Periodontal Disease natural treatment by Ray Sahelian, M.D.
January 20 2016

This page will discuss natural treatment options for periodontal disease. Increasing whole grain in the diet without increasing total energy intake may reduce periodontitis risk.

Garlic could help?
Ayu. 2013. An in-vitro evaluation of the efficacy of garlic extract as an antimicrobial agent on periodontal pathogens: A microbiological study. With the rise in bacterial resistance to antibiotics, there is considerable interest in the development of other classes of antimicrobials for the control of infection. Garlic (Allium sativum Linn.) has been used as medicine since ancient times and has long been known to have antibacterial, antifungal, and antiviral properties. This study was undertaken to assess the inhibitory effect of garlic on Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, to assess the time-kill curve of P. gingivalis and A. actinomycetemcomitans, and to determine the antiproteolytic activity of garlic on P. gingivalis. Ethanolic garlic extract (EGE) and aqueous garlic extract (AGE) were prepared and the inhibitory effects of these extracts for two periodontal pathogens (P. gingivalis and A. actinomycetemcomitans) were tested. Antiproteolytic activity on protease of P. gingivalis was determined. 25 microliter (μl), 50 μl, and 75 μl of AGE showed 16 mm, 20 mm, and 25 mm zone of inhibition, respectively, on P. gingivalis. The AGE showed greater bacteriostatic activity against the P. gingivalis with minimum inhibitory concentration determined at 16.6 μl/ml. The time-kill assay of AGE and EGE were compared for P. gingivalis and A. actinomycetemcomitans. AGE showed better antiproteolytic activity on total protease of P. gingivalis compared to the EGE. Thus, the study concludes the antimicrobial activity of garlic extract against periodontal pathogens, P. gingivalis, A. actinomycetemcomitans. Its action against P. gingivalis includes inhibition of total protease activity, and this raises the possibility that garlic may have therapeutic use for periodontitis and possibly other oral infections.

J Indian Soc Periodontol. 2013. Reactive oxygen species in periodontitis. Recent epidemiological studies reveal that more than two-third of the world's population suffers from one of the chronic forms of periodontal disease. The primary etiological agent of this inflammatory disease is a polymicrobial complex, predominantly Gram negative anaerobic or facultative bacteria within the sub-gingival biofilm. These bacterial species initiate the production of various cytokines such as interleukin-8 and TNF-α, further causing an increase in number and activity of polymorphonucleocytes (PMN) along with these cytokines, PMNs also produce reactive oxygen species (ROS) superoxide via the respiratory burst mechanism as the part of the defence response to infection. ROS just like the interleukins have deleterious effects on tissue cells when produced in excess. To counter the harmful effects of ROS, human body has its own defence mechanisms to eliminate them as soon as they are formed. The aim of this review is to focus on the role of different free radicals, ROS, and antioxidants in the pathophysiology of periodontal tissue destruction.

Effects of vitamin-B complex supplementation on periodontal wound healing.
J Periodontol. 2005. Neiva RF, Al-Shammari K, Nociti FH Jr. Department of Periodontics/Prevention/Geriatrics, School of Dentistry, University of Michigan, 1011 N. University Avenue, Ann Arbor, MI
Reports have demonstrated that nutrient supplements, in particular vitamin-B complex (Vit-B), can positively influence wound healing processes. However, limited information is available on the effects of Vit-B on periodontal wound healing. A total of 30 patients (13 males, 17 females) presenting with generalized moderate to severe chronic periodontitis were enrolled in this study. All subjects presented > or = two teeth in the same sextant with probing depth (PD) > or =5 mm and bleeding upon probing (BOP) in need of access flap surgery (AFS). This study was a randomized, double-masked, placebo-controlled clinical trial. Subjects were instructed to take one capsule a day of either Vit-B (50 mg of the following: thiamine HCl, riboflavin, niacinamide, d-calcium pantothenate, and pyridoxine HCl; 50 microg each of d-biotin and cyanocobalamin; and 400 mcg of folate) or placebo for 30 days following AFS. CONCLUSION: Vitamin B-complex supplement in combination with AFS resulted in statistically significant superior CAL gains when compared to placebo.

Clin Oral Investig. 2013. Effects of probiotics in periodontal diseases: a systematic review. Based on the results of this review, the effectiveness of probiotics on the prevention and treatment of periodontal diseases is questionable. There is currently insufficient evidence demonstrating the benefits of systematic preventative use of probiotics in patients with periodontal diseases.

Periodontal gum disease and cancer
Periodontitis appears to be associated with an elevated risk of developing tongue cancer.

Rheumatoid arthritis
N Y State Dent J. 2015. Rheumatoid Arthritis and Periodontal Disease. An Update. A review of the epidemiological, pathological and immunological relationships between two chronic inflammatory diseases: rheumatoid arthritis (RA) and periodontal disease (PD). RA is a chronic inflammatory disease of the joints, characterized by loss of connective tissue and mineralized structures, the so-called "synovial membrane." Periodontitis is the inflammatory destruction of the periodontal attachment and alveolar bone. While the etiology of these two diseases may differ, the underlying pathogenic mechanisms are similar. And it is possible that individuals manifesting both PD and RA may suffer from a unifying underlying systemic deregulation of the inflammatory response. There is an overproduction of a variety of cytokines and MMPs that appears to be common in both diseases.

Periodontal disease natural treatment questions
Q. Please advise which nutritional supplements treats periodontal disease with 4,5,6,7 mm pockets?
   A. Perhaps B vitamins may help, but dental hygiene is the most important.