BY D A L E KIEFER

Disease PreventionBegins in

THE MOUTHOral hygiene plays a critical role in whole-body health that is sadly

overlooked by most doctors.

As a front-line shield against systemic inflammation, one's oral status

profoundly impacts diseases ranging from type 2 diabetes and cancer

to rheumatoid arthritis and atherosclerosis.^"^

Recent scientific studies show that many of the nutrients we now

swallow also confer benefits when topically applied in the mouth. ^^^

Acting as powerful allies in the fight against periodontal disease,

these natural compounds can help safeguard against lethal age-related

diseases that emanate from our mouths. > >

:2OO8 I LIFE EXTENSIO.

DISEASE PREVENTION BEGINS IN THE MOUTH

I <«^I

The Gums:An Ideal Incubator for Disease

The oral cavity is a near-perfect breeding groundfor microorganisms that lead to decay of gums, teeth,and bone.

Cavities and gum problems that occur in early lifeare just the beginning. Chronic low-grade inflamma-tion affecting the gums (gingivitis) and inflammationanecting the gums and bones supporting the teeth(periodontitis) has been implicated in the promotion ofa variety of insidious systemic disorders, such as coro-nary heart disease,"* arthritis,'' and even cancer.^'^

Oral inflammation has also been clearly linked toelevated markers of inflammation, such as C-reactiveprotein. *'" ' In response to these warning signs, sci-entists noted recently, "Evidence for a link betweenperiodontal disease and several systemic diseases isgrowing rapidly."^^

Cum Disease and StrokeGum disease sets the stage for an increased risk of

stroke. A recent review of literature on periodontal dis-ease, published in the Joumal of the American DentalAssociation, concludes that periodontitis among olderindividuals is associated with an increased risk ofdeveloping systemic diseases such as diabetes mellitus,heari attack, and stroke.^^ Meanwhile, studies showthat efforts to reduce the severity of periodontitis helpreduce systemic inflammation,^"* and may therebyreduce the risk of cardiovascular events linked withinflammation.-'^

Gum Disease and ObesitySome researchers are now suggesting that perio-

dontitis may contribute to obesity by elevatingC-reactive protein, which then acts as a potent inducerof inflammatoiy cytokines and hormones secreted byadipose tissue. ' ^

Scientists have found that elevated C-reactive pro-tein causes fat cells (adipocytes) to store more fat andburn less energy. Indeed, evidence is accumulatingthat there is a link between obesity, type 2 diabetes,and periodontitis. As one research team noted recent-ly, "Obesity is a significant predictor of periodontaldisease and insulin resistance appears to mediatethis relationship."''^ A University of Mississippi studyfound, "...significant correlations between bodycomposition and periodontal disease." and notedthis finding "strengthened arguments that periodon-tal disease and certain obesity-related systemic ill-nesses are related..."•^^

Periodontal Disease Linked With CancerThe link between oral health and cancer remains

somewhat controversial, largely because this infor-mation is so new. But a recently published study byresearchers at the Imperial College of London andHarvard School of Public Health has shed new lighton the matter. By carefully eliminating potential con-founding factors, such as a patients history of ciga-rette smoking, these scientists sought to identify anystatistically significant associations between oralhealth and the incidence of cancer. Their conclusion is

30 LIFE EXTENSION I SEPTEMBER 2008

chilling. "Periodontal disease was associated with asmall, but significant, increase in overall cancer risk,which persisted in never-stnokers, " write the collab-orators, in the medical journal Lancet Oncology.^'^ Thisconclusion has profound implications. The fact thatit arises from data gathered ft^om more than 48,000men over the course of approximately 18 years lendsadditional gravity to the findings.

The research team also found significant associa-tions among oral health status and lung, kidney, andpancreatic cancers, as well as cancers of the blood. Theinvestigators note that their results need independentconfirmation, but they offer this speculation regard-ing the implications of the findings: "...periodontaldisease might be a marker of a susceptible immunesystem or might directly affect cancer ri^jt."'" Ineither case, periodontal disease takes on new signifi-cance, and appears to pose more of a threat to healththan has previously been recognized.

Furthermore, a recent study by researchers at theHarvard School of Public Health tentatively concludesthat peiiodontitis is associated with an increased riskof one of the most deadly cancers. "Compared with noperiodontal disease, history of periodontal diseasewas associated with increased pancreatic cancerrisk, " write the Harvard researchers, in the Journal ofthe National Cancer Institute.^"

The American Dental Association agrees that "oralhealth is important for overall health" and indicatesthat salivary diagnosis may offer a key tool in healthassessment. "A wide range of proteins, nucleic acids,hoiTnones, pharmaceuticals, and pathogens can bemeasured in saliva, making it an excellent candidatefor rapid detection and screening of biomarkers forconditions hke caries, periodontal disease, osteoporo-sis, infectious diseases, and cancer," it says.^'

Botanical and Nutritional Agents ShowPromise in Oral Hygiene

Given the potentially lethal risks of poor dentalhygiene, it makes sense to utilize all the science availableto prevent even the smallest problems in the mouth.

Several nutrients have shown very favorable effectswhen used as part of an oral hygiene program. Amongthese are coenzyme QIO (CoQlO), green tea, aloe vera,and pomegranate. These claims have been verified bypublished research. - '' - ^ Other beneficial ingredientsfor healthy teeth and gums include xylitol, lactofeirin,and folie

Multi-Faceted Benefits of Green TeaGreen tea is well known for its beneficial effects

throughout the body, but it is also effective in the fightagainst dental caries and oral disease. Studies have

Disease PreventionBegins in the MouthOptimizing oral health represents a crucialdisease-prevention strategy.

Poor oral health, particularly periodontitis, cancontribute to a wide range of serious diseasesranging from rheumatoid arthritis to stroke andeven cancer.

Bacteria thriving in the oral cavity contributeto inflammation, which can have detrimentaleffects throughout the body and may particu-larly increase the risk of atherosclerosis. Oralbacteria have even been found living insideatherosclerotic plaques.

Natural agents such as green tea, aloe vera,lactoferrin, xylitol, folie acid, and hydrogenperoxide can help optimize oral health bytargeting plaque-causing bacteria and support-ing gum health.

Coenzyme QIO (CoQlO) shows particularpromise in offsetting the inflammation thataccompanies gum disease. CoQlO offersbenefits both when applied topically to thegums and when consumed as a dietary supple-ment. The benefits of supplemental CoQlObegin at a daily dose of 50 mg.

Pomegranate helps preserve periodontal healthby preventing the adherence of plaque-inducingbacteria to the teeth, by directly killing oralmicroorganisms, and by quieting inflammationin the gums.

Vitamins C and D may also promote healthyteeth and gums.

A two-pronged approach that includes brushingthe teeth and rinsing the mouth with naturalbioactive ingredients provides the foundationof oral health—a cornerstone of whole-bodyWellness.

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DISEASE PREVENTION BEGINS IN THE MOUTH

About Periodontal Disease

Bacteria and other microorganisms are the un-derlying cause of tooth decay. Bacteria break downcompounds from food called fermentable carboby-drates (e.g. sucrose), producing lactic acid and otherorganic acids as a byproduct. These acids promoteenamel and dentin demineralization. Tbis softeningof the enamel then leads to the development of den-tal caries (cavities).

Although bacteria naturally co-exist with us, un-der certain conditions they form a biofilm. A biofilmis a sort of living carpet composed of various bac-teria and even fungi.'^ The microorganisms excretea kind of glue, firmly anchoring themselves to tbeenamel surface of the tooth. Biofilm formation, andespecially biofilm attachment, is at the root of dentaldisease." Plaque is the common term for this liv-ii^g aggregation of various bacteria and fungi. Overtime, plaque hardens and takes on various minerals.At this stage, the coating is called tartar. It is thishard coating that dental hygienists work to scrapeav ay in the dentist's office.

Gingivitis occurs when dental plaque stimulatesan immune response in the soft tissues surroundingthe teeth. The gums become inflamed and irritated,appearing swollen and red and bleeding easily. Ifgingivitis is left untreated, it may progress to perio-dontitis, a condition in which Gram-negative bac-teria destroy the supportive structures of the teeth.Periodontitis may ultimately lead to tooth toss.

Avoiding the buildup of plaque is the reasondentists encourage us to brush our teeth and tofloss regularly. Brushing mechanically breaks upthe film to some extent and rinsing helps removefermentable sugars. But on the biochemical level,tbere is more that can be done to fight what is, afterall, a biological enemy. This is where natural bioac-tive agents that target plaque microorganisms andpromote gum healing come in.

shown that green tea catechins exert direct antibacte-rial activity against Streptococcus mutans, one of thekey microorganisms responsible for tooth decay. Greentea also helps prevent bacteria from sticking to teeth,by inhibiting a bacterial enzyme involved in this pro-cess. It also inhibits production of amylase, an enzymeused by bacteria to break starches down into sugars,which bacteria use to fuel their own growth. '' '

Furthermore, Asian researchers showed recentlythat green tea reduces the invasiveness of oral can-cer and decreases the production of a protein asso-ciated with oral cancer proliferation.^^" Additionally,American researchers report that green tea arrests thegi'owth and causes self-destruction (apoptosis) of oralcarcinoma cells in the laboratory.'**

In Japan, researchers conducted a study in whichgreen tea was applied to the teeth of subjects withperiodontal disease for eight weeks. Symptoms ofperiodontitis improved in subjects receiving green teacatechins and there was objective evidence that greentea killed a significant proportion of the bacteria caus-ing periodontitis in these test subjects. '

CoQlO Helps Fight Oral DiseaseBest known as a potent cardioprotective nutrient,

CoQlO has also been shown to improve symptomsof periodontitis when applied topically in the oralcavity. ' ' ^ Japanese researchers conducted a place-bo-controlled clinical trial in men with establishedperiodontitis. After nine weeks of CoQlO application,investigators found evidence of "significant improve-ments" in periodontal status, which were not seen incontrol subjects.•*

An early study on CoOlO's effectiveness againstperiodontitis impressed the study's authors so much,they wrote, "Heating was so excellent five to sevendays' post-biopsy that the biopsy sites were difficultto locate. The healing was viewed as extraordinarilyeffective."^'* It has been suggested that CoQlO benefitsoral health by reducing the oxidative stress associatedwith low-grade inflammation of gums and bone.'"

Complementary Ingredients for Dental HealthNumerous other natural agents can be incorpo-

rated into a dental health program to protect healthyteeth and gums. For example, the natural sweetenerxyiitol not only has a pleasing sweet taste, it has alsobeen found to help prevent tooth decay.'^ Squaleneboosts the immune system's ability to tackle invadingmicroorganisms,''' while lactoferrin specifically haltsthe growth of bacteria implicated in periodontitis.'^

Hydrogen peroxide is an antiseptic commonly usedto minimize gingivitis, fight plaque, and promote aclean, fresh mouth.'^ Aloe vera {Aloe barbadensis) has

32 LIFE EXTENSION SEPTEMBER 2008

DISEASE PREVENTION BEGINS IN THE MOUTH

Cancer's Oral Health LinkTooth loss or gum disease may increase your risk of

cancer, scientists say. A recent review of studies exam-ining this link by Harvard researchers revealed a signifi-cant increase in risk of the following types of cancers,which persisted in non-smokers:^

• A two to three-fold increase in oral cancer fromtooth loss.

• A strong association between tooth loss and a typeof cancer in the middle to lower stomach callednoncardia gastric cancer, even after controlling forthe common gut bacterium, Helicobacter pylori.

• A more than two-fold increase in the risk ofpancreatic cancer.

long been used in folk medicine to soothe bums andpromote wound beating. Modern science bas sbowntbat aloe bas anti-intlammatoiy properties and does, infact, promote wound bealing and may provide sootb-ing and bealing properties to ibe gum tissues."•"^ ''

Nutritional Supportfor the Gums

In addition to brusbing and/or rinsing witb botani-cal-fortified dentifrices (preparations for cleaning tbeteetb), supplementation witb vitamin C may also belpsupport gingival health. Vitamin C is crucial for tbemaintenance of bealthy connective tissue, such as thegums. In fact, one of tbe clinical signs of scurvy, tbedisease associated witb vitamin C deficiency, is bleed-ing gums.-*'* (Vitamin C sbould not be applied to tbeteeth topically as ascorbic acid may erode enamel.)

Tbe B vitamin, folie acid promotes gingival healthby reducing redness and bleeding of tbese delicatetissues.'^

Vitamin D is also important for oral bealíb.-*' Sincemany people do not generate adequate levels of the

"sunshine hormone," supplementation with vitamin Dmay be necessary to belp ensure gum bealtb.

Power of PomegranatePomegranate is cun'ently finding important appli-

cations in the field of dental health. Clinical studieshave shown that this popular antioxidant superstarattacks the causes of tooth decay at the biochemi-cal level, with remarkable vigor.'^""'''' When usedregularly in combination with toothpaste that hasbeen reinforced with bioactive botanical extracts andCoQlO, pomegranate-containing mouthwash may

The review did not find a strong link between lungcancer risk and tooth loss or periodontal disease, asthe researchers thought any excess risk may have beenconfounded by cigarette smoking,® although one studyhas found such an association.'^

In offering an explanation for their findings, theHarvard scientists believe that gum disease may causegeneral inflammation in the body, which can promotetumor growth. Or, they say, it could be a sign of aweakened immune system. Either way, they concludethat "periodontitis may be a marker for a type of im-mune function that has implications for tumor growthand progression,"^ Jfight dental plaque and tartar formation by inhibitingthe activities of the microorganisms that cause plaque.

Additionally, pomegranate compounds possessanti-inflammatory properties tbat may help soolbeimtated tissues."'"'''

SEPTEMBER 2008 I UFE EXTENSION I 33

DISEASE PREVENTION BEGINS IN THE MOUTH

Pomegranate gets to the root of the problem byliterally hitting bacteria where they Uve. Fascinatingresearch shows that pomegranate extract suppi essesthe ability of these microorganisms to adhere to thesurface of the tooth.'^ The trick is to inhibit a com-mon species of Streptococcus, preventing it fromproducing chemicals that create favorable condi-tions for fimgi and other microorganisms to thrive.Plaque may involve four or more different microor-ganisms combining forces to colonize the surface ofthe teeth. Remarkably, nature's own pomegranatefights the organisms' ability to adhere by interferingwith production of the very chemicals the bacteriause as "glue."^^

In fact, a recent study conducted by Brazilianresearchers showed that pomegranate extract wasmore effective against the adherence of bioñlm micro-organisms than a pharmaceutical antifungal, whenthree or four microorganisms were involved.'^ Theresults of this study suggest that "this phytothera-peutic agent might be used in the control of adher-ence of different microorganisms in the oral cavity, "concluded researchers.'-

A study conducted at the Human Nutrition Centerat Ohio State University in 2007 examined the effectsof using a mouthwash containing pomegranate extracton the risk of gingivitis." Investigators noted thatpomegranate's active components, including polyphe-nolic flavonoids (e.g., punicalagins and ellagic acid),are believed to prevent gingivitis through a number

of mechanisms including reduction of oxidative stressin the oral cavity,' ''- '' direct antioxidant activity; anti-inflammatory effects; '' '* antibacterial activity;^^ anddirect removal of plaque ft-om the teeth."*^ They alsonoted that a published pilot study has already shownthat pomegranate extract can reduce the clinical signsof chronic periodontitis.'*''

For the Ohio State study, researchers recruited 32healthy young men and women, who were randomlyassigned to rinse with pomegranate mouthwash, orplacebo, three times daily for four weeks. Subjects wereinstructed to rinse for five minutes per rinse. Salivasamples were evaluated for a variety of indicatorsrelated to gingivitis and periodontitis. Subjects rinsingwith pomegranate solution experienced a reduction insaliva total protein content,"^'which is nomially higheramong people with gingivitis''*' and may correlate withplaque-form ing bacterial content.^'

Pomegranate-treated subjects also experienced sig-nificant decreases in the salivary activity of the enzymeaspartate aminotransferase. This enzyme is consid-ered a reliable indicator of cell injury and is elevatedamong patients with periodontitis." Pomegranaterinsing also lowered saliva activities of alpha-glucosi-dase, an enzyme that breaks down sucrose (sugar),^^while it increased activities of ceruloplasmin, an anti-oxidant enzyme."'' "The pomegranate extract-inducedincrease in ceruloplasmin activity can be expectedto strengthen antioxidant defenses," noted investiga-tors. Subjects who rinsed with placebo solution didnot experience any of these changes.^^ Taken together,researchers concluded that these changes in salivacontent indicated that routine rinsing with a pome-granate mouthwash, "...could promote oral health,including affecting processes related to gingivitis."^^

Double-Pronged Attack on PlaqueCommercial toothpastes rely largely on mechanical

abrasion to remove the sticky film on teeth that, leftunchecked, develops into plaque. Over time, plaqueprovides the perfect environment for the erosion oftooth enamel, leading to cavities. Mouthwashes maycontain antibacterial compounds, flavorings, andother cosmetically appealing ingredients, but, untilnow, none have included the power of pomegranate.

Fortunately, pomegranate extract suppresses theactivity of various oral bacteria and fungi, which joinforces to cause tooth decay. When combined withtoothpaste formulated with bioactive compounds,such as green tea leaf extract, aloe vera gel, CoQlO,lactoferrin, folie acid, and xylitol, this powerful denti-frice duo actively fights the root causes of plaque andgum disease.

SEPTEMBER 2008 I LIFE EXTENSION I 35

DISEASE PREVENTION BEGINS IN THE MOUTH

ConclusionGood oral hygiene is nol simply a matter of main-

taining appearances. In the absence of vigilant oralcare, plaque and tartar will build up, resulting in gin-givitis and possibly progressing to periodontitis. Andperiodontitis has been associated with increased risksof conditions ranging ft-om heart disease to stroke andeven pancreatic cancer. By harnessing natural bio-active components, such as pomegranate, green tea,CoQlO, lactoferrin, aloe vera, folie acid, and xylitol,these modem dentifrices have improved the odds ofwinning the battle against dental degradation andrelated systemic illnesses. •

Ifyou have any questions on the scientificcontent of this article, please call a Life Extension

Health Advisor at 1 -800-226-2370.

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