Got teeth? Wanna keep ‘em? Brush the ones you want to keep. The others? Might as well brush them while you’re at it. How come? Because we said so? We can do better than that. Since prevention is truly worth more than the cure, give it a go to keep periodontal disease, like gingivitis, at bay. Though the two terms are often interchanged, they are actually different conditions in the spectrum of periodontal (which means “surrounding the tooth”) disease. Gingivitis refers to inflammation of the gums from excess plaque on the teeth, often resulting in redness and swelling, and bleeding when you brush your teeth. In contrast, periodontitis is more severe and the gums pull away from the teeth to form pockets where bacteria can set up house and cause an infection. If it hurts when you chew, if your teeth are getting crooked, if they’re getting loose or overly sensitive, it’s time to see the tooth doctor. Periodontitis is rare in kids; gingivitis is not. Diligent oral hygiene that entails flossing as well as brushing, and regular professional cleaning, go the distance in the prevention of gum disease and the inflammation that comes with it. Free radicals, reactive oxygen species (ROS), and pathogenic micro-organisms can cause collagen and periodontal cell degradation. It’s been found that oral ROS can be scavenged by specific anti-oxidants, thereby reducing collagen abasement (Prakash, 2010). This doesn’t mean that a person can pop pills and forget the paste and brush, but it does allow at least one adjunctive measure to enhance their efficacy. The one we have in mind is also the one with the best reputation and subsequent publicity—Co-Enzyme Q 10, sometimes called ubiquinol, ubiquinone, or CoQ10. CoQ10 belongs to a family of substances that are fat-soluble and participate in the electron transport chain, a pathway that produces energy in the form of adenosine triphosphate (ATP), which is the stuff that fuels our cells.
For the record, number 10 is not the only coenzyme Q. This digital appellation is based on the number of isoprenoids units in the “tail” of the molecule. Isoprenoids, also called terpenoids, are generally the most common hydrocarbons in the human body. In fact, we make them at a rate of about seventeen milligrams a day, to be used in the manufacture of cholesterol and other endogenous steroids, such as the sex hormones and vitamin D. Isoprenes are found in foods. Carotenes, such as beta-carotene, lycopene and lutein are relatives. The coenzymes Q number from 1 to 12.
An enzyme is not the same thing as a coenzyme. Enzymes are proteins (usually) that increase the speed of a chemical reaction without being used up by the reaction; coenzymes are non-proteins (usually) that carry chemicals between enzymes and are continuously recycled. Levels of Co-Enzyme Q10 are depleted by the statin drugs prescribed to reduce cholesterol. This occurs because CoQ10 and cholesterol share a common pathway. When CoQ10 values are diminished, a cell’s mitochondria cannot convert food to usable energy. What compounds the matter is that CoQ10 levels decline with age, which often is the time of life when cholesterol is mistakenly treated as an agent of disease. In some countries outside the U.S., statins are combined with CoQ10 to buffer the drugs’ side effects, namely the myopathies (Zlatohlavek, 2012) (DiNicolantonio, 2012) (Willis, 1990).
Intake of supplemental CoQ10 has benefits beyond statin amelioration. As an anti-oxidant, CoQ10 prevents damage by ROS and increases efficiency of mitochondrial energy production (Saini, 2011). That it has other significant roles in human health is secondary to the aim of this newsletter, however. Persons with active gingival disease have been found to be deficient in Co-enzyme Q10 (Littaru, 1971) as determined by gingival biopsies (Nakamura, 1974). Because these tissue samples exhibit persistent oxidative stress, researchers inferred that CoQ10 could reverse it (Battino, 2005). Investigating leukocytes from gum tissue deficient in CoQ10, scientists found that such a coenzyme deficit could predispose this tissue to periodontitis, and that periodontitis exacerbates CoQ10 deficit (Hansen, 1976), leading to the suggestion that adjunctive use of CoQ10 will improve outcome.
Dry mouth from reduced saliva secretion, often connected to aging, was assuaged in sixty-six patients given oral doses of either ubiquinone or ubiquinol at 100 mg/day (Ryo, 2011). Is this a factor in periodontitis? Yes. Xerostomia is associated with an increase in cavities, gingival disease, and even Candida (Ram, 2011). Prevention of periodontal disease may even be accomplished with xylitol-laced chewing gum (Feio, 2005) (Curro, 2008) because of increased saliva production. Treatment with CoQ10 reduces the likelihood of long-term tooth loss, too, with the promise of reversal of symptoms. If nicotine, especially, is one’s toxin of choice, CoQ10 supplementation is indicated. Spanish investigators discovered that CoQ10 stimulated the pathway of biological mechanisms that promote bone health and growth by exciting the synthesis of powerful hormones dedicated to bone formation (Figuero, 2006). Nicotine is a catabolic oxidative agent—it breaks things down. CoQ10 intervenes.
Good nutrition is related to periodontal health. Several supplements promote the biochemistry of teeth and related bone (Folkers, 1977). For example, zinc and copper enhance immunity; vitamin C helps to prevent bleeding gums; calcium and magnesium help to prevent bone loss; and chamomile tea, though not a supplement, may sooth gum tissue. Control of plaque, therefore, is not the only step to oral health. Diet counts, as well. Topical use of CoQ10 can improve the clinical parameters in periodontal assessment and treatment can heal in a fashion labeled as “extraordinarily effective” (Wilkinson, 1975). If topical sources interest you, there are mouthwashes and toothpastes available made with CoQ10.
Oral supplements of CoQ10 are well-tolerated. Doses of more than 100 mg a day should be separated if mild gastric effects arise. Since most of us don’t eat mammal organ meats regularly, capsules might be the most convenient form, although sardines and mackerel count as decent food sources. Vegetables have only moderate amounts of CoQ10, with spinach, broccoli and sweet potatoes leading the pack. Cooking reduces levels in all food sources. If you opt to take CoQ10 for dental health, you’ll be glad to realize the benefits we didn’t have room to mention.
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