Conditions
Gingivitis / Inflamed Gums
Gingivitis / Inflamed Gums is the most common and mild form of oral/dental disease, it is characterized by inflammation and bleeding of the gums.
Gingivitis is the most common and mild form of the oral/dental disease. According to the Food and Drug Administration, approximately 15 percent of adults between 21 and 50 years old, and 30 percent of adults over 50 have gum disease. Gingivitis is characterized by inflammation and bleeding of the gums. Because gingivitis is rarely painful in its early stages, it often goes unnoticed until severe irritation or receding gums occur.
A number of recent studies suggest that you may already have a cheap and powerful weapon against heart attacks, strokes, and other heart disease conditions. It costs less than R30 and is sitting on your bathroom counter. It is none other than the humble toothbrush. If plaque is not removed within 72 hours, plaque will harden into tartar that cannot be removed by brushing or flossing.
The fact that flossing daily can extend life expectancy falls in the weird-but-true category. In fact, floss does two things: it prevents gum disease (that's rather obvious), and it prevents heart disease (not so obvious). Preventing both of these together is what adds years to your life. Here's how flossing improves life expectancy:
When you floss, you help prevent your gums from becoming inflamed. That's a good thing. What is happening when your gums are inflamed is that you have a chronic bacterial infection in your mouth. This harms your arteries through two mechanisms: the bacteria find their way into your arteries and hang out (causing plaques), and your body mounts an immune response to the bacteria in your mouth, causing inflammation (which in turn can cause your arteries to narrow). This makes it hard for your heart to do its job and can lead to heart disease.
There is some debate about how many years you can gain with heart disease. Dr. Perls says 1.5 years, while Dr. Roizen says 6 years. Both of these doctors are gerontologists (aging docs) and have popular books on aging and life expectancy (see reviews: Living To 100, RealAge and You! Staying Young). Who is right? It doesn't matter. Flossing is good for your gums and good for your heart, so we should all just do it.
The evidence isn't clear yet, experts say, but it's intriguing. According to the American Academy of Periodontology, people with periodontal disease are almost twice as likely to have coronary artery disease (also called heart disease). And one study found that the presence of common problems in the mouth, including gum disease (gingivitis), cavities, and missing teeth, were as good at predicting heart disease as cholesterol levels.
But even if periodontal disease isn't actually causing heart disease, the connection could still be important. For instance, the periodontal disease might be an early sign of cardiovascular problems. Heart disease can be hard to catch early because many of the conditions that precede it have no symptoms. You won't ever feel your arteries hardening or your cholesterol rising. But you might notice bleeding or painful gums.
The main cause of gingivitis is plaque (or biofilm), a soft, sticky film that forms on the teeth when starches and sugars react with bacteria that is naturally present in the mouth. Plaque buildup occurs between the teeth and gums, in faulty fillings, and near poorly cleaned partial dentures, bridges, and braces. If not removed within 72 hours, plaque will harden into tartar that cannot be removed by brushing or flossing.
The best defense against gingivitis is brushing and flossing after meals, as well as professional cleaning by a dental hygienist every three to four months. If left untreated, gingivitis may lead to a more serious condition called periodontitis, in which the inner gum and bone pull away from teeth and form pockets. These pockets can collect bacteria and debris, and become infected or abscessed. Bacterial toxins eventually break down the underlying bone and connective tissue that hold teeth in place. The ultimate outcome is tooth loss. For more information, see Periodontitis and Cavities.
Several studies suggest that gum disease may be passed from parents to children as well as between couples. Based on these findings, the American Academy of Periodontology (AAP) recommends that treatment of gum disease may involve entire families and that if one family member has periodontal disease, all family members should see a dental professional for a periodontal disease screening.
Other conditions that may contribute to gingivitis include:
Infections:
Viral and fungal infections can also adversely affect gum health. The herpes virus, for example, can lead to acute herpetic gingivostomatitis, a condition characterized by swollen gums and small, painful sores in the mouth. Oral thrush is caused by an overgrowth of the yeast known as Candida albicans that are normally found in the mouth. Thrush can produce white lesions on the inner cheeks and tongue that can spread to the gums.
Disease:
Hormonal Changes:
During periods of hormonal fluctuation (e.g., pregnancy and menopause), women may become more susceptible to gingivitis due to decreased salivation and blood supply to the gums. It is also thought that increased hormone levels cause the gums to respond aggressively to bacteria-producing irritation. However, while it is clear that hormone levels play a role in the progression of periodontal disease, hormones do not specifically cause gingivitis. Of particular importance to women is that several recent studies indicate that pregnant women with periodontal disease may be more likely to deliver a pre-term, low-birth-weight infant.
Poor Nutrition:
A diet lacking in adequate amounts of calcium, vitamin C, and B vitamins can increase the risk of developing periodontal disease.
Smoking:
Tobacco use may be one of the largest preventable risk factors for periodontal disease. According to one study, smoking may be responsible for more than half of adult cases of periodontal disease. The same study also found that smokers are four times more likely to develop the advanced periodontal disease than people who have never smoked Smoking diminishes oxygen and nutrient delivery to gum tissue and interferes with the synthesis of cytokines that regulate immunity and inflammation. Smoking also poses a risk of periodontal therapy failure, treatment complications, and increased time to treat the disease.
Stress and Depression:
Stress has been linked to an increased risk of periodontal disease, possibly because it may trigger an increase in behaviors such as smoking and poor oral hygiene. Sustained levels of financial stress and poor coping abilities, which can trigger habits such as poor diet or smoking, double the risk of developing periodontal disease. Researchers have also found that clinically depressed patients are only half as likely to benefit from periodontal treatment as non-depressed patients.
Treatment of gum disease begins with regular brushing and flossing. It is also important to make regular trips to the dentist for cleaning and monitoring. Most dentists recommend yearly full-mouth x-rays to assess the progression of bone loss in the jaws. However , there is concern about the radiation exposure that results from undergoing medical x-rays. Even x-rays that emit low levels of radiation damage DNA, which can lead to cancer. While some dental x-rays are necessary, annual x-rays are not advisable.
A full periodontal probe with a tiny, ruler-like instrument is also performed to measure the pockets surrounding the teeth. In healthy gums, the pockets measure less than 3 millimeters. Pockets measuring 3 to 5 millimeters indicate signs of gingivitis. Pockets measuring more than 5 millimeters signify the development of periodontitis.
A professional cleaning to remove plaque and tartar buildup should be performed at least twice a year. Some people need to have cleanings done more frequently.
Non-surgical deep cleaning involves two procedures known as scaling and root planing, which are sometimes performed in sections of the mouth at different times, especially if there is considerable soreness and bleeding from the gums. Scaling removes plaque and tartar above and below the gum line. Root planing smoothes out the tooth root to remove bacteria buildup and encourage the gums to reattach to the teeth.
Mouth Rinses. Mouth rinses are frequently used to help prevent gingivitis. Medicated mouth rinses containing a 0.1% solution of folic acid have effectively reduced gum inflammation and bleeding in double-blind trials Prescription antibacterial mouthwashes containing the ingredient chlorhexidine are also frequently used to treat gum inflammation.
Decapinol®, a prescription oral rinse, reduces the adherence of bacterial plaque to oral surfaces. This reduces the formation of new plaque as well as breaks up existing plaque, making it easier to remove with normal brushing. Reducing the presence of plaque also reduces the amount of bacterial toxins released into the gums. The result is a reduction in plaque and gingivitis. Decapinol® is only mildly antibacterial, so it does not upset the oral bacterial flora.
Toothpaste. The natural and synthetic antibacterial agents in many brands of toothpaste can help keep gums healthy. Natural toothpastes contain botanical oils that have antibacterial properties, while commercial formulas offer the benefit of fluoride to help prevent cavities. The brand Colgate Total®—the only FDA-approved toothpaste for fighting gingivitis—contains triclosan, a mild antimicrobial proven to reduce plaque and pocket depths associated with gingivitis.
Antibiotic Therapy.
Antibiotic therapy used alone or in combination with other treatments may also be recommended to treat gingivitis. (doxycycline hyclate),(chlorhexidine gluconate), and (minocycline hydrochloride) are antibiotics applied in sustained-release doses directly into the periodontal pocket.
A relatively new drug called Periostat® (doxycycline hyclate) was approved by the FDA in 1998 for use in combination with scaling and root planing. Taken orally, Periostat® suppresses the action of collagenase, an enzyme that causes destruction of the teeth and gums.
Surgery. If a diligent regimen of proper brushing, flossing, and regular dental cleanings is followed, nearly all cases of gingivitis can be reversed in a short time. However, in advanced gingivitis, or conditions that make treatment difficult, the following surgical treatments can help:
Curettage - a procedure in which diseased gum tissue in the infected pocket is scraped away, allowing the infected area to heal. Flap surgery - involves pulling back the gums to remove tartar buildup. The gums are then sewn back in place so that the tissue fits snugly around the tooth, thereby reducing pocket depth.
Guided tissue regeneration - stimulates bone and gum tissue growth, and is often performed in combination with flap surgery. In this procedure, a small piece of mesh-like fabric is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and connective tissue to reattach.
Soft tissue grafts - reinforce thin gums or replace tissue where the gums have receded. The grafted tissue, usually taken from the roof of the mouth, is sewn in place over the affected area.
Hydrogen peroxide. Hydrogen peroxide, which is included in many toothpastes, is valuable for its ability to reach bacteria hiding among gingival folds and gaps. Hydrogen peroxide is also added to some mouthwashes to reduce gingivitis and whiten teeth. Hydrogen peroxide has been used effectively for years in dentistry.
In addition to brushing with a good toothpaste and making regular visits to the dentist, a number of nutrients have been shown to improve gum health.
Coenzyme Q10. Coenzyme Q10 (CoQ10), a vital nutrient needed by every cell in the body to make energy, is beneficial for a variety of diseases and disorders, including periodontal disease. In addition to energy production, CoQ10 plays a vital role as an antioxidant at the cellular level by neutralizing free radicals. As early as the 1970s, researchers found that gum tissue in people with periodontal disease was often deficient in CoQ10 . Subsequent studies have shown that CoQ10 doses of 50 to 75 mg daily can halt deterioration of the gums and allow healing to occur, sometimes within days of starting therapy. In one double-blind trial, 50 mg daily of CoQ10 was significantly more effective than placebo in reducing symptoms of gingivitis after three weeks of treatment.
Stephen T. Sinatra, M.D., clinical cardiologist and author, reports that many of his patients see improvement in their gum health after beginning CoQ10 supplementation for heart disease. According to research by Sinatra, CoQ10's supportive effects on the immune system in general account for its ability to promote healing of diseased gums. Dr. Victor Zeines, a holistic dentist and author, recommends 100 mg of CoQ10 daily in combination with other supplements to help reverse gum disease naturally.
Calcium. A study found that people who do not consume adequate amounts of calcium each day are at significantly higher risk for periodontal disease. According to the American Dietetic Association, three of four people do not fulfill their daily calcium requirement. The study showed that men and women who had low calcium intakes (below the recommended dietary allowance) were almost twice as likely to have periodontal disease, as measured by the loss of attachment of the gums to the teeth.
Vitamin D: According to a recent report from the American Journal of Clinical Nutrition, high blood levels of a vitamin D metabolite are associated with a decreased risk of gingivitis. Researchers at Boston University analyzed data from 6,700 nonsmokers, aged 13-90+, from the National Health and Nutrition Examination Survey. The investigators analyzed blood levels of 25-hydroxyvitamin D and assessed the participants’ gums for the presence of gingivitis. Participants with the highest blood levels of 25-hydroxyvitamin D were the least likely to display signs of gingivitis. The scientists noted that vitamin D may reduce susceptibility to gingivitis by exerting anti-inflammatory effects, and postulated that gingivitis may provide a useful clinical model for further investigation into the anti-inflammatory effects of vitamin D.
Folic Acid: Studies have demonstrated that folic acid is very effective in preserving gum tissue and reducing the risk of gingivitis and periodontitis. Although the benefits of oral folic acid in protecting against heart disease and birth defects are well documented, new evidence suggests that using folic acid topically (as a mouthwash) can also strengthen one's oral defenses. Studies have demonstrated folic acid's ability to improve gingivitis symptoms, reduce gum tissue's inflammatory response, and make gum tissue more resilient to irritants such as bacteria and plaque.
Folic acid has been clinically tested in mouthwash solutions to assess its benefit in treating gingivitis. One study showed significant improvement after four weeks of using a folic acid mouthwash. In this double-blind, placebo-controlled study of 60 patients, dietary folic acid intake did not correlate with treatment results, suggesting the importance of applying folic acid topically to the gums. A double-blind study of 30 patients compared supplementation with 4000 mcg of ingested folic acid to placebo. After one month, plaque and gingival indices showed that folic acid supplementation appeared to increase the resistance of the gingiva to local irritants, leading to a reduction in inflammation.
Green Tea.
Green tea extract is rich in a class of antioxidants called catechins. Two in particular, epigallocatechin gallate (EGCG) and epicatechin gallate (ECG), combat oral plaque and bacteria These green tea polyphenols work as anti-plaque agents by suppressing glucosyl transferase, which oral bacteria use to feed on sugar. Other research has demonstrated that green tea extract can kill oral bacteria and inhibit collagenase activity. Collagenase, a natural enzyme that becomes overactive in the presence of bacterial overgrowth, can destroy healthy collagen in gum tissue.
Green tea extract applied topically( mouth wash) inhibits Streptococcus mutans bacteria, which have been implicated in the development of dental caries (the decay and breakdown of teeth and their bone support). Scientists suggested that certain extracts from green tea might be especially helpful in preventing tooth decay by preventing the development of bacterial plaque . In a Chinese study, green tea extract was used to rinse and brush the teeth. The study demonstrated that S. mutans could be inhibited completely after contact with green tea extract for five minutes. There was no drug resistance after repeat cultures . The scientists concluded that green tea extract is effective in preventing dental caries (You 1993). Other studies have shown that the plaque index and gingival index decreased significantly after green tea extract was used.
Hyperimmune egg extract:
3 to 6 tablets chewed daily on an empty stomach. Agricultural scientists discovered long ago that they could immunize hens against germs that threaten humans. This immunity was then passed on by the hen to her egg. Scientists have now been able to customize eggs to provide different types of immunity. At least 24 different organisms have been used to immunize a single hen, which then lays eggs that offer passive immunity to all of the organisms.
Hyperimmune egg extract has been shown to reduce the volume of dental plaque, which in turn cuts down on the total load of inflammation in the mouth . Animals supplemented with hyperimmune egg against the leading bacterial cause of dental caries developed significantly lower dental caries scores than did control animals Oral hyperimmune egg rinses have also been used successfully in humans to reduce disease-causing bacteria; the extracts remain active and present in the mouth at least overnight, offering long-standing protection.
Pomegranate: Researchers are finding important applications for pomegranate in the field of dental health. Clinical studies have shown that this popular antioxidant attacks the causes of tooth decay at the biochemical level with remarkable vigor. Pomegranate literally attacks bacteria where they live. Research shows that by interfering with production of the chemicals the bacteria use as “glue”, pomegranate extract suppresses bacteria’s ability to adhere to the surface of the tooth.
During a study conducted in 2007 examined the effects of a mouthwash containing pomegranate extract on the risk of gingivitis investigators noted that pomegranate’s active components, including polyphenolic flavonoids are believed to prevent gingivitis through a number of mechanisms including reduction of oxidative stress in the oral cavity, direct antioxidant activity anti-inflammatory effects, antibacterial activity and direct removal of plaque from the teeth. Saliva samples were evaluated for a variety of indicators related to gingivitis and periodontitis. Subjects rinsing with pomegranate solution experienced a reduction in saliva total protein content, which is normally higher among people with gingivitis (Narhi 1994) and may correlate with plaque-forming bacterial content.
Xylitol: Pure xylitol is a white crystalline substance that resembles and tastes like sugar. It is found naturally in fruits such as plums, strawberries, and raspberries. Xylitol is used commercially to sweeten sugarless gum and candies.
Xylitol gum: Xylitol has been shown to inhibit the formation of plaque. In a double-blind and controlled study, Swedish researchers had 128 children chew gum containing either xylitol or the sweeteners sorbitol and maltitol, three times daily for four weeks. While both were effective against the buildup of dental plaque, only the xylitol-sweetened gum eliminated microbes found in saliva, particularly a strain of bacteria implicated in tooth decay . Xylitol could thus be an essential ingredient in a targeted strategy to avert dental disease.
Xylitol toothpaste: a double-blind, placebo-controlled study of 2,630 children compared a standard fluoride toothpaste with one containing 10% xylitol. Over a three-year period, children given the xylitol-enriched toothpaste developed notably fewer cavities than those using the fluoride-only toothpaste.
Probiotics. Probiotics have been defined as “living microorganisms which upon ingestion in certain numbers exert health benefits beyond inherent general nutrition”. Scientists have been interested in the makeup of the microbes that live in the mouth (the “oral flora”) for decades, seeking to identify factors that promote the growth of healthy organisms and reduce the growth of those implicated in disease and inflammation. Probiotics not only improve oral health but can help change the stubborn composition of dental biofilm and plaque. Reducing the total amount of plaque through teeth brushing is always a desirable goal; however, its complete elimination is not possible. Therefore, changing the actual composition of plaque from an inflammatory cytokine-rich environment to a more benign environment (dominated by neutral or even helpful organisms) can contribute to overall systemic health.
In laboratory studies, the probiotic S. salivarius helped inhibit the formation of the sticky biofilm that can contribute to oral disease. Building on these results, an animal study showed that the S. salivarius probiotic helped displace biofilm from the teeth, displacing cavity-causing bacteria and inhibiting tooth decay. Another in vitro experiment demonstrated how effectively a second oral probiotic protects oral health. In this experiment, a form of Bacillus coagulans (known as GanedenBC30™) was shown to competitively inhibit the cariogenic (cavity-inducing) bacterium Streptococcus mutans, which contributes to significant tooth decay.
Lactoferrin. Lactoferrin, a naturally occurring antimicrobial agent, is found in saliva and gingival fluid, breast milk, tears, and other bodily fluids. This protein is a well-known immune system booster involved in the body’s responses to infection, trauma, and injury Lactoferrin may bind to and slow the growth of periodontitis-associated bacteria. In an animal study, locally applied lactoferrin powder appeared to support the healing of oral lesions.
Vitamin C: People deficient in vitamin C may be at risk of developing gingivitis. In one study, a group of subjects with periodontal disease who normally consumed only 25 to 30 mg of vitamin C daily were supplemented with an additional 70 mg. They experienced marked improvement in gum tissue after only six weeks. Although it is established that smoking contributes to gum disease, tobacco users may especially benefit from vitamin C supplementation, as smoking depletes the body of vitamin C.
Herbal Protection. Tea tree oil, used as an oral rinse, has been proven to kill bacteria. In fact, research has shown that a tea tree oil concentration of 0.6 percent inhibited 14 of 15 oral types of bacteria. In a study, the tea tree oil group had improved gingival index and papillary bleeding index scores attributed to the herb’s anti-inflammatory properties.
Chamomile and red thyme oil are mild antimicrobials, herbs such as parsley, spearmint, menthol, and eucalyptus are stimulating to the gums, as well as refreshing and cooling for the mouth in general.
Fish oil and borage oil. Because of the association between gum disease and systemic inflammation, researchers have begun looking at anti-inflammatory nutrients in the context of gum disease. It is reasonable for people with gum disease to consider using these supplements. Other anti-inflammatory supplements include ginger and curcumin, though neither of these has been studied in the context of inflammatory gum disease.
For all health conditions, the nutraceuticals are individually tailored by the Health Renewal Doctor. The doctor will decide- based on your history, physical examination and blood tests what would be the best for you and your specific needs and/or deficiencies. It cannot be overemphasized that one must not self-medicate. Self-Medicating is done when a person takes prescription medication or nutraceuticals on their own without a doctor's supervision and/or consent. By not having a physical examination and blood testing done by a qualified and practising integrative medical practitioner, you could be not treating vital deficiencies or conditions such as elevated blood pressure, high sugar level, high stress levels (that can lead to adrenal burnout ) and high blood clotting factors that could lead to heart attacks and stroke. In addition, aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. There is no single supplement prescribed to clients as there is no magic bullet that can support all the essential nutrients that one's body needs. Today's food is not functional and we need to supplement in order to maintain optimal bodily functions and nutrition.
Make an appointment to consult with your Health Renewal Doctor who is an integrative doctor and he / she will assist you in determining your risk factors and how best to prevent any problems or conditions that you may be susceptible to. The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments, nutritional supplements and a healthy diet and lifestyle.
The initial medical consultation at Health Renewal will be approximately 45 minutes. As this is a prolonged medical consultation, the initial consultation fee will be R 975 on arrival (for non loyalty programme members) you will have to complete an in depth questionnaire before the consultation so please arrive 20 minutes before the time. During the 45 minute consultation your Health Renewal doctor will obtain a FULL medical history from you to determine your personal risk. A physical examination will be done after which the Doctor will decide which blood tests need to be requested from your local pathology laboratory. If you have a medical aid, these should be able to be claimed as well.
Once your blood results are received, they will then be analyzed by your Health Renewal doctor who will begin working on a unique prescription plan for you with the compounding pharmacy. At your pre-scheduled second appointment 2 weeks later, the results and examination findings will be discussed with you. This will determine what abnormalities or deficiencies exist and you will be advised on your treatment options. These options may range from prescription medications, nutraceuticals, bio-identical hormonal creams / tablets or alternatively to having bio-identical implants / pellets inserted.
In office treatments such as carboxytherapy may also be recommended for certain conditions such as hair loss, erectile dysfunction ED, menopause or PMS. If you need to lose weight our Renewal Institute Diet may be recommended. All these recommendations will be summarized on a sheet / print out which you can take home with you. The nutraceuticals offered at Health Renewal are of superior quality (Solgar) and are not rancid nor contain Hg (mercury ) or PCB'S (which is very important for Omega 3 Essential fatty acids EFA's). They are also free of gluten, preservatives, wheat, dairy, soy, yeast, sugar, artificial flavor, sweetener and colour. We have a great professional team made up of doctors, trained and registered nurses and therapists to support you at any time.
1. You are kindly requested to bring any supplements that you are currently taking, along to your consultation. The doctor can check the ingredients in take this into account when prescribing a treatment plan for you.
2. Also, if you have had any blood work done in the past 6 months, please bring the results along to the consultation. Should you not be in possession of the hard copies, please request these results from the lab you visited. Usually your ID number is sufficient.
The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments , nutritional supplements and a healthy diet and lifestyle.
Today, the market is flooded with very strong toothpastes that contain whitening agents (usually hydrogen peroxide or carbamide peroxide). A toothpaste is now available that has been fortified with coenzyme Q10, folic acid, xylitol, green tea, lactoferrin, and other nutrients that are directly delivered to the gums every time one brushes. This novel toothpaste also contains a mild solution of 0.2 percent hydrogen peroxide.
Of course, this is easier said than done. First, you need to make sure you have some floss. There are tons of different kinds of floss (flavored, unflavored, strings, ribbons and on and on). Pick some and give them a try. Next, you have to remember. Put your floss on top of your toothpaste. Hard to forget that way. Then just do it. You already have a habit of brushing your teeth at least twice daily, so just anchor your flossing habit to that.
At first you think it's kind of funny, but the tooth keeps getting looser and looser and one day, in the middle of pushing the tooth back and forth and squinching your eyes shut, you pull it clean out. It's the scariest thing you can think of 'cause you lose control of your tongue at the same time and no matter how hard you try to stop it, it won't leave the new hold in your mouth alone, it keeps digging around in the spot where that tooth used to be.
You tell some adult about what's happening but all they do is say it's normal. You can't be too sure, though, 'cause it shakes you up a whole lot more than grown folks think it does when perfectly good parts of your body commence to loosening up and falling of off you.
Unless you're as stupid as a lamppost you've got to wonder what's coming off next, your arm? Your leg? Your neck? Every morning when you wake up it seems a lot of your parts aren't stuck on as good as they used to be.” ― Christopher Paul Curtis, Bud, Not Buddy
After the two week follow up, the initial blood results will be discussed and patient specific nutraceuticals may be initiated. A second follow up another evaluation and blood test at 8 weeks is recommended to measure serum improvements in your Lipogram, homocysteine and other essential blood results. Follow up appointments should be very 6 months.
Gingivitis is the most common and mild form of the oral/dental disease. According to the Food and Drug Administration, approximately 15 percent of adults between 21 and 50 years old, and 30 percent of adults over 50 have gum disease. Gingivitis is characterized by inflammation and bleeding of the gums. Because gingivitis is rarely painful in its early stages, it often goes unnoticed until severe irritation or receding gums occur.
A number of recent studies suggest that you may already have a cheap and powerful weapon against heart attacks, strokes, and other heart disease conditions. It costs less than R30 and is sitting on your bathroom counter. It is none other than the humble toothbrush. If plaque is not removed within 72 hours, plaque will harden into tartar that cannot be removed by brushing or flossing.
The fact that flossing daily can extend life expectancy falls in the weird-but-true category. In fact, floss does two things: it prevents gum disease (that's rather obvious), and it prevents heart disease (not so obvious). Preventing both of these together is what adds years to your life. Here's how flossing improves life expectancy:
When you floss, you help prevent your gums from becoming inflamed. That's a good thing. What is happening when your gums are inflamed is that you have a chronic bacterial infection in your mouth. This harms your arteries through two mechanisms: the bacteria find their way into your arteries and hang out (causing plaques), and your body mounts an immune response to the bacteria in your mouth, causing inflammation (which in turn can cause your arteries to narrow). This makes it hard for your heart to do its job and can lead to heart disease.
There is some debate about how many years you can gain with heart disease. Dr. Perls says 1.5 years, while Dr. Roizen says 6 years. Both of these doctors are gerontologists (aging docs) and have popular books on aging and life expectancy (see reviews: Living To 100, RealAge and You! Staying Young). Who is right? It doesn't matter. Flossing is good for your gums and good for your heart, so we should all just do it.
The evidence isn't clear yet, experts say, but it's intriguing. According to the American Academy of Periodontology, people with periodontal disease are almost twice as likely to have coronary artery disease (also called heart disease). And one study found that the presence of common problems in the mouth, including gum disease (gingivitis), cavities, and missing teeth, were as good at predicting heart disease as cholesterol levels.
But even if periodontal disease isn't actually causing heart disease, the connection could still be important. For instance, the periodontal disease might be an early sign of cardiovascular problems. Heart disease can be hard to catch early because many of the conditions that precede it have no symptoms. You won't ever feel your arteries hardening or your cholesterol rising. But you might notice bleeding or painful gums.
The main cause of gingivitis is plaque (or biofilm), a soft, sticky film that forms on the teeth when starches and sugars react with bacteria that is naturally present in the mouth. Plaque buildup occurs between the teeth and gums, in faulty fillings, and near poorly cleaned partial dentures, bridges, and braces. If not removed within 72 hours, plaque will harden into tartar that cannot be removed by brushing or flossing.
The best defense against gingivitis is brushing and flossing after meals, as well as professional cleaning by a dental hygienist every three to four months. If left untreated, gingivitis may lead to a more serious condition called periodontitis, in which the inner gum and bone pull away from teeth and form pockets. These pockets can collect bacteria and debris, and become infected or abscessed. Bacterial toxins eventually break down the underlying bone and connective tissue that hold teeth in place. The ultimate outcome is tooth loss. For more information, see Periodontitis and Cavities.
Several studies suggest that gum disease may be passed from parents to children as well as between couples. Based on these findings, the American Academy of Periodontology (AAP) recommends that treatment of gum disease may involve entire families and that if one family member has periodontal disease, all family members should see a dental professional for a periodontal disease screening.
Other conditions that may contribute to gingivitis include:
Infections:
Viral and fungal infections can also adversely affect gum health. The herpes virus, for example, can lead to acute herpetic gingivostomatitis, a condition characterized by swollen gums and small, painful sores in the mouth. Oral thrush is caused by an overgrowth of the yeast known as Candida albicans that are normally found in the mouth. Thrush can produce white lesions on the inner cheeks and tongue that can spread to the gums.
Disease:
Hormonal Changes:
During periods of hormonal fluctuation (e.g., pregnancy and menopause), women may become more susceptible to gingivitis due to decreased salivation and blood supply to the gums. It is also thought that increased hormone levels cause the gums to respond aggressively to bacteria-producing irritation. However, while it is clear that hormone levels play a role in the progression of periodontal disease, hormones do not specifically cause gingivitis. Of particular importance to women is that several recent studies indicate that pregnant women with periodontal disease may be more likely to deliver a pre-term, low-birth-weight infant.
Poor Nutrition:
A diet lacking in adequate amounts of calcium, vitamin C, and B vitamins can increase the risk of developing periodontal disease.
Smoking:
Tobacco use may be one of the largest preventable risk factors for periodontal disease. According to one study, smoking may be responsible for more than half of adult cases of periodontal disease. The same study also found that smokers are four times more likely to develop the advanced periodontal disease than people who have never smoked Smoking diminishes oxygen and nutrient delivery to gum tissue and interferes with the synthesis of cytokines that regulate immunity and inflammation. Smoking also poses a risk of periodontal therapy failure, treatment complications, and increased time to treat the disease.
Stress and Depression:
Stress has been linked to an increased risk of periodontal disease, possibly because it may trigger an increase in behaviors such as smoking and poor oral hygiene. Sustained levels of financial stress and poor coping abilities, which can trigger habits such as poor diet or smoking, double the risk of developing periodontal disease. Researchers have also found that clinically depressed patients are only half as likely to benefit from periodontal treatment as non-depressed patients.
Treatment of gum disease begins with regular brushing and flossing. It is also important to make regular trips to the dentist for cleaning and monitoring. Most dentists recommend yearly full-mouth x-rays to assess the progression of bone loss in the jaws. However , there is concern about the radiation exposure that results from undergoing medical x-rays. Even x-rays that emit low levels of radiation damage DNA, which can lead to cancer. While some dental x-rays are necessary, annual x-rays are not advisable.
A full periodontal probe with a tiny, ruler-like instrument is also performed to measure the pockets surrounding the teeth. In healthy gums, the pockets measure less than 3 millimeters. Pockets measuring 3 to 5 millimeters indicate signs of gingivitis. Pockets measuring more than 5 millimeters signify the development of periodontitis.
A professional cleaning to remove plaque and tartar buildup should be performed at least twice a year. Some people need to have cleanings done more frequently.
Non-surgical deep cleaning involves two procedures known as scaling and root planing, which are sometimes performed in sections of the mouth at different times, especially if there is considerable soreness and bleeding from the gums. Scaling removes plaque and tartar above and below the gum line. Root planing smoothes out the tooth root to remove bacteria buildup and encourage the gums to reattach to the teeth.
Mouth Rinses. Mouth rinses are frequently used to help prevent gingivitis. Medicated mouth rinses containing a 0.1% solution of folic acid have effectively reduced gum inflammation and bleeding in double-blind trials Prescription antibacterial mouthwashes containing the ingredient chlorhexidine are also frequently used to treat gum inflammation.
Decapinol®, a prescription oral rinse, reduces the adherence of bacterial plaque to oral surfaces. This reduces the formation of new plaque as well as breaks up existing plaque, making it easier to remove with normal brushing. Reducing the presence of plaque also reduces the amount of bacterial toxins released into the gums. The result is a reduction in plaque and gingivitis. Decapinol® is only mildly antibacterial, so it does not upset the oral bacterial flora.
Toothpaste. The natural and synthetic antibacterial agents in many brands of toothpaste can help keep gums healthy. Natural toothpastes contain botanical oils that have antibacterial properties, while commercial formulas offer the benefit of fluoride to help prevent cavities. The brand Colgate Total®—the only FDA-approved toothpaste for fighting gingivitis—contains triclosan, a mild antimicrobial proven to reduce plaque and pocket depths associated with gingivitis.
Antibiotic Therapy.
Antibiotic therapy used alone or in combination with other treatments may also be recommended to treat gingivitis. (doxycycline hyclate),(chlorhexidine gluconate), and (minocycline hydrochloride) are antibiotics applied in sustained-release doses directly into the periodontal pocket.
A relatively new drug called Periostat® (doxycycline hyclate) was approved by the FDA in 1998 for use in combination with scaling and root planing. Taken orally, Periostat® suppresses the action of collagenase, an enzyme that causes destruction of the teeth and gums.
Surgery. If a diligent regimen of proper brushing, flossing, and regular dental cleanings is followed, nearly all cases of gingivitis can be reversed in a short time. However, in advanced gingivitis, or conditions that make treatment difficult, the following surgical treatments can help:
Curettage - a procedure in which diseased gum tissue in the infected pocket is scraped away, allowing the infected area to heal. Flap surgery - involves pulling back the gums to remove tartar buildup. The gums are then sewn back in place so that the tissue fits snugly around the tooth, thereby reducing pocket depth.
Guided tissue regeneration - stimulates bone and gum tissue growth, and is often performed in combination with flap surgery. In this procedure, a small piece of mesh-like fabric is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and connective tissue to reattach.
Soft tissue grafts - reinforce thin gums or replace tissue where the gums have receded. The grafted tissue, usually taken from the roof of the mouth, is sewn in place over the affected area.
Hydrogen peroxide. Hydrogen peroxide, which is included in many toothpastes, is valuable for its ability to reach bacteria hiding among gingival folds and gaps. Hydrogen peroxide is also added to some mouthwashes to reduce gingivitis and whiten teeth. Hydrogen peroxide has been used effectively for years in dentistry.
In addition to brushing with a good toothpaste and making regular visits to the dentist, a number of nutrients have been shown to improve gum health.
Coenzyme Q10. Coenzyme Q10 (CoQ10), a vital nutrient needed by every cell in the body to make energy, is beneficial for a variety of diseases and disorders, including periodontal disease. In addition to energy production, CoQ10 plays a vital role as an antioxidant at the cellular level by neutralizing free radicals. As early as the 1970s, researchers found that gum tissue in people with periodontal disease was often deficient in CoQ10 . Subsequent studies have shown that CoQ10 doses of 50 to 75 mg daily can halt deterioration of the gums and allow healing to occur, sometimes within days of starting therapy. In one double-blind trial, 50 mg daily of CoQ10 was significantly more effective than placebo in reducing symptoms of gingivitis after three weeks of treatment.
Stephen T. Sinatra, M.D., clinical cardiologist and author, reports that many of his patients see improvement in their gum health after beginning CoQ10 supplementation for heart disease. According to research by Sinatra, CoQ10's supportive effects on the immune system in general account for its ability to promote healing of diseased gums. Dr. Victor Zeines, a holistic dentist and author, recommends 100 mg of CoQ10 daily in combination with other supplements to help reverse gum disease naturally.
Calcium. A study found that people who do not consume adequate amounts of calcium each day are at significantly higher risk for periodontal disease. According to the American Dietetic Association, three of four people do not fulfill their daily calcium requirement. The study showed that men and women who had low calcium intakes (below the recommended dietary allowance) were almost twice as likely to have periodontal disease, as measured by the loss of attachment of the gums to the teeth.
Vitamin D: According to a recent report from the American Journal of Clinical Nutrition, high blood levels of a vitamin D metabolite are associated with a decreased risk of gingivitis. Researchers at Boston University analyzed data from 6,700 nonsmokers, aged 13-90+, from the National Health and Nutrition Examination Survey. The investigators analyzed blood levels of 25-hydroxyvitamin D and assessed the participants’ gums for the presence of gingivitis. Participants with the highest blood levels of 25-hydroxyvitamin D were the least likely to display signs of gingivitis. The scientists noted that vitamin D may reduce susceptibility to gingivitis by exerting anti-inflammatory effects, and postulated that gingivitis may provide a useful clinical model for further investigation into the anti-inflammatory effects of vitamin D.
Folic Acid: Studies have demonstrated that folic acid is very effective in preserving gum tissue and reducing the risk of gingivitis and periodontitis. Although the benefits of oral folic acid in protecting against heart disease and birth defects are well documented, new evidence suggests that using folic acid topically (as a mouthwash) can also strengthen one's oral defenses. Studies have demonstrated folic acid's ability to improve gingivitis symptoms, reduce gum tissue's inflammatory response, and make gum tissue more resilient to irritants such as bacteria and plaque.
Folic acid has been clinically tested in mouthwash solutions to assess its benefit in treating gingivitis. One study showed significant improvement after four weeks of using a folic acid mouthwash. In this double-blind, placebo-controlled study of 60 patients, dietary folic acid intake did not correlate with treatment results, suggesting the importance of applying folic acid topically to the gums. A double-blind study of 30 patients compared supplementation with 4000 mcg of ingested folic acid to placebo. After one month, plaque and gingival indices showed that folic acid supplementation appeared to increase the resistance of the gingiva to local irritants, leading to a reduction in inflammation.
Green Tea.
Green tea extract is rich in a class of antioxidants called catechins. Two in particular, epigallocatechin gallate (EGCG) and epicatechin gallate (ECG), combat oral plaque and bacteria These green tea polyphenols work as anti-plaque agents by suppressing glucosyl transferase, which oral bacteria use to feed on sugar. Other research has demonstrated that green tea extract can kill oral bacteria and inhibit collagenase activity. Collagenase, a natural enzyme that becomes overactive in the presence of bacterial overgrowth, can destroy healthy collagen in gum tissue.
Green tea extract applied topically( mouth wash) inhibits Streptococcus mutans bacteria, which have been implicated in the development of dental caries (the decay and breakdown of teeth and their bone support). Scientists suggested that certain extracts from green tea might be especially helpful in preventing tooth decay by preventing the development of bacterial plaque . In a Chinese study, green tea extract was used to rinse and brush the teeth. The study demonstrated that S. mutans could be inhibited completely after contact with green tea extract for five minutes. There was no drug resistance after repeat cultures . The scientists concluded that green tea extract is effective in preventing dental caries (You 1993). Other studies have shown that the plaque index and gingival index decreased significantly after green tea extract was used.
Hyperimmune egg extract:
3 to 6 tablets chewed daily on an empty stomach. Agricultural scientists discovered long ago that they could immunize hens against germs that threaten humans. This immunity was then passed on by the hen to her egg. Scientists have now been able to customize eggs to provide different types of immunity. At least 24 different organisms have been used to immunize a single hen, which then lays eggs that offer passive immunity to all of the organisms.
Hyperimmune egg extract has been shown to reduce the volume of dental plaque, which in turn cuts down on the total load of inflammation in the mouth . Animals supplemented with hyperimmune egg against the leading bacterial cause of dental caries developed significantly lower dental caries scores than did control animals Oral hyperimmune egg rinses have also been used successfully in humans to reduce disease-causing bacteria; the extracts remain active and present in the mouth at least overnight, offering long-standing protection.
Pomegranate: Researchers are finding important applications for pomegranate in the field of dental health. Clinical studies have shown that this popular antioxidant attacks the causes of tooth decay at the biochemical level with remarkable vigor. Pomegranate literally attacks bacteria where they live. Research shows that by interfering with production of the chemicals the bacteria use as “glue”, pomegranate extract suppresses bacteria’s ability to adhere to the surface of the tooth.
During a study conducted in 2007 examined the effects of a mouthwash containing pomegranate extract on the risk of gingivitis investigators noted that pomegranate’s active components, including polyphenolic flavonoids are believed to prevent gingivitis through a number of mechanisms including reduction of oxidative stress in the oral cavity, direct antioxidant activity anti-inflammatory effects, antibacterial activity and direct removal of plaque from the teeth. Saliva samples were evaluated for a variety of indicators related to gingivitis and periodontitis. Subjects rinsing with pomegranate solution experienced a reduction in saliva total protein content, which is normally higher among people with gingivitis (Narhi 1994) and may correlate with plaque-forming bacterial content.
Xylitol: Pure xylitol is a white crystalline substance that resembles and tastes like sugar. It is found naturally in fruits such as plums, strawberries, and raspberries. Xylitol is used commercially to sweeten sugarless gum and candies.
Xylitol gum: Xylitol has been shown to inhibit the formation of plaque. In a double-blind and controlled study, Swedish researchers had 128 children chew gum containing either xylitol or the sweeteners sorbitol and maltitol, three times daily for four weeks. While both were effective against the buildup of dental plaque, only the xylitol-sweetened gum eliminated microbes found in saliva, particularly a strain of bacteria implicated in tooth decay . Xylitol could thus be an essential ingredient in a targeted strategy to avert dental disease.
Xylitol toothpaste: a double-blind, placebo-controlled study of 2,630 children compared a standard fluoride toothpaste with one containing 10% xylitol. Over a three-year period, children given the xylitol-enriched toothpaste developed notably fewer cavities than those using the fluoride-only toothpaste.
Probiotics. Probiotics have been defined as “living microorganisms which upon ingestion in certain numbers exert health benefits beyond inherent general nutrition”. Scientists have been interested in the makeup of the microbes that live in the mouth (the “oral flora”) for decades, seeking to identify factors that promote the growth of healthy organisms and reduce the growth of those implicated in disease and inflammation. Probiotics not only improve oral health but can help change the stubborn composition of dental biofilm and plaque. Reducing the total amount of plaque through teeth brushing is always a desirable goal; however, its complete elimination is not possible. Therefore, changing the actual composition of plaque from an inflammatory cytokine-rich environment to a more benign environment (dominated by neutral or even helpful organisms) can contribute to overall systemic health.
In laboratory studies, the probiotic S. salivarius helped inhibit the formation of the sticky biofilm that can contribute to oral disease. Building on these results, an animal study showed that the S. salivarius probiotic helped displace biofilm from the teeth, displacing cavity-causing bacteria and inhibiting tooth decay. Another in vitro experiment demonstrated how effectively a second oral probiotic protects oral health. In this experiment, a form of Bacillus coagulans (known as GanedenBC30™) was shown to competitively inhibit the cariogenic (cavity-inducing) bacterium Streptococcus mutans, which contributes to significant tooth decay.
Lactoferrin. Lactoferrin, a naturally occurring antimicrobial agent, is found in saliva and gingival fluid, breast milk, tears, and other bodily fluids. This protein is a well-known immune system booster involved in the body’s responses to infection, trauma, and injury Lactoferrin may bind to and slow the growth of periodontitis-associated bacteria. In an animal study, locally applied lactoferrin powder appeared to support the healing of oral lesions.
Vitamin C: People deficient in vitamin C may be at risk of developing gingivitis. In one study, a group of subjects with periodontal disease who normally consumed only 25 to 30 mg of vitamin C daily were supplemented with an additional 70 mg. They experienced marked improvement in gum tissue after only six weeks. Although it is established that smoking contributes to gum disease, tobacco users may especially benefit from vitamin C supplementation, as smoking depletes the body of vitamin C.
Herbal Protection. Tea tree oil, used as an oral rinse, has been proven to kill bacteria. In fact, research has shown that a tea tree oil concentration of 0.6 percent inhibited 14 of 15 oral types of bacteria. In a study, the tea tree oil group had improved gingival index and papillary bleeding index scores attributed to the herb’s anti-inflammatory properties.
Chamomile and red thyme oil are mild antimicrobials, herbs such as parsley, spearmint, menthol, and eucalyptus are stimulating to the gums, as well as refreshing and cooling for the mouth in general.
Fish oil and borage oil. Because of the association between gum disease and systemic inflammation, researchers have begun looking at anti-inflammatory nutrients in the context of gum disease. It is reasonable for people with gum disease to consider using these supplements. Other anti-inflammatory supplements include ginger and curcumin, though neither of these has been studied in the context of inflammatory gum disease.
For all health conditions, the nutraceuticals are individually tailored by the Health Renewal Doctor. The doctor will decide- based on your history, physical examination and blood tests what would be the best for you and your specific needs and/or deficiencies. It cannot be overemphasized that one must not self-medicate. Self-Medicating is done when a person takes prescription medication or nutraceuticals on their own without a doctor's supervision and/or consent. By not having a physical examination and blood testing done by a qualified and practising integrative medical practitioner, you could be not treating vital deficiencies or conditions such as elevated blood pressure, high sugar level, high stress levels (that can lead to adrenal burnout ) and high blood clotting factors that could lead to heart attacks and stroke. In addition, aggressive program of dietary supplementation should not be launched without the supervision of a qualified physician. Several of the nutrients suggested in this protocol may have adverse effects. There is no single supplement prescribed to clients as there is no magic bullet that can support all the essential nutrients that one's body needs. Today's food is not functional and we need to supplement in order to maintain optimal bodily functions and nutrition.
Make an appointment to consult with your Health Renewal Doctor who is an integrative doctor and he / she will assist you in determining your risk factors and how best to prevent any problems or conditions that you may be susceptible to. The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments, nutritional supplements and a healthy diet and lifestyle.
The initial medical consultation at Health Renewal will be approximately 45 minutes. As this is a prolonged medical consultation, the initial consultation fee will be R 975 on arrival (for non loyalty programme members) you will have to complete an in depth questionnaire before the consultation so please arrive 20 minutes before the time. During the 45 minute consultation your Health Renewal doctor will obtain a FULL medical history from you to determine your personal risk. A physical examination will be done after which the Doctor will decide which blood tests need to be requested from your local pathology laboratory. If you have a medical aid, these should be able to be claimed as well.
Once your blood results are received, they will then be analyzed by your Health Renewal doctor who will begin working on a unique prescription plan for you with the compounding pharmacy. At your pre-scheduled second appointment 2 weeks later, the results and examination findings will be discussed with you. This will determine what abnormalities or deficiencies exist and you will be advised on your treatment options. These options may range from prescription medications, nutraceuticals, bio-identical hormonal creams / tablets or alternatively to having bio-identical implants / pellets inserted.
In office treatments such as carboxytherapy may also be recommended for certain conditions such as hair loss, erectile dysfunction ED, menopause or PMS. If you need to lose weight our Renewal Institute Diet may be recommended. All these recommendations will be summarized on a sheet / print out which you can take home with you. The nutraceuticals offered at Health Renewal are of superior quality (Solgar) and are not rancid nor contain Hg (mercury ) or PCB'S (which is very important for Omega 3 Essential fatty acids EFA's). They are also free of gluten, preservatives, wheat, dairy, soy, yeast, sugar, artificial flavor, sweetener and colour. We have a great professional team made up of doctors, trained and registered nurses and therapists to support you at any time.
1. You are kindly requested to bring any supplements that you are currently taking, along to your consultation. The doctor can check the ingredients in take this into account when prescribing a treatment plan for you.
2. Also, if you have had any blood work done in the past 6 months, please bring the results along to the consultation. Should you not be in possession of the hard copies, please request these results from the lab you visited. Usually your ID number is sufficient.
The importance of early management of any condition cannot be overstated. Once certain conditions set in and damage to organs occurs, complete recovery may be difficult to attain. Best results for prevention and longevity is early detection of a possible problem combined with conventional treatments , nutritional supplements and a healthy diet and lifestyle.
Today, the market is flooded with very strong toothpastes that contain whitening agents (usually hydrogen peroxide or carbamide peroxide). A toothpaste is now available that has been fortified with coenzyme Q10, folic acid, xylitol, green tea, lactoferrin, and other nutrients that are directly delivered to the gums every time one brushes. This novel toothpaste also contains a mild solution of 0.2 percent hydrogen peroxide.
Of course, this is easier said than done. First, you need to make sure you have some floss. There are tons of different kinds of floss (flavored, unflavored, strings, ribbons and on and on). Pick some and give them a try. Next, you have to remember. Put your floss on top of your toothpaste. Hard to forget that way. Then just do it. You already have a habit of brushing your teeth at least twice daily, so just anchor your flossing habit to that.
At first you think it's kind of funny, but the tooth keeps getting looser and looser and one day, in the middle of pushing the tooth back and forth and squinching your eyes shut, you pull it clean out. It's the scariest thing you can think of 'cause you lose control of your tongue at the same time and no matter how hard you try to stop it, it won't leave the new hold in your mouth alone, it keeps digging around in the spot where that tooth used to be.
You tell some adult about what's happening but all they do is say it's normal. You can't be too sure, though, 'cause it shakes you up a whole lot more than grown folks think it does when perfectly good parts of your body commence to loosening up and falling of off you.
Unless you're as stupid as a lamppost you've got to wonder what's coming off next, your arm? Your leg? Your neck? Every morning when you wake up it seems a lot of your parts aren't stuck on as good as they used to be.” ― Christopher Paul Curtis, Bud, Not Buddy
After the two week follow up, the initial blood results will be discussed and patient specific nutraceuticals may be initiated. A second follow up another evaluation and blood test at 8 weeks is recommended to measure serum improvements in your Lipogram, homocysteine and other essential blood results. Follow up appointments should be very 6 months.
