Got Gum Disease? Treatment Could Save Your Life

ultrasonic scalingPeriodontal disease affects up to 80% of Americans. It’s not just a problem in the mouth, either. It’s been linked to many other conditions, including heart disease, stroke, diabetes, rheumatoid arthritis, and some cancers.

The good news? Periodontal therapy can help reverse gum disease. This may, in turn, help improve your overall health – and, as we noted before, even save you a good chunk of change in the long run.

For instance, a new review of the science suggests that non-surgical perio therapy may improve glycemic control in people with diabetes, at least in the short term.

Patients who underwent [nonsurgical] periodontal treatment had about half a percent lower HbA1c levels three months after treatment than those who did not undergo periodontal therapy.

“Evidence from the literature suggests that successful periodontal treatment, which results in the reduction of inflammation from the periodontal tissues, improves the metabolic control of people with diabetes mellitus,” the authors wrote.

Another recent study looked at the impact of intensive periodontal treatment on blood pressure. In this case, 95 patients were randomly split between control-treatment and intensive-treatment over the course of 4 weeks, then followed for 6 months.

After one month, systolic blood pressure – the top number – was almost 3 points lower in patients who had intensive treatments. After three months, it was almost 8 points lower. Diastolic pressure dropped, too, by nearly 4 points.

At 6 months, systolic pressure had dropped almost 13 points, and diastolic had dropped by nearly 10.

“The present study demonstrates for the first time that intensive periodontal intervention alone can reduce blood pressure levels, inhibit inflammation and improve endothelial function,” said study lead author Jun Tao, M.D., Ph.D., chief of the department of Hypertension and Vascular Disease and director of the Institute of Geriatrics Research at The First Affiliated Hospital of Sun Yat-sen University in Guangzhou, China.

The study was published last summer in the Journal of Periodontology.

Other research has found evidence that periodontal treatment may help those with chronic kidney disease and atherosclerosis (“hardening of the arteries). The latter was especially so for those “already suffering from CVD and/or diabetes.”

On the flipside, some research has found that patients who don’t respond well to periodontal therapy had “an increased risk for future CVD, indicating that successful periodontal treatment might influence progression of subclinical CVD.”

So what are the options for treatments?

While in its early stages, gum disease may often be reversed by more intensive home hygiene, nutritional improvements, and other lifestyle changes, dental help is needed when it becomes more advanced.

This can include frequent deep cleanings, such as with an ultrasonic scaler, along with regular ozone treatment to keep harmful bacteria under control. Probiotics may also be recommended to help right the microbial balance in your mouth.

Between cleanings, a system like PerioProtect can also help keep harmful bacteria at bay so friendly microbes can proliferate.

And when gum disease is particularly advanced? LANAP (Laser Assisted New Attachment Procedure) can be used to remove diseased tissue while preserving healthy tissue and destroying pathogens. It’s a kind of super deep cleaning for your gums and tooth roots, less invasive than conventional surgery yet potentially more effective. Research suggests it may even stimulate the growth of new bone in the jaw, restoring support to the teeth. And it’s comfortable for the patient, essentially pain-free.

Research published in the Journal of Periodontology has stated that LANAP should be considered the first line therapy in restoring health to diseased gums.

But the absolute best way to treat gum disease? Keep it from arising in the first place.

Why Gum Disease Matters – & How We Can Help

periodontal biofilm

Periodontal biofilm

In the day to day, gum disease may not seem like such a big deal. Sure, your gums may bleed a bit when you brush and floss. They may look a little puffy. But on the whole, you don’t really don’t notice it affecting your health all that much – until it’s well advanced. Then you’re looking at possibly losing teeth due to the bone loss that accompanies periodontitis.

You’re also looking at increased risk of other inflammatory conditions, including diabetes, heart disease, stroke, rheumatoid arthritis, kidney disease, Alzheimer’s and cancer.

In short: It’s serious. And it’s why we put such an emphasis on prevention. Gum disease? You just don’t want to go there.

But all too many do go there, which is why we’ve also invested in advanced, non-surgical alternatives to traditional perio treatment that can help you on your way to restored gum health – solutions like the laser therapy known as the LANAP® protocol.

LANAP stands for “laser assisted new attachment procedure,” which lets the dentist remove diseased tissue while preserving healthy connective tissue and destroying harmful bacteria and other pathogens. Here are the basics of how it works:

Think of it as a kind of super deep cleaning for your gums and tooth roots, less invasive than conventional surgery yet potentially more effective. “Clinically,” says Dr. Robert H. Gregg, II, who helped develop LANAP,

what immediately becomes apparent is that post operatively there is minimal discomfort, shrinkage of swollen, puffy gums and reduction of bleeding.

There’s also seldom any of the root sensitivity and long-looking teeth that can accompany traditional perio surgery. .

You can read more about the nuts and bolts of this procedure here.

Recently, we had the opportunity to chat with Dr. John McAllister – a practicing dentist in Downey, California, and clinical instructor of the LANAP protocol at the Institute for Advanced Laser Dentistry – and to ask him a few questions about the protocol, and about periodontal health and disease in general. Here’s what he had to say.

Q: You hear lots of different statistics on periodontal disease – that it affects 50% of the adult population, 75% or even more. Just how common is gum disease? And how serious of a problem is it?

A: Periodontal disease has been underdiagnosed in the profession for years. The challenge is that less than 20% of general dentists do yearly perio probes of their adult patients, according to the research. This same issue was shown in the recent CDC report that gum disease has been underreported by as much as 50%. The reason was that initial CDC statistics had been done with Periodontal Screenings Assessments, not full mouth charting.

So it is the profession that needs to take the lead and insist that patients and third party payers pay for and value full mouth periodontal probing. What gets paid gets done.

The other challenge is that periodontal disease does not hurt until it is too late. Our job is to educate our patients and inform them that periodontal disease is the number one cause of tooth loss.

Q: From the patient’s perspective, what makes LANAP superior to other protocols?

dental laserA: Regeneration, regeneration, regeneration!

Recently, the Journal of Periodontology did a systematic review of the literature, and it was clearly stated that the LANAP protocol should be considered the first line treatment in periodontal regeneration.

The beauty of LANAP for the patient, though, is that it is minimally invasive. No scalpels are used. No sutures are used. No biologics are used. Since it is minimally invasive, patients experience little to no pain. Patients tell me that their pain both the day after treatment and the week after is 2 to 4, on a scale of 1 to 10.

Q: We’ve heard anecdotal evidence that LANAP can stimulate bone growth. Has any research been done in this area yet? What evidence do we have?

A: Yes! Countless radiological bone fill before-and-after cases have been collected by numerous clinicians. But the most valuable science has been done with human histology published in peer reviewed journals done by two different clinicians. Both found evidence for new bone new cementum and new connective tissue attachment.

Q: Although you are not a periodontist, you obviously have a deep interest in perio issues. How did you become so interested in this aspect of dentistry? How does your interest influence your everyday practice?

A: I started in dental school with my first patient, a young lady in her 20s with advanced periodontal disease and mobile teeth. I asked the periodontist on staff, “What can we do to save her teeth?”

“Nothing. Dentures.” I was shocked! How can we get to the moon and not help someone keep their teeth?

Then, my first patient out of dental school was my uncle. He had advanced periodontal disease, and I couldn’t help him other than provide dentures. I was devastated and was on the quest to fight periodontal disease.

Consider: By definition, a dentist without a patient is unemployed. If you ask your patient, “How can I help you?” as long as they’re not in pain, they will tell you, “I want to keep my teeth! I want to keep my teeth!” Since periodontal disease is the number one cause of tooth loss, then it is only logical to accept that periodontal health is THE FOUNDATION to all our restorative dentistry.

Periodontal biofilm image by Mark Bonner, DMD