By Laurence Kirk

Patient: Ms B a 34 year old woman with 5 young children; height 5 feet, weight 7 stones.

Complaint

Chronic gingivitis of 4 years duration with gum recession beyond
the margins of the tooth enamel and loosening of teeth

History

Ms B reported that the irritation to her gums began gradually during the time period when she was breast feeding her last child, Ms B reported that she had been breast feeding almost continuously, other than a gap of perhaps 6 months, for a total of 13 years.

Ms B had been a strict vegan from the age of 17years. She mentioned she had resumed smoking, perhaps 20 rollups per day, partly as an antidote to the stress which she had been experiencing. She generally felt low in vitality and was aware of a noticeable lack of libido. Ms B explained that she had a very passive and unassertive nature but was having to cope with an extremely distressing custody battle.

Initially her dentist had advocated a thorough cleansing and flossing but this had seemed to accelerate the recession. The recession continued to the point where the teeth began to loosen and shift in position and it was then that the option of eventual removal was suggested. Interestingly Ms B reported an absence of bleeding from the gums, but mentioned that the gums had felt very sore for some time.


Examination

Ms B’s teeth were quite striking; nearly all of her teeth showed marked gum inflammation and recession to the extent that the enamel margins were exposed. Ms B’s skin was dry and lacking in elasticity her nails were ridged and grew slowly and her hair had become thinner and dryer. Blood pressure was lowish at 100/60 pulse 70 and thready.

Ms B provided a dietary intake log which showed that she really had little interest in her diet, which, given the potential limitations imposed by her avoidance of meat and dairy products, strongly indicated low nutrient status. Blood haemoglobin level was a little low at 11g/dl

Ms B’s chief concern was the appearance of her teeth and the possibility of losing them. This was compounding her poor self image and further reducing her already low self-esteem.

Between us we agreed that there was still a possibility that the teeth would have to be removed. If this was inevitable it was acknowledged that cosmetically at least the appearance would be preferable. It was decided that we would give 6 months in which to attempt to halt or slow the process and improve health and vitality


Treatment

The first stage was to improve the variety of nutrients provided in Ms B’s diet by increasing variety and combining sources of vegetable protein. Initially as a boost to her system a number of supplements were recommended: Vit C and bioflavenoids (in the form of anthocyanins derived from purple/red berry fruits) for collagen synthesis and organisation, ferrous gluconate and dried apricots to top up iron reserves (given she was a vegan). Co-enzyme Q10 was also suggested as a boost to energy levels but also for its effects on gum health. Ms B also used a home made gargle/mouthwash containing calendula, sage, garlic and honey on a twice daily basis.

We also worked on some simple strategies to boost self esteem and self confidence, as well as some visualization strategies for stress management.


Outcome

Given the severity of the problem I felt it important not to offer false expectations. I saw Ms B for an initial 2 visits and then follow ups at 1 month, 4 months and 6 months with regular telephone contact. There was an improvement in soreness of the gums after about 3 weeks. Ms B remarked that her teeth were less loose after 5 weeks. Her relationship difficulties had now mostly been resolved; she seemed much more energetic and assertive. At six months Ms B reported that her gums had become less spongy and had even appeared to re-grow somewhat.

In a telephone conversation about 8 months from the onset of treatment Ms B remarked that she was now comfortable with the appearance of her teeth and no longer felt any soreness or movement of her teeth. This had apparently been confirmed by her dentist.

I had no great expectations at the onset of treatment and had merely hoped to promote nutrient status and possibly slow the progression of the gum recession. However Ms B had confounded these expectations by making quite a striking recovery although I suspect that her newly restored self-confidence and reduced stress both allowed her to cope more effectively.


About the Author

Laurence Kirk DO, ND BSc (Hons) Ost.Med. MRN
Registered Osteopath and Naturopath

Laurence graduated from the BCNO in 1984. From that time he has been actively engaged in research and education. He is currently clinical co-ordinator at the BCNO, an internationally renowned centre of excellence, in London and a senior lecturer in osteopathic technique and osteopathic diagnosis. He has also acted as an external examiner both in the UK and Europe and is currently accredited by the General Osteopathic Council as an external examiner. His research interests currently include low back pain, joint proprioception, and the effect of dietary factors on the inflammatory response. As well as his teaching commitments Laurence has appeared on radio and television as a speaker on a diverse range of topics within the field of healthcare, he has been cited in articles appearing in The Daily Telegraph, Vogue, and Mens Health amongst many others. Laurence maintains a private practice in picturesque Stratford upon Avon. He believes strongly in the importance of a “therapeutic dialogue” between patient and practitioner and rejects the paternalistic inequality of the stereotypical patient-practitioner relationship.

Contact details

The Greenhill Practice
Greenhill Street
Stratford upon Avon
Warwickshire CV37 6LE
Email: laurencekirk@hotmail .com
Telephone 01789 267888
The British College of Naturopathy and Osteopathy (BCNO)
Fraser House
Netherhal Gardens
London NW3 5RR
Email: lk@bcno.ac.uk
also available for talks and demonstrations to groups and clubs.

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