Periodontitis and Cavities

Nutrition for a Healthy Mouth

Good oral hygiene, regular tooth brushing and flossing, tongue cleaning, regular dental check-ups, and use of high-quality oral care products can prevent or reduce the risk of cavities. At the same time, because of the risk of a dangerous inflammatory response, it is important that people with gum disease protect themselves with powerful anti-inflammatories. The following nutrients protect the health of the gums and reduce inflammation.

Coenzyme Q10. In one study, topical application of CoQ10 to periodontal pockets significantly reduced gingivitis, bleeding of the gums, and pocket depths after five to seven days of treatment (Hanioka T et al 1994). In another study, symptoms of gingivitis and periodontitis improved three weeks after beginning CoQ10 treatment (Wilkinson E et al 1975). Topical application of CoQ10 improved adult periodontitis alone and in combination with non-surgical periodontal therapy (Hanioka T et al 1994).

Essential Oils. Mouth rinses containing essential oils such as eucalyptus oil and menthol significantly reduced both gingival inflammation and bleeding when used in conjunction with fluoride toothpaste (Beiswanger B et al 1997). Tea tree oil ( Melaleuca alternifolia ) is an antiseptic, fungicide, and bactericide that is effective against oral bacteria (Vasquez J et al 2002; Carson C et al 2001).

Folic Acid. Mouthwash containing folic acid is effective in treating gingivitis and its accompanying inflammation. Among pregnant women, who are prone to gingivitis, folate mouthwash has proven superior to oral folate supplementation in preventing gingivitis (Pack A 1980, 1984; Thompson M 1982).

Green Tea. Green tea extract is rich in a class of antioxidants called catechins. Two in particular, epigallocatechin gallate (EGCG) and epicatechin gallate (ECG), combat oral plaque and bacteria (Horiba N et al 1991; Otake S et al 1991; Rasheed A et al 1998). These green tea polyphenols work as anti-plaque agents by suppressing glucosyl transferase, which oral bacteria use to feed on sugar. Other research has demonstrated that green tea extract can kill oral bacteria and inhibit collagenase activity. Collagenase, a natural enzyme that becomes overactive in the presence of bacterial overgrowth, can destroy healthy collagen in gum tissue.

Green tea extract applied topically inhibits S. mutans bacteria in the laboratory. These bacteria have been implicated in the development of dental cavities. The scientists suggested that certain extracts from green tea might be especially helpful in preventing tooth decay by inhibiting the development of bacterial plaque (Hattori M et al 1990). In a Chinese study, green tea extract was used to rinse and brush the teeth. The study demonstrated that S. mutans could be inhibited completely after contact with green tea extract for five minutes. There was no drug resistance after repeat cultures, and the researchers concluded that green tea extract is effective in reducing the risk of developing cavities (You SQ 1993). Other studies have found that the catechins in green tea remain at active levels in saliva for up to one hour following application (Tsuchiya H et al 1997).

More recent studies confirm the benefits of green tea in fighting gum disease, especially when combined with conventional treatments. In a pilot study, hydroxypropylcellulose strips containing green tea catechins as a slow-release local delivery system were applied to the pockets in periodontal patients once a week for eight weeks. The green tea catechins inhibited the bacteria P. gingivalis and Prevotella spp ., and a reduction in pocket depth was observed (Hirasawa et al 2002).

Aloe Vera. Aloe vera gel packings are sometimes used by dentists after tooth extraction to reduce the incidence of infection and dry socket (Poor M et al 2002). They have also been shown to reduce the risk of developing ulcers in the mouth (Garnick J et al 1998).

Propolis. A 20 percent ethanol propolis extract was compared to antifungal agents such as nystatin, clotrimazole, econazole, and fluconazole in a study designed to assess the susceptibility of Candida albicans , an oral bacteria. The researchers concluded that the propolis extract could be an alternative medicine in treating candidiasis, but further studies were needed (Martins RS et al 2002)

The Value of Vitamin C, Vitamin D, and Calcium

Vitamin C has long been known for its ability to prevent gum disease and tooth loss. In fact, the use of vitamin C in dental disease is one of the earliest recorded uses of nutrient therapy in Western medicine. In 1747, a British Naval physician named James Lind noticed that lime juice, which is rich in vitamin C, helped prevent scurvy, which causes tooth loss. As a result, British sailors bottled lime juice for gum disease prevention. Incidentally, this practice later gave rise to the term “Limey.”

Modern studies have confirmed the value of vitamin C, in conjunction with other antioxidants, in promoting good oral health. In one controlled, double-blind study of patients with periodontitis, a multivitamin combined with regular brushing resulted in significant improvements in gum health and a reduction in pockets after 60 days (Munoz C et al 2001). Clinical studies of people with vitamin C deficiencies show that gingival inflammation is directly related to ascorbic acid status, suggesting that ascorbic acid may influence the early stages of gingivitis, particularly bleeding (Leggott P et al 1986).

Researchers have also examined the value of vitamin D and calcium, which are typically used to reduce the risk of osteoporosis. Supplementation with these two nutrients reduces the rate of bone and tooth loss in postmenopausal women and men. Calcium intake of 800 mg or more per day reduced the risk of periodontitis in females (Nishida M et al 2000).

Reducing Gum-Related Inflammation

Because of the association between gum disease and systemic inflammation, researchers have begun looking at anti-inflammatory nutrients in the context of gum disease. In one study, 30 adults with gum disease were given a variety of polyunsaturated fatty acids, including omega-3 fatty acids from fish oil (up to 3000 mg daily) and omega-6 fatty acids from borage oil (up to 3000 mg daily). At the end of the study, clinically significant improvements were measured in both gingival inflammation and the depth of gum pockets (Rosenstein ED et al 2003). Another preliminary human study found that omega-3 fatty acids tended to reduce inflammation, but called for more thorough research (Campan P et al 1997). However, in light of the established connection between omega-3 and omega-6 fatty acids and inflammation, and the fatty acids' lack of side effects, it is reasonable for people with gum disease to consider using these supplements. Other anti-inflammatory supplements include ginger and curcumin, though neither of these has been studied in the context of inflammatory gum disease.