05 Sep 2019 Leona Meditz
Controversy in the dental profession regarding best practices is common. For example, topics such as amalgam filling safety, occlusal restoration design, laboratory versus milled crowns, braces versus aligners, root canal versus extraction, and laser therapy efficacies all can be just as divisive as any political argument.
Each debate brings opportunity for innovation in philosophy, treatment offerings, materials, and technology eventually mooting the original issue with new product development, clinical trials, and research publication—all searching for the “silver bullet” that would solve dental issues.
But what if there is no single silver bullet? What if we are approaching the problem in individual pieces rather than as a system of multiple causes and effects? Since dental issues are multi-causal, what if the silver bullet is multiple therapies delivered in a specific protocol?
Could Lasers Be the Solution?
Dental lasers were introduced to the United States in 1991. On October 7, 2004, the Azuryt Model CTL 1401 carbon dioxide laser was approved for sale in the United States. But even in 2004, few dentists had ever heard of dental lasers. Also, few were aware of the connection between oral and systemic health, even with a plethora of scientific evidence. It was all “woo” to most dentists.
But by 2006, the anecdotal results of more than 100 clients using laser-assisted periodontal therapy (LAPT) were amazing. I thought I had found the “silver bullet” to reverse periodontal disease, which would improve inflammation and A1c, thereby improving patient systemic health. The initial results showed that each laser visit would reduce periodontal pockets by 1 mm. Tissue health improved immediately. It was amazing.
Upon being accepted to speak at an Academy of Laser Dentistry meeting, I decided to conduct a case study to measure sustained results over 6 to 12 months with 50 patients from two of my clients and present it at the meeting.
According to the Centers for Disease Control and Prevention (CDC), 47.2% or 64.7 million American adults over the age of 30 have mild, moderate, or severe periodontitis. Client 1 reported that 66% of its patients over the age of 40 had periodontal disease, and Client 2 said that 44% of its patients over the age of 40 had periodontal disease, consistent with the CDC’s statistics.
The family histories taken from patients included history of heart disease, diabetes, and/or cancer of the patient’s parents. There was a correlation between family history and those patients who tested positive for the Interleukin gene.
Medications included those prescribed for high blood pressure, inflammatory diseases including heart disease and diabetes, and cancer. These medications are not reducing inflammation 42% to 44% of the time, based on percentage of C-reactive protein (Crp) over 3 mg per liter of blood, according to this case study.
Class 2 was determined by six or more periodontal pockets measuring greater than 3 mm but less than 5 mm. Class 3 was determined by six or more pockets greater than 4 mm. The percentage of patients measured statistically coincided with the CDC’s findings.
The presence of the Interleukin gene statistically increases patient inflammatory risks.
Controlling red complex bacteria including Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, formerly Bacteroides forsythus, and Aggregatibacter actinomycetemcomitans is key to sustaining long-term periodontal health.
Client 2 included anti-inflammatory and bone support nutriceuticals as a matter of course and showed more effective control of pathogenic bacteria. Client 2 also auto-shipped its home-care products to its patients’ doorsteps for convenient maintainance.
LAPT plus scaling and root planing (SRP) effectively reduced pocketing 14% and 22% (about 1 mm per pocket) respectively. LAPT plus SRP also effectively reduced bleeding sites by 18.7% in both practices.
A1c is an average of glycated hemoglobin over 90 days. An A1c of greater than 6 often indicates diabetes. Unfortunately, my clients did not measure A1c after treatment unless it was greater than 6, so I couldn’t determine change. Still, 8.3% of Client 1’s patients qualified for referral to their MD for diabetic testing. Periodontal disease doubles risk for diabetes.
Crp is an inflammatory marker. No more than 1 mg per liter is healthy, but most physicians consider 3 mg per liter to be acceptable. A 33% reduction is significant because lowering Crp just 1 mg per liter of blood candecrease heart disease risks by a factor of 100. Client 1 did not measure Crp after treatment, so I couldn’t determine their change.
This research showed me that although LAPT plus SRP initially reduced pocket depths, there is much more to the story. SRP alone isn’t enough. Laser therapy alone is not a silver bullet. The relationship between periodontal disease and systemic health is multifaceted. Therefore, we need multifaceted treatments to sustain health.
This research encouraged me to develop Clean Kiss organic homecare products, which include nutritional supplements coupled with the 30 Second Smile SCRUB Brush and HYDRO FLOSS Oral Irrigator, to improve periodontal health.
Because oral health greatly impacts overall health, it’s time for a clinical trial that measures a system, not just a piece of the puzzle. I believe this approach is the silver bullet. If you agree, contact me at http://gowellnet.comfor details on how you can participate in the clinical trial.
Ms. Meditz is founder and executive director of HCP Wellnet and formulator of Clean Kiss products. Her career mission is to “make HEALTH contagious” via oral health. She can be reached at firstname.lastname@example.org.