Sleepless in Seattle Can Mean Toothless in Tacoma


According to the Journal of Periodontology,¹ high levels of stress and poor coping skills increase twofold the likelihood of development of periodontal disease. What is worse is that certain antidepressants as well as heart and high blood pressure medications can increase your risk further!² Of course, teeth clenching and grinding do not help either. If you would like to keep your teeth, get some peaceful sleep.

Stress is not the only cause of gum disease, but, more important, gum disease is virtually preventable. Still, a walloping 90 percent of Americans have some form of gum disease and tooth decay. More than 13 million of us have lost all of our teeth. Even the average two-year-old has already suffered tooth decay.³ Remember, if you ignore your teeth, they will go away!

Let us take a look at the structure of the teeth, gums, and bone. In a healthy tooth, the collagen matrix (connective tissue) of the periodontal membrane serves as the anchor to the alveolar bone (jawbone) and allows the dissipation of the tremendous amount of pressure exerted during chewing.[sup4]

Periodontal disease is an inflammatory condition in the gums, leading to distress of supporting structures. The process usually starts with gingivitis, marked by red, swollen gums or gums that bleed easily. When these symptoms are ignored, a more serious condition, periodontitis, can lead to bone and eventually tooth loss.[sup4]

The main cause of gum disease is plaque, the sticky, colorless film that constantly forms on the teeth. Plaque breeds bacteria that cause gums to become inflamed.[sup5] Left untreated, plaque is likely to spread below the gum line, worsening the condition. Over time, toxins produced by the bacteria stimulate a chronic inflammatory response that causes destruction of the bone and tissue that support the teeth. When the gums eventually separate from the teeth, an even greater chance for breeding infection exists.

Gingivitis is the mildest form of gum disease and is reversible with professional treatment and good care at home. If your gums bleed easily, see your dentist or periodontist.

Aggressive periodontitis is an advanced form of gum disease that occurs in people who are otherwise clinically healthy. Common features include rapid loss of attachment and bone destruction, resulting in lost teeth. By the way, the bacteria that cause inflammation can be passed from family member to family member through such innocent acts as a loving kiss.

Thankfully, aggressive periodontitis is not the most common form of gum disease; chronic periodontitis is the most common and hazardous form. It is prevalent in adults but can occur at any age. Usually, it comes with loss of attachment and bone and progresses slowly and relentlessly toward tooth loss. The disease is characterized by the formation of "pockets" (the spaces between the teeth and gums) and gum recession, swelling, and bleeding.

Make no mistake, there is more at risk here than just teeth. Dental disease is not only a disease of the mouth but also a disease of the body.

Any time a part of your body becomes diseased, the entire immune system is stressed. This event can be most harmful when disease is chronic or long term. Dental disease, especially gum disease, overloads the body's protective defensives 24 hours a day; this reaction can drain you of energy and can drastically lower your resistance to any other disease to which you may have been exposed.[sub6]

In fact, a study published by the Journal of Periodontology links periodontal disease to elevated C-reactive protein (CRP) levels. The medical profession has known for some time that the CRP level is a good indicator of heart health.[sup7] An elevated CRP level is a stronger predictor of heart attack than elevated cholesterol levels are. This study showed that the inflammatory effects from chronic bacterial infection in the gums can cause oral bacterial by-products to enter the bloodstream. This can cause the liver to make proteins such as CRP that inflame arteries and contribute to clotting. Clotting contributes to clogged arteries that can lead to heart attacks and stroke. Can something as prevalent as gum disease contribute to heart attacks? Some studies suggest that the answer is yes!

In light of the consequences, the question "Have you been brushing and flossing?" takes on new meaning.

So what causes periodontal disease? In addition to plaque, research implicates (in no particular order) the following factors:

poor nutrition, especially low dietary vitamin C
some medications
clenching and grinding the teeth
systemic disease
Being female also appears to raise your risk.[sup8] During puberty, levels of progesterone and, possibly, estrogen overstimulate blood circulation to the gums, making them sore and swollen. Menstruation can bring on temporary gingivitis, which usually starts right before the onset and clear up once the period is over.

For pregnant women or those of childbearing age, it is important to realize that there might be a relationship between periodontal disease and pre-term low-birth-weight babies. Be sure to include teeth and gum evaluation and care into your prenatal regimen. Some women experience a greater incidence of gum disease not only during pregnancy but also if they are taking oral contraceptives.

Menopause and post-menopause may bring on oral discomfort, including dry mouth, pain and burning in the gums, and altered taste. The gums may look dry or shiny and bleed easily, or they may look either very pale or deep red in color.

Even though women tend to take better care of their teeth than men do, at least 23 percent of women ages 30 to 54 have chronic gum disease. As many as 44 percent of those aged 55 to 90 who still have their teeth also have periodontitis.

So what can you do?

Keep your teeth and mouth clean. Brush, floss, and see your dentist regularly.
Avoid sugary, sticky, and sweet foods. Within 5 to 10 minutes after eating sugar, acid production in plaque begins and lasts for 10 to 30 minutes. If you eat sugary foods or take sweetened medications, clean your mouth within 15 minutes by brushing, rinsing, eating a fibrous fruit or vegetable, or chewing a piece of sugarless gum.
Brushing gets rid of the sugar, and eating a fibrous food produces saliva, which neutralizes the acids that bacteria produce.³
Brush your tongue to eliminate food particles and bacteria that can get trapped on the taste buds.
Get enough vitamin A, which is necessary for collagen synthesis, wound healing, and enhancing numerous immune functions. Deficiency of vitamin A is associated with abnormal cell structures in the periodontium, pocket formation, plaque formation, and increased susceptibility to infection.
Get enough vitamin C. One of the first signs of vitamin C deficiency is bleeding gums. .
Zinc is thought to be essential to periodontal health, This mineral stabilizes membranes in the substructures of the teeth and gums, combats free radical activity, inhibits plaque growth, and supports many immune activities.
Vitamin E and selenium work synergistically to fight free radicals, an activity particularly valuable in the presence of "silver" amalgam restorations ("fillings"), and to neutralize the acid waste discharged by bacterial contamination of the gums. The presence of silver amalgam indicates the presence of mercury, which can deplete a powerful antioxidant known as superoxide dismutase and other antioxidants. Antioxidants fight free radicals, and free radicals are basically agents for human rust.
Folic acid has been shown to relieve redness, bleeding, and soreness and to reduce plaque levels.
Calcium and boron are essential to strong teeth and bones. The jaw bone is especially susceptible to destruction during bouts of gum disease. The right nutrients can help in rebuilding.
Finally, coenzyme Q10 (CoQ10), an immune system stimulant, appears to have a healing effect on the gums.
Dr. Edward O. Wilkinson and his team found an extraordinary effect of this supplement back in 1975. In 120 patients who were deficient in CoQ10, the supplements not only stopped the progression of gum disease but initiated "extraordinary healing ... tissue healing in five days, which would ordinarily be expected to take 10-15 days."[sup9] Other studies found that 75 percent of patients responded favorably to supplementation with significant change in pocket formation and tooth mobility.[sup4] CoQ10 acts as a catalyst to create energy at a cellular level. After age 35 or so, our ability to synthesize CoQ10 begins to decline. At a 25 percent deficiency, our organs do not have the energy they need to function correctly; a 75 percent deficiency is fatal. CoQ10 occurs naturally in bran cereals, oats, soy, and dark green vegetables.

So you see, it is not just calcium that is necessary for strong bones and teeth.

Do you have gum disease? Only your dentist or periodontist can tell you for certain, but here are some of the signs:

bleeding gums during brushing
red, swollen, or tender gums
gums that have pulled away from the teeth
persistent bad breath
pus between the teeth and gums
loose or separating teeth
a change in the way your teeth fit together when you bite
a change in the fit of your dentures.
If you suspect that you have periodontal disease, take action. More is at risk than just a missing tooth.

1. J. Periodontol. July 1999.

2. American Academy of Periodontology.

3. Kahalsa, S. Smile Pretty.

4. Murray, M., and Pizzorno, J. Encyclopedia of Natural Medicine, 2nd revised ed. Roseville, Calif., Prima Publishing, 1998.

5. American Academy of Periodontology. What are periodontal diseases?

6. McGuire, T. Tooth Fitness: Your Guide to Healthy Teeth. St. Michael's Press, 1994.

7. N. Engl. J. Med.

8. American Academy of Periodontology. Protecting oral health throughout your life.

9. CoQ10: The key to good health and energy.




By Gail Gorman

At least 36 million people in the United States have periodontitis. (Source: Journal of Periodontology, 1999. 70, 13-29.)

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