Periodontal Disease
What is it?
Periodontal disease is an inflammation and degeneration of the bone and gum structures that support the teeth. It starts when a bacterial infection attacks the gums, bone and ligaments that support the teeth and hold them in the jaw. The initial damage is painless and a person may not be aware of the disease until severe damage is done, making tooth loss inevitable. The early stages of periodontal disease are seen in as many as 50 per cent of adults. By age 35, about 75 per cent of people are affected; and by age 65, as many as 90 per cent suffer from the disease. Even children aged as young as five or six can have signs of periodontal disease.
Causes of periodontal disease
Periodontal disease is caused by bacteria in plaque - the sticky, colorless film that constantly forms on teeth. The bacteria create toxins that irritate the gums, causing breakdown of gum tissue. As periodontal disease develops, the gums become detached from the teeth. The tooth roots are then susceptible to decay and sensitive to cold and touch. As the disease progresses further, it becomes more painful; and in the advanced stages, the supporting bone is destroyed, causing the teeth to become loose and fall out.
Gingivitis, in which the gums become red, swollen, tender and likely to bleed easily, almost always precedes periodontal disease but does not always lead to it. In gingivitis, small gaps open up giving bacteria access to teeth and gums. Regular brushing and flossing can help to treat gingivitis and thus lessen the risk of periodontal disease. Smoking, poor dental work, some medications, clenching or grinding teeth, and diseases such as diabetes may contribute to periodontal disease.
Preventing periodontal disease
Regular dental check ups and good dental hygiene may help to prevent periodontal disease. A healthy diet also plays a role in slowing the progress of the disease. Avoiding simple sugars, eating plenty of whole grains and other high fiber foods, and thoroughly chewing food are important preventive measures.
Vitamins, minerals and periodontal disease
Antioxidants
Antioxidants protect against free radical damage to connective tissue that may contribute to periodontal disease.
Vitamin C
Vitamin C is necessary for the production of collagen in the gums. Deficiency affects this process and leads to increased redness and swelling. Vitamin C deficiency may also impair immune function, affecting the body's ability to fight plaque bacteria which cause periodontal disease.1
A weak association between periodontal disease and vitamin C deficiency has been shown in the analysis of data collected from population studies.2 In a 1993 Finnish study, low vitamin C levels did correlate with disease severity.3 Adequate dietary intake of vitamin C is important in protecting against gum and tooth disorders but there does not seem to be any evidence that supplementation is beneficial when the diet contains healthy levels of vitamin C.
Folic acid
Topical or internal folic acid has been shown to reduce plaque and gum inflammation and bleeding in periodontal disease. Folate mouthwash seems to be more effective than oral supplements, suggesting a local effect.4
Calcium
Calcium is vital for the formation and maintenance of healthy teeth, and inadequate intake throughout life may contribute to periodontal disease. Low intakes are often seen in those with the disease but calcium supplements do not seem to produce improvement. It may be that the damage is too late to repair or that factors other than calcium deficiency are more important for the development of periodontal disease.
Fluoride
Fluoride has been shown to protect against dental caries but the relationship between fluoride and periodontal health and disease is not clear. Some studies suggest that fluoride should be used with conventional periodontal therapy while other studies suggest that it should be avoided.5
Zinc
Mouthwashes containing zinc salts may be useful in the treatment of periodontal disease. Zinc levels may be decreased and copper levels increased in sufferers. Zinc is essential for collagen synthesis, a healthy immune system, and for wound-healing.
Coenzyme Q10
Coenzyme Q10 may be beneficial in the treatment of periodontal disease. It acts as an antioxidant and may improve tissue repair and healing. Topical application may also be useful.
Herbal medicine and periodontal disease
Useful herbs treat periodontal disease include echinacea (Echinacea angustifolia and E. purpurea), hawthorn (Crataegus oxyacantha), aloe vera (Aloe vera), goldenseal (Hydrastis canadensis), myrrh (Commiphora molmol) and bilberry (Vaccinium myrtillus).