Mastic Helps Curb Inflammation

Mastic Is Good for Your Mouth and More

Mastic Helps
Curb Inflammation

Putting mastic in your mouth can have far-reaching benefits—
just ask a cardiologist
By Will Block

uick, what part of your body do you think is the most versatile? Odds are that you said, “My hands.” And you’re probably right (although your brain might think otherwise). What a wondrously dexterous object is the human hand, thanks to the opposable thumb, one of evolution’s greatest achievements. The uncountable things we can accomplish with our hands enrich our lives in countless ways, freeing us from the cruel fate of having to live hand-to-mouth.

Oh, yes, the mouth—talk about versatility! And talk we do, as well as sing and whistle (maybe even yodel); we also, occasionally, whisper or growl or moan or roar. To be sure, we could live in total silence, as some monks and nuns do, but we would still have to eat and drink (and take nutritional supplements), which are pretty hard to do without a mouth. And, since the mouth works both ways when it comes to food, it lets us vomit when necessary—a useful defense mechanism against poisoning. Spitting can be useful too, and it helps with shining shoes and pitching a sneaky baseball.

Mouths help us read (you’re moving your lips, aren’t you?) and they wet our fingertips to help with turning the pages. We use our mouths to taste wine to see if we like it, to hold nails while we’re building a doghouse, to lick our wounds when we’re injured, to hide diamonds we’re trying to smuggle (what—you don’t do that?), to smoke cigarettes (don’t do that!), and to clench a rose between our teeth when we’re being crazily romantic.

The Mouth that Won’t Quit

Most mouths like to chew gum, and some blow bubbles. The Inuit chew on leather to soften it up; East Indian natives chew betel nuts as a stimulant; and Kalahari Bushmen chew on a remarkable succulent, Hoodia gordonii, to suppress their appetite on long hunts. Throughout the world, our mouths send unspoken messages in the universal language of smiles and sneers and pouts and grimaces—or tongue stick-outs, à la Maori warriors or the famous Einstein birthday photo. In the USA, our mouths put dentists’ kids through college and make lipstick manufacturers happy.

The latter reminds us, of course, of one of the mouth’s stellar roles: oral gratification. Babies suckle breasts, and they suck thumbs and toes and anything else they can get their tiny hands on. Kids suck lollipops. Grownups suck things like—well, you’re a grownup, so you know. And can you imagine life without kissing a loved one or nibbling on a succulent earlobe from time to time?

Take Your Mouth to Heart

Face it (so to speak), your mouth is a treasure, and you shouldn’t take it for granted, like breathing (aha—there’s another mouth thing, and a pretty important one too). The fact is, though, that most people don’t give as much thought, let alone care, to their mouths as they should. Just ask any dentist or cardiologist.

A cardiologist? But hearts don’t have teeth! No, but they can suffer the consequences of failure to take good care of the teeth and gums in their owners’ mouths. That’s because poor oral hygiene can lead to periodontitis, a severe form of gum disease caused by the accumulation of bacterial plaque at the base of the teeth. If the bacteria infiltrate the bloodstream (which is easy when the gums are bleeding), they can exacerbate cardiovascular risk factors, such as hypertension (high blood pressure) elevated lipid levels, and elevated levels of molecules or cells associated with systemic inflammation.

For about a century, physicians have suspected periodontitis of being a risk factor for various serious systemic diseases, and epidemiological evidence obtained mainly during the past decade has tended to confirm their suspicions. Among the diseases in question are various aspects of cardiovascular and cerebrovascular disease, such as coronary atherosclerosis and hypertension (including preeclampsia, which is hypertension associated with pregnancy); periodontitis may also be implicated in some respiratory disorders and the metabolic syndrome, which often leads to type 2 diabetes. (For more on these subjects, see the sidebar “How Inflammation Can Ruin Your Life.”)

How Inflammation Can Ruin Your Life

An important trend in modern medicine has been the growing realization that many chronic degenerative diseases are associated with inflammatory processes. We tend to think of inflammation in terms of its four classic symptoms—redness, heat, swelling, and pain—when it occurs at or near the surface. But inflammation can also be subtle and deep, occurring in insidious and unnoticed ways that produce no obvious symptoms. It’s a complex phenomenon with many manifestations, no one of which is necessarily present in all cases.

With inflamed gums,
why is this person smiling?
The paradox of inflammation is that it can be a healthy response to some type of chemical or physical injury, but it can also be a source of injury to our tissues or organs if it persists as a chronic condition. Chronic inflammation can last for weeks or months or years, or even a lifetime—a lifetime likely to be shortened by that very fact.

Researchers in the United Kingdom and the United States recently undertook a study to assess the impact of inflammation caused by periodontal disease on two types of cardiovascular risk factors.1 They classified these factors as either “traditional” or “novel.” The traditional factors they chose were blood pressure and lipid levels (cholesterol and triglycerides). The novel factors were some that are associated with inflammation—in this case, C-reactive protein (CRP), interleukin-6 (IL-6), and white blood cells.

The first two of these, CRP and IL-6, are hormonelike proteins that are sensitive, reliable markers (indicators) of inflammatory processes, and they’re good predictors of future systemic diseases, such as cardiovascular disease and type 2 diabetes. White blood cells, by comparison, are crude markers of systemic inflammation, but they too have a significant ability to predict future cardiovascular events and glucose intolerance (a precursor to diabetes) in different populations.

In a 6-month pilot intervention trial, the researchers enrolled 40 otherwise healthy adults (average age 48) with severe, chronic, generalized periodontitis. All the patients received either of two treatment regimens: (1) “standard” periodontal therapy, consisting of one 4–6-hour session of subgingival scaling and root planing (oh joy), plus instructions regarding good oral hygiene; or (2) “intensive” therapy, consisting of the standard therapy plus the antibiotic minocycline, administered locally (in the pockets) in the form of microspheres for slow release over 21 days. The patients were evaluated for cardiovascular risk factors at baseline and again at 2 months and 6 months.

Both treatment regimens produced improvements in both the traditional and novel cardiovascular risk factors. Overall, the intensive therapy yielded better results, mainly in terms of speed: significant improvements were noted after 2 months, vs. 6 months for the standard therapy. And what were these results? Naturally, the patients’ periodontal symptoms improved: both the plaque score and the gingival bleeding score were substantially reduced. More significantly, their traditional cardiovascular risk factors also improved, to varying degrees. They had a slight but transitory reduction in systolic blood pressure (no change in diastolic pressure), and their lipid levels improved somewhat.

Of greatest interest was the patients’ response in terms of inflammatory markers, which previous studies had found to be highly correlated with measures of obesity, systolic blood pressure, HDL-cholesterol (the “good cholesterol”), fasting glucose levels, and insulin sensitivity.2 In the current study, there were significant reductions in all three of the inflammatory markers, and the patients’ calculated Framingham risk scores (in reference to the long-running Framingham Heart Study) were also reduced. The authors concluded,

These data indicate that severe generalized periodontitis caused a chronic systemic inflammatory response and changes in serum cholesterol and systolic blood pressure in these patients. … The significance of periodontitis as a cause of systemic inflammation and, potentially, disease has to be discussed in the context of chronic periodontitis, which affects in mild forms up to 40%, and in more severe forms a good 10%, of the adult population.


  1. D’Aiuto F, Parkar M, Nibali L, Suvan J, Lessem J, Tonetti MS. Periodontal infections cause changes in traditional and novel cardiovascular risk factors: results from a randomized controlled clinical trial. Am Heart J 2006;151:977-84.
  2. Yudkin JS, Juhan-Vague I, Hawe E, Humphries SE, di Minno G, Margaglione M, Tremoli E, Kooistra T, Morange PE, Lundman P, Mohamed-Ali V, Hamsten A; the HIFMECH Study Group. Low-grade inflammation may play a role in the etiology of the metabolic syndrome in patients with coronary heart disease: the HIFMECH study. Metabolism 2004;53:852-7.

Mastic, a Natural Antimicrobial from a Tree

Your oral health (or lack of it) can impact your cardiovascular health.
Effective treatment of periodontal diseases requires a meticulous regimen of oral hygiene (brushing and flossing), and antimicrobial agents are also helpful. Among the most potent of these is the drug chlorhexidine, which is used as a mouthwash. Although it works well, its use is limited to short periods owing to its tendency to discolor the teeth. It can also cause hemolysis, the destruction of blood cells, if it enters the bloodstream. A safer alternative to chlorhexidine would be desirable.

Just such an alternative has been found in mastic, a gum resin known mainly for its antimicrobial action against the ulcer-causing bacterium Helicobacter pylori. Mastic gum comes from the mastic tree, Pistacia lentiscus, which grows primarily on the Greek island of Chios. It has been used for thousands of years as a folk medicine in the Mediterranean region, where it has also been popular as a chewing gum and an ingredient in foods, especially cakes and candies.

Mastic Kills Gingivitis Bug but Not Blood Cells

A researcher at the Hebrew University–Hadassah School of Dental Medicine in Jerusalem recently evaluated the effectiveness of mastic gum vs. that of chlorhexidine against one of the pathogens implicated as a key factor in the development of periodontal diseases (and halitosis).1 The pathogen is an anaerobic (non-oxygen-dependent) oral bacterium called Porphyromonas gingivalis. As its name suggests, this bug is associated with gingivitis, an inflammation of the gingivae, or gums. Gingivitis is a precursor to the more severe periodontitis, which involves not just the gum tissue but also the bone sockets surrounding the teeth.*

*For more on these diseases and how they affect the jawbone, see “Mastic and Licorice Are Good for Your Belly” in the June 2006 issue. And for evidence suggesting a possible link between halitosis and dyspepsia (and, perhaps, between halitosis and H. pylori infection), see “Halitosis May Be Linked to Dyspepsia” in the April 2003 issue.

Using an alcoholic extract of mastic gum, the Israeli researcher evaluated its ability, along with that of chlorhexidine, to kill P. gingivalis that had been prepared in a standardized culture medium containing sheep’s blood. Although mastic proved to be effective in this regard, chlorhexidine was far more effective. There was, however, another important difference between the two: chlorhexidine showed strong hemolytic activity, but mastic showed none. The researcher concluded,

These results taken together might suggest that mastic gum could be considered as a potential nontoxic agent in the treatment of oral malodor and gum disease that is more suited perhaps for local application rather than rinsing.
By “local application,” he meant insertion (by a dentist) of the mastic directly into the diseased periodontal pockets around the teeth, where it can do the most good. At home, our best approximation to this ideal is to take the mastic in a form—such as a chewing gum or a chewable wafer—that keeps it in the mouth for awhile so as to increase the chances that its biologically active constituents will penetrate those pernicious pockets.

It’s noteworthy that other research has shown mastic to be effective against the bacterium Streptococcus mutans, which is the chief culprit in periodontal disease because of its dominant role in the formation of dental plaque (it also causes cavities). If it enters the bloodstream, S. mutans can infect the interior linings of the heart, causing endocarditis, a serious inflammatory disease. (For more on this, see “Chewing Mastic Gum Can Prevent Tooth Decay” in the March 2006 issue.)

Mastic . . . Help!

Some comedians with a scatological bent have referred to the human oral cavity as the mouthhole (insert your own joke). Granted that not everything coming out of our mouthholes is socially acceptable, but we should at least ensure that what goes in is good for us. One such good thing is mastic, which has been helping people with oral and gastrointestinal problems for millennia. Whether it’s swallowed as a capsule, chewed as a gum, or chewed as a wafer, mastic can help kill some of the microbes that plague us.

One disorder that mastic cannot cure, alas, is logorrhea, defined as an abnormal or pathological talkativeness or garrulousness—in short, a tendency to be extremely verbose. Which means using way too many words. You know, verbiage—which does not, incidentally, mean mere “wording,” but rather, excessive wordiness. So verbiage is always bad. Logorrhea afflicts people who don’t know when to shut up … their mouths just keep running … please help me …


  1. Sterer N. Antimicrobial effect of mastic gum methanolic extract against Porphyromonas gingivalis. J Med Food 2006;9(2):290-2.

The Hidden Cost of Periodontal Disease

We are often told, “Put your money where your mouth is.” And sometimes, it seems, we do that just so a dentist can extract it from said mouth. Let’s be quick to point out, though, that we have nothing but respect for dentists, who are unsung heroes of the medical profession. But darn it, if we would only take better care of our teeth, we wouldn’t need dentists as much as we do.

Nor, for that matter, would we need physicians and hospitals as much as we do, according to a study reported on recently at the 84th General Session of the International Association for Dental Research, held in Brisbane, Australia.1 Japanese researchers had investigated the associations between periodontal disease and increased costs for inpatient, outpatient, and other healthcare services in a population of 4285 civil servants.

The researchers used the subjects’ dental histories to divide them into three categories of periodontal disease (PD): severe, moderate, or none. They then examined health insurance claims and other information from the subjects’ medical and dental records to evaluate the healthcare costs incurred by the three groups. They found, for starters, that overall costs were 21% higher for men and women with severe PD than for those who had none. Furthermore, those with severe PD were more likely to be admitted to a hospital than those with moderate or no PD, and for men in particular, hospital costs were 75% higher for those with severe PD than for those with none.

The researchers concluded, “Periodontal disease impacts healthcare cost increases through not only dental care costs but also inpatient care costs, especially in males.” And Dr. Kenneth A. Krebs, president of the American Academy of Periodontology, commented,1

It’s not surprising that periodontal diseases may be associated with increased healthcare costs and dental costs, because periodontal disease may be linked to general health conditions such as diabetes, heart disease, preterm low birth weight, and respiratory disease.
How are your teeth and gums doing?


  1. Huggins C. Preventing gum disease would save teeth and money. Reuters Health report, July 11, 2006.

Will Block is the publisher and editorial director of Life Enhancement magazine.

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