January 22, 2019
Dentistry struggles with the idea that mouth germs cause heart attacks. It's about to get hit with another paradigm shift.
We know that the bacteria in our mouths can enter the bloodstream where they cause systemic diseases like heart attacks, strokes, even Alzheimer's. The job of dentistry should be to prevent systemic diseases (not treat them) by managing the periodontal disease that causes them. This is the first paradigm shift that frankly dentistry has been slow to transition through. Periodontal disease, the source of these bacteria, has been described as an infection, but the problem is much deeper than that. The book Missing Microbes by Dr. Martin J. Blaser describes a troubling scenario. We have altered the normal, healthy bacterial flora, the microbiome, by the use of chemicals in our agriculture, through the use of antibiotics and eating unhealthy foods. The microbiome has lost its protective function and some important bacteria may be lost forever. What we have created is dysbiosis, dysfunction of the microbiome where instead of protecting us, it hurts us. This is the second paradigm shift, the idea that dental plaque originally had a healthy and a protective function. (Keep brushing and flossing, because, trust me, you don't have healthy plaque.) At least, that is my hypothesis. We have definitely not connected all of the dots as far as the complex bacteriological picture in our mouths, but recent advances in genetics have allowed for the detection of bacteria we didn't know were there. Can the oral microbiome be restored to a healthy, protective state? This will be the focus of my reading and survey of the scientific literature and questioning of the experts in the coming days and months. What an exciting time to be a dentist.
December 16, 2018
BEAT THE HEART ATTACK GENE
Beat the Heart Attack Gene is a detailed but readable explanation of the Bale-Doneen Method and I highly recommend it. It fell into my hands a year ago at just the right time in my life. I was going to be turning 63 in a few months, and was a little anxious about the fact that my father dropped dead of a sudden, unexpected heart attack at 63. This book has been helpful in my making a number of changes in my lifestyle, and I was privileged last month to meet Amy and Brad at the AAOSH Scientific Session in Las Vegas. My patients have also benefitted from this new approach to treatment.
This book details a new medical philosophy of prevention, the Bale-Doneen Method. Rather than the standard of care calculation of the risk of an adverse event, i.e., "Mr. Anderson, you have a 5% chance of a heart attack in the next 10 years," they seek to identify and remove or mitigate all of the known causes of heart attacks and strokes in their patients. Arterial inflammation is a major cause of heart attacks and strokes, and periodontitis--gum disease--is a cause of arterial inflammation.
Drs. Bale and Doneen worked together for many years at the Heart Attack and Stroke Prevention Center in Spokane. They are on the faculty of WSU's new Elson S. Floyd College of Medicine where their ideas now form part of the curriculum.
November 26, 2018
Oral Soft Tissues Invaded by Bacteria
Oral lichen planus (OLP) is a condition affecting the soft tissues of the mouth with extremely painful sores that present as white plaques, striations or large ulcerated patches, think canker sores two inches wide. For many years OLP was thought to be an autoimmune disease, but recent research is revealing that it might actually be considered an oral infection. This finding opens up the possibility for sufferers of more effective treatments aimed at controlling the bacteria. Oral pathogens such as Td and Fn have been found alive within the oral tissues affected by OLP, and these are some of the same bacteria known to enter the bloodstream through the gums where they damage tissues throughout the body. In fact, they are a cause of heart attacks, strokes, diabetes and even Alzheimer's (they have been found alive in the brain). Good gum health is more than an end in itself, it is a key to good health in general. Seeing your dentist might not only save your teeth, just possibly it could save your life.
October 23, 2018
Non-surgical treatment for the wound of periodontal disease
If periodontal disease, the gum disease that affects 80% of Americans, were a chronic wound on people's arms instead of in their gums, they would immediately seek medical care. But somehow in the mouth, it's easy to accept the signs of a chronic wound, bleeding, suppuration (pus), tenderness and swelling as normal--for gums.
When the recommendations by the American Medical Association for treatment of a chronic wound are followed for treating gum disease, amazing things happen. Pockets shrink, inflammation is reduced, gums don't bleed and most important of all, the bacterial pathogens that cause gum disease are reduced or eliminated.
What if there were a treatment that could deliver oxygen deep into chronically inflamed gums, promoting healing of the wound and making a very unfriendly environment for the pathogens that cannot live in the presence of oxygen? There is, and its ingenious. A tightly fitting plastic tray with gel containing a low level of hydrogen peroxide is the delivery system that takes oxygen therapy to the depth of periodontal pockets. It's called Perio Protect, and we are seeing amazing results.
If you are interesting in treatment for your gum disease that doesn't involve surgery, and is effective at reducing pathogen levels and pocket depth, we can help.
September 26, 2018
Testing for gum disease germs for all pregnancies
The consequences of gum disease go far beyond the mouth. OralDNA, the medical lab that developed the MyPerioPath test for oral pathogens, recommends that all women be tested during pregancy for the germs that cause not only gum disease but also cause heart attacks, strokes and adverse pregnancy outcomes. Hormonal changes during pregnancy lead to greatly increased levels of these bacterial colonies in the gums due to the bacteria using the hormones as digestive enzymes.
The OralDNA notes on their website that "The oral microbiota changes when women become pregnant, and levels of periodontal pathogens increase. During pregnancy, periodontal inflammation worsens, mostly due to increased levels of A.a., P.g., F.n. and P.i*. Among these oral pathogens, there is a marked risk of infection of the maternal blood and the placenta, which leads to an increase in pre-term labor, lower birth weight and even the chance of fetal loss due specifically to the bacteria P.g. and F.n. Further, the long-term risk for systemic disease in mothers with periodontitis is evident in the progression of atherosclerosis and the increased risk of venous thrombosis due to F.n., P.g., T.f. and A.a."**
They conclude with the following recommendation: "For these reasons, consider testing all women who are planning a pregnancy with the goal of reducing these bad bacteria."
If you are pregnant or planning pregnancy in the near future, call us to give you the MyPerioPath saliva test. It only takes a few minutes and you don't even need an appointment.
*A.a., Aggrigatibacter actinomycetemcomitans; P.g., Porphyromonas gingivalis; F.n., Fusobacterium nucleatum; P.i., Prevotella intermedia; T.f., Tannerella forsythia.
**Han YW, Houcken W, Loos BG, Schenkein HA, Tezal M. Periodontal disease, atherosclerosis, adverse pregnancy outcomes, and head-and-neck cancer. Adv Dent Res 2014;26:47-55. 4 TM-000083 17. Andonova I, Iliev V, Zivkovic N, Susic E, Bego I, Kotevska V. Can oral anaerobic bacteria cause adverse pregnancy outcomes? Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2015;36:137-43. 1
September 12, 2018
You don't have soft enamel, you have a dental infection that causes decay.
Correction: The DIY bleach solution described below should be used twice a week. An earlier version stated an incorrect frequency of use. As with all treatments, use under the supervision of your dental health provider.
Over the years, many people have tried to tell me that the reason they get so many cavities is that they have soft teeth. Unfortunately, this isn't quite the truth. Not only have people had this idea that they have defective teeth and there is nothing they can do about it, we in dentistry have tended to view tooth decay from primarily a surgical, rather than a medical model in treating decay. The problem is not only the expectations of people, but the point of view of dentists. My degree is as a doctor of dental surgery, after all. I am trained and licensed to surgically remove your tooth decay and to place a filling. But I have had to make a professional transition in order to properly begin to view dental decay as an infection that can respond to treatment much like other infections.
While it is very important to have regular dental cleanings and examinations, to brush and floss and to be careful about consuming a lot of sugar, tooth decay is a dental infection, and chances are it won't be eliminated without killing the germs that cause it and shifting your oral bacterial flora in a more healthy direction.
We have a wide range of ways to treat cavities as an infection, antibiotic rinses, fluoride, mouth trays to deliver medications to the teeth and gums, even a DIY recipe for a mouth rinse that will kill germs. We offer Perio Protect trays, the CariFree product line of cavity fighting products, chlorhexidine prescription rinse, prescription fluoride toothpastes and more. You can even use a probiotic for your mouth. A simple rinse you can make yourself at home is to add two teaspoons of Chlorox bleach (unscented, regular strength) to 1 cup of water* and rinse for one minute twice a week. Follow the rinse by brushing all the surfaces of your teeth with a prescription fluoride toothpaste (they contain much more fluoride than those you can buy over the counter) and then floss the paste between your teeth after that.
If you have a cavity, we will still need to treat it surgically, by removal of the diseased tooth structure and replacement with an artificial filling. However, we can reduce the need for further fillings by treating tooth decay biologically and medically. The possibility exists for you to win the fight against tooth decay, beginning with the understanding that what you are really fighting is an infection. We can help.
*Slots, J. Low cost periodontal therapy, Periodontology, 2000, vol. 60, 21012, pp. 110-137
August 20, 2018
Welcome to Dental Health Group!
Recent studies have established the connection between the mouth and systemic disease, like strokes, heart attacks, diabetes, miscarriages, even Alzheimer's. It almost sounds like a bad science fiction movie, bacteria from periodontal disease circulate in your blood stream where they increase the levels of bad cholesterol and help make arterial plaques that cause cardiovascular disease. Living oral bacteria have been extracted from human arterial plaques. Oral plaque connected to arterial plaque, who knew?
The mouth is front and center in the fight against disease, and an important part of that fight is seeing us to keep it in tip top shape. How long has it been since your last visit for an oral examination and dental cleaning?
Give us a call today. More may be riding on it than just clean teeth and fresh breath.