Gingivitis and periodontal disease

Gingivitis

Gingivitis is inflammation of the gingival (or gums). Gingivitis is characterized by swelling, redness, watery exudation, and bleeding. This may be an early stage of periodontal disease if plague build up and swelling allow pockets to form between the teeth and gums that trap food, plaque and bacteria. Gingivitis may be acute, chronic, or recurrent. In the early stages, gingivitis is reversible as long as you conscientiously clean your teeth at home and visit your dentist a couple of times a year for professional cleanings.

Periodontal disease

Periodontal disease involves the inflammation of tissues that surround and support the teeth. This inflammation can progress to degeneration of these structures and is the major cause of adult tooth loss.

Dental plaque is the primary cause of both gingivitis and periodontitis. Plaque is an adhesive fluid made up of epithelial cells, mucin and bacteria. It begins to form about 12 hours after we brush our teeth. If it is not removed, mineral salts in the foods we eat trigger the formation of tartar (calculus). The calculus is irritating to gum tissue. It also changes the pH in the mouth, allowing bad bacteria to thrive and eventually eat away at the support structures that hold our teeth in place.

Aetiology

• Poor dental hygiene and the formation of plague and tartar.
• Food impaction around teeth and gums.
• Poor dental work.
• Gingivitis is more common during puberty and pregnancy, and in those using oral contraceptive pills.
• May occur more commonly in those with diabetes mellitus, scurvy, and leukemia and other leukocyte disorders.

Possible supplements

• Vitamin C and bioflavonoids: One important nutrient that can help heal red, swollen gums is vitamin C. This antioxidant boosts your immune system, brings down inflammation, and speeds up wound healing. In fact, a deficiency of vita min C can lead to gingivitis, which may cause teeth to become loose and even fall out.

Vitamin C has proven to be vital for the production of collagen, the basic protein building block for the fibrous framework of all tissues, including gums. The vitamin strengthens gum tissue and helps the gum lining resist bacteria.

Vitamin C can repair and rebuild connective tissue. "Moreover, it will boost your immune system so that you can fight off the infection," says Liz Collins, N.D., a naturopathic doctor and co-owner of the Natural Childbirth and Family Clinic in Portland, Oregon.

Dr. Collins recommends taking 3,000 to 4,000 milligrams of vitamin C daily in divided doses. As part of your daily vitamin C regimen, Dr. Collins also recommends taking bioflavonoids. Naturopathic doctors believe that these nutrients are very effective at reducing inflammation and repairing and healing gum tissue. They're strong antioxidants that can prevent damage from free radicals, the free-roaming, unstable molecules that harm cells. Bioflavonoids are also known to boost the effectiveness of vitamin C.

• Folic acid (B complex vitamins): Several studies have shown that folic acid can reduce inflammation, bleeding, and plaque buildup on the teeth when taken in pill form or used as a mouthwash. Research has also shown that it can help treat periodontitis, the advanced stage of gum disease.

"Folic acid is a B vitamin that keeps the cells in your mouth healthy. Your mouth contains some of the fastest-dividing cells in the body, and any cell that divides quickly needs folic acid to replicate properly," says Dr. Collins. Take 400 to 800 micrograms of folic acid daily to treat gingivitis, she says. You can also make a mouthwash, which some studies say is more effective.

• Vitamin A or beta-carotene.
• Vitamin E and selenium, Co Q10: Coenzyme Q₁₀, or coQ₁₀, is a vitamin-like compound found in human tissue that stimulates the immune system. It's chemically similar to vitamin E and is a powerful antioxidant that helps treat gingivitis and maintain healthy gums and other tissues by increasing the flow of oxygen to cells. Food sources include salmon, sardines, beef, peanuts, and spinach. In Japan, coQ₁₀ is widely used to treat gum disease.

When researchers reviewed seven studies that used coQ₁₀, they found that 70 percent of the 332 people with periodontal disease who took supplements of the substance showed signs of improvement. In one of these studies, the group taking coQ₁₀ showed a reduction in inflammation, receding gums, and tooth mobility.

Dr. Brett recommends taking 150 to 200 milligrams daily if your gums are inflamed and bleeding. As soon as the bleeding stops and the inflammation goes down, you can stop taking it.

• Zinc

Diet and lifestyle

Increase intake of fresh fruits and vegetables, whole grains, and fibre rich foods to exercise the teeth and gums. Reduce intake of soft foods, sugar and refined carbohydrates.

Other

• Treat any underlying causes.
• Assess nutritional status and diet.
• Apply aloe vera gel to the gums or use aloe vera juice as a mouthwash.
• Use a herbal mouthwash containing herbs such as: thyme, myrh, golden seal, St Johns wort, calendula, sage and marshmallow.
• Echinacea: Echinacea stimulates the immune system by galvanizing white blood cell production. It increases levels of a chemical in the body called properdin, which activates the part of the immune system responsible for shoring up defense mechanisms against bacteria and viruses. Dosages vary, so follow the directions on the label. If the Echinacea supplements are 380 milligrams, a typical dose would be one to three capsules three times daily with water at mealtimes.
• Apply vitamin E topically.
• Change to a new toothbrush regularly (monthly) and floos on a daily basis. When brushing, brush the mouth, teeth, gums and tongue.
• Store toothbrush in water with some grapefruit seed extract as antibacterial agent.
• Ensure regular dental visits.