Five steps to better dental and overall health

You may not know — and what dentists are just now discovering — is that gum disease also can drastically increase a person’s odds of suffering very serious ailments such as stroke and some types of pneumonia.

by Dr. Michael P. Bonner — 

You already know that gum disease can cause cavities, bad breath and tooth loss. You also may know that infected gums increase one’s risk for heart damage. What you may not know — and what dentists are just now discovering — is that gum disease also can drastically increase a person’s odds of suffering very serious ailments such as stroke and some types of pneumonia.

The problem

Gum disease is caused by plaque, a sticky film of bacteria that coats the teeth. Mild inflammation along the gum line is known as gingivitis. More serious periodontal disease occurs when plaque migrates underneath the gums and causes pockets of infection.

Gum disease is not exclusively a dental problem. Gum infection triggers the production of inflammatory cytokines, immune chemicals that are converted in the liver to C-reactive protein (CRP). Some doctors now believe that elevated CRP is a more accurate marker for heart attack and stroke than high cholesterol.

A normal CRP level is 0.8 mg or less, per liter of blood. The level increases by 500 to 1,000 times in people who have more advanced gum disease. Conclusion: gum disease increases risk for heart attack by 200 percent to 400 percent and can double the risk for stroke. Gum disease and elevated levels of CRP also have been linked to life-threatening blood clots in the legs (deep vein thrombosis) or in the lungs (pulmonary embolism).

How to protect yourself 

Daily flossing, brushing and the use of mouthwash help, but they do not eliminate gum disease because these methods do not reach the microorganisms that collect beneath the gums. To improve your dental regimen, follow this five-step program:

Step 1: Use a power brush. A manual toothbrush with soft, rounded bristles removes most surface plaque, but ultrasonic toothbrushes are more effective. They pulsate about 31,000 times a minute, generating waves of fluid that remove plaque from the microscopic pits found in the teeth. Brush with a power brush, such as Sonicare, two to three times a day.

In combination with flossing, daily power brushing greatly decreases the risk for systemic infection, which occurs when a break in gum tissue allows germs to enter the bloodstream. Avoid toxic toothpastes and mouthwashes. If you read the labels on commercial products, you will find warnings, such as “Do not swallow,” or “In case of accidental misuse, contact a poison control center.” That is because these products can be toxic.

Some toothpastes contain propylene glycol, the key ingredient in some antifreezes. Some mouthwashes contain ethyl alcohol, which dries out the oral tissues. It is better to use all-natural products that clean the teeth and inhibit harmful organisms without toxicity.

Step 2: Floss thoroughly, yet gently, at least once a day. Use waxed or unwaxed floss. If your teeth are close together, use flat dental tape, such as Glide, which is available at most pharmacies.

Step 3: Scrape your tongue. The large surface of the tongue harbors tremendous quantities of disease-causing organisms and inflammatory chemicals. Even if you floss and brush several times daily, microorganisms from the tongue can constantly re-infect gum tissue and increase the risk for systemic infection.

Tongue scrapers are inexpensive and available as plastic strips with serrated edges or as single-handled metal or plastic devices with a scraping edge at one end. Both types are equally effective. When scraping the tongue, reach as far back as possible. A few passes once or twice daily is usually enough.

Step 4: Irrigate your gums. The narrow space (sulcus) between a tooth and surrounding gum tissue harbors up to 100 trillion microorganisms. Infection in the sulcular spaces generates enormous quantities of inflammatory chemicals which should be removed daily to prevent chronic infection.

Home irrigation devices shoot water into the mouth and flush out accumulated buildup of cellular debris and infectious microorganisms that brushing and flossing do not reach.

Step 5: Supplement your diet. Several nutrients play a crucial role in gum health and can help reduce or eliminate systemic inflammation and infection. Take these amounts daily in two divided doses, with meals. Tablets are fine unless otherwise noted. Ask your doctor about the following key supplements:

• Vitamin C — Can reduce gum bleeding and tenderness and, as an antioxidant, may also improve the immune system’s ability to control harmful organisms. Typical daily dose: 500 mg to 1,000 mg. It is smart to take 1,500 mg of vitamin C tablets in chewable form about 15 minutes before going to the dentist. This quickly suppresses inflammation that may occur when oral procedures push infectious organisms into the bloodstream.
• Bioflavonoids — Derived from citrus fruits, they strengthen gums and help prevent germs from entering the bloodstream. Bioflavonoids also boost immunity and reduce infection. Typical daily dose: 500 mg.

• Co-enzyme Q10 — Required for collagen formation, it should be taken only in soft capsule form. Typical daily dose: 60 mg to 120 mg.
• Grape seed extract — It contains proanthocyanidins, antioxidant compounds, that inhibit the release of inflammatory compounds. Typical daily dose: 50 mg to 100 mg.
• Methylsulfonylmethane (MSM) — A form of organic sulfur that builds healthy gum tissue. MSM is absorbed better when taken with 500 mg to 1,000 mg vitamin C. Typical daily dose: 1,000 mg to 3,000 mg.

Warning: You may need to take antibiotics before you have any kind of oral procedure performed, including a routine cleaning, if you have had a joint replacement within the past year, or if you have a heart murmur. Dental procedures may allow bacteria to enter the bloodstream, which can infect artificial joints or heart valves in people with heart murmurs. If you are experiencing any of these symptoms, consult your physician or dentist.

Michael P. Bonner, D.D.S., is a dentist in private practice in Rockdale, Texas, and a member of the Academy of General Dentistry and the American Academy of Anti-Aging Medicine. He is coauthor of The Oral Health Bible, (Basic Health).

Reprinted from AzNetNews, Volume 25, Number 5, October/November 2006.