Please note:  Product names used by Dr. Walker are listed below.     

        Periodontal disease is an infection and inflammation of the gum tissue, involving damage to the attachment of the gum tissue around the teeth and bone loss. It is diagnosed by licensed dental professionals with the insertion of a calibrated probe in six different areas around each tooth and measuring the depth of the readings. Normal readings are 3 mm or less. Readings of 4 mm or more are referred to as pockets. Pockets of 4 – 6 mm can usually be successfully treated within a general dentist’s practice and readings of 7 mm or more are often referred to a gum specialist known as a periodontist.

       Since returning to dentistry in 2003, I have found great professional satisfaction in helping many of my clients improve their periodontal problems. Some of the reasons our dental office has been successful include examination and education of clients in the following ways:

• My dentist requires that I do a periodontal exam on every patient, every visit.  We chart six readings per tooth each year and chart only abnormals between the yearly visits. Our clients are very concerned with whether they are making progess in the problem areas and appreciate  feedback on whether their efforts are bringing about any significant  improvement. It helps to keep their attention inspires them to cooperate with advice I offer. Plus, if things have gotten worse it allows me to quickly find out exactly what has gone wrong and develop a solution to get them back on track.

• We use a plastic probe that has colored markings. This is not only easier for us to read, it is easier for the client to see where we are demonstrating pockets in their mouth. Many clients do not have a clue what 5 mm looks like. We must make sure to show them the markings on the probe so they understand how deeply they must clean around their teeth at home.

• It is very easy to point out to both adults and children the red and inflamed gum tissue on their front teeth. We suggest to our clients that this is one of the signs they can use to gauge whether they have been flossing enough (or properly). We show them how flossing under the gum line will remove the bacteria that are responsible for this redness. We describe how this inflammatory process gets progressively worse to cause blunting of the gum tissue that exposes unsightly spaces between their teeth.

• We clarify to clients that periodontal disease is not just a mouth problem that could cause loss of teeth. It is an infectious disease that could cause loss of life. When the gums bleed easily, this indicates the loss of a very important barrier against bacteria, which now have access into their bloodstream and internal organs. The same thing is true of abscessed teeth. The blood is supposed to be a sterile environment. When this environment is breeched, the germs can travel throughout the bloodstream and cause infection in the cardiovascular system, lungs, liver, pancreas, kidneys, brain and joint implants. Gum disease is associated with heart attacks, stroke and difficulty getting control of blood sugar  in diabetics. Hemolytic bacteria literally consume our blood for food and can cause anemia. Mouth infections are nothing to take lightly.

• We demonstrate to clients how to get to the bottom of their pockets to remove the sticky biofilm of bacteria that causes periodontal disease. If you disrupt the bacterias’ home on a daily basis, they will not be able to organize, multiply and release their toxins (translation: bacterial poop). One of the best tools to effectively get to the bottom of a 5 or 6 mm pocket is a plastic device known as a Perio-Aid. It allows you to hold a half-inch section of a round toothpick at such an angle that you can sweep around the perimeter of a tooth and reach vertically downward into the pocket. This is totally different from the way people commonly use a toothpick horizontally against the tooth to pick food out from in between the teeth. It must be used at a vertical angle to reach into the space along the root surface of the tooth. It is extremely effective and has been one of the best tools to help our clients improve their periodontal readings.

• Smoking is one of the biggest risk factors for periodontal disease. It depletes calcium, vitamin C and the B vitamins, especially folic acid which is so important for tissue healing. It also diminishes the number of small blood vessels (peripheral vascular disease), which decreases the ability of our gum tissue to remove toxins and receive nutrients and infection-fighting antibodies. The gum tissue of someone who has smoked for many years looks very pale and rubbery, much like that of a cadaver. Smoking has indeed been proven to be a faster way to die.

• Clients need to understand that the better nourished they are and the less nourished the bad germs are, the faster their gums will heal. Therefore, a healthy diet and lifestyle and the addition of targeted nutritional products will speed the healing process. (see also comments under Extractions) Germs grow in huge numbers in the presence of simple sugars. Decreasing sugar, white flour, white rice, alcohol and potatoes will help starve out the germs. Substituting brown rice, whole grain cereals, and bread made from 100% whole wheat is extremely helpful.

• Over 100 medications including statin drugs such as Zocor, Lipitor, Mevacor and Pravachol deplete CoEnzyme Q10, a valuable nutrient involved in energy production, including the ability of our heart muscle to contract without ceasing. Research has shown that depletion of CoEnzyme Q10 is associated with gum disease, possibly due to its many benefits. It increases circulation, improves energy production, boosts the immune system and provides better blood flow to the heart. The most common side effect of statin drugs is muscle pain, which is reportedly relieved with 100 – 200 mg daily of CoEnzymeQ10. According to www.DearPharmacist.com, cardiac symptoms of CoEnzyme Q10 depletion include congestive heart failure, increased blood pressure, angina, mitral valve prolapse, cardiac rhythm problems and stroke. This site (under the FAQ’s section) lists the many medications that deplete this important nutrient.

• Professional treatment of periodontal disease relies heavily on methods of anti-bacterial mouthwashes and pharmaceutical bacteria control. Antibiotic application under the gumline, into infected periodontal pockets can be very helpful but has short-term benefit. Using antibiotics as a primary method of germ control is similar to the futility I had trying to stay healthy during the first 22 years of my life. I took antibiotics at least 3 times a year but still suffered from frequent bacterial infections of the throat, lungs, ears, sinuses and bladder. My infections finally ceased when I stopped feeding the germs and started better nourishing myself. This not only included a better diet and nutritional supplements, but also the regular consumption of bacterial probiotics that allowed me to develop a natural immune defense within my body. Likewise, these methods of bacterial control should help to greatly decrease the need for antibiotics in the treatment of gum disease.
• When using anti-bacterial mouthwashes for gum disease, we give our clients a plastic syringe that allows them to squirt a full strength dose directly into the pockets. Usually this is only necessary for a few weeks. It would be interesting to note whether a second rinsing of these pockets with a solution of probiotics and L-glutamine could provide increased benefit and the faster resolution of symptoms. I am very wary of recommending the general use of mouthwashes to be swished around the entire mouth, especially by the healthy, general public. Please contact me via email on this site if you can provide information on the impact of mouthwash on the normal flora of the mouth.

       The elevation of homocysteine has been implicated in many inflammatory diseases, including strokes, heart attacks, cancer, diabetes and Alzheimer’s disease. Periodontal disease is an inflammatory disease that has already been associated with an increased incidence of heart attacks, strokes and diabetes. Keeping homocysteine under control requires nutritional factors that provide healthy methylation in the body, including B vitamins, especially B6, B12 and folate.

       It is estimated that approximately 30% of the population has a genetic enzyme deficiency that prevents them from converting folate to its active form. This would certainly explain the increased family tendencies in developing cancer and cardiovascular diseases. In my health coaching practice, I use both multivitamins and a B complex product that supplies a proprietary blend of active folates to allow people with such genetic deficiencies to resume normal folate metabolism and prevent a wider variety of diseases.

       Dental research should examine how blood tests that examine markers for inflammation relate to the incidence and severity of periodontal disease. Such markers include serum levels of homocysteine, high sensitivity C Reactive Protein (CRP), and the erythrocyte sedimentation rate (ESR or sed rate). Again, if anyone can provide information on this, I would be pleased to post it on this site.

       When considering ways to decrease inflammation, consider that insulin is one of the most inflammatory hormones in the body. Increased stress and the intake of stimulants increases cortisol production, which also activates insulin. The following are ways to improve insulin regulation and normalize cortisol production:

• Avoid refined carbohydrates that trigger excessive insulin release
• Get moderate exercise, which normalizes both hormones
•  Eliminate stimulants such as caffeine and various prescription and illegal drugs
• Get adequate sleep
• Improve stress management with relaxation techniques, yoga or breathing exercises
• Create harmonious relationships, both at work and at home

       There are many nutritional factors for decreasing inflammation that have been extensively researched and clinically tested at the Institute for Functional Medicine in Gig Harbor, WA. I have used these products, including a patented medical food, in my health coaching practice to decrease the inflammatory markers mentioned above.

          Since bone loss is strongly associated with periodontal disease, please also read discussions under the heading Bone Loss.

       For more product information go to the product categories and select Medical Foods, Multiple Vitamin/Mineral formulas, Fatty Acid Formulas, Probiotics and Intestinal Support Formulas, Antioxidant and Phytonutrient Formulas, and B vitamins.