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Role of zinc in gum health

Did you know zinc exhibits anti-bacterial, anti-plaque, and anti-caries effects which can help in combating periodontal diseases? Read this article to know more.

zinc pill

The importance of zinc in our body

Zinc is an essential trace element found in the tissues throughout the body. The human body in whole contains about 2g of zinc, of which ~60% is found in the muscle tissue, 30% in bone and 5% in skin.1

Zinc is essential for the growth of several internal organs, for stabilizing cell membranes, and modulating membrane‑bound enzymes and insulin action. This micronutrient participates both in the synthesis and actions of the hormones, which are intimately linked to bone metabolism. In vitro studies have shown that Zinc stimulates osteoblastic bone formation. The basic mechanisms of action of these trace elements are intimately linked to the structure and action of countless enzymes involved in many different metabolic processes.3

Zinc has several major roles in the functioning and development of the body. 1

  • It is essential for growth and development in humans and has diverse roles, being a critical component of several hundred enzymes and proteins.
  • It is implicated in biomineralization, where it stimulates both bone growth and mineralisation and influences osteoclast activity

The uptake and release of zinc are mediated by the bone reservoir. Zinc is mostly found in foods like meat, cereals, milk and milk products. 1

Zinc and its relation to oral health

Presence of zinc in saliva

Due to the abundance of zinc in the human body, naturally zinc can be found in saliva and dental plaque.2

Prevalence of zinc deficiency among patients with periodontal diseases

In a study conducted by Taru et al, the mean serum levels of magnesium and zinc were found to be significantly low in patients with chronic periodontitis as compared to healthy controls. 3

Serum zinc level was found to be ~33% less in patients with chronic periodontitis compared to control patients3

Fig 1: Comparison of mean serum zinc levels in chronic periodontitis

Fig 1: Comparison of mean serum zinc levels in chronic periodontitis3

Polenik et al observed the pre-treatment and post-treatment levels of serum zinc compared with serum zinc levels in participants with healthy periodontium. It was seen that patients with periodontal diseases have lower level of zinc and with adequate zinc therapy the zinc concentration reached the adequate concentration comparable to that of patients with healthy periodontium.

Fig. 3 Serum zinc concentrations in patients with periodontitis before and after zinc sulphate administration and in persons with healthy periodontium

Fig. 3 Serum zinc concentrations in patients with periodontitis before and after zinc sulphate administration and in persons with healthy periodontium6

Role of zinc in maintaining periodontal health

Zinc has a major influence on the oral mucosa, bone metabolism, and host response. Deficiency in zinc alters the thickness and keratinization of oral mucosa which becomes more susceptible to infections. It can also deepen the periodontal pockets and thicken the palatal tissues.

  • Zinc deficiency affects the functioning of immune cells such as monocytes, natural killer cells, neutrophils, T‑cells, and lymphocytes.
  • It also increases the secretion of pro‑inflammatory cytokines which is an integral component of antioxidant enzymes and its altered levels result in the generation of oxidative stress.

Zinc acts as an antioxidant to decrease oxidative stress. When the oxidative stress in the body is increased, the zinc starts to exhibit its antioxidant property and combat the oxidative stress. This leads to the depletion of zinc level in the body.3

Effect of zinc on oral microorganisms

There are many reports that zinc has several biologic effects in the oral cavity. Zinc has shown to exhibit anti-bacterial, anti-plaque, and anti-caries effects.4

  • Zinc can displace cations which are essential for enzymatic processes of the bacteria.4
  • Zinc inhibits the trypsin like protease activity of organisms such as Porphyromonas gingivalis as well as being an effective inhibitor of acid production by mutans streptococci.5
  • Zinc may act indirectly by inhibiting protease induced adhesion thereby changing the structure of bacterial cell proteins. 4
  • Zinc can bind to the surface of oral bacteria and alter their surface potential, and this may affect bacterial adhesion to teeth. 4
  • Zinc inhibits the phosphotransferase transport system (PTS) and may reduce glucose uptake by inhibition of enzyme I in the PTS. 4

Effect of zinc when used in a toothpaste

Zinc is generally added to toothpaste as an anti-bacterial agent to help to control plaque, reduce oral malodour and calculus formation through crystal-growth modification/inhibition. To exert these effects, zinc must be present at the site of action at an effective concentration for a long duration of time. 1

After application of zinc, 15-40% of the concentration is retained in the mouth. Good oral substantivity was confirmed by several studies, which reported that when zinc when applied from a toothpaste, 30% of the concentration is retained in the mouth and only 5.7% was removed by rinsing three times. Zinc is generally cleared from saliva bi-modally, with relatively high post-application concentrations falling rapidly after 30-60 min, after which it will be present in low concentrations for many hours. This trend reflects rapid clearance of loosely bound zinc followed by slower clearance of more firmly bound zinc.1

Fig 2: Zinc clearance

Fig 2: Zinc clearance

Summary

Zinc is an essential element necessary for the functioning and development of the body as it is a critical component of several hundred enzymes and proteins. Zinc can help in maintaining the function of the immune system and also exhibits anti-bacterial, anti-plaque, and anti-caries effects which can help in combating periodontal diseases.

 

Reference

  1. Lynch R. Zinc in the mouth, its interactions with dental enamel and possible effects on caries; a review of the literature. International Dental Journal. 2011;61:46-54.
  2. Fatima T, et al. Zinc: A precious trace element for oral health care. J Pak Med Assoc. 2016 Aug;66(8):1019-23.
  3. Taru S, et al. Magnesium and Zinc Levels in Individuals Having Generalized Chronic Periodontitis. Journal of the International Clinical Dental Research Organization. 2017;9(2):71.
  4. Kim Y, et al. Effects of Zinc on Oral Bacteria and Volatile Sulfur Compound (VSC) in Oral Cavity. Journal of the Korean Academy of Oral Medicine. 2007;32(3):273-281.
  5. Brading M, et al. The oral environment: the challenge for antimicrobials in oral care products. International Dental Journal. 2003;53(S6P1):353-362.
  6. Poleník P, et al. Zinc in etiology of periodontal disease. Medical Hypotheses. 1993;40(3):182-185.

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