Natural medicines and oral health: a look at the literature

Townsend Letter for Doctors and Patients,  June, 2005  by Jason Barker,  Chris Meletis

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The Dentists have it right. In fact, one could consider them to have the preventive medical concept down to a science. We are encouraged to visit the dentist every 6 months for a professional cleaning and general checkup that may often include fluoride treatments and early detection utilizing radiographic imaging. They even give you the tools necessary (toothbrush, floss and toothpaste) for maintaining oral health at the end of your visit. Granted, some of these (and several other) treatments are criticized for their inherent toxicity, however as a model of prevention the dental profession is intent on maintaining American's oral health. And it shows--consider all of the healthy smiles we see around us each and every day ... and now think about what our mouths may have looked like not too long ago prior to regimented brushing and flossing. The point we are trying to make is, that if we cared as well as we do for the rest of our bodies as we do our teeth, the health of humanity would be infinitely improved. Think about it ... every 6 months you are scheduled to visit a physician who asks about any symptoms, performs a physical exam, does some laboratory testing, and spends some time talking to you about how you can improve some aspect of your general health. What an incredible model to follow.

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Regardless, there are many ways we can maintain our dental health utilizing the vast armamentarium of natural medicines, especially when we look at some of the indigenous uses of natural substances. After all, oral hygiene involves more than toothpaste. Moreover, some of these historical approaches continue to be scientifically validated, making them all the more appealing today when we are presented with a hundred different kinds of toothpaste and X-rays every 6 months.

Co-Enzyme Q-10

Coenzyme Q-10 (CoQ10) is widely held as a treatment for periodontal disease based on some older studies. CoQ10 is found throughout the body and in higher amounts in heart, kidney, liver and pancreatic tissues. CoQ10 plays an important role in the production of adenosine triphosphate, or ATP--the body's energy currency. CoQ10 also functions as an antioxidant and in several metabolic pathways. (1) CoQ10 is manufactured by the body and is also ingested in the diet, especially from animal products. Much of the argument for using CoQ10 in the treatment of periodontal disease is based on a study that found reduced CoQ10-enzyme activity in gingival tissue (gums). (2) Furthermore, the investigators in this study also noted decreased CoQ10 activity in the subjects' leukocytes, presumably signifying systemic deficiency of this nutrient, which they proposed was a contributor to periodontitis. A small collection of studies from the mid-1970's demonstrates some effectiveness for this nutrient in gum disease, (3-5) and a more recent Japanese study (utilizing topically-applied CoQ10) found "significant improvements" in various measures of periodontal disease progression; these investigators concluded that CoQ10 is a useful treatment for periodontal disease as a singular treatment or in combination with other nonsurgical therapies. (6) These limited, yet enticing findings regarding the use of CoQ10 and periodontal disease certainly provide plausible reason for its use. It is surprising that further studies have not occurred further delineating this preventive therapy for a costly health condition.

Xylitol

Xylitol is an up-and-coming dietary sweetener that has gained attention because of its utility as a sugar substitute due to its negligible effects on insulin levels (7) and its apparent ability to prevent tooth decay (8) and ear infections. (9) Xylitol is more of an alcohol than a sugar and is becoming more extensively used in diabetic food products and chewing gum. Xylitol is the alcohol form of xylose, a component of hemicellulose, a plant fiber. Xylitol is found in various fruits, vegetables, cereal grains, mushrooms and farm foods such as hay straw and corncobs. In large-scale manufacturing, xylitol is derived from birch wood chips.

Xylitol is not fermentable by the oral microbes responsible for causing dental caries (cavities). (10) The discovery of xylitol's preventive and remineralizing effects on teeth were first elucidated in the Turku Sugar Studies in Finland, 1971-73. (11) The effects of xylitol and sucrose were compared in their abilities to prevent dental caries and for their contribution in plaque removal (xylitol chewing gum removed 47% more plaque than did sucrose chewing gum). (12) Results of these initial investigations have been replicated several times; Finnish dental professionals incorporate xylitol chewing gum as a part of the daily oral health regimen and the entire group of Nordic dental associations recommend xylitol use for dental health. (13) Not as well endorsed in the US, xylitol has not yet achieved similar recommendation status. However, it is noteworthy that the US army has created an initiative program for its dental corps encouraging the use of this sugar substitute in dental care programs. (14)