I commend you for your recent article on periodontal disease, its role in systemic illness, and your recommendation that dentists really pay attention to addressing the needs of our patients. It won’t be long before we as a profession are forced to address the serious health issues that are either associated with or proven to be associated with this infection.
I advise all of my patients of not only the potential connection of PD to SD, but also recommend blood tests for CRP (hsCRP), homocystiene, lipid panel, and fasting glucose - all of which have been proven to be elevated by periodontal infection as well as lowered by treatment. PG2E, Lp(a) and HBA1C are also evaluated on occasion.
Patients are advised but not forced to follow these recommendations. My in-office treatment is the usual SRP, irrigation, etc., but I use CLO2-based products (ClosysII) that are known to kill the bugs, destroy biofilms, and neutralize volatile sulfur compounds. VSC activates proteolytic enzymes and can be the agent causing ulceration of the crevicular epithelium, creating the portal of entry for bugs to vacation throughout the body. We are also into tongue scraping and irrigation at home (Hydrofloss).
I suppress inflammation pretreatment with pharmaceutical-grade supplements with known oral-health-enhancing ingredients. With follow-up blood tests after treatment, I determine how and if any changes or referrals are necessary for the patient. CRP, for instance, can dramatically increase while the mouth has become healthy. Tumor necrosis factor alpha (TNF-a) will not be affected by SRP, supplements, or changes in home care, and referral is made to the patient’s physician for follow-up.
I apologize for subjecting you to a long message, but our profession is about to be at the forefront of a revolution in health care, and few of us would disagree that the old methods, products, and advice simply haven’t been effective.
Michael P. Bonner, DDS
San Antonio, Texas
(Dr. Bonner is the author of “The Oral Health Bible,” available at www.amazon.com.)
