The coenzyme Q10 periodontal therapy.[ILLUSTRATION OMITTED]
Our dental hygiene program, Cerritos College, participates in the California Dental Hygienists' Association convention table clinic presentation every year. While searching for a table clinic topic, we kept in mind that we wanted to research new products that could potentially aid in the treatment of periodontal disease. Through a review of literature, we selected Coenzyme Q10 due to its therapeutic effects on periodontal disease. Also, we selected Coenzyme Q10 because we wanted to introduce a natural approach to the treatment of periodontal disease.
Coenzyme Q10 and Its Benefits
Coenzyme Q10 is an important nutrient found in the mitochondria of every cell in our body and has three specific functions: energy production, immune system support and anti-oxidation. Its primary function is to produce energy. (1) Coenzyme Q10 is involved in making the important molecule needed for energy known as adenosine tri-phosphate (ATP). An adequate supply of Coenzyme Q10 in the cell ensures efficient energy production and tissue oxygenation for healing and repair of periodontal tissue. (2)
Coenzyme Q10 has been documented to strengthen the body's immune system. (2) New research has discovered that Coenzyme Q10 also improves the host defense mechanism by reducing the number of motile microorganisms that are found in the periodontal pocket during periodontal disease, like rods and spirochetes. (3)
Another benefit of Coenzyme Q10 is its antioxidant power. As an antioxidant, Coenzyme Q10 controls oxygen flow within the cell and inhibits the progression of free radical damage on cell membranes and DNA.
The greatest advantage that we discovered about Coenzyme Q10 is how easily it can be administered to have a therapeutic effect. The following studies are evidence that Coenzyme Q10 can be used as an adjunct periodontal treatment with scaling and root planing procedures.
In a study conducted to evaluate the effects of topical application of 85 mg of Coenzyme Q10 with non-surgical periodontal therapy on adult periodontitis, Coenzyme Q10 was applied in periodontal pockets with probing depths of more than 4 mm for a period of six weeks. The results demonstrated significant improvement of pocket depths, clinical attachment levels, modified gingival index, and bleeding on probing. (3) Other studies suggested that topical application promotes healing by reconditioning the gum tissue, reducing inflammation and bleeding, inhibiting bacterial growth, and modifying the immune response to protect gums from future bacterial attacks. (3)
Oral administration of Coenzyme Q10 has also provided beneficial effects on periodontal tissue. One study monitored the ingestion of 50 mg of Coenzyme Q10 for 21 days. After 21 days, there was a significant reduction in pocket depth when comparing the preand post-administration of Coenzyme Q10. Post biopsy results revealed excellent healing in gingival tissues; also, there were no adverse reactions experienced. (1)
In a clinical trial evaluating the oral administration of Coenzyme Q10, patients with periodontal disease were treated orally with 100 mg of Coenzyme Q10 per day for two months. This trial concluded that oral administration of Coenzyme QIO is an effective method to reduce and eliminate microorganisms at the gingival level of patients with periodontal disease by increasing the efficacy of the host's immune system.
Coenzyme Q10 Products
There are several products available that contain Coenzyme Q10.
Coenzyme Q10 is included in toothpastes and mouth rinses. When using these products, Coenzyme Q10 is in contact with the gingival tissue during the time the patient is using the product.
Another topical application product includes a gel that can be purchased or extracted directly from a Coenzyme Q10 capsule and directly placed on the gingival tissues.
Coenzyme Q10 is also contained in capsules/supplements dispersed in soybean oil that are normally digested in the GI tract.
Many of these products can be found in health food stores.
Other Therapeutic Effects of Coenzyme QIO
Because Coenzyme Q10 works at a cellular level, research suggests that it can help in the treatment of diseases such as congestive heart failure, diabetes and breast cancer when taken orally. (4)
Researchers believe that the beneficial effect of Coenzyme Q10 in the prevention and treatment of heart disease is due to its ability to improve energy production in cells, inhibit blood clot formation, and act as an antioxidant. (4) One important clinical study, for example, found that people who received daily Coenzyme Q10 supplements within three days following a heart attack were significantly less likely to experience subsequent heart attacks and chest pain. (4) In addition, these same patients were less likely to die of heart disease than those who did not receive the supplements.
In patients who suffer from diabetes, Coenzyme Q10 supplements may help lower blood sugar, improve heart health, and help manage high cholesterol and high blood pressure. (4) High blood pressure, high cholesterol, and heart disease are all common problems associated with diabetes.
Studies of women with breast cancer suggest that Coenzyme Q10 supplements (in addition to conventional treatment and a nutritional regimen including other antioxidants and essential fatty acids) may shrink tumors, reduce pain associated with the condition, and cause partial remission in some individuals. (4) It is important to recognize that the beneficial effects these women experienced cannot be attributed to Coenzyme Q10 alone. Additional antioxidants used in these studies include vitamins C, E, and selenium.
Sources of Coenzyme Q10
Our bodies are able to produce some of the Coenzyme Q10 that we need. The rest is synthesized from the foods we eat. The highest dietary sources come from fish, meat, and eggs. There are also plenty of vegetable sources containing Coenzyme Q10, the richest being spinach, broccoli, peanuts, and whole grains.
Young people are able to naturally produce Coenzyme Q10, but the sick and elderly may not be able to produce enough, therefore placing them at a higher risk for periodontal disease. Coenzyme Q10 becomes an essential vitamin later in life and in illness. For this purpose, there are dietary supplements available.
Our bodies are able to produce some of the Coenzyme Q10 that we need. The rest is synthesized from the foods we eat.
Pediatric oral dose: Use of Coenzyme Q10 in children under 18 years of age is only recommended under the supervision of a health care provider.
Adult oral dose: The recommended dosage for adults 19 years and older is 30-200 mg daily. Coenzyme Q10 is fat-soluble so it should be taken with a meal containing fat for optimal absorption.
Oral rinse: An oral mouth rinse can be made with one teaspoon (5 mL) of Coenzyme Q10 gel, and it should be used 1-2 times daily.
Possible Drug Interactions
Some medications that can lower the levels of Coenzyme Q10 in the body include statins for high cholesterol such as Iovastatin; beta-blockers for high blood pressure such as atenolol; and tricyclic antidepressant medications including amitriptyline.
No toxicity has been reported with the use of Coenzyme Q10, except for mild gastrointestinal symptoms such as nausea and diarrhea when higher doses were taken. Patients should consult with their physician before taking Coenzyme Q10 when taking warfarin because Coenzyme Q10 can decrease its effectiveness.
We found that this vital nutrient, Coenzyme Q10, is an important, all natural element of overall health. Its therapeutic potential for periodontal disease is far reaching, and we as dental hygienists can implement Coenzyme Q10 into our patient therapy plan to help treat, prevent and promote healing of periodontal disease.
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(3.) Hanioka T, Tanaka M, Ojima Met al. Effect of topical application of coenzyme Q10 on adult periodontitis. Mol Aspects Ned 1994; 15: s241-s248.
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Kristina Pavone is Mexican-American born and raised in Southern California. She graduated from the Cerritos College Dental Hygiene Program in California in 2008. She is excited to be a positive role model and looks forward to providing quality patient care to her patients.
Paula Nguyen is Vietnamese; she graduated from the Cerritos College Dental Hygiene Program in California in 2008. She enjoys being a dental hygienist.
By Kristina Pavone, RDH, and Paula Nguyen, RDH