Hello Everyone:
I hope you all are enjoying the Spring season. Seattle is a spectacular city to live in during the Spring season. You see so much color around peoples' homes and the blooming flowers and trees make walking up the street smell so good.
This May E-newsletter is on Dr. Sinatra's article on periodontal diseases. Dr. Sinatra in this article makes an important assumption that I became aware of a few years ago and I wanted all of you to also be aware of it.
Dr. Sinatra's article assumes that there is a strong relationship between periodontal diseases and heart diseases and that the CoEnzyme Q10 supplement can strongly contribute to the health of gums and heart.
My awareness of this relationship started when I visited a holistic Chinese doctor in the past to receive consulting on my chronic eczema condition (back in 1999). He mentioned to me how my gum condition reflects my heart condition.
Holistic Chinese doctors start examining their patients by looking into their mouth. They believe that the condition of the body parts in our mouth reflect the health of our internal body systems. For example, a healthy tongue should be pink in color and should not have a groove in the middle. If your tongue color is mostly white and you can see a deep groove in the middle of your tongue (almost like a deep cut), then the doctor will know that you may have intestinal dysfunction. The deeper the groove on your tongue, the more dysfunctional your intestinal tract will be. In addition, a healthy gum condition reflects a healthy heart. A healthy gum should be pink in color, no receding gum, no ease of bleeding when brushed, no offensive odor, no sensitivity....etc.
Since my awareness of the relationship of gum health to heart health, I always kept my eyes open for scientific information that can confirm the same things my Chinese doctor shared with me but I had not found any written materials on this subject. However, last week I read Dr. Sinatra's article on periodontal diseases and in this article he confirmed what I heard from my Chinese doctor, that gum diseases may be a red flag indicating heart problems.
I hope you will enjoy reading this article as I believe it offers important insights that may allow us to protect one of the most important systems in our body, the cardiovascular system.
Periodontal Disease
Stephen Sinatra, M.D.
The Coenzyme Q10 Phenomenon, pgs. 86-90
While they were taking Coenzyme Q1O to treat their heart disease, many of my patients commented that their gums became healthier. This observation is not surprising since there are many diseases which respond favorably to CoQ1O supplementation. Remember that metabolically active tissues are highly sensitive to a CoQ1O deficiency. And because CoQ1O works at the cellular and biochemical level, it helps promote strong, active and healthy cells whether they are in the heart or in the gums. What happens in your mouth is actually a mirror for your whole body.
For example, when I see patients who have bleeding gums, pus pockets, foul breath and other characteristics of periodontal disease, it suggests to me that they may have underlying heart disease or even cancer. Diseased gums may be a red flag for Q10 deficiency in the mouth and other tissues of the body. Thus, I believe that periodontal disease may be a warning sign for coexisting problems, a virtual tip of the iceberg, revealing vulnerable CoQ1O levels in the body.
This direct relationship has been observed between various degrees of tooth loss and general health. Patients with good dental health had good medical health, while those who had lost considerable numbers of teeth reported histories of poor circulation, heart disease and stroke. This is why it is important for dentists, oral surgeons and periodontists to have direct dialogue sharing their negative findings with their patients' physicians, especially cardiologists. Periodontist Salvatore J. Squatrito, Jr., D.D.S., shared the following letter with his colleagues:
I was introduced to Coenzyme Q10 by Dr. Stephen Sinatra at a hospital staff lecture. The cardiovascular system, especially the heart and the
periodontium, have large quantities of Q 10 in normal situations.
International studies have shown that cardiovascular problems develop with low Q10 levels. Dr. Sinatra asked me to consider the possibility of using Q10 in periodontal treatment to see if Q10 would make a difference in the outcome of periodontal therapy.
Over the years, periodontal therapy has developed a sophistication of treatment and management of contributing factors such as heredity,
diabetes, radiation therapy, various chemotherapy manifestations and other conditions which diminish the movement of the white blood cells in the human system. When I was an Army bacteriologist, I developed an understanding of bacterial infections and antibiotic therapies. I tried a number of different antibacterial therapies during 30 years as a periodontist, only to be disappointed in the lasting effect of this kind of therapy. Antibiotics did not stop the periodontal disease process.
The recurrence of periodontal problems could also not be explained by inadequate plaque control. Many patients continued to be infected by periodontal pathogens no matter how thoroughly or frequently their plaque was removed. High concentrations of tetracycline gave some relief for intermittent periods of time, but over the long course, the penodontium would once again break down.
Now my patients who have refractory periodontitis are treated with C0Q1O. We have been reexamining these patients for approximately a year, and have verified that the bleeding sites are diminished. The patients claim that they are still doing essentially the same plaque control therapy. The refractory periodontitis patients were placed on a regimen of 120 mg of Q10 twice daily. There was no overnight dramatic change, but we see a gradual improvement in the patients' periodontal health verified at our three-month recall reexamination. The areas that previously bled when probed no longer do so. The patients report that their mouths feel generally healthier.
A typical case history of one of the 16 refractory periodontitis patients who was treated with C0Q1O:
C.G. is a 53-year-old male diagnosed as having periodontitis Complex IVA in 1982. Treatment was a full course of scaling, curettage, occlusal adjustment and osseous surgery to reduce the 5 to 10 mm pockets. The healing was slower than normal. For the next 15 years, the patient had three-month periodontal maintenance recalls. During that time, approximately every six months, he had scattered areas of recurrent breakdown treated with antibiotics and additional surgical procedures. A full medical exam with blood tests and glucose analysis were negative.
One year ago, I told him to try Coenzyme Q10, 120 mg twice daily. He presented at this three-month recall with negligible bleeding; he has had no recurrent bony infections requiring surgery and was able to go a year
without more surgery. Additionally, he reported no leg pains after walk-
ing up a few flights of stairs.
I will continue to prescribe CoQ1O for my patients. Its safety is well- documented. I can only attribute the increased health of the gingiva to better health of the periodontal circulatory system due to the C0Q10,
Dr. Squatrito's expertise and clinical observations have helped us realize that gum disease depends not only on the frequency of our teeth being cleaned, brushed or flossed, but also on the state of our immune system, which can be a reflection of C0Q1O deficiencies. Basically, periodontal disease is a bacterial/inflammatory process compounded by inadequate host defense mechanisms.
Periodontitis begins as an infection at the edge of the gums. Bacterial plaque accumulates in the teeth, resulting in local destruction of the connective tissue adjacent to the teeth. The infection advances into a narrow pocket between the gum and the neck of a tooth. Bacterial antigens penetrate these adjacent tissues, initiating an inflammatory response. Gradually, the inflammation spreads to the root membrane, cement and bone, causing irreversible destruction to the bone.
With erosion of these supporting tissues, the teeth gradually loosen.
Research Findings on Periodontal Disease and CoQ10
Patients with periodontal disease have been reported to have lower levels of Coenzyme Q10 in their gingival tissue' and research has reported clinical improvement after CoQ10 supplementation.
Several studies have demonstrated that the oral administration of CoQ1O to patients with periodontal disease was effective in suppressing inflammatory changes in the gingiva as assessed by gingival index, pocket depth and tooth mobility scores.2-6
In an early study by Wilkinson and colleagues, 18 patients with periodontal disease received 50 mg of CoQ1O per day or placebo in a three-week double-blind trial. Clinical improvement in periodontal scores showed that all eight patients receiving CoQ10 improved, compared to only three of ten receiving the placebo.6 A subsequent study by Iwamoto and colleagues was conducted at Hiroshima University Hospital over a 12-week period. Fifty-six patients were engaged in the study; their average age was 42. Patients in this double-blind, controlled study received 60 mg of C0Q1O a day in 20 mg divided doses. The mean score of tooth mobility was significantly lower in the ex- perimental group when compared to the placebo group. It was interesting to note that in this study Coenzyme Q 10 alone, without the adjunctive treatments of debridement and scaling, also showed improvement in the clinical aspects of periodontal disease.
How does Coenzyme Q10 support periodontal health? Most of the research in this area, including animal studies, seems to indicate that Q10's supportive effect on the immune system accounts for its ability to heal ailing gums. It is also suspected that oral administration of Coenzyme Q10 may improve oxygen utilization in gingival tissue as well as nurture the cellular membranes in the gums.
Periodontal disease is extremely common, affecting many people to variable degrees. There are detailed case histories of patients on record which have demonstrated that even the most severe cases of periodontal disease showed renewed oral health with CoQ1O supplementation.7 However, not all the literature is supportive of CoQ1O. One very critical editorials with a partial review of the literature suggests that CoQ1O really has no place in the treatment of periodontal disease. Certainly when more controlled trials are performed and more objective data is collected, a scientific basis for using Q10 in a wide variety of dental diseases could be realized. For now, however, my recommendation is to consider CoQ10 for periodontal disease, especially since in my experience it has helped large numbers of patients.
CoQIO levels fall in many disease situations such as heart disease and periodontal conditions. Actually, falling Q10 levels are part and parcel of the aging process itself. Since periodontal disease affects more elderly people than young people, it is important to consider Coenzyme Q10 as a therapeutic adjuvant in periodontal disease.
References:
1. Littarru, G. P., et al., Deficiency of Coenzyme Q10 in gingival tissue from patients with periodontal disease, Proc Nati Acad Sci, 1971; 68:2332-2335.
2. Hanioka, T., et al., Therapy with Coenzyme Q 10 for patients with peri-
odontal disease. Effect of Coenzyme Q 10 on the immune system, J of Den- tal Health, 1993; 43:667-672.
3. McRee, J. T., et al., Therapy with Coenzyme Q 1O for patients with periodontal disease. Effect of Coenzyme Q10 on subgingival microorganisms, J of Dental Health, 1993; 43:659-666.
4. Shizukuishi, S., et al., Clinical effect of Coenzyme Q10 on periodontal dis- ease: Evaluation of oxygen utilization in gingiva by tissue reflectance spec- trophotometry. In: Biomedical and clinical aspects of Coenzyme Q1O. Editors: Folkers, K., Yamamura, Y., Elsevier, Amsterdam, 1986; 5:359-368.
5. Iwamoto, Y., et al., Clinical effects of Coenzyme Q 10 on periodontal disease. Biomedical and clinical aspects of Coenzyme Q10, 1981; 3:109-119.
6. Wilkinson, F. G., Arnold, R. M., Folkers, K., Treatment of periodontal and other soft-tissue diseases of the oral cavity with Coenzyme Q. In Folkers, K., Yamamura, Y., (eds.). Biomedical and Clinical Aspects of Coenzyme Qi 0, vol. 1, Elsevier/North-Holland Biomedical Press, Amsterdam, 1977; pp. 251- 265.
7. Bliznakov, E. G., Hunt, G. L., The Miracle Nutrient-Coenzyme Q10. New
York: Bantam, 1987.
8. Watts, T. L. P., Coenzyme Q10 and periodontal treatment: Is there any
beneficial effect? Br Dent J, 1995; 178:209-213.
Wishing you extraordinary health, |
