GUM STORIES

Head tilted back, mouth stretched to the max to accommodate fingers, cotton, and something metallic and vaguely medieval, my plaque was sandblasted to smithereens. My dentist wrinkled his nose and peered inside, cocked an eye, and remarked, “You have very youthful gums.” 

I cannot deny my unalloyed pleasure hearing this. I’d been thinking about aging recently, recalling actress Bette Davis’ warning, “Old age is not for sissies.” I’d noticed my eyes resembling the hound of the Baskervilles, spots on the back of my hands spreading like pond scum, and my muscles, deprived of their once inexhaustible supply of testosterone, were now unresponsive to endless reps on Nautilus machines. 

So I was pleased, really, with this compliment to my gums and answered an enthusiastic “Neeennngowgggrrth,” meaning, “Really? Wow, great!” 

He understood immediately, “Yes, really. Good job.” An experienced dentist can translate the stuffed-mouth garble of patients with the alacrity of a UN interpreter. 

“Mmmggghh. Aaahgg. Ghhrrgh.” Enough. I’ll simply translate myself directly.

I wanted to say, “Anyone can do it”.

As a quick aside, though I’m a physician and over the years have seen just about everything that might make a non-medical person recoil with dread, for me personally my toes curl in horror at the idea of gum scaling and its evil twin, root planing. Just the thought of anyone digging deeply around my teeth with a sharp object…wait. I’m pausing to recover before I continue.

While Phillip Roth’s 1995 novel, Sabbath’s Theatre, garnered generally positive reviews and ultimately won the National Book Award for Fiction; one critic remarked that it contained something to offend just about everyone. I had no issues with the explicit sex scenes, misanthropy, perversions, and foul language. What was unforgettable to me is that one character was a periodontist and several paragraphs were (excruciatingly) devoted to the details of gum scraping. 

The novel drove my gum diligence to even higher levels. 

I know this was all a series of coincidences, but last week, three patients over three days began launching into issues about their gums. Either they were being scheduled for extensive (and expensive) gum surgery or had completed some apparently very painful (and expensive) surgery which had not lived up to expectations and more was anticipated or they were on a quest for multiple opinions on the necessity of surgery in the first place. 

Periodontists limit their practice to surgery on your gums and their vehicle of choice is the Lexus LX 600. The commonest procedures are a gingivoplasty (reconfigure your gums), gingivectomy (removal of gum tissue), gum contouring, gum grafting, crown lengthening, and pocket reduction. Yikes! 

But before you find yourself seeing a periodontist, wondering if your dental insurance will cover any of whatever he is talking about (“Did he just say, also some implants?”), you and your dentist can look for signs of gingivitis, gum inflammation, which can lead to “periodontitis”. 

Periodontitis follows untreated gingivitis and can be serious. It can destroy the supporting structures of the teeth, including the alveolar bone. Periodontitis is one of many major causes of tooth loss in American adults and is entirely preventable with proper oral health habits. Since the dental specialists who treat this condition, periodontists, are quite expensive, as you refinance your condo to pay your bill, you’ll think, “If I had only brushed and flossed, none of this would be happening.”

Symptoms of periodontitis: 

• Gums that bleed easily, 
• Red, swollen, or tender gum tissues, 
• Gums that pull away from your teeth, 
• Pus between your teeth and gums, 
• Loose teeth, 
• Sensitive teeth, 
• Changes in the natural bite alignment, 
• Persistent bad breath. 

Consider chronic gum disease (which can begin in childhood and be present for decades) as a constant source of infection seeding bacteria into your bloodstream. Your immune system responds with steady state inflammation, irritating the linings of your blood vessels and rendering them susceptible to deposits of cholesterol. 

Here’s a list of conditions known to be significantly higher among patients with chronic gingivitis and periodontitis: 

• Cardiovascular diseases (strokes, heart attacks, vascular dementia),
• Alzheimer’s Disease (from chronic inflammation), 
• Certain cancers (mouth, tongue, esophagus, stomach, pancreas),
• Diabetes, 
• Autoimmune diseases, 
• Increased fatality from COVID infection, 
• Increased pregnancy complications and birth defects. 

So, anyone with a sand grain of intelligence who reads this list can see the connection between healthy gums and longevity. Skeptics can read this link from the New York Times, “Healthy Gums May Signal a Longer Life.”

Keeping your Gums Healthy: the Prevention Protocol 

First, everything you already know. Stop smoking (does anyone still smoke?), for antioxidants eat fresh fruit and veggies, for omega-3s eat fish (or take fish oil capsules), for calcium eat dark green leafy veggies and dairy, and slash your intake of sugar and sugary foods. 

Also: 

• Floss twice daily. 
• Choose a toothpaste specifically designed for gum health. PerioBiotic contains a strain of Lactobacillus that gets rid of a harmful Streptococcus mutans, which proliferates in chronic gum disease. 

The most important supplements for preventing gum disease are: 

• Vitamin D, 5,000 IU daily (you can get your D level tested to determine if you need an even higher dose). 
• UBQH (high potency CoQ10), 100 daily. 
• B complex, once daily. 

Reversing Gum Disease 

You’ve just heard, “Looks like we have some gingivitis here. Might need to see a periodontist.” 

Your thoughts freeze. The hygienist no longer makes eye contact with you, turns away, busying herself with her tools. You know friends who have had gum surgery and you don’t want it yourself.

“Oh, God,” you think. “There must be something I can do.” There is. Many cases of gingivitis can be reversed with a few diligent weeks engaged in the following daily ritual. 

First stock up on these supplies some of which are available in WholeHealth Chicago’s Apothecary. We can mail them to you: 

• Liquid folate 
• Vitamin C powder 
• Vitamin E capsules 
• Q-tips 
• A soft toothbrush (“Baby’s First Toothbrush”) 

On Mondays, Wednesdays, and Fridays 

After flossing and brushing your teeth, switch to the soft toothbrush and gently brush your gums. At bedtime, pierce one vitamin E capsule with a pin, squeeze the oil onto your fingertip, and massage it into your gums, inside and out. Then, using the Q-tip, paint your gum line (top and bottom) with the liquid folic acid. 

On Tuesdays, Thursdays, and the weekends 

Floss and brush as usual. Then, switching to the soft brush, pour a little of the powdered C into your hand and use it as a tooth powder to brush. Gently brush your gums inside and out. Rinse and paint your gum line with folic acid as described above. 

You should see improvement within three or four weeks. When your gums are healed, you can drop this ritual and return to the prevention protocol. Think of the pleasure you’ll experience when your dentist says, “Looks like we can skip that periodontist referral.” 

Be well,

David Edelberg, MD