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Gumming Up The Works
By Bonnie Jenkins, Advanced Natural Medicine Bulletin
While I was at the dentist’s office this morning for a routine cleaning, I overheard my dentist telling another patient that she had severe gingivitis. Naturally, the woman was upset and I had to feel bad for her. But at the same time I was reminded of a recent study linking gum disease to a high death risk in diabetics. Now I don’t know if this woman was diabetic or not, but it does raise the issue of oral health – something most of us don’t think about when we talk about life-threatening diseases. But maybe we should.
Even though diabetics are more prone to developing gum disease, according to the American Dental Association (ADA), 75 percent of all adults over the age of 35 suffer from periodontal disease. So this study by the National Institute of Diabetes and Digestive and Kidney Diseases in Phoenix really affects all of us.
A dental dilemma
In the study of 549 Pima Indians with Type II diabetes, the researchers found that 60 percent suffered from severe periodontal disease. Over the next 10 years, 172 of the participants died of natural causes. But, while the participants without gum disease died from cancer, liver disease or other causes, the deaths among those with severe, untreated gum disease were almost exclusively due to heart disease and kidney failure (diabetic nephropathy). After adjusting for factors such as age, sex, obesity and cholesterol levels, the researchers concluded that diabetics with severe gum disease were twice as likely as those without it to die from either heart disease or kidney failure.
While this particular study focused on diabetics, earlier studies show that periodontal disease can lead to more serious diseases in non-diabetics too. It seems that gum disease increases the risk of infections and inflammation that can ultimately promote blood-vessel damage in the heart and kidneys.
Although gum disease might not be diagnosed until mid-life or later, infection with the bacteria that cause it can occur decades earlier. Combined with years of inadequate oral hygiene, infection can result in gingivitis, an early form of gum disease characterized by inflamed gums that often bleed easily. Fortunately, this form of the disease can usually be reversed with more careful brushing and flossing.
Brush-a, brush-a, brush-a
Most of us probably think that we take pretty good care of our teeth and gums. After all, good oral hygiene has been drummed into our psyches since we were kids. But, since three-quarters of us eventually develop some form of gum disease, we’re obviously missing something. So maybe it’s time for a refresher course in dental hygiene. Think of it as Oral Health 101. To help us out, I thought it would be a good idea to tap into the brain of San Francisco-based dentist Jack M. Saroyan.
When we think of teeth, we usually think of the visible dentin that rises out of the gumline. Made up of calcium and phosphorus, this bone-like structure is sealed with a thin coating of enamel. Tough stuff, right? Yet, deep inside each tooth lies a soft core of nerves and blood vessels. When the enameled armor is breached, this inner pulp becomes vulnerable to attack by an army of decay-causing microorganisms. These harmful bacteria roam around the inside of your mouth, feasting on bits of leftover food and ultimately turning into plaque, the No. 1 enemy of teeth. If plaque is allowed to remain on teeth, it forms an acid that eats through the tooth’s enamel and then the tooth itself, resulting in cavities. Left unchecked, plaque becomes tartar, a hard, toxic coating that erodes healthy gum tissue and leads to gingivitis, the first stage of gum disease. While regular dental visits are an important component of health maintenance, there’s plenty you can do to keep your teeth and gums healthy.
According to Dr. Saroyan, when it comes to brushing your teeth, a lick and a promise won’t do. Using a soft-bristled toothbrush, brush with short back-and-forth strokes for at least two minutes twice a day, taking the time to brush both the outer and inner tooth surfaces, as well as the chewing surfaces of teeth. Finish by using a tongue scraper or your toothbrush to remove any bacteria hiding on the back of your tongue.
The older we get, the more our gums recede, exposing the root and increasing our chances of tooth and gum disease. Dr. Saroyan says, “No matter how frequently you brush, the bacterial plaque remaining on your teeth can only be completely removed by dental flossing.” Using either waxed or unwaxed dental floss, scrape both sides of each tooth to snare any plaque tucked in between. Proper flossing requires practice. If, despite your best efforts, you can’t master the technique, try a water irrigator. Used with saltwater or an herbal rinse, irrigators can remove even the most stubborn plaque from between teeth and around the gumline.
To protect and preserve
In addition to conscientious brushing and flossing, is there anything else we can do to give us an edge against periodontal disease? You bet there is.
According to British researchers at the University of Birmingham, glutathione may be the key to good oral health. Glutathione is a small protein made from three amino acids – cysteine, glutamic acid and glycine. It’s an incredibly powerful antioxidant that’s found in every cell of the body. But glutathione doesn’t just protect individual cells. It also helps to safeguard tissues in the arteries, brain, heart, immune system and yes, the gums by fighting inflammation. Another reason glutathione is such as valuable compound is that it may prolong the effectiveness of other antioxidants like vitamins C and E by preventing their oxidation.
In the study, the researchers took samples of gingival fluid from 20 subjects – half who had healthy gums and half with severe gum disease. What they discovered was that the participants with healthy gums also had high glutathione levels. But those with periodontal disease had significantly lower levels of the antioxidant.
Does that mean you should run out and buy glutathione supplements? Well, you can – but you’d be throwing your money away since most experts agree that oral glutathione isn’t well absorbed by the body. The problem is that the glutathione molecules are simply too large to easily pass through the intestinal wall.
Luckily, there are other ways to increase this critical antioxidant. Glutathione precursors can boost your body’s natural production of glutathione. These precursors can be found in meats and fish. Fresh fruits and vegetables are also good sources, especially asparagus, avocado and walnuts. But an even more effective way to trigger production is with the amino acid N-acetylcysteine (NAC), a stable form of the glutatione component cysteine.
Unlike glutathione, NAC can be absorbed by the body and most nutritionists recommend taking 500 mg. a day in divided doses, up to 1,000 mg. a day. If you’re tempted to take the maximum dose, however, make sure you’re monitored by your doctor. Although most people don’t have a problem taking NAC, ironically this precursor can interfere with the effectiveness of insulin. So if you’re a diabetic, check with your health care provider before taking the supplement.
One last thing . . .
As a finishing touch, many of us reach for the mouthwash in an attempt to kill the bacteria that brushing and flossing miss. But, Dr. Saroyan says don’t bother since most over-the-counter brands are simply breath fresheners and do nothing to eliminate the offending bacteria. Instead of relying on that minty-fresh mouthwash to banish bacteria, Japanese researchers suggest swapping your traditional mouthwash for some green tea.
In their study, which was conducted at the Nihon University School of Dentistry, patients with gum disease used cellulose strips infused with green tea catechins once a week. After eight weeks, the researchers found that the catechins effectively killed the renegade bacteria and significantly improved the participant’s gum health. While the scientists in this study used a different type of delivery system, researchers at Pace University recently concluded that using green tea as a mouthwash could be just as effective to reduce plaque and kill the bacteria that leads to gingivitis. The Pace team also noted that loose tea was more potent than tea bags. So brew up a cup of green tea, let it cool and swish it around your mouth for a minute or two. Better yet, if you use a water irrigator, give your mouth extra protection by substituting green tea for the saltwater.
This just in . . .
It’s no secret that dietary supplements, including vitamins, have been under attack lately. You’ve seen the headlines: “Excessive Vitamin A Linked to Hip Fractures,” “Zinc Supplements Tied to Increased Risk of Prostate Cancer,” Beta-carotene and Vitamin E Don’t Cut Heart Disease Risk.” What the media doesn’t tell you about are the hundreds of studies showing how beneficial supplements really are.
Here’s one of the studies you might not hear about on the nightly news: according to a recent study in the Journal of the American College of Cardiology, women who take vitamin C supplements may lower their risk of developing coronary heart disease.
The study used dietary information from approximately 85,000 female nurses along with 16 years of follow-up data on heart disease cases that were collected during the Nurses' Health Study. After adjusting for age, smoking and a variety of other coronary risk factors, the researchers discovered that the women taking an average of 700 mg. of supplemental vitamin C a day had a 28 percent lower risk of coronary heart disease compared to those who didn’t boost their vitamin C intake at all.
So, despite the media’s bias, keep taking your antioxidants, especially vitamin C. In the long run, your heart will thank you for it.
***
References:
Chapple IL, et al. “Glutathione in gingival crevicular fluid and its relation to local antioxidant capacity in periodontal health and disease.” Molecular Pathology. 2002; 55:367-373.
Hirasawa M, et al. “Improvement of Periodontal status by green tea catechin using a local delivery system: a clinical pilot study.” Journal of Periodontal Research. 2002; 37:433-438.
Stenson J. “Gum disease raises death risk in diabetics: study.” Reuters. 4 Jul 2003.
“Vitamin C trial backs heart protective effects.” Novis. 17 Jul 2003. |
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