YOUR PERIODONTAL DISEASE:
We take it seriously!
If you’re over 30 years old, you’re more likely to have some periodontal disease than not.
It’s that prevalent! And it’s relatively painless, which means you’re handicapped by a lack of feedback that might stimulate your desire to get some help.
Periodontal disease can be devastating in the mouth, causing bleeding gums, permanent bone loss, drifting teeth, foul breath, loose teeth and significant infection. It can also be devastating to the body, as the dangerous pathogens cruise
through the blood stream to act as a root cause of heart attack and stroke, and a significant link to 57
other ailments including dementia, immune suppression, chronic systemic inflammation, and erectile dysfunction.
If you’ve ever been diagnosed and/or treated for gum disease, you’ve likely had a traditional form of treatment which includes getting your teeth scraped to remove calcified plaque and accepting a recommendation to improve your brushing and flossing. This mechanical scraping process is called scaling and root planing (SRP).
Unfortunately, SRP usually isn’t enough to eradicate the infection, as we tend to see continued bleeding when we probe the deeper pockets of your bone loss over time. Bleeding gums are not healthy gums! And we refer to this ongoing effort to stabilize the disease as the “peri-go-round.”
Our hope is to treat this once and for all. As with all infectious diseases, we must first identify the specific bug population at work and at what dose (the size of the bug population). By swishing with sterile salt water and spitting into a cup, we can have a microbiology laboratory identify which (of the 11 most dangerous) pathogens are present and their concentrations. We can then identify which antibiotic(s) are most effective against this particular crop of bugs.
Next, we must evaluate the “host immune response.” This means we must look at the whole body, including lifestyle factors such as sleep and diet, to help each infected patient shift toward a state of optimal healing. We must address such critical, evidence-based factors as:
- Insulin Resistance or hyperglycemia (Pre-Diabetes or Diabetes)
- Dry mouth (often from medications)
- Acid Reflux
- Inflammatory diet
- Obstructive Sleep Apnea risk factors
- Tobacco/cannabis smoking
- Nutrient deficiencies
- Underlying fungal infections
- Chemical/food sensitivities
- Underlying immunocompromising conditions
- Multiple medications (prescription and OTC)
Many of these factors are challenging to change but can be the missing piece for periodontal disease suppression.
Finally, there’s your part. Effective daily self-care is about one third of the necessary treatment. Before we start the full mouth disinfection process, we will engage you in effective skill- building visits, where we will temporarily stain the plaque at your gumline and help you navigate every surface, in every pocket, with the best instruments (power brush, water jet, pointed brushes, triangular tooth pics, floss, etc.) and skills for effective daily plaque removal.
Digging for root cause and addressing these before the full mouth disinfection—scaling and root planing in the presence of the right antibiotics and chemo-therapeutic rinse(s)—takes TIME. We will explore all these factors before scraping your teeth, and Dr. Susan or Dr. Tracey will consult with you and your hygienist regularly throughout your periodontal therapy.
Included in your periodontal therapy package:
- Periodontal examination and a complete clinical diagnosis
- Evaluation of all probable causes
- Saliva testing for identification of specific pathogens
- Saliva testing for identification of specific pathogens for your spouse/partner (if desired)
- Saliva testing for genetic predisposition to periodontal disease and cardiovascular disease (if suspected)
- Saliva testing for 9 possible fungal infections (if suspected)
- A1C finger stick blood testing (if you have two or more risk factors for Type 2 Diabetes)
- Risk evaluation for sleep disorders such as UARS and Obstructive Sleep Apnea
- Health coaching for lifestyle changes necessary for a positive outcome
- Dispensing of all necessary instruments for daily self-care (power brush, water pic and adjunctive instruments)
- Dispensing of necessary antimicrobial rinse(s)
- Fluoride Varnish and CTX gel
- Skill-building series of visits (as many as necessary prior to full mouth disinfection)
- High quality probiotics (as adjunctive therapy for antibiotic prescription)
- Consultation letter(s) and coordination with your other health care professionals
- Full mouth disinfection (including scaling and root planing)
- Collaboration between your hygienist and Dr. Susan/Dr. Tracey at each visit
- Saliva testing for specific pathogens, 6 weeks after all bleeding-on-probing is alleviated
Our intention is to work with you all the way to periodontal stability. Because bone doesn’t grow back around your teeth, periodontal maintenance will be necessary for ongoing stability and the recommended frequency will be established on an individual basis. Our hope is to help you achieve an optimal state of healing and treat your periodontal disease once and for the rest of your life.
Periodontal Disease Self-Assessment:
Here is a simple self-assessment to help you determine your risk of periodontal disease: (You can take the test below or click here to take it electronically at selfscreen.net .)
Scoring: Yes=2 points, Occasionally=1 point, No=0 points
_______Do your gums bleed when you brush or floss?
_______Do your gums appear red (Do they match your lips rather than your skin)?
_______Do you suffer from bad breath?
_______Do you have any loose teeth or teeth that have shifted?
_______Do you smoke?
_______Are there areas on your gums that ever get swollen or sore?
_______Do you get food wedged between your teeth?
_______Do you see exposed roots at the gumline?
_______Are your teeth sensitive to cold temperatures?
_______Have you ever been told you have "gingivitis", "bone loss", "gum disease"?
_______Has it been more than a year since your last professional dental cleaning?
_______Have your parents or siblings lost teeth due to periodontal disease?
Score total points:
0-3 unlikely host of periodontal disease: learn more about prevention
4-7 low suspicion of localized periodontal disease/inflammation: seek consultation
8-11 moderate suspicion of generalized disease: seek consultation
12+ high suspicion of generalized disease: get immediate attention