Treatment of gum disease begins with regular brushing and flossing. It is also important to make regular trips to the dentist for cleaning and monitoring. Most dentists recommend yearly full-mouth x-rays to assess the progression of bone loss in the jaws. Life Extension, however, has long been concerned about the radiation exposure that results from undergoing medical x-rays. Even x-rays that emit low levels of radiation damage DNA, which can lead to cancer. While some dental x-rays are necessary, annual x-rays are not advisable.
A full periodontal probe with a tiny, ruler-like instrument is also performed to measure the pockets surrounding the teeth. In healthy gums, the pockets measure less than 3 millimeters (one-eighth of an inch). Pockets measuring 3 to 5 millimeters indicate signs of gingivitis. Pockets measuring more than 5 millimeters signify the development of periodontitis. For more information, see Life Extension’s Periodontitis and Dental Cavities protocol.
A professional cleaning to remove plaque and tartar buildup should be performed at least twice a year. Some people need to have cleanings done more frequently. Non-surgical deep cleaning involves two procedures known as scaling and root planing, which are sometimes performed in sections of the mouth at different times, especially if there is considerable soreness and bleeding from the gums. Scaling removes plaque and tartar above and below the gum line. Root planing smoothes out the tooth root to remove bacteria buildup and encourage the gums to reattach to the teeth.
Mouth Rinses. Mouth rinses are frequently used to help prevent gingivitis. Medicated mouth rinses containing a 0.1% solution of folic acid have effectively reduced gum inflammation and bleeding in double-blind trials (Pack 1984; Vogel 1978b). Prescription antibacterial mouthwashes containing the ingredient chlorhexidine (Peridex®, PerioGard®) are also frequently used to treat gum inflammation.
Decapinol®. Decapinol®, a prescription oral rinse, reduces the adherence of bacterial plaque to oral surfaces. This reduces the formation of new plaque as well as breaks up existing plaque, making it easier to remove with normal brushing. Reducing the presence of plaque also reduces the amount of bacterial toxins released into the gums. The result is a reduction in plaque and gingivitis. Decapinol® is only mildly antibacterial, so it does not upset the oral bacterial flora.
Toothpaste. The natural and synthetic antibacterial agents in many brands of toothpaste can help keep gums healthy. Natural toothpastes contain botanical oils that have antibacterial properties, while commercial formulas offer the benefit of fluoride to help prevent cavities. The brand Colgate Total®—the only FDA-approved toothpaste for fighting gingivitis—contains triclosan, a mild antimicrobial proven to reduce plaque and pocket depths associated with gingivitis (Niederman 2004; Davies 2004).
Antibiotic Therapy. Antibiotic therapy used alone or in combination with other treatments may also be recommended to treat gingivitis. Atridox® (doxycycline hyclate), PerioChip® (chlorhexidine gluconate), and Arestin® (minocycline hydrochloride) are antibiotics applied in sustained-release doses directly into the periodontal pocket. A relatively new drug called Periostat® (doxycycline hyclate) was approved by the FDA in 1998 for use in combination with scaling and root planing. Taken orally, Periostat® suppresses the action of collagenase, an enzyme that causes destruction of the teeth and gums (Lee 2004; Lee 2004).
Surgery. If a diligent regimen of proper brushing, flossing, and regular dental cleanings is followed, nearly all cases of gingivitis can be reversed in a short time. However, in advanced gingivitis, or conditions that make treatment difficult, the following surgical treatments can help:
- Curettage - a procedure in which diseased gum tissue in the infected pocket is scraped away, allowing the infected area to heal.
- Flap surgery - involves pulling back the gums to remove tartar buildup. The gums are then sewn back in place so that the tissue fits snugly around the tooth, thereby reducing pocket depth.
- Guided tissue regeneration - stimulates bone and gum tissue growth, and is often performed in combination with flap surgery. In this procedure, a small piece of mesh-like fabric is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and connective tissue to reattach.
- Soft tissue grafts - reinforce thin gums or replace tissue where the gums have receded. The grafted tissue, usually taken from the roof of the mouth, is sewn in place over the affected area.
Hydrogen peroxide. Hydrogen peroxide, which is included in many toothpastes, is valuable for its ability to reach bacteria hiding among gingival folds and gaps. Hydrogen peroxide is also added to some mouthwashes to reduce gingivitis and whiten teeth (Hasturk 2004). Hydrogen peroxide has been used effectively for years in dentistry.