How Poor Oral Health Promotes Systemic DiseasesNovember 2004
By Nelson Wood, DMD, DSc, MS
|LE Magazine November 2004|
| How Poor Oral Health Promotes Systemic Diseases |
By Nelson Wood, DMD, DSc, MS
Nutrients to Improve Oral Health
The benefits of the nutrients in the Life Extension™ toothpaste formulation have been scientifically researched in both the dental and medical literature. Its unique formulation includes coenzyme Q10, tea tree oil, xylitol, hydrogen peroxide, folic acid, lactoferrin, and squalene.27,28
Topical application of CoQ10 to periodontal pockets has been associated with significant improvements in gingivitis and bleeding of the gums.29 In one clinical study, topical application of CoQ10 was so effective in promoting healing and reducing periodontal pocket depth that after five to seven days of treatment, the diseased gingival sites were difficult to locate.30
Patients with periodontitis frequently have significant gingival and white-blood-cell CoQ10 deficiencies, indicating both a local and a systemic nutritional imbalance. A local deficiency of CoQ10 could predispose the gingiva to periodontitis, and periodontitis could even exacerbate systemic CoQ10 deficiency.31 Topical application of CoQ10 improves adult periodontitis not only as an individual treatment, but also in combination with traditional non-surgical periodontal therapy.29 CoQ10 is also known for its cardioprotective properties.32
Tea tree oil (melaleuca alternifolia) is known for its antiseptic, fungicidal, and bactericidal effects.33 It has been found to be effective in reducing oral bacteria.33 Topically applied tea tree oil gel was found to significantly reduce gingivitis and bleeding of the gums in people with severe gingivitis.34
Xylitol, a naturally occurring sweetener that is not fermentable by cavity-inducing oral bacteria, demonstrates numerous benefits in promoting oral health. When tested as a dietary supplement, xylitol was associated with impressive reductions in cavity incidence. Xylitol may decrease the production of acids that demineralize the teeth.35 It may also stimulate the production of saliva, a helpful effect for individuals taking medications that produce mouth dryness. The use of xylitol is compatible and complementary with all current oral hygiene recommendations. Its pleasant taste facilitates a wide array of applications to promote oral health.36
Hydrogen peroxide, long used for its antiseptic properties, has been shown to inhibit plaque formation and to reduce gingivitis.37 Its bubbling action exposes oral bacteria that are difficult to reach with ordinary brushing and flossing, promoting a more thorough cleansing of the teeth and gums.
Folic acid is required by the body on a daily basis to build new cells, and is essential for the integrity of the gingival tissues. Topical folic acid in the form of mouthwash has been shown to be effective in the treatment of gingivitis and its accompanying inflammation. Folic acid significantly reduces gingival redness and bleeding of the gums in people with gum disease.38 This effect is thought to be the result of topical application of folic acid and not of its systemic influences. Denture wearers and individuals with impaired dentition have significantly lower blood and dietary levels of folate.39,40 Dietary folic acid supplementation may also increase the resistance of the gingiva to local irritants.41
Lactoferrin has been shown to reduce the adhesion of several bacteria found in the oral cavity,42,43 to stop the growth of periodontitis-causing bacteria,43 and to kill cavity-causing bacteria.43 In a study of cats, lactoferrin powder appeared to offer benefits in resolving oral lesions when applied locally.44
Squalene, a nutrient with a chemical makeup similar to vitamin A, is easily emulsified and spreads easily. Squalene has been shown to be effective in inducing bone formation45 and improving immune health. The squalene in the Life Extension™ toothpaste formula is derived from shark liver oil.
Conventional treatment for periodontitis may not always be enough to maintain optimal oral health. Nutritional therapeutics may be useful adjuncts in improving healing, reducing inflammation, and strengthening the body’s immune system. These nutritional approaches include coenzyme Q10, folic acid, xylitol, lactoferrin, and squalene. These nutrients may be useful when used internally as well as when applied topically to the oral tissues. Optimizing oral health is an important step in preventing disease and promoting a long and healthy life.
1. Genco R, Offenbacher S, Beck J. Periodontal disease and cardiovascular disease. Epidemiology and possible mechanisms. J Am Dent Assoc. 2002 Jun;133:14S- 22S.
2. Loos BG, Craandijk J, Hoek FJ, Wertheim- van Dillen PM, van der V. Elevation of systemic markers related to cardiovascular disease in peripheral blood of periodontitis patients. J Periodontol. 2000 Oct;71(10):1528-34.
3. Wu T, Trevisan M, Genco RJ, Falkner KL, Dorn JP, Sempos CT. Examination of the relation between periodontal health status and cardiovascular risk factors: Serum total and high density lipoprotein cholesterol, c-reactive protein, and plasma fibrinogen. Am J Epidemiol. 2000 Feb 1;151(3):273-82.
4. Scannapieco F, Ho A. Potential associations between chronic respiratory disease and periodontal disease: Analysis of National Health and Nutrition Examination Survey III. J Periodontol. 2001 Jan;72(1):50-6.
5. Mercado F, Marshall R, Bartold P. Inter-relationships between rheumatoid arthritis and periodontal disease. A review. J Clin Periodontol. 2003 Sep;30(9):761-72.
6. Wood N, Johnson R, Streckfus C. Comparison of body composition and periodontal disease using nutritional assessment techniques: third National Health and Nutrition Examination Survey (NHANES III). J Clin Periodontol. 2003 Apr;30(4):321- 7.
7. Jeffcoat M. Osteoporosis: a possible modifying factor in oral bone loss. Ann Periodontol. 1998 Jul;3(1):312-21.
8. Krall E, Dawson-Hughes B, Papas A, Garcia R. Tooth loss and skeletal bone density in healthy postmenopausal women. Osteoporosis Int. 1994 Mar;4(2):104-9.
9. Jeffcoat M, Geurs N, Reddy M, Cliver S, Goldenerg R, Hauth J. Periodontal infection and preterm birth: results of a prospective study. J Am Dent Assoc. 2001 Jul;132(7):875-80.
10. Krejci C, Bissada N. Women’s health issues and their relationship to periodontitis. J Am Dent Assoc. 2002 Mar;133(3):323-9.
11. Grossi S, Genco R. Periodontal disease and diabetes mellitus: a two way relationship. Ann Periodontol. 1998 Jul;3(1):51-61.
12. Beck J, Elter J, Heiss G, Couper D, Mauriello S, Offenbacher S. Relationship of periodontal disease to carotid artery intima- media wall thickness: the atherosclerosis risk in communities (ARIC) study. Arterioscler Thromb Vasc. Biol. 2001 Nov;21(11):1816- 22.
13. Grossi S. Treatment of periodontal disease and control of diabetes: an assessment of the evidence and need for future research. Ann Periodontol. 2001 Dec;6(1):138-45.
14. Ridker P, Rifai N, Rose L, Buring J, Cook N. Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med. 2002 Nov 14;347(20):1557-65.
15. Haraszthy V, Zambon J, Trevisan M, Zeid M, Genco R. Identification of periodontal pathogens in atheromatous plaques. J Periodontol. 2000 Oct;71(10):1554-60.
16. Wood N, Johnson R. Recovery of Periopathogenic Bacteria From Embalmed Human Cadavers. Clinical Anatomy In Press.
17. Iacopino A, Cutler C. Pathophysiological relatioships between periodontitis and systemic disease: recent concepts involving serum lipids. J Periodontol. 2000 Aug;71(8):1375-84.
18. Wactawski-Wende J. Periodontal diseases and osteoporosis: association and mechanisms. Ann Periodontol. 2001 Dec;6(1):197- 208.
19. Champagne C, Madianos P, Lieff S, Murtha A, Beck J, Offenbacher S. Periodontal medicine: emerging concepts in pregnancy outcomes. J Int Acad Periodontol. 2000 Jan;2(1):9-13.
20. Paquette D. The periodontal infection-systemic disease link: a review of truth or myth. J Int Acad Periodontol. 2002 Jul;4(3):101-9.
21. Jeffcoat M, Lewis C, Reddy M, Wang CY, Redford M. Post-menopausal bone loss and its relationship to oral bone loss. Periodontol. 2000;23:94-102.
22. Mercado F, Marshall RI, Klestov AC, Bartold PM. Is there a relationship between rheumatoid arthritis and periodontal disease? J Clin Periodontol. 2000 Apr;27(4):267-72.
23. Merchant A, Pitiphant W, Rimm E, Joshipura K. Increased physical activity decreases periodontitis risk in men. Eur J Epidemiol. 2003;18(9):891-8.
24. Grossi S. Smoking and stress: common denominators for periodontal disease, heart disease, and diabetes mellitus. Compend Contin Educ Dent Suppl. 2000;(30):31-9.
25. Tezal M, Grossi S, Ho A, Genco R. Alcohol consumption and periodontal disease. The Third National Health and Nutrition Examination Survey. J Clin Periodontol. 2004 Jul;31(7):484-8.
26. Neiva R, Steigenga J, Al-Shammari K, Wang H. Effects of specific nutrients on periodon- tal disease onset, progression and treatment. J Clin Periodontol. 2003 Jul;30(7):579-89.
27. Tsunemitsu A, Honjo K, Nakamura R, Kani M, Matsumura T. Effect of ubiquinone 35 on hypercitricemia. J Periodontol. 1968 Jul;39(4):215-8.
28. Tsunemitsu A, Matsumura T. Effect of coen- zyme Q administration on hypercitricemia of patients with periodontal disease. J Dent Res. 1967 Nov;46(6):1382-84.
29. Hanioka T, Tanaka M, Ojima M, Shizukuishi S, Folkers K. Effect of topical application of coenzyme Q10 on adult periodontitis. Mol Aspects Med. 1994;15 (Suppl):s241-8.
30. Wilkinson E, Arnold R, Folkers K, Hansen I, Kishi H. Bioenergetics in clinical medicine. II. Adjunctive treatment with coenzyme Q in periodontal therapy. Res Commun Chem Pathol Pharmacol. 1975 Sep;12(1):111-23.
31. Hansen I, Iwamoto Y, Kishi T, Folkers K, Thompson L. Bioenergetics in clinical medicine. IX. Gingival and leucocytic deficiencies of coenzyme Q10 in patients with periodontal disease. Res Commun Chem Pathol Pharmacol. 1976 Aug;14(4):729-38.
32. Sunamori M, Tanaka H, Maruyama T, Sultan I, Sakamoto T, Suzuki A. Clinical experience of coenzyme Q10 to enhance intraoperative myocardial protection in coronary artery revascularization. Cardiovasc Drugs Ther. 1991 Mar;5(Suppl 2):297-300.
33. Saxer UP, Stauble A, Szabo SH, Menghini G. Effect of mouthwashing with tea tree oil on plaque and inflammation. Schweiz Monatsschr Zahnmed. 2003;113(9):985-96.
34. Soukoulis S, Hirsch R. The effects of a tea tree oil-containing gel on plaque and chronic gingivitis. Aust Dent J. 2004 Jun;49(2):78- 83.
35. Touger-Decker R, van Loveren C. Sugars and dental caries. Am J Clin Nutrition. 2003 Oct;78(4):881S-92S.
36. Peldyak J, Makinen K. Xylitol for caries prevention. J Dent Hyg. 2002;76(4):276-85.
37. Rosin M, Kocher T, Kramer A. Effects of SCN-/H2O2 combinations in dentrifices on plaque and gingivitis. J Clin Periodontol. 2001 Mar;28(3):270-6.
38. Pack A. Folate mouthwash: effects on established gingivitis in periodontal patients. J Clin Periodontol. 1984 Oct;11(9):619-28.
39. Nowjack-Raymer R, Sheiham A. Association of edentulism and diet and nutrition in US adults. J Dent Res. 2003 Feb;82(2):123-6.
40. Sahyoun N, Lin C, Krall E. Nutritional status of the older adult is associated with dentition status. J Am Diet Assoc. 2003 Jan;103(1):61-6.
41.Vogel R, Fink R, Schneider L, Frank O, Baker H. The effect of folic acid on gingival health. J Periodontol. 1976 Nov;47(11):667-8.
42. Fine D, Furgang D. Lactoferrin iron levels affect attachment of Actinobacillus actino-mycetemcomitans to buccal epithelial cells. J Periodontol. 2002 Jun;73(6):616-23.
43. Kalfas S, Andersson M, Edwardsson S, Forsgren A, Naidu A. Human lactoferrin binding to Porphyromonas ginvgivalis, Prevotella intermedia and Prevotella melaninogenica. Oral Microbiol Immunol. 1991 Dec;6(6):350-5.
44. Addie D, Radford A, Yam P, Taylor D. Cessation of feline calcivirus shedding coincident with resolution of chronic gingivos tomatitis in a cat. J Small Anim Pract. 2003 Apr;44(4):172-6.
45. Kawakami T, Kawai T, Takei N, Kise T, Eda S, Urist M. Evaluation of heterotopic bone formation induced by squalane and bone morphogenetic protein composite. Clin Orthop. 1997 Apr;337:261-6