Study Examines CoQ10’s Benefit for Gum Disease

New review of research says evidence is uncertain, complicating common advice

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It’s not entirely unusual for a dentist to suggest coenzyme Q10 as a good anti-inflammatory supplement for preventing or treating early stages of gum disease. But a new study raises skepticism.

The molecule—often referred to as CoQ10—is known for its anti-inflammatory, antioxidant properties. CoQ10 deficiencies have been found to be deficient in patients with periodontal disease, the inflammation resulting from a bacterial attack in the mouth—commonly called gum disease.

Gum disease is a spectrum of inflammation that begins when pathogenic bacteria break down the tissues that support teeth. It can lead to tooth loss, as well as systemic inflammation that puts a person at risk for a host of serious diseases such as cardiovascular disease, Type 2 diabetes, Alzheimer’s disease, and autoimmune diseases, according to a 2021 article in Frontiers in Cellular and Infection Microbiology. Nearly half of adults over the age of 30 in the United States have periodontal disease with just over 70 percent of occurrences in those over the age of 65.

CoQ10 is a naturally occurring nutrient in the body, with the highest levels in the organs associated with metabolism—heart, kidneys, and liver. Levels decline with age and certain lifestyle factors, like smoking and drinking. CoQ10 is found in oily fish, organ meats, and whole grains, but getting sufficient amounts of it through diet is problematic for those who have health conditions—which equates to a growing number of Americans and especially the elderly. That’s why some cardiologists, dentists, and others have long recommended CoQ10 supplementation.

That logic, however, is at risk of being smothered by the findings of a new review article published in March in Nutrients. The review examined research on CoQ10 as an adjunct to non-surgical periodontal therapy and concluded the evidence is “very uncertain regarding an additional benefit of the adjunct use of CoQ10.”

Why CoQ10 Matters

CoQ10 plays a vital role in fueling the cell’s energy cycle, specifically because it synthesizes adenosine triphosphate, the source of energy for every cell in the body—necessary for all tissues and organs to function. CoQ10 also operates as one of the most important antioxidants in a highly complex process that prevents the generation of free radicals. Free radicals are unstable molecules that can attack nearby cells and lead to damage that may reveal itself through a variety of symptoms of poor health.

Not only is the role of CoQ10 vital for basic functions of immunity, it also can help the body improve physical performance, making it a popular molecule among elite athletes. Essentially, it keeps us moving and functioning optimally.

“You need CoQ10. To avoid CoQ10 would be very harmful for the body,” Dr. Al Danenberg, functional periodontist, told The Epoch Times.

Examining the nutrient by itself, however, is meaningless, he added. CoQ10 is part of a chain of actions and reactions that rely on a healthy host, which includes the microbiome—the symbiotic community of bacteria, viruses, and fungi that live on and in the body. Both the digestive tract microbiome, where most of the immune system’s functions originate, and the mouth microbiome are impacted by CoQ10.

Misleading Advice

Dr. Mark Burhenne, a functional dentist who has been recommending CoQ10 for years, also told The Epoch Times that the review article is misleading—despite also being a good study with solid methods and results.

“Most supplements need other vitamins and enzymes to be effective,” Burhenne said. “It’s multi-factorial. I don’t like these studies that pick one supplement and narrow in on that. If you’re going to take one supplement and think it’s going to protect you against periodontal disease, it’s just misguided.”

Though the review has gathered and considered a great deal of evidence, it is foolhardy to assume it’s put to rest any inclination that CoQ10 could benefit oral health. It stands as a testament to a body of poor research on the supplement.

The article points out that protocols of the studies it examined vary dramatically in terms of dosing, the amount of time patients were followed, and administration—sometimes CoQ10 is given in gel or liquid forms. Other times it’s given by capsule or tablet.

Some studies didn’t even include dosing, but none of them mentioned more than 90 mg, which Burhenne said is the standard dose recommended for heart health. Literature often recommends 30 mg to 90 mg. He suggests 120 mg for patients with gum disease. The effects may also take up to eight weeks to be realized.

Part of the dilemma with recommending CoQ10 as an anti-inflammatory supplement is the lack of cohesive advice that can assure dentists of its effectiveness. The article put forth suggestions that could strengthen future research. Among the protocol suggested:

• Exacting of CoQ10 administration, including product, dose, application methods, duration, and timepoints.
• Double-blind studies to avoid bias, which would require using a placebo.
• Pretreatments, instructions after treatment, and oral hygiene instructions. Use of antiseptics and antibiotics should exclude study participants as they kill off even commensal, or good, microbes and can impact one’s overall immunity and influence study results.
• Extended observation periods to note long-term efficacy and clinical relevance.

Combating Gum Disease

Though common, gum disease severity varies and depends on many risk factors, including modifiable ones like smoking and diet. Oral hygiene helps with prevention. Regular dental visits are important for removing the microbial biofilm, called plaque that leads to cavities, gingivitis, and other oral health conditions. Plaque is made up of bacteria, leftover food bits, and saliva.

New treatment options include antimicrobial therapy, laser therapy, tissue engineering for tissue repair and regeneration, and others.

Danenberg suggested taking CoQ10 in the form of desiccated organ supplements from grass-fed cattle, as well as correcting imbalances in the gut microbiome.

“Gum disease is essentially a factor of dysbiosis of the oral microbiome,” Burhenne said, adding that CoQ10 naturally wanes with age but needs to be addressed alongside other deficits.

CoQ10 works best with optimal levels of vitamins D and vitamin C taken three times daily, he said. Because supplement quality varies greatly, he recommends verifying efficacy on consumerlab.com.

Additionally, Burhenne said inducing autophagy has shown to be beneficial to prepare for gum surgery or deep cleaning, as well as in recovery. Autophagy is the natural process of a cell breaking down and recycling parts for important cellular functions, and it helps destroy infection-causing microbes. Essentially, it boosts the immune system to protect the body.

Autophagy can be achieved by putting the body into ketosis—a process in which the body is burning fat instead of carbohydrates—with intermittent fasting or a ketogenic diet, though Burhenne said it’s very difficult to achieve. An alternative is spermidine supplementation, which also allows cells to enter “clean-up mode,” he said.

Additionally, Burhenne warned against using disinfectants in the mouth which destroy the entire microbial community and lower immunity against gum disease and other pathogenic-related invasions.

One final note is to check your sources, he said. Anyone who says CoQ10 has no value, for instance, doesn’t understand the biochemical relationship it has with overall health.

“We have to be very careful about who we are listening to,” Burhenne said. “If I’m not sure, I say that.”