One third of the population have a genetic tendancy to develop periodontal disease.  Many people are born with a "sensitivity" to plaque bacteria. One could describe it as an "allergy". For these individuals, plaque causes inflammation on contact and triggers their immune system to go into hyperdrive, creating an overproduction of harmful enzymes, thus periodontal destruction ensues.   

For more information on genetics and periodontal disease go to these sites:

http://www.perio.org/consumer/geneticbasis.htm  http://www.dentistry.com/articles/Genetic_Marker_Discovered_for_Periodontal_Disease.aspx  http://www.umm.edu/patiented/articles/who_gets_periodontal_disease_000024_4.htm 

The good news is that advanced technologies will now allow us to alter the usually predictably poor outcome of genetic periodontal disease. Host factors, such as genetics, must be addressed to effectively put periodontal disease into remission. No longer will only cutting the pockets out with surgery, or only doing perioscopy, be the entire "cure".

Individuals with a genetic predisposition must be identified before anything we do clinically will be successful long term. These individuals over-produce destructive enzymes four fold, which causes severe destruction of the periodontium. The chronic nature of this disease can fool even the most astute clinician. Damage to the periodontium can occur quickly or slowly, therefore, preventative care becomes crucial.

Utilizing a safe and effective "Host Modulated Therapy" (low dose Doxycycline 20mg -LDD), or PerioStat(TM), will considerably change the course of chronic periodontal disease.

Low Dose Doxycycline 20mg (LDD) - Subantimicrobial Dose Doxycycline  www.periostat.com

"Host Modulated Therapy", or low dose doxycycline 20mg, also known as "subantimicrobial dose doxycycline (SDD)", is one of the most effective ways to control systemic host factors associated with chronic inflammation in periodontal diseases. Host factors may include genetics, smoking, diabetes, AIDS, hormones, medications contributing to periodontitis, and stress.

More about host factors in periodontal disease:

http://www.umm.edu/patiented/articles/who_gets_periodontal_disease_000024_4.htm

Low dose doxycycline, 20mg taken twice daily, slows the progression of the disease by suppressing the "over-production" of a destructive enzyme called collagenase.    

Over-production of collagenase before LDD - the body is out of balance due to host response - chronic inflammation - break down is exceeding repair and bone loss results.

Normal collagenase levels restored by LDD - equal breakdown and repair occuring.  Stability and health is restored. 

LDD puts collagenase levels back into balance.  Although doxycycline 20mg, or PerioStat, is in the tetracycline class of drugs, its use is often misunderstood.

At this very low dose, it is sub-clinical (sub-antimicrobial dose), meaning it has no effect on the bacteria whatsoever; only the production of the destructive enzyme collagenase is suppressed.  The therapeutic benefit has nothing to do with killing bacteria; that is not the goal.  To kill bacteria, doxycycline would have to be at a much higher dose.

This medication is powerfully effective at reducing and/or eliminating chronic periodontal inflammation.  Thus, it is one of the most valuable tools available in the fight against periodontal disease, especially if there are systemic host factors which cannot be controlled.

Other benefits of taking LDD daily include keeping blood sugar levels in check in diabetics, lowering CRP (C-Reactive Protein) levels and cholesterol in patients with chronic periodontitis and cornonary artery disease.  LDD is effective in the successful treatment of rosacea and rheumatoid arthritis.

Preventative periodontal care is about helping a patient to understand what is causing their disease, giving options for treatment, and reasonably predicting long term outcomes.  There are host factors which cannot be controlled with all the best intentions.  Low dose doxycycline (LDD) is one of the most powerful tools available to alter the course of periodontitis safely.

excerpts from Journal of Clinical Periodontology 2004 Sept.;31(9):697-707

Subantimicrobial dose doxycycline as adjunctive treatment for periodontitis. A review.

Preshaw PM, Hefti AF, Jepsen S, Etienne D, Walker C, Bradshaw MH.

School of Dental Sciences, University of Newcastle upon Tyne, UK.

Studies have shown that SDD, when prescribed as an adjunct to scaling and root planing (SRP), results in statistically and clinically significant gains in clinical attachment levels and reductions in probing depths over and above those that are achieved by SRP alone. SRP must be thorough and performed to the highest standard to maximise the benefits of adjunctive SDD.

SDD does not result in antibacterial effects, or lead to the development of resistant strains or the acquisition of multiantibiotic resistance. The frequency of adverse events is low, and does not differ significantly from placebo.   

Articles about sub-antimicrobial dose doxycycline (SDD):

http://uuhsc.utah.edu/pharmacy/bulletins/doxycycline.html

http://www.umm.edu/patiented/articles/how_antibiotics_being_used_long-term_prevention_of_periodontal_disease_000024_9.htm 

http://www.natural-hrt.com/artman/publish/article_133.shtml

http://ezinearticles.com/?Low-Dose-Doxycycline-Therapy&id=552971

Published research with low dose doxycycline:

http://www.ncbi.nlm.nih.gov/pubmed/15766366?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstractPlus

The connection of periodontal disease and overall health has actually been "known" for 100's of years, but now the research is starting to support that claim.  Finally, the health connection has been made...the most significant movement in the history of dentistry is here and it is gaining momentum...it is long overdue! 

Periodontal disease has now been linked with  heart disease, stroke, diabetes, and pancreatic cancer.  The list of serious health complications associated with periodontal disease is growing and the studies surrounding these findings has been given priority in recent years.  The mouth afflicted with periodontal disease is full of ulcerations (periodontal pockets), and is an easy "breeding ground" for opportunistic pathogenic bacteria, which then enter the blood stream and infect other areas of the body, setting off a dangerous chronic inflammatory response in the body.  These toxic bacteria have been found in the arteries of heart attack and stroke victims, and have also been found in the placenta.

The goal at PerioPeak Innovations is not only to eliminate the periodontal pockets harboring dangerous bacteria, but also to stop the chronic inflammation associated with gum disease and other serious health problems.  We take a complete "cause and effect" approach which addresses all the health issues associated with periodontal disease.  We successfully treat the source of the disease, not just the effect.

This insidious disease of chronic infection and inflammation should not be ignored.  We can no longer take a "head in the sand" approach to periodontal disease. 

Unfortunately for the person with periodontal disease, it is for the most part a painless condition, therefore it may not be discovered early enough so periodontal surgery and/or extractions may be indicated.  Undiagnosed periodontal infection festering beneath the gums wreaks havoc in overall health, elevating the inflammatory mediator response, and setting off a cascade of dangerous problems.

Below are links with recent information and studies about the connection between periodontal disease and overall health:

• December 2005 - Readers Digest - How your dentist can save your life http://www.rd.com/content/openContent.do?contentId=19084
• January 2006 - ADA/Colgate Begin Oral Systemic Education Campaign http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=1611
• January 2006- CIGNA begins Dental Oral Health Maternity Program http://www.cigna.com/health/consumer/dental/oral_health_maternity_program.html
• January 2006 Canada Begins Just Say Gingivitis Program http://www.justsaygingivitis.ca/english/2006%20contest/default.asp?s=1
• February 2006 - First Joint ADA-AMA Conference http://www.ada.org/prof/resources/pubs/adanews/adanewsarticle.asp?articleid=1815
• March 2006- Consumer Articles Increase - Save Your Smile and Health http://www.azcentral.com/health/news/articles/0321dentalsins0321.html
• March 2006- Aetna-Columbia U. Research- periodontal care appears to have a positive effect on the cost of medical care, with earlier treatment resulting in lower medical costs for members with diabetes, coronary artery disease (CAD), and stroke. http://www.aetna.com/news/2006/pr_20060317.htm  

It's important to ask questions about the current condition of your gum health...it's more important than we ever realized.