Forty years ago, the link between poor oral health and other systemic health issues like cardiovascular disease was poorly understood, and those health practitioners and researchers who were seriously exploring the concept were considered outliers who were possibly a bit kooky. But this attitude is changing along with a mounting body of research that reinforces the concept that gum disease is an independent risk factor for heart disease.
Periodontal disease (PD) is the most common infectious oral disease among humans. Statistics presented by the Centers for Disease Control and Prevention and the National Institutes of Health reveal that almost half of U.S. adults 30 years or older have some form of periodontal disease. Some estimates are even higher, noting that close to 80% of adults worldwide have some form of gum disease.
“Periodontal disease is complex and multifaceted; there’s a great deal of mystery associated with it,” says Dr. Lisa Marie Samaha of Port Warwick Dental Arts in Newport News. Samaha has been a pioneer on the topic of the mouth/body connection and an advocate for concept of total health dentistry and is published widely on the subject. “It’s a chronic disease that affects us so dramatically and silently, that people often aren’t aware of it until it has reached a late stage and so much systemic damage has already occurred. I believe that every cell, every system in the human body is negatively impacted by periodontal disease, especially cardiovascular disease (CVD) and diabetes; there’s an intense connection between PD and overall wellness that deserves more attention.”
That connection centers around oral disease, the accumulation and accompanying spread of multiple species of bacteria, and their role in initiating chronic inflammation. Periodontal pathogens introduced into the bloodstream via bleeding gums can travel into cardiovascular, neurological, and other body systems where they set up house. These disease-causing bacteria have been detected within arterial plaque. The scientific research shows a strong association between certain bacteria and the development and progression of numerous diseases of the body as a result of bacterial invasion into the bloodstream and the brain, as well as through the process of inflammation.
How does PD develop? Samaha explains it this way: “Not just the bacteria, but virus, fungi and parasites—yes, some bacteria are parasitic—band together tightly, ultimately creating a toxic biofilm not unlike the scum that builds up inside a fishbowl. That biofilm, otherwise known as plaque, must be successfully removed daily in order to prevent periodontal disease. Over time, what began as a milder and reversible form of the disease (gingivitis) morphs into a more aggressive form of PD, which destroys gum tissue and leads to bone and tooth loss. At the same time, it is creating inflammation in the rest of the body.
“Good self-care matters. Good nutritional support matters. Knowing the risk factors for PD matters. But professional care is critical to the maintenance of oral health. Although periodontal disease might initially appear as bad breath and bleeding, swollen, or recessed gums, the condition develops under the radar. Early detection is key.”
In her practice, Samaha sees people every day who suffer from late stages of poor oral health. She understands that for numerous reasons, dentistry seems to have cornered the market on phobic patients. “People are often embarrassed about their condition,” she shares. “They think that no one can help them, and their fears grow. These are the people we want to see the most. We want them to feel welcomed and comfortable.”
Fortunately, ongoing research has led to some innovative ways to treat and manage PD, and Samaha has been an early adopter and advocate for the concept of Total Health Dentistry, the belief that dental health and whole-body health are intrinsically intertwined and that dentists are an integral part of a person’s healthcare team. In her practice, personalized and targeted protocols may include:
- DNA testing to assess a patient’s genetic susceptibility
- DNA bacterial testing to determine the exact type and concentration of periodontal bacteria that is causing each patient’s infection
- Blood testing evaluations, in collaboration with her patient’s physicians to assess the connection between oral and systemic disease
- Targeted pharmaceutical-grade nutrients to support the periodontal tissues.
- Ozone therapy
- Xylitol therapy
- Gentle dental laser therapy to detoxify, disinfect, decontaminate and encourage new soft tissue and bone formation
After decades of trying to manage periodontal disease successfully, Samaha and others are acutely aware of the limitations of traditional non-surgical and surgical periodontal therapies to manage the disease long-term. This is what led Samaha to create her multifaceted protocol for the non-surgical treatment of periodontal disease, a protocol she has been called upon to teach other doctors. “We’ve helped thousands of patients successfully manage their periodontal disease and improve their total health with our multifaceted, personalized approach to care.”
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