Disease Prevention Begins in the MouthSeptember 2008
By Dale Kiefer
Oral hygiene plays a critical role in whole-body health that is sadly overlooked by most doctors.
As a front-line shield against systemic inflammation, one’s oral status profoundly impacts diseases ranging from type 2 diabetes and cancer to rheumatoid arthritis and atherosclerosis.1-8
Recent scientific studies show that many of the nutrients we now swallow also confer benefits when topically applied in the mouth.9-17
Acting as powerful allies in the fight against periodontal disease, these natural compounds can help safeguard against lethal age-related diseases that emanate from our mouths.
The Gums: An Ideal Incubator for Disease
The oral cavity is a near-perfect breeding ground for microorganisms that lead to decay of gums, teeth, and bone.
Cavities and gum problems that occur in early life are just the beginning. Chronic low-grade inflammation affecting the gums (gingivitis) and inflammation affecting the gums and bones supporting the teeth (periodontitis) has been implicated in the promotion of a variety of insidious systemic disorders, such as coronary heart disease,18 arthritis,6 and even cancer.8,19
Oral inflammation has also been clearly linked to elevated markers of inflammation, such as C-reactive protein.20,21 In response to these warning signs, scientists noted recently, “Evidence for a link between periodontal disease and several systemic diseases is growing rapidly.”22
Gum Disease and Stroke
Gum disease sets the stage for an increased risk of stroke. A recent review of literature on periodontal disease, published in the Journal of the American Dental Association, concludes that periodontitis among older individuals is associated with an increased risk of developing systemic diseases such as diabetes mellitus, heart attack, and stroke.23 Meanwhile, studies show that efforts to reduce the severity of periodontitis help reduce systemic inflammation,24 and may thereby reduce the risk of cardiovascular events linked with inflammation.25
Gum Disease and Obesity
Some researchers are now suggesting that perio-dontitis may contribute to obesity by elevating C-reactive protein, which then acts as a potent inducer of inflammatory cytokines and hormones secreted by adipose tissue.26-29
Scientists have found that elevated C-reactive protein causes fat cells (adipocytes) to store more fat and burn less energy. Indeed, evidence is accumulating that there is a link between obesity, type 2 diabetes, and periodontitis. As one research team noted recently, “Obesity is a significant predictor of periodontal disease and insulin resistance appears to mediate this relationship.”28 A University of Mississippi study found, “…significant correlations between body composition and periodontal disease,” and noted this finding “strengthened arguments that periodontal disease and certain obesity-related systemic illnesses are related…”29
Periodontal Disease Linked With Cancer
The link between oral health and cancer remains somewhat controversial, largely because this information is so new. But a recently published study by researchers at the Imperial College of London and Harvard School of Public Health has shed new light on the matter. By carefully eliminating potential confounding factors, such as a patient’s history of cigarette smoking, these scientists sought to identify any statistically significant associations between oral health and the incidence of cancer. Their conclusion is chilling. “Periodontal disease was associated with a small, but significant, increase in overall cancer risk, which persisted in never-smokers,” write the collaborators, in the medical journal Lancet Oncology.19 This conclusion has profound implications. The fact that it arises from data gathered from more than 48,000 men over the course of approximately 18 years lends additional gravity to the findings.
The research team also found significant associations among oral health status and lung, kidney, and pancreatic cancers, as well as cancers of the blood. The investigators note that their results need independent confirmation, but they offer this speculation regarding the implications of the findings: “…periodontal disease might be a marker of a susceptible immune system or might directly affect cancer risk.”19 In either case, periodontal disease takes on new significance, and appears to pose more of a threat to health than has previously been recognized.
Furthermore, a recent study by researchers at the Harvard School of Public Health tentatively concludes that periodontitis is associated with an increased risk of one of the most deadly cancers. “Compared with no periodontal disease, history of periodontal disease was associated with increased pancreatic cancer risk,” write the Harvard researchers, in the Journal of the National Cancer Institute.30
The American Dental Association agrees that “oral health is important for overall health” and indicates that salivary diagnosis may offer a key tool in health assessment. “A wide range of proteins, nucleic acids, hormones, pharmaceuticals, and pathogens can be measured in saliva, making it an excellent candidate for rapid detection and screening of biomarkers for conditions like caries, periodontal disease, osteoporosis, infectious diseases, and cancer,” it says.31
Botanical and Nutritional Agents Show Promise in Oral Hygiene
Given the potentially lethal risks of poor dental hygiene, it makes sense to utilize all the science available to prevent even the smallest problems in the mouth.
Several nutrients have shown very favorable effects when used as part of an oral hygiene program. Among these are coenzyme Q10 (CoQ10), green tea, aloe vera, and pomegranate. These claims have been verified by published research.9-11,32-35 Other beneficial ingredients for healthy teeth and gums include xylitol, lactoferrin, and folic acid.12,13,15,17
Multi-Faceted Benefits of Green Tea
Green tea is well known for its beneficial effects throughout the body, but it is also effective in the fight against dental caries and oral disease. Studies have shown that green tea catechins exert direct antibacterial activity against Streptococcus mutans, one of the key microorganisms responsible for tooth decay. Green tea also helps prevent bacteria from sticking to teeth, by inhibiting a bacterial enzyme involved in this process. It also inhibits production of amylase, an enzyme used by bacteria to break starches down into sugars, which bacteria use to fuel their own growth.34,35
Furthermore, Asian researchers showed recently that green tea reduces the invasiveness of oral cancer and decreases the production of a protein associated with oral cancer proliferation.36,37 Additionally, American researchers report that green tea arrests the growth and causes self-destruction (apoptosis) of oral carcinoma cells in the laboratory.38
In Japan, researchers conducted a study in which green tea was applied to the teeth of subjects with periodontal disease for eight weeks. Symptoms of periodontitis improved in subjects receiving green tea catechins and there was objective evidence that green tea killed a significant proportion of the bacteria causing periodontitis in these test subjects.39
CoQ10 Helps Fight Oral Disease
Best known as a potent cardioprotective nutrient, CoQ10 has also been shown to improve symptoms of periodontitis when applied topically in the oral cavity.9,32,33 Japanese researchers conducted a placebo-controlled clinical trial in men with established periodontitis. After nine weeks of CoQ10 application, investigators found evidence of “significant improvements” in periodontal status, which were not seen in control subjects.9
An early study on CoQ10’s effectiveness against periodontitis impressed the study’s authors so much, they wrote, “Healing was so excellent five to seven days’ post-biopsy that the biopsy sites were difficult to locate. The healing was viewed as extraordinarily effective.”40 It has been suggested that CoQ10 benefits oral health by reducing the oxidative stress associated with low-grade inflammation of gums and bone.41
Complementary Ingredients for Dental Health
Numerous other natural agents can be incorporated into a dental health program to protect healthy teeth and gums. For example, the natural sweetener xylitol not only has a pleasing sweet taste, it has also been found to help prevent tooth decay.13 Squalene boosts the immune system’s ability to tackle invading microorganisms,14 while lactoferrin specifically halts the growth of bacteria implicated in periodontitis.15
Hydrogen peroxide is an antiseptic commonly used to minimize gingivitis, fight plaque, and promote a clean, fresh mouth.16 Aloe vera (Aloe barbadensis) has long been used in folk medicine to soothe burns and promote wound healing. Modern science has shown that aloe has anti-inflammatory properties and does, in fact, promote wound healing and may provide soothing and healing properties to the gum tissues.10,42,43