.” (Tulpule, Dringen, 2013)

Our body really doesn’t want oral bacteria to enter through a cavity. (Galler, et al., 2021)

Addition: Dr. Mercola just published an article about tooth decay bacterial species being found in the brains of people with Alzheimer's. Pdf in my Dropbox (dropbox.com/oral health and dementia) (Dr. Mercola’s site link) Additional motivation to care for our gums and teeth.

Mitochondria and bacteria mostly avoid producing formaldehyde during methylation cycles though. They have an enzyme, dimethylglycine oxygenase, which seems to promote a different chemical to be formed instead of formaldehyde. We would convert the waste product formaldehyde into useful formate as long as there is not too much formaldehyde to cope with and there was enough methyl folate (but not an excess either) to drive the chemical reaction forward. In typical cellular metabolism betaine is converted back into methionine instead of staying in the dimethylglycine form. The dimethylglycine may be made into other chemicals though too, and then a formaldehyde is produced. (Tralau, et al., 2009)

“The catabolism of betaine (a breakdown product of choline) and other methylated amines liberates one-carbon (C1) units derived from substrate methyl groups (1). Whereas C1 units derived from the oxidation of betaine are coupled to methionine production, the subsequent oxidation of dimethylglycine, sarcosine, and glycine can potentially release formaldehyde, a toxic product (2), by hydrolysis of unstable imine intermediates (3–5), which is a problem common to many amine oxidases and dehydrogenases (6). Thus, rapid hydrolysis of these imines yields formaldehyde and the demethylated amine product (Fig. 1).” (Tralau, et al., 2009)

*This may all seem difficult, hard to understand, yet we are doing these chemical reactions every day. Nature is amazing and so are you and me.

Tooth series:

What are teeth? "Teeth are not Bones" a Twitter saga about magnesium deficiency and miscommunication, or maybe about Tribalism showing its Fangs. (Substack) *I plan to add a shorter post with just the summary self-care points and a briefer overview.
Teeth; TRP channels that sense pressure, cold, and promote remineralization in teeth with cavities. Post too long for email, but it isn't 34 pages. ;-) (Substack)

*On length - I write until the topic is done, my curiosity satisfied, and hopefully my teeth on the way to better mineralization. My vegan-ish diet (autoimmune issues), post-menopausal age, and subpar dental hygiene habits have had some negative effects. With knowledge, we can improve! But not everyone wants 34 pages.

Natural Tooth care products -

Activated charcoal: Activated charcoal is a natural method used for tooth whitening but in a toothpaste may not be ideal. The teeth do not need to be sandpapered. The method I learned was to just swish the powder, with a little water, in your mouth for several minutes. It removes surface impurities and leaves a shiny smooth, just went to the dentist, feeling. Scrubbing it with a toothbrush directly on your teeth would be too gritty and can cause tooth roughness. It would not help restore age related yellowing of the teeth. The problem then is too little enamel is left due to age changes and the yellower dentin is showing through the thinner white enamel layer.

Baking soda: Baking soda is mentioned in many places as a toothpaste substitute but it may be too harsh for frequent use. (webmd.com/oral-health/what-to-know-about-activated-charcoal-whitening)

Coconut oil: Swishing with a teaspoon of coconut oil for several minutes each day (then spit out the oil) can be healing to the gumline and cleans the teeth well but be cautious not to aspirate (inhale) fats - they don’t belong in your lungs.

Hydroxyapatite toothpaste: Here is an example product wieh 35% hydroxyapatite toothpaste from a Japanese company in licorice flavor rather than salicylate richer mint flavor (bonus for me). It is not inexpensive but has more hydroxyapatite (“from scallop shell”) than other brands I saw with 10% or no specific content mentioned on the ‘Remineralizing’ product.

Hokuei Sherupika Hydroxyapatite Remineralizing Toothpaste Enamel Repair, Pack of 2 (Amazon) *unaffiliated.

High protein intake effects methylation cycles in a way that leads to excess ammonia production and the body may not be able to keep up with detox of it. This topic was included briefly in the What are Teeth? post. (Substack)

A very high protein diet would be dangerous to the developing fetal brain due to the ammonia that is produced as a waste product from breakdown of the excess amount of nitrogen rich amino acids. Our energy and methylation cycles wouldn’t produce ammonia as a waste from burning sugar or fats for energy. (Herring, et al., 2018)

Disclaimer: This information is being provided for educational purposes within the guidelines of Fair Use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.

Reference List

(Galler, et al., 2021) Galler KM, Weber M, Korkmaz Y, Widbiller M, Feuerer M. Inflammatory Response Mechanisms of the Dentine-Pulp Complex and the Periapical Tissues. Int J Mol Sci. 2021 Feb 2;22(3):1480. doi: 10.3390/ijms22031480. PMID: 33540711; PMCID: PMC7867227. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7867227/

(Macpherson, et al., 2007) Macpherson, L.J., Xiao, B., Kwan, K.Y., Petrus, M.J., Dubin, A.E., Hwang, S.-W., Cravatt, B., Corey D.P., Patapoutian, A., An Ion Channel Essential for Sensing Chemical Damage, J of Neuroscience, 17 October 2007, 27 (42) 11412-11415; DOI: https://doi.org/10.1523/JNEUROSCI.3600-07.2007 https://www.jneurosci.org/content/27/42/11412

(Metz, et al., 2004) Metz, B., Kersten, G.F.A., Hoogerhout, P, Brugghe, H.F., Timmermans, H.A.M., de Jong, A., Meiring, H., et al., Identification of Formaldehyde-induced Modifications in Proteins: REACTIONS WITH MODEL PEPTIDES*, Journal of Biological Chemistry, Volume 279, Issue 8, 2004, Pages 6235-6243, ISSN 0021-9258, https://doi.org/10.1074/jbc.M310752200. https://www.sciencedirect.com/science/article/pii/S0021925818445723

(Tralau, et al., 2009) Tralau, T., Lafite, P., Levy, C., Combe, J.P., Scrutton, N.S., Leys, D., An Internal Reaction Chamber in Dimethylglycine Oxidase Provides Efficient Protection from Exposure to Toxic Formaldehyde, The J of Biological Chemistry, Vol 284(26a0;7826 –17834, June 26, 2009, https://www.jbc.org/article/S0021-9258(19)82065-3/pdf

(Tulpule, Dringen, 2013) Tulpule K, Dringen R. Formaldehyde in brain: an overlooked player in neurodegeneration? J Neurochem. 2013 Oct;127(1):7-21. doi: 10.1111/jnc.12356. Epub 2013 Jul 15. PMID: 23800365. https://pubmed.ncbi.nlm.nih.gov/23800365/