One Size Does Not Fit All

Periodontal disease is an inflammatory, polymicrobial, multifactorial disease that not only affects the periodontium but has also been linked with systemic diseases such as cardiovascular disease, rheumatoid arthritis, and diabetes. Periodontal disease is a silent disease that affects over 64 million Americans. Most are unaware they have it or possess the bacteria placing them at risk.

The use of MyPerioPath® is essential in determining which bacteria are present. It is a key factor in patient acceptance of their disease or potential risk of disease. Implementing salivary diagnostics into your practice will help determine what type of therapy can be used. Although MyPerioPath® will recommend an antibiotic regimen which is an added bonus, it doesn’t have to be used. Our office takes a proactive approach and uses the systemic antibiotic option sparingly.

The oral microbiome is diverse, complex and unique to each individual. As clinicians, it is important that we recognize it is not a one size fits all standard of care. We must shift the focus away from destroying the oral microbiome with the use of antibiotics to improving the oral microbiome with supplements like probiotics and prebiotics.

The implementation of oral probiotics, both as a supplement and through diet, is key in establishing a balanced oral flora. Probiotic rich foods like sauerkraut, grape leaves, kimchi and kefir milk are a good source. Probiotics like EvoraPro® and Pro-Dental® are designed especially for the mouth.

Prebiotics are necessary in conjunction with probiotics. Think of them as food for the probiotics so that the probiotics can take residency. They are found in foods like raw garlic, onions, raw leeks, artichokes and less ripe bananas. They can also be found in lozenges like Daily Dental Care™ and Revitin® toothpaste.

Nutrition also plays an important role. A diet that is anti-inflammatory, rich in antioxidants, and alkaline promotes overall health. As well as the use of whole food supplements and omega-3, which aid in healing. Water is essential in reducing dry mouth and restoring pH levels. Not all water is created equal. Sparkling water and a majority of bottled water tend to be acidic.

The use of an oral irrigator like the Waterpik® and a motorized toothbrush are essential in reduction of plaque levels. Tongue scraping with the Tongue Sweeper® morning and night reduces the incidence of halitosis, aids in digestion and overall health.

The best holistic approach to co-managing periodontal disease is to treat the “whole” person. The right environment in the mouth can promote health or wreak havoc. Ask the right questions, be knowledgeable of all dental products, take the time to educate your patients and effectively communicate with your patient’s physician are necessary skills oral health care professionals need to process and continually develop.

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Sandra Lindo RDH