| | | | Other Names | | | Conjunctivitis, Gums, Gum Problems, Inflamed Gums, Gum Inflammation,
Bleeding Gums.
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| | | Also known as: Dental Disease, Gum Disease, Periodontal
Disease.
Gingivitis is an inflammation of the gums (gingivae),
caused by bacteria. Periodontitis is a deeper and more serious
inflammation of both the gingivae and tissue that surrounds and supports
the teeth. These common conditions are often progressive and can
eventually result in loss of the underlying bone that supports the teeth.
After age 30, periodontal disease is responsible for more tooth loss than
are dental cavities. Severe periodontitis sometimes requires surgery to
repair damaged gum tissue.
What are the symptoms of gingivitis?
Gingivitis is usually painless, although the gums may be red, swollen, and
bleed easily with brushing. There can also be a bad taste in the mouth or
persistent bad breath (halitosis). In advanced stages of gingivitis, the
gums recede, exposing the nerve roots, and the teeth may become loose.
This may be an indication of periodontitis.
Conventional treatment
options: Conventional treatment usually involves a regimen of good oral
hygiene, including correct tooth brushing, flossing, and professional
cleanings. Antibacterial mouthwashes such as chlorhexidine (e.g.,
Betaseptr, Dynahexr, Hibiclensr, Peridexr, PerioGardr, and Spectrumr) are
frequently prescribed. In severe cases, gum surgery may be
recommended.
Nutritional supplements that may be helpful: A 0.1%
solution of folic acid used as a mouth rinse (5 ml taken twice a day for
30 to 60 days) has reduced gum inflammation and bleeding in people with
gingivitis in double-blind trials.1 2 The folic acid solution is rinsed in
the mouth for one to five minutes and then spit out. Folic acid was also
found to be effective when taken in capsule or tablet form (4 mg per
day),3 though in another trial studying pregnant women with gingivitis,
only the mouthwash-and not folic acid in pill form-was effective.4
However, this may have been due to the body's increased requirement for
folic acid during pregnancy.
Phenytoin (Dilantinr) therapy causes
gum disease (gingival hyperplasia) in some people. A regular program of
dental care has been reported to limit or prevent gum disease in people
taking phenytoin.5 6 7 Double-blind research has shown that a daily oral
rinse with a liquid folic acid preparation inhibited phenytoin-induced gum
disease more than either folic acid in pill form or
placebo.8
People who are deficient in vitamin C may be at increased
risk for periodontal disease.9 When a group of people with periodontitis
who normally consumed only 20-35 mg of vitamin C per day were given an
additional 70 mg per day, objective improvement of periodontal tissue
occurred in only six weeks.10 It makes sense for people who have a low
vitamin C intake (e.g., people who eat few fruits and vegetables) to
supplement with vitamin C in order to improve gingival health.
For
people who consume adequate amounts of vitamin C in their diet, several
studies have found that supplemental vitamin C has no additional
therapeutic effect. Research,11 including double-blind evidence,12 shows
that vitamin C fails to significantly reduce gingival inflammation in
people who are not vitamin C deficient. In one study, administration of
vitamin C plus flavonoids (300 mg per day of each) did improve gingival
health in a group of people with gingivitis;13 there was less improvement,
however, when vitamin C was given without flavonoids. Preliminary evidence
has suggested that flavonoids by themselves may reduce inflammation of the
gums.14
Preliminary evidence has linked gingivitis to a coenzyme
Q10 (CoQ10) deficiency.15 Some researchers believe this deficiency could
interfere with the body's ability to repair damaged gum tissue. In a
double-blind trial, 50 mg per day of CoQ10 given for three weeks was
significantly more effective than a placebo at reducing symptoms of
gingivitis.16 Compared with conventional approaches alone, topical CoQ10
combined with conventional treatments resulted in better outcomes in a
group of people with periodontal disease.17
Some,18 but not all,19
research has found that giving 500 mg of calcium twice per day for six
months to people with periodontal disease results in a reduction of
symptoms (bleeding gums and loose teeth). Although some doctors recommend
calcium supplementation to people with diseases of the gums, supportive
scientific evidence remains weak.
Are there any side effects or
interactions? Refer to the individual supplement for information about any
side effects or interactions.
Herbs that may be helpful: Bloodroot
contains alkaloids, principally sanguinarine, that are sometimes used in
toothpaste and other oral hygiene products because they inhibit oral
bacteria.20 21 Sanguinarine-containing toothpastes and mouth rinses should
be used according to manufacturer's directions. A six-month, double-blind
trial found that use of a bloodroot and zinc toothpaste reduced gingivitis
significantly better than placebo.22 However, a similar study was unable
to replicate these results.23 Thus, at present, it is unknown who will
respond to bloodroot toothpaste and who will not. Concerns also exist
about the long-term safety of bloodroot.
A mouthwash combination
that includes sage oil, peppermint oil, menthol, chamomile tincture,
expressed juice from echinacea, myrrh tincture, clove oil, and caraway oil
has been used successfully to treat gingivitis.24 In cases of acute gum
inflammation, 0.5 ml of the herbal mixture in half a glass of water three
times daily is recommended by some herbalists. This herbal preparation
should be swished slowly in the mouth before spitting out. To prevent
recurrences, slightly less of the mixture can be used less
frequently.
A toothpaste containing sage oil, peppermint oil,
chamomile tincture, expressed juice from Echinacea purpurea, myrrh
tincture, and rhatany tincture has been used to accompany this mouthwash
in managing gingivitis.25
Of the many herbs listed above,
chamomile, echinacea, and myrrh should be priorities. These three herbs
can provide anti-inflammatory and antimicrobial actions critical to
successfully treating gingivitis.
Are there any side effects or
interactions? Refer to the individual herb for information about any side
effects or interactions.
References:
1. Pack ARC.
Folate mouthwash: effects on established gingivitis in periodontal
patients. J Clin Periodontol 1984;11:619-28.
2. Vogel RI, Fink RA,
Frank O, Baker H. The effect of topical application of folic acid on
gingival health. J Oral Med 1978;33(1):20-2.
3. Vogel RI, Fink RA,
Schneider LC, et al. The effect of folic acid on gingival health. J
Periodontol 1976;47:667-8.
4. Pack ARC, Thomson ME. Effects of
topical and systemic folic acid supplementation on gingivitis in
pregnancy. J Clin Periodontol 1980;7:402-14.
5. Francetti L,
Maggiore E, Marchesi A, et al. Oral hygiene in subjects treated with
diphenylhydantoin: effects of a professional program. Prev Assist Dent
1991;17(30):40-3 [in Italian].
6. Fitchie JG, Comer RW, Hanes PJ,
Reeves GW. The reduction of phenytoin-induced gingival overgrowth in a
severely disabled patient: a case report. Compendium
1989;10(6):314.
7. Steinberg SC, Steinberg AD. Phenytoin-induced
gingival overgrowth control in severely retarded children. J Periodontol
1982;53(7):429-33.
8. Drew HJ, Vogel RI, Molofsky W, et al. Effect
of folate on phenytoin hyperplasia. J Clin Periodontol
1987;14:350-6.
9. Vaananen MK, Markkanen HA, Tuovinen VJ, et al.
Periodontal health related to plasma ascorbic acid. Proc Finn Dent Soc
1993;89:51-9.
10. Aurer-Kozelj J, Kralj-Klobucar N, Buzina R, Bacic
M. The effect of ascorbic acid supplementation on periodontal tissue
ultrastructure in subjects with progressive periodontitis. Int J Vitam
Nutr Res 1982;52:333-41.
11. Woolfe SN, Kenney EB, Hume WR,
Carranza FA Jr. Relationship of ascorbic acid levels of blood and gingival
tissue with response to periodontal therapy. J Clin Periodontol
1984;11:159-65.
12. Vogel RI, Lamster IB, Wechsler SA, et al. The
effects of megadoses of ascorbic acid on PMN chemotaxis and experimental
gingivitis. J Periodontol 1986;57:472-9.
13. El-Ashiry GM,
Ringsdorf WM, Cheraskin E. Local and systemic influences in periodontal
disease. II. Effect of prophylaxis and natural versus synthetic vitamin C
upon gingivitis. J Periodontol 1964;35:250-9.
14. Carvel I,
Halperin V. Therapeutic effect of water soluble bioflavonoids in gingival
inflammatory conditions. Oral Surg Oral Med Oral Pathol
1961;14:847-55.
15. Nakamura R, Littarru GP, Folkers K. Deficiency
of coenzyme Q in gingiva of patients with periodontal disease. Int J Vitam
Nutr Res 1973;43:84-92.
16. Wilkinson EG, Arnold RM, Folkers K.
Bioenergetics in clinical medicine. VI. Adjunctive treatment of
periodontal disease with coenzyme Q10. Res Commun Chem Pathol Pharmacol
1976;14:715-9.
17. Hanioka T, Tanaka M, Ojima M, et al. Effect of
topical application of coenzyme Q10 on adult periodontitis. Mol Aspects
Med 1994;15(Suppl):S241-8.
18. Krook L, Lutwak L, Whalen JP, et al.
Human periodontal disease. Morphology and response calcium therapy.
Cornell Vet 1972;62:32-53.
19. Uhrbom E, Jacobson L. Calcium and
periodontitis: a clinical effect of calcium medication. J Clin Periodontol
1984;11:230-41.
20. Dzink JL, Socransky SS. Comparative in vitro
activity of sanguinarine against oral microbial isolates. Antimicrob
Agents Chemother 1985;27(4):663-5.
21. Hannah JJ, Johnson JD,
Kuftinec MM. Long-term clinical evaluation of toothpaste and oral rinse
containing sanguinaria extract in controlling plaque, gingival
inflammation, and sulcular bleeding during orthodontic treatment. Am J
Orthod Dentofacial Orthop 1989;96(3):199-207.
22. Harper DS,
Mueller LJ, Fine JB, et al. Clinical efficacy of a dentifrice and oral
rinse containing sanguinaria extract and zinc chloride during 6 months of
use. J Periodontol 1990;61(6):352-8.
23. Mauriello SM, Bader JD.
Six-month effects of a sanguinarine dentifrice on plaque and gingivitis. J
Periodontol 1988;59(4):238-43.
24. Serfaty R, Itic J. Comparative
trial with natural herbal mouthwash versus chlorhexidine in gingivitis. J
Clin Dentistry 1988;1:A34.
25. Yamnkell S, Emling RC. Two-month
evaluation of Parodontax dentifrice. J Clin Dentistry
1988;1:A41.
Source: NOW Foods
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Please Note: This Traditional Use information is provided as a courtesy only. The products indicated above may be listed in error. This information is based on Traditional and Folklore Medicine which uses natural materials to support health. This information has not been evaluated or approved by the FDA and is not based on scientific evidence from any source. These statements have not been evaluated by the Food and Drug Administration (FDA). These products are intended to support general well being and are not intended to treat, diagnose, mitigate, prevent, or cure any condition or disease. If conditions persist, please seek advice from your medical doctor.
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Gingivitis - Health - Sage Leaf - 500 mg
100 capsules
11.01 US
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