Forget apples, eating fish and nuts are the way to keep the doctor and the dentist away…

GumsIs there no end to the benefits bestowed upon us by the multi-talented good fats?

The old saying goes ‘an apple a day keeps the doctor/ dentist away – delete former/latter depending on your generation. But there seems to be something which can knock any fruit or vegetable into a cocked hat: yes, the humble polyunsaturated fatty acids (PUFAs).

A new piece of research has suggested that Omega 3 fatty acids found in foods such as oily fish, nuts and eggs will help people avoid gum disease and the more serious periodontitis.

The research examined the diet of 182 adults between 1999 and 2004, and found that those who consumed the highest amounts of fatty acids were a whole 30 per cent less likely to develop gum disease and 20 per cent less likely to develop periodontitis (severe gum disease).

Lead researcher of the study, Dr Asghar Z. Naqvi of Beth Israel Deaconess Medical Centre in Boston, said: “We found that n-3 fatty acid intake, particularly docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are inversely associated with periodontitis in the US population.”

As a result of this research, Dr Naqvi believes that dietary therapy could become a less expensive and safer way of preventing/treating periodontitis. Currently treatment involves mechanical cleaning and the application of antibiotics. Encouraging sufferers to eat more fish and nuts would also benefit their health in other ways.

Chief Executive of the British Dental Health Foundation, Dr Nigel Carter, said: “Most people suffer from gum disease at some point in their life. What people tend not to realise is that it can actually lead to tooth loss if left untreated… This study shows that a small and relatively easy change in people’s diet can massively improve the condition of their teeth and gums, which in turn can improve their overall wellbeing.”

The study was published in the November issue of the Journal of the American Dietetic Association.

Gum disease is caused by plaque (the film of bacteria that forms on the surface of the teeth). To prevent and treat gum disease all the plaque must be removed from the teeth every day by brushing twice a day for two minutes each time. This should be followed by cleaning in between teeth with interdental brushes or floss.

Inflammation and soreness of the gums is one of the first signs of gum disease, and often gums bleed when they are brushed during cleaning. You will notice your gums look puffy and inflamed where they meet your teeth.

Over time gum disease becomes more severe and can impact the tissues supporting the teeth. The bone anchoring the teeth in the jaw is lost and the teeth become loose, if not treated this can lead to teeth eventually falling out. 

Anyone with inflamed and bleeding gums should visit their dentist to find out the appropriate way to treat it. If caught early, gum disease can be easily cured by short term use of medicated gels and mouthwash.

The British Dental Health Foundation is the UK’s leading oral health charity, with a 39-year track record of providing public information and influencing government policy. It maintains a free consumer advice service, an impartial and objective product accreditation scheme, publishes and distributes a wide range of literature for the profession and consumers, and runs National Smile Month each May, to promote greater awareness of the benefits of better oral health.

The Dental Helpline, which offers free impartial advice to consumers, can be contacted on 0845 063 1188 between 9am and 5pm, Monday to Friday. Alternatively, they can be contacted by email on

The Foundation’s website can be found at



Gum Disease – animation and Qs & As



Q What is gum disease?

A Gum disease describes swelling, soreness or infection of the tissues supporting the teeth. There are two main forms of gum disease: gingivitis and periodontal disease.

Q What is gingivitis?

A Gingivitis means inflammation of the gums. This is when the gums around the teeth become very red and swollen. Often the swollen gums bleed when they are brushed during cleaning.
Q What is periodontal disease?

A Long-standing gingivitis can turn into periodontal disease. There are a number of types of periodontal disease and they all affect the tissues supporting the teeth. As the disease gets worse the bone anchoring the teeth in the jaw is lost, making the teeth loose. If this is not treated, the teeth may eventually fall out.
Q Am I likely to suffer from gum disease?

A Probably. Most people suffer from some form of gum disease, and it is the major cause of tooth loss in adults. However, the disease develops very slowly in most people, and it can be slowed down to a rate that should allow you to keep most of your teeth for life.
Q What is the cause of gum disease?

A All gum disease is caused by plaque. Plaque is a film of bacteria, which forms on the surface of the teeth and gums every day. Many of the bacteria in plaque are completely harmless, but there are some that have been shown to be the main cause of gum disease. To prevent and treat gum disease, you need to make sure you remove all the plaque from your teeth every day. This is done by brushing and flossing.
Q What happens if gum disease is not treated?

A Unfortunately, gum disease progresses painlessly on the whole so that you do notice the damage it is doing. However, the bacteria are sometimes more active and this makes your gums sore. This can lead to gum abscesses, and pus may ooze from around the teeth. Over a number of years, the bone supporting the teeth can be lost. If the disease is left untreated for a long time, treatment can become more difficult.
Q How do I know if I have gum disease?

A The first sign is blood on the toothbrush or in the rinsing water when you clean your teeth. Your gums may also bleed when you are eating, leaving a bad taste in your mouth. Your breath may also become unpleasant.
Q What do I do if I think I have gum disease?

A The first thing to do is visit your dentist for a thorough check-up of your teeth and gums. The dentist can measure the ‘cuff’ of gum around each tooth to see if there is any sign that periodontal disease has started. X-rays may also be needed to see the amount of bone that has been lost. This assessment is very important, so the correct treatment can be prescribed for you.
Q What treatments are needed?

A Your dentist will usually give your teeth a thorough clean. You’ll also be shown how to remove plaque successfully yourself, cleaning all surfaces of your teeth thoroughly and effectively. This may take a number of sessions with the dentist or hygienist.
Q What else may be needed?

A Once your teeth are clean, your dentist may decide to carry out further cleaning of the roots of the teeth, to make sure that the last
pockets of bacteria are removed.

You’ll probably need the treatment area to be numbed before
anything is done. Afterwards, you may feel some discomfort for up to 48 hour.
Q Once I have had periodontal disease, can I get it again?

A Periodontal disease is never cured. But as long as you keep up the home care you have been taught, any further loss of bone will be very slow and it may stop altogether. However, you must make sure you remove plaque every day, and go for regular check ups by the dentist and hygienist.

Fatal fangs – is your mouth making you ill?


Cosmetic dentist Nik Sisodia on the increasing evidence to link poor oral hygiene with heart disease, stroke and premature births

Gum disease affects 70% of the population in varying degrees. In its mildest form, gingivitis, the tissues of the gum surrounding the teeth become inflamed and bleed.

Left untreated this may progress to more advanced forms of the disease known as peridonitis where the gums shrink and teeth may fall out. But increasingly gum health is now seen as a marker for more serious health problems including cardiovascular disease and diabetes. It is also increasingly implicated in problems in pregnancy such as premature births and underweight babies.

So the extent of gum disease in the general population is a real and growing health concern. US statistics reveal that by the age of 17 60% of the population have early signs of the disease and by the age of 50 this translates to periodontal disease for 70-80% of the population, with half suffering the severest form.

In the past research attempted to investigate the cause of gum disease but more recently the emphasis has switched its affect general health and its links to several serious illnesses. The evidence points to an assault on the body’s immune system from the bacterial infection in the mouth as a result of gum disease which leads to a degeneration in general health.

If we look at the total surface area of the roots of a full complement of adult teeth, the area is approximately equivalent to the size the forearm. If you then imagine this whole area is teaming with a cocktail of millions of bacteria which the body is fighting off on a 24-hour basis, you can imagine how this might undermine the immune system.

Cardiovascular Disease

In the US research indicates that gum disease is a risk factor for atherosclerosis (furring of the arteries) and thromboembolic (blood clotting) incidences. In other words gum disease increases the risk of stroke and coronary heart disease.

Again the theory is that the bacterial load placed on the body together with the fact that some individuals have a greater predisposition to a heightened inflammatory response leads to both gum and cardiovascular problems.

So it is prudent for all of us to take preventative oral hygiene measures, as well as sophisticated diagnostic tests that screen for levels of certain substances associated with heightened health risk, such as that for the protein homeocysteine, which is implicated in both cardiovascular disease and Alzheimer’s. Bacterial analyses can also be carried out.

It is now accepted that treatment of gum disease can lead to an improvement in cardiovascular health and that the health of a patient’s gums is now seen as a risk marker for heart disease. Smoking is another modifiable risk factor for both gum and cardiovascular diseases. Scientists at the University of Helskinki recently concluded that gum disease can no longer be considered just a local problem but one for the health of the whole body.

Premature births and foetal development

Gum disease is increasingly implicated in adverse pregnancy outcomes such as premature births. The University of North Carolina identified it as a significant risk factor for preterm labour, premature rupture of membranes, small-for-gestational-age (babies who are smaller than expected even for premature babies) and low birth weight babies. Additional research at Tulane University in New Orleans in three clinical trial studies determined that the treatment of the gum condition led to a 57% reduction of preterm low birth weight and more significantly a 50% reduction in preterm births.


Evidence now suggests that severe untreated gum disease increases the risk of diabetic complications, and that these symptoms can be alleviated by treatment. It is thought that uncontrolled severe periodontal disease has an adverse effect on sugar levels and that anyone with a family history of diabetes is advised to take a blood test.

General medical physicians do not usually examine or screen their patients for signs of gum disease, but given the mounting evidence implicating it in many of the diseases of ageing they should.

Dr Sisodia is in private practice in London and serves as Congress Director for the British Academy of Cosmetic Dentistry. Contact info: or alternatively visit the practice website


Types of Oral Bacteria
• Bacteria in the human mouth fall into two categories – (a) ‘planktonic’ or free-floating bacteria, which can be found in the saliva in the mouth, and (b) ‘biofilm’, the bacteria that colonise on the hard surfaces of the mouth, such as teeth, to form plaque
• Bacteria in the mouth feed on leftover food particles and some, such as the cavity-causing Streptococcus mutans, produce acid that attacks teeth, causing decay
• Anaerobic bacteria produce enzymes and toxins as by-products, which damage and irritate the gums causing inflammation and bleeding. If left untreated gum disease can lead to tooth loss
• Bad breath is also caused by anaerobic bacteria, which live predominantly on the tongue and produce sulphurous odours

Shocking Facts
• The human mouth harbours up to 300 different types of bacteria (see image right) and the amount of total bacteria in the average mouth is estimated to be around the ten billion mark
• There are more bacteria in your mouth than there are people on Earth
• The average toilet seat harbours fewer bacteria per square centimetre than the human mouth!
• Right now there are more bacteria in your mouth than on a standard banknote

Oral Hygiene Facts
• Brushing only reaches 60% of the surfaces of your teeth, leaving plaque in hard to reach areas such as in-between teeth
• Teeth represent only 25% of the surface of your mouth and bacteria live throughout the whole mouth. When you stop brushing, bacteria left behind re-settle on your teeth and gums
• Due to its liquid action, a mouthwash reaches virtually 100% of the mouth, thereby attacking and killing bacteria across the whole mouth

Bacteria facts provided by Listerine Bacterial Mouthwash. For more information

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Public unaware of gum health

New York: US consumers named having “whiter teeth” or a “better smile” most often when asked to list the benefits of practicing good oral hygiene, despite a growing body of evidence that suggests that the gum disease gingivitis, if allowed to progress to periodontitis (advanced gum disease), may increase one’s risk for broader health problems over time.

There are several explanations for a possible causal relationship between oral health and overall health. The scientific community is still exploring and debating this potential connection, examining the role of germs that cause periodontitis (advanced gum disease), chronic inflammation of the gums resulting from periodontitis, genetics and lifestyle habits, such as smoking.

Nearly 100 percent of dental professionals (98 percent) and physicians (91 percent) indicate that they believe that there is a link between oral health and overall health, and many are already trying to educate consumers about the mouth-body association. In fact, 65 percent of physicians and 94 percent of dental professionals surveyed reported that they are discussing the association between poor oral health and broader health problems with at least some of their patients.

The makers of Listerine this week launched a print advertising campaign to help educate consumers on the association between oral health and overall health as well as to remind consumers of the benefits of a twice-daily rinse with Listerine Antiseptic.

“It’s great to see that physicians as well as dentists are informing their patients about this emerging science, but we also need to take it a step further by recommending immediate actions that our patients can take to make a difference,” says nationally recognized dentist Dr. Gregg Lituchy, a pioneer in the dental health field. “My patients appreciate it when I can recommend simple ways to achieve improvement in their oral care. For example, in addition to regular visits to the dentist, twice-daily brushing and once-daily flossing, I recommend rinsing with Listerine for 30 seconds twice a day, which has been shown to reduce significantly more plaque and gingivitis when added to brushing and flossing. That’s a small time commitment, but a big win.”

In addition, physicians should encourage their patients to make regular visits to their dental professional so that they may detect early any oral health problems, which can be a sign of other health problems.

While more than 80 percent of consumers surveyed reported brushing their teeth two or more times a day, only 56 percent said they regularly floss and 60 percent use an antiseptic mouthrinse such as Listerine(R) Antiseptic.

Dental professionals surveyed named gum diseases (gingivitis and periodontitis) more frequently than cavities when asked to list the most common oral health issues their patients face.

More about the mouth-body connection

There are several possible explanations for the link between oral health and overall health. One theory involves the germs that cause advanced gum disease (periodontitis). Another theory points to the potential effects of chronic inflammation of the gums caused by advanced gum disease. In any event, genetics or bad habits, such as smoking, may increase the chances of both poor oral health and poor overall health.

“The connection between poor oral health and broader health problems is not yet completely understood. We do know, however, that periodontitis is a bacterial infection, characterized in part by inflammation of the gums,” says William Meggs, M.D., author of The Inflammation Cure and professor and chief of the Division of Toxicology, and vice chair for Clinical Affairs for the Department of Emergency Medicine at the Brody School of Medicine at East Carolina University School of Medicine in Greenville, North Carolina. “Many experts believe that inflammation, in the mouth and elsewhere in the body, is a common thread linking a broad range of health problems.”

While the nature of the link is not yet fully understood and no cause-and-effect relationship has been established, what has been shown is that some sort of an association exists between oral health and overall health, and that both dental professionals and physicians agree that it is a good idea to maintain the health of your mouth, including your gums.

About the Surveys

The surveys, with a focus on the association between oral health and overall health, were conducted in May 2006, interviewing a nationwide sample of 1,001 U.S. adults 18 years of age and older and 301 medical doctors and 303 dentists. Data for the total sample were weighted to be representative of the total U.S. adult population on the basis of region, age within gender, education, household income, and race/ethnicity. The surveys were sponsored by Pfizer Consumer Healthcare, makers of Listerine Antiseptic.

About Plaque and Gum Disease

Plaque, a soft, sticky film of bacteria, is directly responsible for the development of gingivitis, an early and reversible form of gum disease. When the bacteria that cause plaque stick to the teeth and gum tissue and multiply, the tissue becomes infected and inflamed, and the gums become red, swollen and sometimes bleed easily. More than half of Americans have some form of gingivitis, but because it’s painless, many people don’t realize they have it.

If left untreated, gingivitis can lead to the advanced gum disease periodontitis, which when left untreated can lead to eventual tooth loss. Periodontitis also is difficult to detect, because it is often painless. Up to 15 percent of adults will experience the severe form of this disease. The best way to determine whether or not you have gingivitis or periodontitis is to see your dentist.

About Listerine

Listerine Antiseptic is the number one dentist-recommended brand of mouthrinse and the only major brand name over-the-counter mouthrinse that carries the American Dental Association (ADA) Seal of Acceptance. Made by Pfizer Consumer Healthcare, Listerine contains a fixed combination of four essential oils and is clinically proven to kill germs that cause bad breath and to help prevent or reduce plaque and gingivitis. Listerine is not indicated for the treatment of periodontitis. To learn more about Listerine Mouthwash and to further explore the mouth-body connection, visit

About Pfizer

Pfizer Inc discovers, develops, manufactures and markets leading prescription medicines for humans and animals and many of the world’s best-known consumer products. The Consumer Healthcare division of Pfizer, headquartered in Morris Plains, New Jersey, is the world’s second-largest consumer healthcare company, with a portfolio of market-leading brands that also includes Purell(R), Neosporin(R), Benadryl(R), Sudafed(R), Visine(R), and Rogaine(R).