Gum Disease Connected to Stroke  

How Oral Hygiene Can Affect the Brain 

Gum disease: The idea of this malady doesn't exactly shock you into thinking about making out your last will and testament. But if you don't take care of your oral hygiene, you could one day be in for an unpleasant surprise. The latest word is that gum disease is associated with an increased tendency to form blockages in the carotid arteries which upwardly traverse the neck to feed the brain. A stroke (or heart attack) can be caused by significant partial arterial blockage due to thickening plaque or by full arterial blockage due to an embolus (a piece of plaque that breaks off and flows to a smaller vessel) which obstructs blood flow to the brain. Since gum disease has recently been associated with increased build-up of plaque in the carotid arteries, it's possible that a person lax about his or her oral hygiene is at greater risk for stroke.

At the annual meeting of the American Academy of Neurology this past April, Dr Mitchell Elkind, assistant professor of neurology at Columbia University College of Physicians and Surgeons in New York made his case along with his colleagues. "If the association proves true, it may be that antibiotic treatment of periodontal disease could have a role to play in preventing stroke and heart disease," said Elkind.1

Gum Disease May Boost Stroke Risk
In a study of 62 people (averaging 66 years of age), those with the most diseased gums also tended to have the greatest amount of plaque in their carotid arteries. Using ultrasound to measure thickness of the build-up in the carotid arteries, Elkind and associates found that the plaque thickness of those with the most severe gum disease was more than 50% greater than those with the healthiest gums. This thicker plaque build-up was associated with an increased risk of stroke.

Periodontal gum disease is in effect a chronic, low-grade infection. Because it develops gradually, it generally is not thought of as a serious health threat. But because gums and teeth involve such a significant area of tissue and bone, periodontal disease allows bacteria and toxic inflammatory compounds to gain access into the bloodstream. Once in the blood vessels, bacteria insult the lining of the blood vessels, which makes the lining more susceptible to plaque formation and build-up. This situation can increase risk of stroke.

Other research supports the periodontal-stroke connection as well. At the University of Heidelberg in Germany, researchers found that people who experience a stroke are more than twice as likely as other neurology patients to have a history of chronic bronchitis or periodontal disease.2

CoEnzyme Q10 Is Not New News for Gum Health
While the net effect of gum disease on arteries has yet to be fully assessed, there is enough evidence to warrant new strategies that go beyond the standards most health professionals still deem sufficient. If they only knew: For more than 20 years, research has been demonstrating that CoQ10 can significantly inhibit damaging bacteria when topically applied to the gums.

One Japanese study found that topical treatment of CoQ10 was efficacious not only as adjunctive treatment for adult periodontitis but also as a sole treatment.3 When used along with traditional nonsurgical periodontal therapy, CoQ10 had a synergistic effect.

Another study showed that people with gum disease typically have significant leucocytic and CoQ10 deficiencies. White blood cells called leukocytes are the first cells that migrate into periodontal tissues and gingival crevices in response to invading pathogens. When CoQ10 supplements were given, leukocyte deficiencies were reversed.4 Oral treatment with CoQ10 has also been found to control plaque and decrease periodontal pocket depth,* eliminating the need for surgical intervention in one study.5 Five to seven days after biopsies were taken to initially ascertain periodontal damage, the healing process induced by CoQ10 use was so excellent that the biopsy sites were no longer easily identified. The healing was viewed as extraordinarily effective.

* Pocket depth is an assessment tool for measuring the severity of gum disease. A pocket is a space between the tooth and the gum margin. The deeper the pocket, the more significant the gum disease . Gingival pockets are due to bacterial conditions.

Other Important Nutrients That Impact Gum Health
Folic acid is also associated with the reduction of gingival growth. Anticonvulsive patients have long been noticed to be especially subject to gingival problems which may be helped by folic acid supplementation.6 In a study involving pregnant women, folic acid mouthwash helped produce a highly significant improvement in gingival health.7 In a double blind placebo-controlled study, folic acid supplements were found to increase the resistance of the gingiva to local irritants and thus lead to a reduction in inflammation.8

Finally, Vitamin K compounds and especially Vitamin K3 (medadione) have been found to elevate levels of collagen, the "glue" of connective tissue found in skin and bone.9 Collagen is necessary to keep teeth firmly implanted. Vitamin K has been found to enhance the ability of saliva to inhibit bacteria, thus improving the potency of saliva against gingival and periodontal bacteria.10 Vitamin K also may improve the status of gingival gum tissue by enhancing natural antioxidant defenses.11

To put the importance of Vitamin K3 in perspective; back in the late 1930's to mid 1940's, Dr Leonard Fosdick published a series of papers establishing the cause of tooth decay as the bacterial fermentation of simple sugars and starches which then transform into lactic acid. Lactic acid, in turn, decays teeth.12,13 He then showed that Vitamin K3 blocks this transformation thus helps to prevent prevent tooth decay. In one study, he found that regular oral use of Vitamin K3 in modest amounts of a few hundred to 1,000 mg could reduce cavities by 60-80%.14 That's significant!

We believe that a mouth spray with these ingredients can help improve normal saliva function, strengthen immune function, and bolster your natural mechanisms for maintaining gum and tooth health. We would recommend it as part of your everyday hygiene program.


  1. Toronto, Apr 21 (Reuters Health) - Copyright © 1999 Reuters Ltd.
  2. Stephenson J. Rising stroke rates spur efforts to identify risks, prevent disease. JAMA 22 Apr 1998;279(16):1239-1240.
  3. Hanioka T, Tanaka M, Ojima M, Shizukuishi S, Folkers K. Effect of topical application of coenzyme Q10 on adult periodontitis. Mol Aspects Med. 1994;15 Suppl:s241-248.
  4. Hansen IL, Iwamoto Y, Kishi T, Folkers K, Thompson LE.  Bioenergetics in clinical medicine. IX. Gingival and leucocytic deficiencies of coenzyme Q10 in patients with periodontal disease. Res Commun Chem Pathol Pharmacol. 1976 Aug;14(4):729-38.
  5. Wilkinson EG, Arnold RM, Folkers K, Hansen I, Kishi H. Bioenergetics in clinical medicine. II. Adjunctive treatment with coenzyme Q in periodontal therapy. Res Commun Chem Pathol Pharmacol. 1975 Sep;12(1):111-23.
  6. Mallek HM, Nakamoto T. Dilantin and folic acid status. Clinical implications for the periodontist. J Periodontol. 1981;52(5):255-259.
  7. Pack ARC, Thomson ME. Effects of folic acid (FA) supplementation on gingivitis in pregnancy. New Zealand Dent J. 1979;75(342):22.
  8. Vogel RI, Fink RA, Schneider LC, Frank O, Baker H. The effect of folic acid on gingival health. J Periodontol. 1976 Nov;47(11):667-668.
  9. Zubarev ON, Sharaev PN. The effect of vicasol and pelentan on the biopolymers of the periodontium. Eksp Klin Farmakol. 1992 Sep-Oct;55(5):60-61.
  10. Goyette N, Parrot M, Sutzescu D, Leduc M, Dufour L, Trahan L, Lavoie MC. Inverse correlation between the proportion of salivary bacteria inhibiting S mutans and the percentage of untreated carious teeth. J Oral Pathol Med. 1995 Nov;24(10):462-467.
  11. Khmelevskii IuV, Danilevskii NF, Borisenko AV, Poberezkina NV. Effect of Vitamins A, E and K on the indices of the glutathione antiperoxide system in gingival tissues in periodontosis. Vopr Pitan. 1985 Jul-Aug;(4):54-6.
  12. Fosdick L. J Dent Res. 1948;27:235-241.
  13. Berg M, Fosdick LS. Studies in periodontal disease. II. Putrefactive organisms in the mouth. J Dent Res. 1946;25:73-78.
  14. Fosdick L. J Canad Dent Assoc. 1943;9:359-366.

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