Periodontal disease begins with gum inflammation and progresses to pockets of infection, bone loss, and loosening of the teeth. It is present in 90% of individuals over the age of 65.
Conventional prevention and treatment include regular flossing, using mouthwash that contains extracts of the herb thyme (such as thymol, found in Listerine), and using special toothbrushing appliances. If the condition becomes advanced, special deep-cleaning techniques and even surgery may be necessary.
According to one small, double-blind, placebo-controlled study, the supplement lycopene, taken at a dose of 8 mg per day, may be helpful for the treatment of periodontal disease, whether taken alone or used to augment the effectiveness of standard treatment.22
One double-blind study of 89 people tested a European herbal mouthwash (used with a special gum irrigator) containing chamomile, echinacea, myrrh, mint, sage, and ratania.12 The herbal preparation proved more effective than a conventional mouthwash at reducing gingival inflammation.
Oligomeric proanthocyanidins (OPCs) have antioxidant and anti-inflammatory properties. A 14-day, double-blind, placebo-controlled trial of 40 people evaluated the potential benefits of a chewing gum product containing 5 mg of OPCs from pine bark.9 Use of the OPC gum resulted in significant improvements in gum health and reductions in plaque formation; no similar benefits were seen in the placebo group.
A double-blind study of 30 people found weak evidence that use of borage oil (a source of GLA) at a dose of 3,000 mg daily may reduce gingival inflammation.13 The study also examined fish oil at a dose of 3,000 mg daily, or combined fish oil and borage oil at the dose of 1,500 mg each, but failed to find significant benefits with these treatments as compared to placebo.
Other natural dental products that have shown promise in small double-blind studies include a toothpaste containing Macleya cordata (plume poppy) and Prunella vulgaris (also known as heal-all or self-heal),14 a chew candy containing green tea,7 an irrigation fluid containing propolis extract,15 a toothpaste containing sea cucumber,16 and a gel containing tea tree oil.17
Preliminary studies suggest that folate mouthwash may help in periodontal disease. Oral folate supplementation does not appear to be especially effective.1-4 However, one small double-blind study found potential benefit with a mixed B-complex supplement (containing 50 mg of each of thiamin, riboflavin, niacinamide, pantothenate, and pyridoxine; 50 mcg each of biotin and vitamin B12; and 400 mcg of folate) .18
One test tube study suggests that cranberry juice might be useful for treating or preventing gum disease.5 However, there is one kink to work out before cranberry could be practical for this purpose: the sweeteners added to cranberry juice are not good for your teeth, but without them cranberry juice is very bitter.
Xylitol is a naturally occurring sugar that appears to help suppress the development of cavities when it is used in gum, candy, or toothpaste. Highly preliminary evidence suggests that it may help prevent gum disease, as well.8
A thorough review of 11 randomized, controlled trials found that the use of mouth rinses containing essential oils is effective against gingivitis and dental plaque formation when used in combination with regular oral hygiene.23 In one double-blind study, chewing gum containing eucalyptus extract was more beneficial for moderate gingivitis compared to a placebo gum.24
A study failed to find that an herbal mouthwash containing the herb mangosteen significantly improved gum health.20
A mouthwash containing a type of green algae called E. linza proved to be similar to the commercial product Listerine in reducing gum bleeding, swollen gums, and plague in patients with gingivitis.25
Other treatments sometimes proposed for periodontal disease, but that lack meaningful scientific support, include beta-glucan, bioflavonoids, bloodroot, calcium, caraway, magnesium, vitamin C, witch hazel, and zinc.
1. Pack AR. Folate mouthwash: effects on established gingivitis in periodontal patients. J Clin Periodontol. 1984;11:619-628.
2. Thomson ME, Pack AR. Effects of extended systemic and topical folate supplementation on gingivitis of pregnancy. J Clin Periodontol. 1982;9:275-280.
3. Pack AR, Thomson ME. Effects of topical and systemic folic acid supplementation on gingivitis in pregnancy. J Clin Periodontol. 1980;7:402-414.
4. Vogel RI, Fink RA, Frank O, et al. The effect of topical application of folic acid on gingival health. J Oral Med. 1978;33:20-22.
5. Weiss EI, Lev-Dor R, Kashamn Y, et al. Inhibiting interspecies coaggregation of plaque bacteria with a cranberry juice constituent. JADA. 1998;129:1719-1723.
6. Watts TL. Coenzyme Q 10 and periodontal treatment: is there any beneficial effect? Br Dent J. 1995;178:209-213.
7. Krahwinkel T, Willershausen B. The effect of sugar-free green tea chew candies on the degree of inflammation of the gingiva. Eur J Med Res. 2000;5:463-467.
8. Makinen KK, Pemberton D, Makinen P-L, et al. Polyol-combinant saliva stimulants and oral health in Veterans Affairs patients—an exploratory study. Spec Care Dent. 1996;16:104-115.
9. Kimbrough C, Chun M, dela Roca G, et al. PYCNOGENOL chewing gum minimizes gingival bleeding and plaque formation. Phytomedicine. 2002;9:410-413.
10. Kopczyk RA, Abrams H, Brown AT, et al. Clinical and microbiological effects of a sanguinaria-containing mouthrinse and dentifrice with and without fluoride during 6 months of use. J Periodontol. 1991;62:617-22.
11. Kuftinec MM, Mueller-Joseph LJ, Kopczyk RA. Sanguinaria toothpaste and oral rinse regimen clinical efficacy in short- and long-term trials. J Can Dent Assoc. 1990;56(suppl 7):31-33.
12. Pistorius A, Willershausen B, Steinmeier EM, et al. Efficacy of subgingival irrigation using herbal extracts on gingival inflammation. J Periodontol. 2003;74:616-22.
13. Rosenstein ED, Kushner LJ, Kramer N, et al. Pilot study of dietary fatty acid supplementation in the treatment of adult periodontitis. Prostaglandins Leukot Essent Fatty Acids. 2003;68:213-218.
14. Adamkova H, Vicar J, Palasova J, et al. Macleya cordata and Prunella vulgaris in oral hygiene products—their efficacy in the control of gingivitis. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2004;148:103-105.
15. Gebaraa EC, Pustiglioni AN, de Lima LA, et al. Propolis extract as an adjuvant to periodontal treatment. Oral Health Prev Dent. 2005;1:29-35.
16. Taiyeb-Ali TB, Zainuddin SL, Swaminathan D, Yaacob H. Efficacy of 'Gamadent' toothpaste on the healing of gingival tissues: a preliminary report. J Oral Sci. 2003;45:153-159.
17. Soukoulis S, Hirsch R. The effects of a tea tree oil-containing gel on plaque and chronic gingivitis. Aust Dent J. 2004;49:78-83.
18. Neiva RF, Al-Shammari K, Nociti FH, et al. Effects of vitamin-B complex supplementation on periodontal wound healing. J Periodontol. 2005;76:1084-1091.
19. English HK, Pack AR, Molan PC. The effects of manuka honey on plaque and gingivitis: a pilot study. J Int Acad Periodontol. 2004;6:63-67
20. Rassameemasmaung S, Sirikulsathean A, Amornchat C, et al. Effects of herbal mouthwash containing the pericarp extract of Garcinia mangostana L. on halitosis, plaque, and papillary bleeding index. J Int Acad Periodontol. 2007;9:19-25.
21. Shinada K, Tagashira M, Watanabe H, et al. Hop bract polyphenols reduced three-day dental plaque regrowth. J Dent Res. 2007;86:848-851.
22. Chandra RV, Prabhuji ML, Roopa DA, et al. Efficacy of lycopene in the treatment of gingivitis: a randomised, placebo-controlled clinical trial. Oral Health Prev Dent. 2007;5:327-336.
23. Patel RM, Malaki Z. The effect of a mouthrinse containing essential oils on dental plaque and gingivitis. Evid Based Dent. 2008;9:18-19.
24. Nagata H, Inagaki Y, Tanaka M, et al. Effect of eucalyptus extract chewing gum on periodontal health: a double-masked, randomized trial. J Periodontol. 2008;79:1378-1385.
25. Cho HB, Lee HH, Lee OH, Choi HS, Choi JS, Lee BY. Clinical and microbial evaluation of the effects on gingivitis of a mouth rinse containing an Enteromorpha linza extract. J Med Food. 2011;14(12):1670-1676.
Last reviewed September 2014 by EBSCO CAM Review Board
Last Updated: 9/18/2014