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Smokers and Periodontal Disease: The Role
of Antioxidant Therapy
Dentists and other professionals involved with the science of oral
hygiene have dealt with a number of symptoms and pathologies of
the mouth, gum and teeth. Periodontal disease, which includes inflammation
of the gums, is one of the most prevalent health problems in the
world and is the major cause of tooth loss in the adult population.
Compelling evidence indicates that periodontitis is initiated and
exacerbated through tobacco consumption, both smoked and chewed,
and may be responsible for more than half of the periodontitis cases
among adults in the United States.
Tobacco, whether smoked as cigarettes, cigars or pipe or used as
smokeless tobacco, causes devastating effects in the oral cavity.
Tobacco smoke has two chances to exert its deleterious effects in
the mouth – first, when it is inhaled by the smoker, and second,
on its exit during exhalation. In addition to the destruction it
does to the gums (gingivitis and periodontitis), smokers have more
dental calculus than non-smokers and suffer from increased discoloration
of the teeth and bad breath. Over 30,000 new cases of cancer of
the oral cavity are diagnosed annually. Oral cancer also kills 8,000
patients each year and only half of the cases diagnosed annually
have a five year survival. The good news here is that by understanding
exactly how periodontal disease and oral cancers develop, we can
begin to take measures to prevent and interfere with the destructive
path of these diseases. Prior attempts to treat diseases of the
gingiva and oral cavity have failed for they have not recognized
the role played by toxic molecules known as “free radicals”
and the healing and protective benefits of the endogenous antioxidant
Periodontal disease is caused by inflammation and infection in
both the gingiva and the connective tissue that supports the teeth.
There is initially an inflammation in the local blood vessel walls,
which accounts for the most common sympton of bleeding gums. This
is also accompanied by migration of white blood cells to help combat
the tissue invasion by pathogenic mouth bacteria. During this inflammatory
reaction, most cells liberate histamine and also locally generate
countless toxic free radicals, both of which contribute to tissue
pathology. Collagen production may also then be interfered with
due to local vitamin C deficiency, which contributes to the swelling
and redness of gum tissues.
Cigarette smoke is divided into two phases, tar and gas-phase smoke.
Cigarette tar contains high concentrations of free radicals, however,
the cigarette filter acts as a “trap” for the free radicals
in cigarette tar. By comparison, each puff of a cigarette in the
gas-phase smoke is said to contain 1015 of toxic free radicals.
The filter does not currently protect the smoker (or the secondary
smoker) from these free radicals and left unchecked, these billions
of free radicals are free to induce inflammatory reactions (resulting
in periodontal disease), destroy cell structure and function and
damage DNA, all of which are implicated in oro-pharyngeal diseases
Thankfully, the body has a built-in system of defense from these
toxic free radicals – antioxidants. Antioxidants scavenge
and neutralize free radical species to a less toxic or non-toxic
compound. Antioxidants have also been found to inhibit all stages
of carcinogenesis. However, when the body’s built-in antioxidant
defense system fails to suppress uncontrolled toxic free radicals
in the body due to either an overwhelming production of free radicals
such as from smoking or a depletion of critical compounds used by
the body’s antioxidant defenses, the body goes into a state
of “oxidative stress.” Since oxidative stress leads
to disease, free radicals are considered to be contributors to over
fifty prevalent and chronic diseases, including cardiovascular disease,
immune disorders, neurodegenerative diseases, premature aging and
a variety of cancers. Indeed, periodontal disease is now considered
a risk factor for atherosclerosis through the genesis of oxidative
stress on the vascular tree.
The state of oxidative stress is remedied by increasing antioxidants
through diet (fruits and vegetables) and by antioxidant supplements.
Reduction of the noxious stimulus of free radicals, such as through
the elimination of tobacco abuse, likewise will reduce this oxidative
stress. While there are numerous antioxidants within the body, however,
the latest scientific studies reveal two critical points: (1) all
antioxidants are not equal; and (2) combinations of synergistic
antioxidants are far superior to singular antioxidants.
While each of the many antioxidants in the body play a role in
ridding the body of excess free radicals, it is the antioxidant
known as glutathione that acts as “commander in chief.”
Glutathione is found in body fluids and in every cell in the body.
Working intra and extra-cellularly in its reduced form, glutathione
acts as the body’s key antioxidant, detoxificant and protectant.
It is the gatekeeper in the respiratory tract and lining of the
gut and has multiple functions in disease prevention and in detoxification
of chemicals and drugs. The body uses glutathione to preserve the
integrity of cell structure from deterioration and to nullify the
effect of toxic free radicals that operate at the cellular level
and in extra-cellular fluids.
Glutathione levels inside the cells must be maintained in order
to have healthy cells and a strong defense system. Cells die without
adequate levels of glutathione, suggesting that glutathione may
be a key anti-aging factor. However, glutathione does not work alone.
To provide maximum beneficial effects against free radicals, glutathione
must work SYNERGISTICALLY with other cellular enzymes and antioxidants
such as glutathione peroxidase, selenium and vitamins C and E.
It works like this. One antioxidant molecule attacks and neutralizes
one free radical molecule, but in the neutralization process, the
antioxidant molecule itself becomes oxidized. It then has to undergo
a reduction reaction in order to be regenerated as an antioxidant
otherwise it remains as an inert molecule, unable to fulfill its
antioxidant function. In some cases, the oxidized by-product is
itself a toxic free radical and remains so until it is neutralized
or regenerated into an antioxidant again.
This is the point where synergy becomes critical. A singular antioxidant
cannot regenerate itself. In order to continue to perform its antioxidant
function, each oxidized “antioxidant” must be regenerated
by a specific SYNERGISTIC antioxidant or by specific cellular enzymes.
In the body, glutathione and selenium assume the pivotal role in
this process. In other words, although singular antioxidants such
as vitamin C or vitamin E are physiologically useful, once they
have accomplished their job, attacking a free radical, they themselves
are oxidized and become a free radical. However, if they are combined
with other specific synergistic antioxidants, particularly glutathione
and selenium, they become rejuvenated and then can continuously
do their job – just like the cellular defense system. The
Thione Antioxidant Complex™, a unique patented formulation,
was created to replicate and enhance the incredibly complex synergistic
antioxidant defense system in the body, repleting the body of critical
compounds, particularly at the site of the injury or inflammation,
so that the defensive antioxidant cycle can keep functioning even
when it is overwhelmed by free radicals.
Nevertheless, while replication of the cellular antioxidant defense
system could have far-reaching implications for systemic disease
prevention and therapy, the inventor of the Thione Antioxidant Complex™,
Dr. Theodore Hersh, a gastroenterologist, recognized that ingestion
of an antioxidant capsule would be less than adequate to help prevent
or treat periodontal disease because it bypasses the oral cavity.
Determined to treat periodontal disease in addition to systemic
disease, Dr. Hersh drew upon his 30 years of academic, clinical
and research experience with “buccal absorption” (absorption
by the lining cells in the oral cavity) and decided to use a tablet,
lozenge and intra-oral spray method of delivering his antioxidant
complex to the body rather than a capsule.
Here’s why. Ingestion of a capsule delivers the antioxidants
to the small intestine. The capsule itself protects the active ingredients
from being denatured or inactivated by the gastric acids, but then
has to dissolve in order to permit the active ingredients to be
absorbed by the small intestine. In some cases, the capsule does
not dissolve and instead travels through the entire gut from which
it is later expelled without delivering the active ingredients.
When the capsule does dissolve properly, the active ingredients
are released into the small intestine. At this point, two reactions
occur. First, some of the active ingredients remain in the lumen
of the gut while others are absorbed by the lining cells of the
small intestine (allowing it to retain some of the active ingredients
for its own use). Thereafter, the remainder of the active ingredients
are transported through the portal vein to the liver. The liver
then utilizes the portion of the active ingredients that it needs
and releases the remaining active ingredients to the general systemic
circulation for delivery to the body’s other organs. Intestinal
absorption of antioxidants results in a lower initial peak blood
level of the antioxidants and less sustained concentrations for
continuous delivery to the other organs.
Conversely, buccal absorption of antioxidants, particularly those
contained in the Thione Complex, results both in an early high peak
blood level and then in sustained higher concentrations for continuous
delivery to all tissues. The buccal mucosal cells in the lining
tissues of the oral cavity are capable of absorbing intact molecules,
like glutathione and other ingredients contained in the Thione Complex,
via various physiologic transport mechanisms. Once absorbed by these
cells, these compounds are picked up and transported in the blood
by the systemic circulation to all the organs of the body. Thus,
unlike intestinal absorption, when the active ingredients are delivered
to the body through buccal absorption, all of the tissues, the major
organs and the body fluids receive their proportionate amount of
the antioxidants rather than receiving “left-overs”
from the small intestine and liver. As a result, the Thione Complex
can replenish and maintain synergistic antioxidant levels in all
cells and body fluids for preventative and therapeutic functions.
Most importantly, in addition to providing systemic circulation
of these critical antioxidants, through absorption of the Thione
Complex directly into the buccal mucosal cells, the antioxidants
are also delivered directly to the oral cavity and in the oral cavity,
glutathione and its synergistic partners have been shown to reduce
the inflammatory reaction and to promote the normal process of attachment,
spreading and growth of gingival fibroblasts, vital in periodontal
Tobacco, whether smoked or chewed, and betel quid chewing, worldwide
health problems, inhibit these mechanisms and locally deplete intracellular
glutathione levels. 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. Since scientists have recently
discovered a link between periodontal disease and numerous other
conditions such as cardiovascular disease, strokes and diabetic
complications, the unique formulation and delivery format of Thione’s
products make them the first products specifically designed to treat
both periodontal disease and the potentially associated devastating
systemic effects it causes.
Periodontal disease and other oro-pharyngeal pathologies, including
cancers of the mouth and throat, are serious complications of smoking
and chewing tobacco. The topical application of the Thione Antioxidant
Complex™ helps reduce potential tobacco damage to the oral
cavity and helps reduce the signs and symptoms of the inflammatory
reaction caused by tobacco. When used locally and systemically,
the Thione Antioxidant Complex™ helps replete the tissue stores
of defensive antioxidants and helps promote the body’s repair
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