To Your Health

I notice bleeding gums when I brush my teeth. My dentist is concerned and wants me to come more often for cleaning. Am I really risking the loss of my teeth if I don't, and what else will help me preserve my teeth?

Q. I notice bleeding gums when I brush my teeth. My dentist is concerned and wants me to come more often for cleaning. Am I really risking the loss of my teeth if I don't, and what else will help me preserve my teeth?

A. The most common form of periodontal disease begins as gingivitis, usually painless, and at first bleeding gums upon brushing may be the only sign of a problem. Other cues that your have periodontal disease include pressure or itchy feeling in gums, red or bluish-red gum color, a bad taste in your mouth, or sensitivity to hot and cold foods. Periodontal disease may be inconspicuous at first, but the disease can spread until it damages the bones and ligaments that support your teeth. When that happens you can lose your teeth.

Professional cleaning alone is inadequate to prevent periodontal disease and tooth loss, but it can delay progression because the dental hygienist can remove plaque and calculus from areas that you cannot reach. In adults, periodontal disease is responsible for more loss of teeth than cavities, so it is well worthwhile to invest in both professional cleaning and augmented home care.

Gingivitis and other periodontal diseases are associated with accumulation of bacterial plaque, which is what the dental hygienist removes. Several specific bacteria are associated with periodontal disease, and some bacterial infections are capable of causing rapid and severe bone loss. At home, frequent tooth brushing, flossing, and use of a good antibacterial mouth rinse will disturb the colonies of these bacteria and help your immune system to keep them under control.

Nutritional remedies include vitamin C, coenzyme Q-10, and folic acid, taken as food supplements and also in mouth rinses. In clinical trials, gingival inflammation is directly related to the vitamin C status. Benefits are evident after only a few weeks of supplementation at 600 mg per day. Vitamin C works best in the early stages of periodontal disease, particularly at the "bleeding gums" stage, which most people recognize as a classic vitamin C deficiency symptom.

Less well known are the benefits of coenzyme Q-10, which is ordinarily associated with helping heart function. Several published studies report that coenzyme Q-10 supplements yield remarkable improvements in people suffering from periodontal disease. In one double-blind study, 18 patients with periodontal disease exhibited substantial improvement on a coenzyme Q-10 supplement compared to patients who received none. In another study, coenzyme Q-10 was applied directly to gingival tissue for six weeks. Two-thirds of the pockets of inflammation in each patient were treated with coenzyme Q-10 and one-third treated with soybean oil, which is presumed to have no effect. Significant reduction in gum disease was found only at sites the treated with coenzyme Q-10.

Gingivitis is more common during pregnancy and one of the first studies using folic acid to treat gingivitis was a double-blind study of pregnant women using a folic acid mouthwash. Direct application of folic acid twice a day in the form of a mouthwash proved better than folic acid supplements for maintaining gum health.

Ask anyone who has lost teeth from periodontal disease and they will testify that whatever measures are necessary to retain your teeth will be rewarded.

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