Text: PERIODONTAL DISEASE PERIODONTAL MEANS "located around a tooth," and periodontal disease refers to any disorder of the gums and jawbone. The first stage of periodontal disease is gingivitis, an inflammation of the gums that causes them to become red, soft, and shiny, and to bleed easily, particularly when the teeth are brushed. Gingivitis is caused by accumulations of plaque, which attract the bacteria that destroy the tissues of the gum. Too many soft foods in the diet and the lack of proper nutrients also cause gingivitis. If left untreated, the bacteria cause abscesses, or pockets in the gum, which then pulls away from the tooth. Eventually, the damage progresses to the bone, softening it and weakening its support of the teeth. Gum disease in its various stages has reached epidemic proportions in the United States. Three out of four adults suffer from some form of the disease, which often starts in childhood. The American Academy of Periodontology estimates that the majority of children suffer from gingivitis, which if unattended can progress into the more destructive stages of periodontal disease with loss of gums, bone structure, and teeth. Since the main cause of gingivitis is tartar buildup, the main prevention and treatment is flossing at least once a day: Flossing after each meal, though not always practical, would be even better. Brushing alone does not remove the food particles that accumulate between the teeth and gums. In case you're fuzzy on how to floss, here's a refresher: Take about 20 inches of floss and wind the bulk of it around the middle finger of one hand, winding the rest around the middle finger of the other hand, leaving a few inches free between the fingers: This is the working part of the floss. Holding the floss tightly, slip it between the teeth, gently moving t back and forth until it reaches the gums. Curve the floss around one of the adjacent teeth and, sliding it back and forth, move it toward the biting edge of the tooth, freeing any debris. Then curve the floss around the other tooth and repeat the motion. When you're finished with one tooth, unwind a bit more floss from the finger with the bulk of the floss, wind used floss onto the other finger, and continue flossing the next tooth. Floss each tooth in turn and don't forget to floss the innermost side of the last tooth. If you're unsure of your flossing technique, consult your dentist. In addition to flossing, a professional dental cleaning every six months will keep the gums clear of plaque. Cleaning alone will not necessarily prevent or arrest gingivitis. The gums are constantly assaulted by an infectious mixture of food particles and bacteria, and need adequate nutrients to resist inflammation and disease. The gums and teeth, however, are the last to receive their share of vitamins and minerals from the nutrition cycle, and the first to lose these nutrients if they are needed elsewhere in the system. If you have gingivitis, you need nutrients to promote healing and get the inflammation under control. For balanced nutrition and to give your gums and teeth the "exercise" and stimulation they need, you should eat a variety of fresh fruit, leafy vegetables, fish, meat and grain breads, and take supplements. A number of years ago, one of my patients complained that his gums bled when he brushed his teeth, though he flossed every day and went for semiannual professional dental cleanings. I recommended vitamin and mineral supplements, and within two weeks the bleeding stopped. But when he went away on vacation, he didn't take his supplements along; bleeding began within ten days. When he returned, he resumed the supplements, and once again tile bleeding stopped. Since adhering to his supplement regime, he has had not further problems with his gums. Vitamin C is one of the key vitamins needed for healthy gums. While it's not known exactly how vitamin C works, it appears to battle bacteria while promoting the formation of healthy new gum tissue. Numerous experiments in many Western countries have demonstrated that vitamin C as a supplement is extremely effective in reducing the inflammation and infection of periodontal disease, and in promoting the regeneration of gum tissue. To stimulate the gums, eat fresh fruit and vegetables rich in vitamin C, such as oranges, grapefruit, tomatoes, pineapple, broccoli, cantaloupe, cauliflower, asparagus, and strawberries. Coenzyme Ql0, which is essential to healthy tissues, is a significant breakthrough in the fight against periodontal disease. Tests both here and in Japan have shown the remarkable effectiveness of CoQ10 supplements in reversing periodontal disease in both its early and later stages and in growing new tissue. There have been many instances of dramatic improvement in the case histories of patients who were no longer able to eat solid food until given CoQ10. I've had great success with my patients with this supplement. Folic acid, which appears to make the cells more resistant to infection, is also help fill for periodontal disease. Food rich in folic acid includes spinach, chickpeas, and pinto beans. Vitamin A, sometimes called the "skin vitamin," is helpful in repairing damaged tissue and fighting infection. Calcium is also very important to prevent the loss of bone around the gums. This is called the alveolar bone, and it's the most active bone in the body, picking up calcium from the blood and giving it back. Calcium is particularly important for pregnant women and women past menopause, who frequently suffer from calcium deficiencies. Vitamin E, which promotes a healthy vascular system while enhancing the immune response and fighting toxicity, is also valuable in restoring gums and reducing inflammation. Foods rich in vitamin E that are also good for stimulating the gums include wheat germ, peanut brown rice, walnuts, and almonds. In addition to eating fresh foods to stimulate your gums, and taking to give your gums the nutrients they need to fight inflammation and infection, you must take a few minutes each day to take care of your teeth and gums. DAILY CARE * Floss and brush after each meal. Floss between the teeth and at the gumline. * Brush at the gumline. Since plaque is trapped at the gumline, hold your toothbrush at a 45-degree angle, so that part of it brushes your gums while the other part cleans your teeth. * Keep two toothbrushes and alternate them so they can dry between uses. * Or get an electric toothbrush, which is twice as effective in removing plaque. * Use one of the rinses intended to loosen plaque. * Massage your gums to stimulate circulation. Grip the gum between thumb and index finger, with the index finger on the outside, and rub. Better yet, use a rubber gum stimulator. * If some infection is present, you can use a method recommended by Dr. Paul Keyes, the dentist and researcher who pioneered the nonsurgical approach to periodontal disease: "Dip your toothbrush in a solution of half hydrogen peroxide, half water, then dip it in baking soda, and smear the mixture along the gumline, making sure to get it in all the crevices between the teeth and gums." (See more about Keyes's techniques at the end of this section.) NATURAL PRESCRIPTION FOR PERIODONTAL DISEASE: * Every six months, visit your dentist for a professional cleaning. * Follow the recommendations listed above under "Daily Care." IN ADDITION TO YOUR DALLY SUPPLEMENTS, TAKE: * Vitamin C: 1,000 mg. three times a day. * Coenzyme Q10:30 mg. three times a day. * Folic acid: 800 mcg. a day. * Vitamin A: 10,000 I.U. a day. * Calcium: 1.200 mg. a day. * Vitamin E: 400 mg. a day. IN ADDITION: Dr. Paul Keyes developed a nonsurgical approach to periodontal disease that involves professional and home care. His approach also includes a particular technique that involves scaling and root planning of the problem area not just above the gumline, but also within the pocket of the tooth. This technique has been proven to be as effective as surgery for many people. If you're facing periodontal surgery, or if you have gum problems that must be dealt with by a professional you might first consult with a dentist who is familiar with Keyes's techniques to see if' you can remedy the situation without an operation.

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