Gordon H. West, DDS
Article published in the Lafayette News, 12/20/2006
There has been widespread research on the topic of periodontal disease in the past five years.
Why is there such an interest now?
Studies are correlating systemic health problems associated with inflamed gum tissues.
There are correlations with cardiovascular disease, adult onset diabetes, and low birth weight children. When a person’s gum tissue has periodontal disease (which is the process of your gums losing it’s attachment to the tooth along with irreversible loss of the bone that keeps your tooth in place) your body is fighting the infection with an infiltration of inflammatory cells.
Depending on the person, this inflammatory process can be very pronounced, these cells are running through the entire body and need to be broken down.
Pathogenic bacteria, their by products and cytokines enter circulation form the periodontal lesion, stimulating the liver and white blood cells to increase their production of inflammatory proteins such as C-Reactive Protein(CRP) (journal of periodontology).
This protein has been found to increase your chances of heart attack by causing arterial damage, Time magazine called this “the secret killer.”
The American Heart Association has said CRP is a better predictor of heart attacks than cholesterol.
Now you can see why this is a very important topic, now let’s address recent advances in periodontal management.
There has been a paradigm shift in periodontics, back in 1975 there was a non-specific plaque theory, which basically states that bacteria cause the problem with gum tissues but did not know which bacteria was really doing the damage, treatment was basically scrape the side of the teeth because that is where the bacteria are attached.
We now know there are two types of biofilm (bacterial complexes), one that resides on the tooth, the other resides in the gum tissue. The most destructive pathogens are located in the gum tissue biofilm, of which scraping the side of the tooth which is the normal cleaning, is very ineffective in removing the pathogenic bacteria.
All of the new periodontal protocols are geared towards removing the gum tissue biofilm.
Here are some of the latest innovations in periodontal therapy:
• Laser assisted perio therapy:
This is done with a CO2 laser, pulses energy into the gum tissue where the biofilm is embedded, and eliminates most of the pathogenic bacteria.
The CO2 is a great laser for this procedure due to the control we have with the energy pulses, can make them penetrate as little as .1 millimeter so surrounding gum tissue does not get affected, most procedures do not require anaesthetic.
• DNA bacteria testing:
This is a test to find out which type of bacteria reside within the gum tissue and perform susceptibility tests to antibiotics.
The result is knowing exactly what type of systemic antibiotic to place the patient on to aid in biofilm removal.
• Localized antibiotic therapy:
This is placing antibiotics directly into the affected area. Very helpful in isolated areas of periodontal disease.
• Patient Susceptibility Testing:
This is to check to see if the patient is prone to an elevated inflammatory response and to see if the patient has higher than normal bacterial counts in their mouth. This is helpful to determine due to the fact that if they are positive on this test, they are three to seven times more likely to develop severe periodontal disease.
Cavatrons are used to clean the teeth, these use ultrasonic technology and a water spray to aid in lysing of endotoxins, acoustic streaming, cavitation of microflora, lavage, and faster healing.
Profound advantages over scraping alone.
Dr. Gordon West DDS is a 1998 graduate of The Marquette School of Dentistry and has practiced exclusively in Colorado since his graduation.
Dr. West completed his residency at Denver General, where he studied advanced emergency medicine and comprehensive care of patients with complex medical histories.
He practices at Lafayette’s Centaur Dental, 1140 W. South Boulder Road, Suite 201.
For more information, call 303-665-5578.