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Glutathione Antioxidants, Periodontal Disease and Atherosclerosis in Senescence

Theodore Hersh, MD, MACG
Professor of Medicine, Emeritus, Emory University
Chairman, Thione International, Inc

Epidemiologic studies have revealed the association and prevalence of gingival (gum) disease and coronary artery disease in the elderly. There is nearly a three fold increase of heart disease in patients with gingivitis and periodontitis, independent of risk factors such as tobacco abuse. Blood and tissue levels of glutathione, the body’s pivotal antioxidant, and its synergistic partners tend to be decreased in the elderly and have been related to early senescence and geriatric conditions. The free radicals generated in the inflammation of periodontal disease promote the oxidation of low density lipo-proteins and thereby enhance the development of atherosclerosis. Local and systemic repletion of glutathione and its synergistic partners help repair gingival disease and thus may decrease the risks of atherosclerosis in the elderly, another anti-aging function of glutathione.

In the oral cavity, glutathione has been shown to promote the normal process of attachment, spreading and growth of gingival fibroblasts, vital in periodontal tissue repair. Tobacco, whether smoked or chewed, and betel quid chewing, worldwide health problems, inhibit these mechanisms and locally deplete intracellular glutathione levels. Through these injurious free radicals, the noxious factors interfere with collagen synthesis and cause DNA mutations which increase the risks of oro-pharyngeal malignancies. Repletion with glutathione and its endogenous antioxidant partners abolishes the damaging effects of the free radicals on the periodontal tissues, thereby promoting normal functioning gingival fibroblasts, decreasing the inflammation and enhancing collagen synthesis for gum repair.

Periodontal disease results from invasion of pathogenic micro-organisms and bacterial toxins in the gingiva causing both inflammation and destruction of the connective tissue. These generate toxic free radicals which aggravate gingival problems while both bacteria and free radicals may contribute to inflammation of arterial walls and oxidation of low density lipo-proteins, linking gum disease to atherosclerosis. The elderly are greatly afflicted by periodontal disease and loss of teeth, a condition which complicates coronary heart diseases. Oxidative stress also accelerates gingival disease in elderly diabetic patients and promotes the vascular complications of diabetes.

Local antibacterial therapy and odontologic procedures are mandatory to help heal gingivitis and periodontitis.The administration of antioxidants, low in senescent subjects, are adjuncts in the management of gingival disease. Healthy gums thus may equate to a healthy heart; and glutathione therapy with its synergistic antioxidants may then maximize longevity.

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