Coenzyme Q10 (CoQ10), or ubiquinone, is a naturally occurring coenzyme found in almost every cell of the human body. It plays a role in energy production and acts as a powerful antioxidant. Although it's most often associated with heart health and cellular energy, CoQ10 has garnered increasing attention for its benefits in oral health.
It’s a fat-soluble, vitamin-like substance found in high concentrations in the mitochondria, where it helps generate adenosine triphosphate (ATP), the cell's primary energy source. It’s essential for the maintenance and repair of tissues, particularly in high-energy-demanding organs such as the heart, liver, and kidneys.
The body naturally produces CoQ10, but levels tend to decline with age, certain medical conditions, and the use of some medications such as statins.1 This reduction can contribute to a variety of health issues, including gum disease, as the cells in the oral tissues require sufficient energy and antioxidant protection to function optimally.
CoQ10 and periodontal health
A major factor in periodontal disease is oxidative stress. Gum inflammation produces free radicals, which harm tissue structures. CoQ10's role as an intercellular antioxidant helps neutralize these free radicals, reducing oxidative stress and minimizing tissue damage.2 Research has shown that people with gum disease often have low levels of CoQ10 in their gingival tissues, which suggests that supplementation could help restore balance and promote healing.3
When paired with scaling and root planing, an oral CoQ10 supplement has been shown to provide a powerful boost to gum health, effectively lowering inflammation beyond what’s achieved by scaling and root planing alone. The combination enhances healing and offers better outcomes for reducing gum inflammation.4 This may work through a specific pathway that involves a protein that controls the expression of certain genes. NFκB1 plays a critical role in inflammation, so when CoQ10 affects this pathway, it influences which genes are turned on or off, ultimately reducing inflammation.5
For cellular energy support, CoQ10 enhances the energy production of cells, supporting the repair and regeneration of gum tissues, which is important for maintaining the integrity of the gums, especially in patients with periodontal disease, where tissue breakdown is a major concern.6 CoQ10 has been shown to improve microcirculation in the gums, delivering more oxygen and nutrients to the tissues and promoting healing.7
CoQ10 may help lower asymmetric dimethylarginine (ADMA) levels, which are associated with endothelial dysfunction and cardiovascular risk. ADMA is an inhibitor of nitric oxide (NO) synthesis, which is crucial for maintaining healthy blood vessel function. NO enhances blood flow, reduces inflammation, possesses antibacterial properties, stimulates osteoblast activity for bone support, and speeds up wound healing—a win for oral health.
CoQ10 in dentistry: Practical applications
CoQ10 is found in a variety of forms, including oral supplements, topical gels, and mouth rinses. Topical CoQ10 gel can be applied directly to the gums, where it’s absorbed into the tissues and delivers localized anti-inflammatory and antioxidant benefits. Studies have shown that applying CoQ10 gel to periodontal pockets can help reduce gum inflammation, promote faster healing, and yield better outcomes.7,8
Using CoQ10 with hyaluronic acid as a gel adjunctively proved to be effective in treating chronic periodontal disease in 2016.9 Dental professionals could even recommend CoQ10 supplementation as part of a comprehensive periodontal treatment plan, with clinical evidence indicating that CoQ10 supplementation in doses of 200 mg per day or higher taken over extended periods is safe, well-tolerated, and leads to a significant increase in plasma CoQ10 levels. This dosage also effectively reduces oxidative stress and lowers mortality from cardiovascular causes.10
I’m very hopeful for products that support the oral microbiome and enhance its health without disrupting its delicate balance. Think about making tonight’s dinner a piece of fatty fish, with a spinach salad, nuts, seeds, and avocados to elevate your CoQ10. Bon appétit!
References
1. Young AJ, Johnson S, Steffens DC, Doraiswamy PM. Coenzyme Q10: a review of its promise as a neuroprotectant. CNS Spectr. 2007;12(1):62-68. doi:10.1017/s1092852900020538
2. Al-Hasso S. Coenzyme Q10: A review. Hospital Pharm. 2001;36.(1):51-66.
3. Rasoolzadeh EA, Shidfar F, Rasoolzadeh RA, Hezaveh ZS. The effect of coenzyme Q10 on periodontitis: a systematic review and meta-analysis of clinical trials. J Evid Based Dent Pract. 2022;22(2):101710. doi:10.1016/j.jebdp.2022.101710
4. Manthena S, Rao MV, Penubolu LP, Putcha M, Harsha AV. Effectiveness of CoQ10 oral supplements as an adjunct to scaling and root planing in improving periodontal health. J Clin Diagn Res. 2015;9(8):ZC26-ZC28. doi:10.7860/JCDR/2015/13486.6291
5. Schmelzer C, Lindner I, Rimbach G, Niklowitz P, Menke T, Döring F. Functions of coenzyme Q10 in inflammation and gene expression. Biofactors. 2008;32(1-4):179-183. doi:10.1002/biof.5520320121
6. Nakamura R, Littarru GP, Folkers K, et al. The effects of coenzyme Q10 on periodontal tissue regeneration. Proc Nat Acad Sci. 1974;71(4):1456-1460. https://www.pnas.org/doi/pdf/10.1073/pnas.71.4.1456
7. Hanioka T, Tanaka M, Ojima M, Shizukuishi S, Folkers K. Effect of topical application of coenzyme Q10 on adult periodontitis. Mol Aspects Med. 1994;15 Suppl:s241-s248. doi:10.1016/0098-2997(94)90034-5
8. Raut CP, Sethi KS, Kohale B, Mamajiwala A, Warang A. Subgingivally delivered coenzyme Q10 in the treatment of chronic periodontitis among smokers: a randomized, controlled clinical study. J Oral Biol Craniofac Res. 2019;9(2):204-208. doi:10.1016/j.jobcr.2018.05.005
9. Sharma V, Gupta R, Dahiya P, Kumar. Comparative evaluation of coenzyme Q 10 -based gel and 0.8% hyaluronic acid gel in treatment of chronic periodontitis. J Indian Soc Periodont. 2016;20(4):374-380. doi:10.4103/0972-124X.183097
10. Rabanal-Ruiz Y, Llanos-González E, Alcain FJ. The use of coenzyme Q10 in cardiovascular diseases. Antioxidants (Basel). 2021;10(5):755. doi:10.3390/antiox10050755
