Periodontal Disease

The oral-systemic link has irrefutably been documented. As dental professionals we are all aware that the inflammation from periodontal disease is not a localized event but one with life-threatening global consequences.

So the question that confounds us is how to incorporate the research into our practices as clinical protocol. Traditional therapies alone are frustratingly ineffective at resolving periodontal disease long term. The fact that periodontal disease exacerbates every inflammatory process in our body mandates that if we want to move our patients to long term health we must address the patient systemically.

Screening for inflammatory biomarkers and oral pathogens, treating sleep apnea and having protocols for smoking cessation are lifesaving services that should be offered by dentists. Nutritional screening and counseling is another essential piece of the oral-systemic equation that cannot be ignored if we want to provide optimal care for our patients.

There is increasing evidence that the link between periodontal and other inflammatory diseases is being driven by reactive oxygen species (ROS). The presence of periodontal pathogens leads to a hyper-inflammatory state and the formation of ROS. A leading hypothesis of aging is based on the free radical theory of aging by Harman(1) who argued that oxygen-free radicals produced cumulative damage to molecules which progressively leads to loss of functionality of the organism. These same free radicals create oxidative stress induced damage to gingiva, periodontal ligament and alveolar bone.(2) There is extensive research showing that antioxidants play a vital role in minimizing oxidative damage caused by free radicals.

Iain Chappel recently published research in the JADA that stated: “Higher serum antioxidant concentrations were associated with lower odds ratios for severe periodontal disease.Antioxidants are micronutrients sourced from our food from colorful fruits and vegetables and pharmaceutical grade supplements. A list of the best 20 food sources for antioxidants follows:

1. Small red beans

2. Wild blueberries

3. Kidney beans

4. Pinto beans

5. Blueberries

6. Cranberries

7. Artichokes

8. Blackberries

9. Prunes

10. Raspberries

11. Strawberries

12. Red Delicious, GS apples

13. Pecans

14. Sweet cherries

15. Black plums

16. Russet potatoes

17. Black beans

18. Plums

19. Gala apples

20. Walnuts

The nutrients from these foods limit oxidative tissue damage by neutralizing free radicals or ROS and preventing the oxidation of our cells. By preventing cellular and DNA damage from free radicals, we reduce the inflammatory burden on the entire body and effectively enhance immune function, and improve our patients overall health.(6)

So how do we implement nutrition into our already busy practices?

We need to be able to measure nutritional levels in the body. We could assume that everyone is nutritional deficient, and probably be right most of the time, but that is not science. Traditionally, obtaining a biomarker for nutrition has been expensive and invasive, only blood or tissue sampling was available. However, obtaining an inexpensive and non-invasive measurement of antioxidant status is now possible with a device called the Biophotonic Scanner. This technology inexpensively and more accurately than blood serum testing can measure antioxidant status in the body in 90 seconds.

It is critical in dentistry or medicine to have a way to measure effectiveness of therapies. Up until now there have been limited ways to monitor our patients’ nutritional status so many practitioners have not understood how effective nutritional intervention can be. This technology was recently introduced on the Dr. Oz show as the ultimate nutritional lie detector test. He told the audience he was astounded by the results and the technology completely blew his mind. See the video at http://www.doctoroz.com/videos/cancer-fighting-antioxidants-pt-1.

The ability to measure and monitor nutritional status will enable us to make nutritional recommendations that will enhance our treatment outcomes and improve our patients lives. We see our patients on a more regular basis than any other health care provider. In fact, in some cases, we might be the ONLY health care provider they see. We have a unique opportunity to influence our patients to live their very best lives.
By Jacqueline Russo, RN, DDS