• Detailed Results of Nutrition Survey

More than half of the 135 periodontists polled report that either they or their staffs talk to patients on a regular basis about the role of good nutrition in maintaining good oral health. “I tell them that a well balanced diet is important for the body and subsequently the mouth’s health,” said one responding periodontist. “I inform my patients that vitamin C is important for tissue health and calcium is important for bone health.”

The majority of periodontists recommend calcium supplements and multivitamins for patients who are not getting adequate amounts from their diet. Many patients seem to listen to this advice. In a separate poll of consumers visiting the AAP’s Web site, nearly 57 percent of 477 respondents said they have tried improving their diet to help improve periodontal health.

“Research has proven that people who consume inadequate amounts of calcium and vitamin C have higher rates of periodontal disease,” said Michael McGuire, D.D.S., president of the AAP. “However, many other nutrients likely play a role in maintaining good periodontal health too.”

Conversely, some foods are best avoided to maintain good periodontal health. The top culprit chosen by periodontists was popcorn, because the husks can get caught in between the teeth and gums and cause abscesses.

A referral to a periodontist in your area and free brochure samples are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

“Research has suggested that periodontal disease may affect overall systemic health,” said study author Dr. Yoshihiro Shimazaki of Kyushu University in Fukuoka, Japan. “This study reinforces what much of the public already knows – the importance of dairy in helping achieve a healthy lifestyle, including a healthy mouth.”

Study participants aged 40 through 79 were examined on two periodontal parameters that can indicate gum disease, periodontal pocket depth (PD) and clinical attachment loss (CAL) of gum tissue. Researchers observed that subjects that consumed 55 or more grams of products containing lactic acid each day had a significantly lower prevalence of deep PD and severe CAL, therefore demonstrating a lower instance of periodontal disease.

Periodontal, or gum, disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease is a major cause of tooth loss in adults and has been connected to the development of heart disease and increased risk of stroke, and can contribute to complications from diabetes, respiratory disease or osteoporosis.

“Millions of adults already suffer from periodontal disease,” says Dr. Susan Karabin, DDS, President of the AAP. “By regularly consuming dairy products such as cheese and milk, something many people do each day, the risk of developing gum disease may decrease. These findings are important since maintaining healthy gums is a critical component to maintaining a healthy body.”

To find a periodontist or to learn if you are at risk for periodontal diseases, take the Academy’s risk assessment test. You can also get free brochure samples online at www.perio.org, or by calling toll-free (800) FLOSS-EM (800/356-7736).

“Both vitamin D and calcium counteract deficiencies and reduce bone resorption,” said Dr. Charles Hildebolt, Department of Radiology, Washington University School of Medicine, St. Louis, MO. “Numerous studies indicate that vitamin D and calcium deficiencies result in bone loss and increased inflammation. Inflammation is a well recognized symptom of periodontal diseases, which is why it has been suggested that calcium and vitamin D deficiency may be a risk factor for periodontal diseases.”

Research shows that the best means of obtaining the required amount of vitamin D is from sunshine. According to the National Institutes of Health, season, geographic latitude, time of day, cloud cover, smog and sunscreen affect ultraviolet ray exposure and vitamin D synthesis. Ten to 15 minutes of sun exposure at least two times per week to the face, arms, hands or back is usually sufficient to provide adequate vitamin D. People who live in an area with limited sun exposure may want to eat foods fortified with vitamin D such as milk, eggs, sardines and tuna fish.

“We are not encouraging people to forego their sun protection, nor to spend prolonged periods of time in the sun” said Vincent J Iacono, DMD and president of the American Academy of Periodontology. “According to the American Academy of Dermatology, there is no such thing as a total UV block. Even the most effective sunscreens currently on the market let through enough UV to allow for adequate vitamin D formation.”

Periodontal diseases are bacterial infections that, if left untreated, may cause damage to the bone and even tooth loss. A number of infectious diseases have been linked with low levels of vitamin D, and it has been demonstrated that vitamin D can suppress proinflammatory cytokine production. (Proinflammatory cytokines are molecules that have destructive effects throughout the body.)

“Periodontal disease increases the production of cytokines, but it has been demonstrated that vitamin D can suppress cytokine production, and possibly decrease the risk of periodontal disease,” explains Hildebolt.

“Further research is needed to define the health risks associated with inadequate levels of vitamin D and calcium intake and how they affect periodontal diseases,” said Iacono. “Until we have further information, it is prudent for patients to talk to their healthcare providers about the possibility of taking vitamin D and calcium supplements.”

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

Early in the game, Survivor‘s Kucha tribe won a reward challenge that included in the prize toothbrushes and toothpaste. The other Survivor contestants’ lack of oral hygiene and their soft diet with little nutritional value could cause periodontal problems to flare up. Bacterial plaque, a sticky, colorless substance that forms on the teeth constantly, can turn into a hard substance called calculus in less than two days. If calculus develops below the gums onto the tooth root, it can irritate the gums, causing infection.

A Journal of Periodontology study followed a group of 15 third-year dental students who gave up oral hygiene activities for 21 days to monitor the effects on their oral health. By day 21, all subjects exhibited signs of gingivitis, including plaque and overt clinical inflammation. The toxins produced by gingival infections can destroy the supporting tissues around the teeth, including the bone. When this happens, gums separate from the teeth, forming pockets that will fill with even more plaque and infection. As the disease progresses, these pockets deepen, more gum tissue and bone are destroyed and the teeth eventually become loose. In addition to being a major cause of tooth loss, periodontal disease has been linked to serious health threats such as heart attacks, diabetes and preterm births. Study Abstract *

“While most people don’t have to worry about not being able to brush their teeth for several days, they should understand that plaque, when not removed, can harden to the point it can only be removed during a professional cleaning after only a day or two,” said Michael McGuire, D.D.S., president of the American Academy of Periodontology (AAP). “When people don’t floss daily, plaque builds between the teeth, and periodontal disease often begins between teeth where a toothbrush can’t reach.”

One possibility for people without access to toothbrushes and floss may be to chew on sticks. Dental researchers have studied the periodontal status of Sudanese populations who use Miswak chewing sticks and found that their periodontal health status was comparable to Sudanese toothbrush users.

A referral to a periodontist in your area and free brochure samples including one titled How to Brush and Floss are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

The study looked at 13,665 people, and all participants underwent a periodontal examination. Body mass index and waist circumference were used to indicate obesity. The prevalence of periodontal disease amoung obese individuals aged 18-34 years was 76% higher than normal weight individuals in this age group.

No significant association was found between body weight and periodontal disease in the middle and older age groups.

Several explanations for the association between obesity and periodontal disease in younger adults and not older adults are plausible. The younger people in the study may have different dietary patterns than older study participants. Research in dietary trends in adolescents ages 11 to 18 reveal a significant decrease in raw fruit and non-potato vegetables, which are sources of vitamin C. In addition, adolescents have decreased their calcium intake, and increased their intake of soft drinks and non-citrus juices. This is important to oral health because low dietary intake of calcium and vitamin C have been associated with periodontal disease.

“Periodontists have known for awhile that people who consume less than the recommended dietary allowance (RDA) for calcium and vitamin C have slightly higher rates of periodontal disease. Young people are now drinking more soft drinks and non-citrus juices than milk and healthier beverages, decreasing their vitamin C and calcium intake” said Mohammad S. Al-Zahrani, D.M.D., Centers for Health Promotion Research, Case Western Reserve University. “Periodontitis has long been considered an ‘older person’s’ disease, as more than half of people aged 55 or older have it. We now know that widespread risk factors such as obesity may also compromise periodontal health in younger populations.”

“This is one more finding that shows healthy nutrition and adequate physical activity are necessary for overall health, and may also help to improve periodontal health by reducing the rate of progression of periodontal disease, said Gordon Douglass, D.D.S. and president of the American Academy of Periodontology.”

The study mentions other reasons for the association between obesity and periodontal disease including the social stigma associated with obesity in younger adults. Obesity for this age group may be a greater source of chronic stress than in older adults where increased body weight is considered more acceptable. Stress and how an individual copes with stress has been shown to increase a person’s risk for periodontal disease.

“These findings add one more health risk to the list, and further demonstrate the importance of preventing and managing obesity, said Douglass. “Like obesity, periodontal disease can take away a person’s confidence and smile.”

A referral to a periodontist in your area and free brochure samples including one titled Periodontal Diseases: What You Need to Know are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

“A diet low in important nutrients can make it harder for the body’s immune system to fight off infection,” said Michael P. Rethman, DDS, MS, and president of the American Academy of Periodontology. “Periodontitis is a bacterial infection that destroys the tissues and bone that support the teeth, consequently a well-balanced diet may benefit oral health.”

A study that appeared in the Journal of Periodontology found that men and women who have calcium intakes of fewer than 500 milligrams, or about half the recommended dietary allowance, were almost twice as likely to have periodontal diseases as measured by the loss of attachment of the gums from the teeth. This association was particularly evident for young adults in their 20s and 30s. Study Abstract *

“The relationship between calcium intake and periodontal diseases may be due to calcium’s role in building density in the alveolar bone that supports the teeth,” said Rethman. “Calcium is necessary for healthy bones, teeth, muscle contractions and other functions.”

Research has also shown that patients who consumed less than the recommended 60 mg per day (about one orange) were at nearly one-and-a-half times the risk of developing severe gingivitis as those who consumed three times the RDA (more than 180 mg). Gingivitis is the mildest form of periodontal diseases, and it causes the gums to become red, swell and bleed easily.

“The relationship between vitamin C and periodontal disease may be due to vitamin C’s role in maintaining and repairing healthy connective tissue along with its antioxidant properties,” said Rethman.

Dr. P. Rory O’Neill, D.M.D., and private practitioner in North Andover, Mass. encourages his patients with diabetes to keep their blood glucose levels under control because uncontrolled diabetes increases their risks of periodontal disease. “It is important for patients with diabetes to reduce cholesterol and serum triglyceride levels through diet and exercise. Research shows increased serum triglyceride levels in uncontrolled diabetics seems to be related to greater attachment loss and probing depths,” said O’Neill. “I also recommend patients limit their intake of fruit juice because juices are high in sugars, and the acid could lead to abrasion and possibly gum recession.”

Other nutritional recommendations to help keep you smiling include:

• Drinking lots of water. Keeping your mouth moist is important in warding off tooth decay and periodontal diseases because it washes away food and neutralizes plaque.
• Brushing and flossing after eating sticky foods such as raisins, fruit rolls or candy.

A referral to a periodontist in your area and free brochure samples including one titled Protecting Your Oral Health are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

Since its discovery in 1917, melatonin has been found to be involved in many biological functions such as setting the body’s sleep rhythms and fighting off free radicals that may lead to cancer and other autoimmune diseases. The authors of this study conducted an extensive review of the literature (e.g., PubMed, Science Direct, Web of Knowledge, etc.) to evaluate the potential effects of melatonin on the oral cavity, including: melatonin as an antioxidant and free radical scavenger; melatonin as a host modulation agent; melatonin as a promoter of bone formation; and melatonin and periodontal disease. This review found strong evidence that melatonin may play a key role in periodontal health by helping to maintain bone levels in the oral cavity through suppressing the cells that work during bone resorption, and enhancing the body’s host response to the periodontal bacteria. One of the most devastating effects of periodontal disease is bone loss in the jaw which often leads to tooth loss.

“Although the review did not directly look at melatonin as a treatment option for periodontal diseases, this is an area that might be worth investigating in the future,” said review author Antonio Cutando, DDS. “Melatonin has important physiological functions that have not yet been explored in dentistry or in the treatment of periodontal diseases.”

Melatonin also has strong antioxidant and anti-inflammatory effects that help to improve the body’s immune response to infection. Recent studies have shown that salivary melatonin levels may actually vary according to the degree of periodontal disease, indicating that melatonin may act to protect the body from periodontal bacteria and inflammation.

“While natural supplements such as vitamin D, calcium, and vitamins E and C have been shown to have possible effects on periodontal diseases patients should be aware that supplements alone are not a substitute for periodontal care,” explained Preston D. Miller, DDS, and AAP president. “Patients should make an effort to know their pocket probing depths, which are the key to understanding their periodontal disease. A healthy probing depth of one to two millimeters with no bleeding represents a healthy mouth. Probing depths of three to four, that bleed, generally need more than a simple cleaning- they may require a procedure called scaling and root planing. When probing depths reach five millimeters or greater the patient has reached a level which may require surgical treatment to restore lost bone. Patients should keep this pocket size guide to their oral health in mind and should not hesitate to ask their dental professionals about their probing depths if this information is not volunteered.”

To find out if you are at risk for periodontal diseases, please visit the AAP’s Web site and take a free risk assessment test. A referral to a periodontist in your area and brochure samples including one titled Protecting Your Oral Health are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

Researchers analyzed vitamin C intakes and periodontal disease indicators in 12,419 U.S. adults. They found that patients who consumed less than the recommended 60 mg per day (about one orange) were at nearly one-and-a-half times the risk of developing severe gingivitis as those who consumed three times the RDA (more than 180 mg). Gingivitis is the mildest form of periodontal disease, and it causes the gums to become red, swell and bleed easily. Study Abstract *

Researcher Robert Genco, D.D.S., Ph.D., chair of the Oral Biology Department at The State University of New York at Buffalo, says the relationship between severe vitamin C deficiency and gum health has long been known. “In the late 18th century, sailors away at sea would eat limes to prevent their gums from bleeding,” Genco said. “The relationship between vitamin C and periodontal disease is likely due to vitamin C’s role in maintaining and repairing healthy connective tissue along with its antioxidant properties.”

“Periodontal disease is an inflammatory disorder that increases tissue damage and loss. Since vitamin C is known as a powerful scavenger of reactive oxygen species, which form part of the body’s antioxidant defense system, low levels of dietary vitamin C may compromise the body’s ability to neutralize these tissue destructive oxidants,” explained Genco.

Researchers also found that tobacco users especially had higher levels of periodontal disease if they also consumed lower levels of dietary vitamin C. “Since oxidants from cigarette smoking lower vitamin C levels in the blood, smokers need higher levels of dietary vitamin C to help counteract smoke’s oxidants,” said Genco.

“It’s also important to add that cigarette smoke contains numerous oxidants that can cause periodontal tissue damage regardless of vitamin C intake,” Genco added.

“Diet plays an important role in the overall well-being of oral health. Especially in light of other new research between calcium and periodontal disease,” said Jack Caton, D.D.S., M.S., president of the American Academy of Periodontology (AAP). “However, people need to keep in mind that vitamins, dietary supplements and good nutrition are not cures for periodontal disease. Patients must also brush and floss, and ask their dentist or periodontist about the state of their periodontal health to help prevent tooth loss.”

A referral to a periodontist in your area and free brochure samples including one titled Periodontal Disease: What You Need to Know are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

Researchers analyzed government data on calcium consumption and periodontal disease indicators in nearly 13,000 people representing U.S. adults. They found that men and women who had calcium intakes of fewer than 500 milligrams, or about half the recommended dietary allowance, were almost twice as likely to have periodontal disease, as measured by the loss of attachment of the gums from the teeth. The association was particularly evident for people in their 20s and 30s.

Researcher Robert Genco, D.D.S., Ph.D., chair of the Oral Biology Department at The State University of New York at Buffalo, says the relationship between calcium and periodontal disease is likely due to calcium’s role in building density in the alveolar bone that supports the teeth. “Periodontal disease is an infection caused by bacteria that accumulate in pockets between the teeth and gums. Eventually, the infection can break down and destroy the tissues and bone that support the teeth. But, if the jaw bone is kept strong with enough calcium, it may be better able to withstand the bacterial onslaught,” explained Genco.

“Warding off periodontal disease is one more good reason to make an effort to consume enough calcium,” says Janet Helm, a registered dietitian and spokesperson for the American Dietetic Association. “Calcium is necessary for healthy bones, teeth, muscle contractions and other body functions. Yet, about three out of four people do not meet their daily need.” The American Dietetic Association says good sources of calcium include dairy foods such as milk, yogurt and cheese, dark green veggies, fortified orange juice, as well as rice and beans.

“A relationship between calcium intake and periodontal disease makes sense in light of other new research linking osteoporosis with tooth loss,” said Jack Caton, D.D.S., M.S., president of the American Academy of Periodontology (AAP). “However, people need to keep in mind that several other risk factors also exist for periodontal disease, including tobacco use, oral hygiene habits, genetics, diabetes, certain medications and stress,” said Caton. “In addition to drinking milk, people should ask their dentist or periodontist about the state of their periodontal health to help prevent tooth loss and protect overall health. He or she can help identify and control the risk factors for periodontal disease.”

A referral to a periodontist in your area and free brochure samples including one titled Periodontal Disease: What You Need to Know are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

“It has been long speculated that green tea possesses a host of health benefits,” said study author Dr. Yoshihiro Shimazaki of Kyushu University in Fukuoka, Japan. “And since many of us enjoy green tea on a regular basis, my colleagues and I were eager to investigate the impact of green tea consumption on periodontal health, especially considering the escalating emphasis on the connection between periodontal health and overall health.”

Male participants aged 49 through 59 were examined on three indicators of periodontal disease: periodontal pocket depth (PD), clinical attachment loss (CAL) of gum tissue, and bleeding on probing (BOP) of the gum tissue. Researchers observed that for every one cup of green tea consumed per day, there was a decrease in all three indicators, therefore signifying a lower instance of periodontal disease in those subjects who regularly drank green tea.

Green tea’s ability to help reduce symptoms of periodontal disease may be due to the presence of the antioxidant catechin. Previous research has demonstrated antioxidants’ ability to reduce inflammation in the body, and the indicators of periodontal disease measured in this study, PD, CAL and BOP, suggest the existence of an inflammatory response to periodontal bacteria in the mouth. By interfering with the body’s inflammatory response to periodontal bacteria, green tea may actually help promote periodontal health, and ward off further disease. Periodontal disease is a chronic inflammatory disease that affects the gums and bone supporting the teeth, and has been associated with the progression of other diseases such as cardiovascular disease and diabetes.

“Periodontists believe that maintaining healthy gums is absolutely critical to maintaining a healthy body,” says Dr. David Cochran, DDS, PhD, President of the AAP and Chair of the Department of Periodontics at the University of Texas Health Science Center at San Antonio. “That is why it is so important to find simple ways to boost periodontal health, such as regularly drinking green tea—something already known to possess certain health-related benefits.”

To learn more about gum disease, locate a periodontist or find out if you are at risk for periodontal diseases, visit www.perio.org, or call 800-FLOSS-EM (800/356-7736).

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for