Gum Disease Info
The Basics

The mouth is host to more than 500 species of bacteria at any given time. Most of these bacteria are “friendly” their presence is necessary to maintain healthy teeth and gums. But about 5% of these bacteria are potentially harmful. The starches and sugars you consume become fuel for these unfriendly bacteria, which in turn form plaque, an invisible, sticky film that can cling to teeth. Brushing can remove this plaque, but any plaque that is missed can harden under your gumline and can turn into tartar within days. Tartar binds so tightly to teeth that it can only be removed by professional cleaning. The problem with tartar is twofold: it acts as a reservoir for bacteria and makes plaque more difficult to brush away in the first place.

Persistent tartar and plaque can give rise to the first stage of gum disease: gingivitis. Gingivitis is an irritation and inflammation of the gum around the base of your teeth. In the early stages, it generally does not cause pain or discomfort. Although gum disease can be found in teenagers, most people do not experience the signs of gingivitis until their 30s or 40s. These include:

  • Bad breath that won’t go away
  • Red or swollen gums
  • Tender or bleeding gums
  • Painful chewing
  • Pus around teeth and gums
  • Sensitive teeth
  • Loose teeth

Left untreated, gingivitis can develop into a more severe form of gum disease called periodontitis. Gums inflamed by prolonged gingivitis can pull away from the teeth and form pockets between your gums and teeth. This gives bacteria, plaque, and tartar the opportunity to spread below the gum line and cause infection. When this occurs, bacterial toxins, and even host enzymes that have mobilized to fight the infection, can begin to break down the bone and connective tissues that hold teeth in place. In advanced stages of periodontitis, teeth become loose and have to be removed.

Risk Factors for Gum Disease

  • Smoking
  • Poor nutrition
  • Stress
  • Certain diseases such as diabetes
  • Medications
    • Birth control pills
    • Antidepressants
    • Heart medicines
    • Medications used to treat seizures
    • Chemotherapy medications for cancer treatment
    • Medications used to treat AIDS
    • Immunosuppressant medications
  • Age
    • 25% of people between 30-44 years have at least mild periodontitis
    • 40% of people between 45-54 years have at least mild periodontitis
    • 50% of people between 65-74 years have at least mild periodontitis

Gum Disease Stages

Gingivitis (Level 1): Initiallythere is an inflammation of the gums caused by plaque buildup at the gumline. If the plaque remains even after daily brushing and flossing then it becomes home for bacteria that produce harmful toxins (virulent). Some bleeding may occur with brushing. One example of the body’s natural defense system is that the gum (gingival) cells produce antibodies that fight off the threat from bacteria and the toxins it releases. Damage can be reversed since the bone and connective tissue that hold the teeth in place have not yet been affected. Proper dental treatment and improved home care can usually help prevent further damage.

Periodontitis (Level 2): Gums inflamed by prolonged gingivitis can pull away from the teeth and form pockets. These pockets offer bacteria, plaque, and tartar the opportunity to spread below the gumline and cause infection. When this occurs, the toxins produced by bacteria, and even the body’s own enzymes that have mobilized to fight the infection, can begin to break down the bone and connective tissues that hold teeth in place. At this point diligent oral care at home combined with conventional treatments for periodontitis that your dentist will employ can reverse this problem

Advanced Periodontitis (Level 3): In this final stage of gum disease, the connective tissue and bone supporting your teeth are destroyed, causing your teeth to shift or loosen. This can affect your bite and, if aggressive treatment can’t save them, teeth may need to be removed

Conventional Treatments for Gum Disease

Treatment options for periodontitis include deep cleaning, medications, and surgical options.

  • Scaling and root planing are deep-cleaning methods used to remove plaque. In scaling, the dentist or dental hygienist scrapes tartar from above and below the gumline. In root planing, rough spots on the tooth root where germs gather are removed, helping to remove bacteria.
  • Medications may include antimicrobial mouth rinse or antiseptic chips, gels, or microspheres placed in the gum pockets after scaling and root planing, which slowly release antibiotics over a period of time. Enzyme suppressants may also be prescribed to block the breakdown of gum tissue. Depending on the severity of gum disease, medications cannot always take the place of surgery.
  • Flap surgery involves lifting back the gums and removing tartar. The gums are then sutured back in place so they fit snugly around the tooth again. Bone and tissue grafts may also be used to replace or encourage the growth of bone or gum tissue destroyed by periodontitis.

Technical References

Effect of Topical Application of CoQ10 on Adult Periodontitis – T. Hanoika, et. al., 1994, Molec. Aspects Med. Vol. 15, Elsevier Science Ltd; topical application of CoQ10 to periodontal pockets was evaluated with results indicating that topical application of CoQ10 complex improves adult periodontitis not only as a sole treatment but also in combination with traditional non-surgical periodontal therapy.

Therapy with CoQ10 complex for Patients with Periodontal Disease, Effect of CoQ10 on Subgingival Microorganisms – J. McRee, et.al., 1993, The Journal of Dental Health Vol. 43; reported significant decreases in gingival index, pocket depth and motile rods score after both two and six month therapy with 100mg CoQ10 per day.

Treatment of Periodontal & Other Soft Tissue Diseases of the Oral Cavity with CoQ10 – Wilkinson, et. al., 1977, Institute for Biomedical Research, Univ. of Texas; demonstrated that significant CoQ10 deficiencies were present in patients with periodontal disease and meaningful improvements were achieved with CoQ10 supplementation.

Treatment of Periodontal & Other Soft Tissue Diseases of the Oral Cavity with CoQ10 – Wilkinson, et. al., 1977, Institute for Biomedical Research, Univ. of Texas; demonstrated that significant CoQ10 deficiencies were present in patients with periodontal disease and meaningful improvements were achieved with CoQ10 supplementation.

A Critique of 25 Years of Research Which Culminated in the Successful Therapy of Periodontal Disease with Coenzyme Q10 – K. Folkers, 1992, Journal of Dental Health V42; a review of multiple study results concluding that treatment of periodontal disease with CoQ10 is an effective therapy as evident from reduced disease, an improved immune system and restored periods of natural prevention of disease.

Xylitol: Our Sweet Salvation? – S. Sellman, 2003, The Spectrum Vol.4, No. 8; a complete review of xylitol, its history, uses and benefits, with particularly good background information concerning oral health implications.

Enhanced Anticaries Efficacy of a 0.243% Sodium Fluoride/10% Xylitol/Silica Dentrifice – Sintes, Escalante, Stewart, et. al., 1995, American Journal of Dentistry, 8:231-5; three year clinical results.

The Effect of Non-Cariogenic Sweeteners on the Prevention of Dental Caries: A Review of the Evidence – Catherine Hayes, Harvard School of Dental Medicine, 2001, Journal of Dental Education; concluded that xylitol can significantly reduce the incidence of dental caries.

Low Dietary Vitamin C Can Increase Risk for Periodontal Disease – R. Genco, et. al., 2000, Journal of Periodontology; vitamin C deficiency leads to higher rates of periodontal disease.

Periodontal (Gum) Disease – National Institutes of Health and National Institute of Dental and Craniofacial Research; all about gum disease and conventional treatments, online at Gum (Periodontal) Diseases.

Research Links Gum Disease to More Serious Ills – J. Lyons, Knight Ridder Newspapers – Detroit Free Press, December 30, 2003; a review of numerous ailments linked to gum disease

American Academy of Periodontology – voluminous information available on the website; www.perio.org

CoQ10 for Oral Health