There aren’t many health habits I’m religious about, but I am a flossing zealot. I vividly remember the day I was baptized into my newfound religion. Eight years ago I stood at a coworker’s cubicle, jaw agape at a description of her father’s dental nightmare. The story involved the poor man’s gums being scraped off, put into some kind of blender, and then stuck back in his mouth again. The image of gum tissue whirling around in a blender has terrified me into flossing every day since.
But lately I’ve begun to worry that flossing alone isn’t enough to ensure that my gums won’t ever end up in a small kitchen appliance. Even with my diligent routine, I still have the occasional bleeder or sensitive spot near my incisors. According to the American Dental Academy, both could be signs of gum disease.
If this is my fate, I’m in good company. Up to 80 percent of Americans have some form of gum disease, ranging from a simple case of mild inflammation to the kiss-your-teeth-good-bye variety. (If your dentist has ever said you have “pockets,” you’ve got it.) When it comes to frequency of infections, gingivitis (the garden-variety version) is second only to the common cold.
Why so ubiquitous? Consider the odds: The number of microorganisms in a single human mouth is greater than the number of people on the planet. That’s right: the entire planet.
What’s more, gum disease is sneaky. “Pain is usually the first real indicator that you’ve got a problem, but by the time it’s painful, it’s really far gone,” says Michael Rethman, president of the American Academy of Periodontology. That means it isn’t likely to get your attention until it’s progressed beyond the scope of your…Scope. (Actually, Listerine is the only mouthwash clinically proven to kill the bacteria.) Even dyed-in-the-wool flossers like myself aren’t immune.
That’s because some of those billions of bacteria can evade brushing and flossing and nestle into the teeny hammock of skin, called the sulcus, where gum meets tooth. As they attract more of their own kind, a sticky, colorless plaque forms. In less than a day, plaque can harden into tartar, which clings to teeth so stubbornly it can only be scraped off by a professional wielding a sharp instrument. Toxins produced by the bacteria go on to cause inflammation, and before you know it you’ve got a chronic, low-grade infection called gingivitis.
Left untreated, gingivitis can progress to periodontitis, and that’s where the real trouble begins. At this stage, the hammock pulls farther away from the tooth and deepens, creating a gap all the way down to the root and leaving not just the tooth but the underlying bone vulnerable to infection. Eventually the tooth may loosen and even fall out.
That’s bad news for more than just your mouth: The chronic inflammation triggered by periodontitis is thought to set off an inflammatory cascade throughout the body that raises a person’s risk of more deadly disease, including diabetes, heart attack, and stroke.
With oral health a harbinger of such systemic ills, caring for your chops is more important than ever before. Here’s how to keep gum disease from getting out of hand—and give your gums the best possible odds of staying out of the blender.
Don’t neglect the basics
The first line of defense, of course, is your toothbrush and dental floss. “Nothing I’ve seen in 33 years of practice measures up to simple brushing and flossing,” says Stanley Dintcho, a San Francisco dentist. “It’s cheap, it’s beautiful, and it works.” But, he says, only about 20 percent of us manage to do it properly.
What to do: Dintcho recommends brushing at least three times a day, and flossing—before brushing—at least once. Use a toothbrush with polished, rounded, and soft bristles (and replace it every two months). Start brushing at the bottom of the tooth near the gumline, then move to the tongue side. Give your molars lots of attention, and don’t forget to brush the roof of your mouth and the top of your tongue. Be sure to get a dental checkup every six months.
Eat fruits and veggies
Along with everything else they do, antioxidant-rich fruits and vegetables are good news for your grin. Antioxidants tamp down areas of inflammation and neutralize free radicals, harmful molecules produced not only by bacteria in the gums but also by the white blood cells fighting the low-grade infection.
In one recent study, scientists examined antioxidant activity in people’s saliva. They found that those with periodontal disease had 40 percent less of this activity than those with healthy gums. “In the mouth, there is a constant battle between destructive and healing forces,” says Rethman. “An antioxidant-rich diet may help support new cells that rebuild bone and gum tissue.”
What to do: Aim for five to nine servings of produce per day.
Take vitamin C
This antioxidant deserves special mention. It not only reduces inflammation directly but also helps the mouth knit the gums back onto the base of the teeth, by supporting the growth of connective tissue. If your diet is low in C, collagen can’t link correctly and the capillaries get fragile, which leads to easy bleeding, says Jane Higdon, a research associate at the Linus Pauling Institute and author of Evidence-Based Approach to Vitamins and Minerals.
What to do: If you suspect you aren’t eating as many fruits and vegetables as you should, shoot for a supple-ment that delivers at least 400 milli- grams a day—enough to saturate cells. Your best bet is to opt for tablets instead of chewables; the high acid content of vitamin C supplements may erode your teeth when you chew them, says Higdon. If you prefer the chewable variety, at least drink a glass of water afterward to flush any lingering particles from between the teeth.
Another key dietary component of a healthy smile is calcium. An adequate supply helps ensure that the bone anchoring teeth stays strong, which can lower the odds of tooth loss.
What to do: Adult men and women should aim to get 1,000 to 1,200 mg of calcium a day. If you dislike dairy or grow weary of greens, you may want to hedge your bets with a supplement. Take calcium carbonate with meals or calcium citrate anytime. For best absorbability, take only 500 mg at a time, and add 400 to 800 mg of vitamin D.
Consider coenzyme Q10
What about all those natural dental products that tout coenzyme Q10 (coQ10) for gum health?
While it’s true that coQ10 is a powerful antioxidant, no scientific evidence clearly links the nutrient to the successful treatment or prevention of gum disease. Besides, the measly amount contained in a dollop of toothpaste won’t put a dent in a raging case of gingivitis, says Dintcho.
That said, boosting your body’s overall levels of coenzyme Q10 may help mop up free radicals released by inflamed gum tissue.
What to do: If you have gingivitis, consider taking a daily dose of 100 mg of coenzyme Q10, but don’t count on it as your primary defense.
How to keep your kisser kissable
Gum disease itself is insidious, but other maladies of the mouth can be painful—both physically and socially. Fortunately, natural remedies can make a difference. Here’s what to try for some common conditions.
Halitosis, the official name for bad breath, is a frequent consequence of gum disease. Mouthwash will freshen things up; choose a natural version like Herbal Mouth and Gum Therapy by Natural Dentist (check at mothernature.com, or amazon.com), or Dentaforce by Bioforce (herbsmd. com). Or try a warm sea-salt solution, which will neutralize acids and kill bacteria, says Sandra Senzon, a dental hygienist in New York City and author of Reversing Gum Disease Naturally. Add 1 teaspoon of sea salt to a small glass of warm water and rinse three times a day.
No one knows just what causes these small, painful ulcers. Some believe they are a malfunction of the body’s immune system; others chalk them up to nutritional deficiencies and even stress.
Whatever the cause, there are a few tricks you can try to speed healing. Senzon suggests rubbing a little lavender oil onto the sore several times a day. Or try propolis, a gummy resin made by bees that covers the ulcer like a Band-Aid. (Try the version from Beehive Botanicals, beehive-botanicals.com, but be careful: It can stain teeth.) A new herbal product, CankerCare+ (quantumhealth.com), may also help. For recurrent canker sores, buy toothpaste without sodium lauryl sulfate, a detergent that can dry out the mouth’s mucous membranes and make the sores more painful.
Cold sores, also known as fever blisters, are caused by the herpes simplex virus and may pop up when your immune system gets run down. One of the best topical remedies is an extract of the antiviral herb Melissa officinalis or lemon balm. Shop for a cold sore cream that contains lemon balm and apply a thick covering to the lips up to four times a day. (Senzon recommends Cold Sore Relief, available at Phytopharmica.com and Enzy.com.)