Case report: 71-year-old patient with bleeding gums

About a year ago I was asked to evaluate a patient who had bleeding gums that were not responding to a daily, high-quality oral hygiene regimen. A deep cleaning by the hygienist in his dentist's office also had no positive effect.

This was a 71-year old man who had ongoing gum issues for more than three years. When I spoke to him, he did not complain of pain all the time, but he explained that his gums would bleed when he brushed his teeth and were a little sore. He wanted a quick fix such as an antibiotic.

Alvin Danenberg, DDS.

I told him we first needed to rule out infections and any blood diseases, including serious diseases like cancers. As I questioned him, he told me that he had bouts of diarrhea and bloating. He also said his physician put him on an acid-reducing prescription for acid reflux disease.

When I questioned him about his eating habits, he told me he had a healthy bowl of oatmeal every morning and usually a pasta dish with dinner. I suggested that some of his problems could come from the grains that he was eating.

He immediately dismissed my idea because he had been eating this way his entire life and that obviously could not be at the cause of his gum sores. He left my office to seek other opinions.

The return visit

Then several months later, I saw him again. He had seen an oral surgeon and then his own medical doctor. His physician had prescribed an anti-inflammatory prescription drug. This medicine did not resolve his bleeding gums. He finally allowed me to make my suggestions.

I had him fill out a three-day food journal listing everything he ate. He also had to write down the frequency of his bowel movements and any exercise he participated in during these three days.

When I reviewed his journal with him, we discovered he was eating some type of grain product with every meal and every snack. He also realized that he was eating very few green vegetables and that most of his drinks were laden with sugar.

I had him promise to do an experiment for 30 days. Since he's had bleeding, sore gums for several years, to experiment on himself for 30 days would not be too much to ask of him. Here is what I recommended:

• He would eliminate all grains. I described the foods that had grains and grain products, which had to be eliminated. I also gave him a list of foods that could be substituted for these grains and snacks. I even included some of my favorite recipes.
• He would eliminate all sugary drinks. I recommended various drinks, including regular water, that he should be drinking.
• I suggested that he begin to take a nutrient-dense supplement of fermented cod liver oil capsules and organic kelp powder capsules every day. I gave him resources online where he could purchase them.
• I explained the benefits of coconut oil as an excellent mouthwash to be used for a short period of time. He would place about 0.5 teaspoon of coconut oil in his mouth and swish. At the end of one to two minutes, he would spit it out into a paper towel to throw away, and then he would rinse with water. He could do that several times a day if he wanted.

What happened

After 30 days, we met again.

To his astonishment, the patient's bleeding gums were significantly better after 30 days. While they were not yet healed, they were much better. My further discussions with him were to include improving the bacteria in his gut and continuing to modify his diet to remove all offending items and replace what needed to be there.

If necessary at a later date, I would suggest some functional testing to delve into specific cellular problems.

A version of this column first ran on Dr. Danenberg's blog. DrBicuspid.com appreciates the opportunity to reprint it. His book Crazy-Good Living from Elektra Press is available here.

Alvin Danenberg, DDS, practices at the Bluffton Center for Dentistry in Bluffton, SC. He is also on the faculty of the College of Integrative Medicine and created its integrative periodontal teaching module. He also spent two years as chief of periodontics at Charleston Air Force Base earlier in his career. His website is drdanenberg.com.

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