Every time you go to the dentist, you hear the same story: you're not brushing and flossing well enough. Plaque, caused by bacteria and food, gets stuck to your teeth after eating and hardens, inflaming your gums and causing them to bleed or recede.
If you carry on as you are, he warns again in a sober voice, you can look forward to a future of periodontal disease, loose or missing teeth and eventually dentures. You're given another appointment with the hygienist and a bag full of the latest in scientifically proven toothpaste and powerful antibacterial mouthwashes and you vow, once again, to scrub a little harder.
Although brushing, flossing and interdental brushes all help to keep plaque at bay, this daily exercise is like digging out a mountain with a teaspoon. Plaque reappears just 24 hours later, so keeping your gums healthy is not simply a matter of going to the dentist regularly for a good descaling, spit and polish. And even the most diligent twice a day brushing or a Dettol of a mouthwash won't work if you don't pay attention to the rest of your body.
The fact is the state of your gums simply mirrors the state of your health, particularly the state of your diet, and vice versa. In fact, most of the main modern degenerative diseases are actually linked to gum disease in some way, most likely because inflammation caused by gum disease quickly spreads throughout the body via the blood circulation and leads to increased levels of cancer-causing compounds. Your gums offer an instant snapshot of your immune system and your overall health, so to keep your gums healthy, you need to approach the issue holistically by paying attention to your body and its requirements as a whole, particularly your diet. Many dentists consider gum disease simply evidence of malnutrition.
It's also wise to keep in mind that the composition of dental bacteria is dynamic, constantly changing as the environment in your mouth changes too. You may not be able to eliminate plaque altogether, but you can actually change the bugs in your mouth to make them more health supportive.
Here are seven hidden causes of gum disease. Before you consider any preventative medicine, make sure you take care of these first.
1. Too many refined carbs
The bacteria responsible for causing dental plaque feed and quickly ferment on sugar, and all the high glycaemic index (GI) white stuff (refined sugar, white rice, potatoes, processed white bread) quickly turns into sugar and lactic acid. As a rule of thumb, the more refined carbs you eat, the more likely you are to have gum problems. Remember too that many foods that are healthy when raw (like carrots) become high GI when cooked. The humble spud is another one of those high GI foods, particularly when fried. Ditto beer. Keeping your mouth healthy is just one more reason to rid your diet of these foods.
Check out the official website of the late French Dr Michel Montignac, who pioneered the low GI diet, for a list of the highest glycaemic foods (www.montignac.com/en/search-for-a-specific-glycemic-index/#tab) and avoid anything with a GI over 50.
2. Nutritional deficiencies
Strong evidence links gum problems to a range of nutritional deficiencies, including the following nutrients.
Co-enzyme Q10 Virtually all patients with gum disease are found to have marked deficiencies of this vital nutrient, and supplementing can often quickly heal periodontal disease. In one study, patients with periodontal disease taking 50 mg/day of CoQ10 showed marked improvements in swelling, redness, pain and gappy or loose teeth after three weeks. Suggested daily dosage: 50 mg
Vitamin C Low circulating levels of vitamin C have been linked to periodontal disease, and minimal supplements of just 70 mg/day can lead to rapid improvement. However, most nutritionists advise that you need far more of this vitamin for optimal health. Suggested daily dosage: 1-3 g
Omega-3 fats According to American research, those with diets high in these essential fatty acids have a lower incidence of gum disease.Suggested daily dosage: 1g of fish oil containing 180 mg of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)
Vitamin D and calcium Boston University research shows that people with the highest blood levels of a form of vitamin D are the least likely to have gingivitis and periodontal disease, possibly due to the vitamin's anti-inflammatory effects. And low levels of calcium appear to nearly double your chances of developing periodontal disease because your gums are then more likely to attach poorly to your teeth. Suggested daily dosage: at least 1,000 IU of vitamin D; for calcium, high-dose supplements are poorly absorbed, so it's best to get your daily amount from food, especially dairy products and green leafy veg.
B vitamins The entire B-vitamin complex strengthens gum tissue, and 2 mg twice a day of folic acid in particular has been shown to improve bleeding gums compared with a placebo. Vitamin B6 helps promote the good-guy bacteria in the mouth while killing off the decay-producing variety.Suggested daily dosage: one B-50 complex capsule (containing mostly 25 or 50 mg of all of the B vitamins, plus 50 mcg of vitamin B12)
3. Mercury in the mouth
Amalgam fillings undoubtedly play a role in poor gum health. If you have a mouth full of metal, consider having your 'silver' fillings taken out, but only by a dentist highly experienced in their removal, who will use rubber dams and air hoses to remove the mercury vapour as he drills them out. (See WDDTY February 2013 for a full plan of safe dental mercury removal.)
The filthy habit, estimated to account for about half of all cases of gum disease, quadruples your chances of developing advanced periodontal disease. Smoking greatly diminishes both the oxygen and nutrient supply to the gums and also interferes with the production of cytokines, essential for your body's immune system control of inflammation.
5. Mouth breathing
Saliva plays an important role in dental hygiene, but if you're a mouth breather, particularly during sleep, your saliva dries up, removing one of Nature's major safeguards for keeping bacteria at bay. Some dentists even blame gum problems on incorrect swallowing, which we develop, they say, from being bottle-fed as infants.
Learning to swallow while bottle-feeding forces the baby's tongue into an incorrect position to prevent choking, and as children who learned to feed this way grow up, they tend to swallow too much air and push food against the teeth when they eat. If you're a mouth breather, work with an alternative practitioner to correct this.
6. Prescription drugs
Levels of gum-disease-causing bacteria in a woman's mouth may increase after she begins using the Pill-one more reason to ditch oral contraceptives. Other prescription drugs, including antidepressants, typically cause dry mouth as a side-effect and so reduce levels of saliva, again encouraging germs to breed in the mouth. The same goes for over-the-counter cold remedies. Antihypertensive drugs like calcium-channel blockers and antiseizure drugs like phenytoin all also affect gum tissue and encourage bacterial overgrowth.
In one study, after a large group of soldiers in active service were discovered to have severe gum disease, the cause was put down to stress, which reduces the amount of saliva in the mouth and causes its pH to become more acidic. Constant stress in everyday life can also affect the state of your gums; an inability to cope well with unrelenting financial stress, for instance, can double your chances of developing gum disease.
Other evidence shows that besides stress, depression in general has been linked to periodontal disease.
What to do instead
Now that you've cleaned up your act, here are six good ways to keep your mouth healthy
1. Eat whole, organic and unprocessed
As a general rule of thumb, the less processed and interfered with, the lower the glycaemic index and the better the food is for you and your mouth. The late New York-based holistic dentist Dr Jerome S. Mittelman, one of the authors of Healthy Teeth for Kids (New York, NY: Kensington Publishing Corp., 2001), found that the patients who started off their day with a protein breakfast, including plenty of vitamin C and calcium, improved the state of their gums.
2. Drink lots of cuppas
Both green and black teas offer high levels of flavonoids that have been shown to halt the activity of oral bacteria, as do the catechins in green tea.They work by suppressing the enzyme that oral bacteria need to feed on sugar.
3. Feast on pomegranates
This superfruit contains polyphenolic flavonoids that attack bacteria on every front, interfering with the production of the chemicals used by bacteria to glue themselves to your teeth. Mouthwashes containing pomegranate extract have antibacterial and anti-inflammatory effects, and can even help to remove plaque from teeth.
Besides a good daily multivitamin (containing calcium, magnesium, vitamin D, vanadium and silicon), take additional supplements of:
Coenzyme Q10 (dosage: 50 mg/day)
Vitamin C (dosage: at least 1 g/day)
Vitamin D (dosage: at least 1000 IU/day)
B-50 Complex (dosage: one capsule/day)
Omega-3 fatty acids (dosage: 1 g of fish or flaxseed oil, and add purslane to your diet, as this vegetable contains high levels of omega-3s)
Vitamin E tocotrienols (dosage: at least 400 IU/day).
5. Pop a probiotic
Taking these friendly bacteria daily not only affects the gut flora (the composition of bacteria living in the intestines), but also the bugs in your mouth, lowering the numbers of bacteria contributing to plaque and inflammation, and even changing the composition of the gunky biofilm used by bacteria to stick to teeth.
Get hold of products (available online) containing Bifidobacterium adolescentis and Streptococcus salivarius (strain K12) as they have been shown in lab and animal studies to prevent the formation of the biofilm that contributes to gum disease and tooth decay.
6. Use natural toothpaste and mouthwash
Native and traditional cultures all over the world use the leaves, twigs and kernels of plants to effectively control mouth bacteria rather than trying to completely blast it away, as we do in the West. The best herbal products include:
Liquorice (Glycyrrhiza glabra), proven to be highly effective against plaque formation.
Myrrh (Commiphora molmol), which helps heal mouth ulcers.
Salvadora persica, called 'the toothbrush tree'-for good reason: for centuries, North African native cultures used its twigs ('miswak chewing sticks'), which splay out like a toothbrush, to scrub their teeth, and benzyl isothiocyanate, one of its active ingredients, is effective against mouth bacteria. One study concluded that the twigs are just as effective as ordinary brushing for normal plaque reduction.
Krameria triandra (rhatany or ratanhia root), used by South Americans as a mouthwash, is effective for fighting plaque.
Propolis, the sticky stuff brought to us by honeybees, appears to effectively fight plaque, gum disease, mouth ulcers and even cavities. Research on a mouthwash containing 5 per cent Brazilian green propolis showed significant effects in reducing plaque and gum inflammation after just three months.
Xylitol This natural sugar derived from plums, strawberries and raspberries, is used to sweeten sugarless candy and gum. It inhibits plaque formation and, in one study of children, eliminated the salivary bacteria associated with tooth decay. If you're going to chew gum, let this be the one.
Which came first-bad gums or the disease?
Bad teeth and gums are linked with many modern degenerative diseases, including:
Type 2 diabetes Both gingivitis and severe periodontitis exacerbate diabetes-and may even be a cause of it in the first place. The reverse is also true: diabetes makes gum disease worse. In one study, those with gum disease were twice as likely to develop diabetes while, in another, diabetics found it impossible to achieve glycaemic control if they also had gum disease.One study found that 90 per cent of people with gum disease are at risk of developing diabetes or may even already have the disease but don't know it.
Infertility If you're finding it difficult to conceive, check out the state of your mouth, as unhealthy gums can affect your ability to get pregnant. In one study of nearly 4,000 pregnant women, those with gum disease took seven months to conceive-two months longer than women with healthy gums. In particular, non-Caucasian women with gum disease took a full year longer to conceive than women with healthy gums.
Heart disease People who don't take good care of their teeth and gums are 70 per cent more likely to develop heart disease than those who brush their teeth twice a day and visit their dentists regularly.
Arthritis Poor oral health also predisposes to inflammatory diseases such as arthritis, according to researchers from University College London.
Stroke Serious gum disease like periodontitis quadruples your chances of suffering a stroke, which is about the same risk as if you have high blood pressure and twice the risk of diabetics. And those who have already had a stroke are nearly three times more likely to have another one if they have gingival bacteria too.
Plaque-clogged arteries Italian researchers have linked atherosclerosis with poor gum health, as did a major review of the current research.
Cancer Gum disease increases the risk of pancreatic cancer, the fourth most common cause of cancer deaths. In fact, losing a tooth from gum disease within the past four years nearly trebles your risk of developing pancreatic cancer.
Mental decline Gum disease like gingivitis can also signal mental dysfunction.
Osteoporosis This degenerative bone disease is linked to gum disease, especially in women with low vitamin D levels.