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Novel Ways to Achieve Optimal Oral Health

August 2007

By Debora Yost

Neglecting one’s oral health not only leads to gum and enamel erosion, but also a wide range of life-threatening diseases.1

A recent study found that diabetics with gum disease had more than twice the risk of premature death due to kidney or heart disease, compared to diabetics with good oral health.2 And earlier this year, the American Dental Association (ADA) declared that the death of a 12-year-old boy from severe brain infection “may have resulted from his deplorable degree of untreated dental disease.”3

In fact, C. Everett Koop, MD, the former Surgeon General of the United States, noted years ago, “You’re not healthy unless you have good oral health.”4,5

Given the potentially devastating consequences of poor oral hygiene, averting gingivitis and periodontitis through proper daily dental care is an essential cornerstone of a comprehensive wellness program.1,5 Research demonstrates that natural ingredients such coenzyme Q10, lactoferrin, squalene, folic acid, hydrogen peroxide, and tea tree oil offer advanced support against periodontal disease.

Exciting new findings show remarkable benefits with oral use of pomegranate extract.6 In this article, we’ll explore the latest research linking dental disease and bodily illness, and how you can use natural agents6-11 to protect your dental and whole-body health.

The Epidemic of Periodontal Disease

The most recent American Dental Association poll reported that only 25% of adults brush their teeth after each meal, while only 49% of men and 57% of women brush their teeth twice daily.12 It is therefore not surprising that up to 75% of Americans are affected by chronic inflammatory periodontal diseases such as gingivitis or periodontitis.13 Given studies showing how poor oral hygiene markedly increases degenerative disease risk, taking assertive steps to optimize oral health is imperative.14-16

Peridontal Disease Linked to Deadly Illnesses

While serious in itself, the trouble of periodontal disease doesn’t stop at the gum line. Researchers have observed that people with poor oral health have other medical problems.17 Scientists know that periodontal disease contributes to pathologic inflammatory processes throughout the body. Since chronic inflammation has been linked with a host of problems including cancer and heart disease, it is easy to see the connection between periodontal inflammation and the chronic diseases of aging.3,14,18,19

How Periodontal Disease Contributes to Heart Disease and Stroke

Evidence continues to support the association between cardiovascular disease and periodontal infection. According to researchers from the Mailman School of Public Health at Columbia University, periodontal disease is a risk factor for cardiovascular disease.20 Similarly, individuals suffering from documented periodontal infection demonstrate an increased risk for stroke.21

Several species of bacteria that cause periodontitis have been found in the atherosclerotic plaque in arteries in the heart and elsewhere.22 In addition, researchers from the State University at Buffalo found that people with periodontal disease have elevated blood levels of C-reactive protein, an inflammatory marker associated with heart disease and stroke.23

Gum Disease Worsens Blood Sugar Control in Diabetes

More and more research shows that diabetes and dental disease are closely linked. In fact, diabetics who do not control their blood sugar develop periodontal disease more often and more severely than diabetics who keep their disease in check.24 Further, periodontal disease can predispose individuals to developing diabetes, or exacerbate the condition in those with existing diabetes.25

In one study of people with type 2 diabetes, severe periodontitis was strongly associated with an increased risk of poor blood sugar control.26 In another investigation, scientists found that a measure of long-term blood sugar control, hemoglobin A1c, was elevated in people with type 2 diabetes and severe periodontal disease. Further, eliminating periodontal infection and reducing periodontal inflammation in diabetic patients led to significant improvements in their hemoglobin A1c levels, suggesting that ensuring optimal dental health could be crucial to prevent the damaging consequences of diabetes.27

Understanding Periodontal Disease

The pathway to gum disease begins when the starches and sugars in the food you eat interact with the bacteria in your mouth and form a bacteria-harboring sticky film of plaque on your teeth and gums. If not properly removed through brushing, plaque hardens into tartar, which clings so tightly to the teeth and under the gum line it can only be removed through professional cleaning.

There are two different types of periodontal (gum) disease: gingivitis and periodontitis. Gingivitis is an inflammation of soft tissues surrounding the tooth. This is a direct immune response to microbial plaque attached to the surface of the tooth. The clinical manifestations of gingivitis are redness and swelling of the gums and bleeding upon soft touching or probing. Gingivitis in the early stages does not significantly affect deeper structures such as the periodontal ligaments and alveolar bone.

Left untreated, gingivitis can lead to periodontitis. Periodontitis occurs when pathogenic gram-negative bacteria destroy the dental supportive structures of the teeth, leading to progressive destruction of periodontal ligaments and alveolar bone. The result is tooth loss.

Poor Oral Health Increases Risk of Pneumonia

A common consequence of poor oral health in older adults is an increased risk of a particular type of pneumonia. This form of pneumonia occurs when periodontal bacteria in the secretions of the mouth and pharynx are aspirated into the lungs,28,29 where they take hold and establish an infection. The risk of this type of pneumonia is greatest when periodontal disease, dental cavities, and poor oral hygiene are compounded by swallowing disease, feeding problems, or poor functional status.

One study that followed the rate of respiratory illness among a group of older adults in Japan demonstrated the importance of thorough oral hygiene as the best prevention strategy. During a six-month period, only one in 98 aging adults who had their oral health cared for by dental hygienists came down with respiratory infections, compared to nine out of 92 people who did not get the same dental care.30

Premature Labor and Low Birth Weight Associated with Gum Disease

For decades, doctors have observed that about half of low-birth-weight babies are delivered to women with periodontal disease. They believe that the womb’s protective environment may be compromised by the cascading effect of inflammation that begins in the mouth.31,32 The evidence is strong enough that researchers from Singapore recommend early intervention to arrest periodontal disease as a measure to reduce the risk of pre-term labor.31

Osteoporosis and Periodontal Disease

Osteoporosis is a potential risk factor in periodontal disease, so strategies for reducing osteoporosis risk—such as ensuring optimal intake of calcium and vitamin D—can also help retard alveolar bone loss.33 In a recent research review, scientists noted that treatment with bisphosphonate drugs such as Boniva® and Fosamax®, which are widely used to prevent and treat osteoporosis, may offer benefits for periodontal tissues. Further, these medications could provide an alternate treatment strategy when periodontal therapy is not convenient. Bisphosphonate drugs are associated with a rare but serious possible side effect of osteonecrosis (death) of the jaw bone, so further research may be needed to develop safer strategies that support both periodontal and body-wide bone health.34

While scientists are still investigating whether preventing or treating periodontal disease may offer benefits for optimal bone density throughout the body,17 a just-released review of the scientific literature relating to osteoporosis and periodontal disease published in the Journal of the American Dental Association concluded, “a healthy lifestyle has multiple benefits for the mouth and throughout the body.”3