Maintaining Optimal Periodontal Health
How to Maintain Optimal Periodontal Health
Regenerative Periodontal Endoscopy – RPE, helps to repair the periodontal foundation and sets the stage for improved periodontal health by eliminating microscopic calculus (tartar) and bacteria deep below the gumline, removing infected tissue, and stimulating attachment repair with natural proteins. How to maintain this level of health long term is the subject of this post. We strive to empower periodontal sufferers through education. There are several aspects to be considered, including excellent home care and diet (including proper supplementation), regular professional cleanings, addressing bite problems, sleep apnea and mouth breathing, smoking cessation, taking anti-inflammatory medications when necessary, having good blood sugar control, reducing stress, and promoting overall general health and wellness.
Home Care:
Excellent self care (home care) is of course very important if optimal periodontal health is to be maintained. It has been our experience that once the chronic inflammation and destruction are addressed with RPE, maintaining excellent periodontal health becomes much easier. We highly recommend the Water Pik (or HydroFloss) and Sonicare or Oral B complete sonic toothbrush. We have found this combination of home care tools to be most beneficial for daily removal of biofilm more effectively.
It is important to note that using any irrigation product, or home care aid, will not definitively address the very serious nature of the periodontal disease process alone.
Periodontal disease is a multifactorial medical condition and requires a very comprehensive, multifaceted, and definitive professional treatment approach.
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Competent Professional Care with preventative periodontal maintenance - what to look for in your provider:
We highly recommend that our patients find an excellent dental hygienist who attends advanced course work in all preventative periodontal therapy strategies. You can consider interviewing your dentist and hygienist to find out what advanced course work they attend annually. We also highly recommend that our clients look for a competent clinical provider of GBT (Guided Biofilm Therapy), or similar air polishing methodology.
Addressing sleep disordered breathing, including obstructive sleep apnea and snoring.
This is one of the most important risk factors patients with periodontal disease can address definitively. We highly recommend that patients have a home sleep test with a qualified sleep specialist (this can be a dentist who only focuses on sleep medicine).
Find a sleep specialist in my area
Addressing Orofacial Myofunctional Disorders: these issues are probably the most often undiagnosed and overlooked risk factors, yet are very important for periodontal homeostasis and quality of life (tongue thrust, mouth breathing, chewing disorders, facial grimaces, weak and parted lips, and clenching/bruxism).
Find a provider of myofunctional therapy
Host response modulation:
For many individuals good home care along will not be enough to
maintain optimal periodontal health (highly susceptible individuals). Genetic tendencies will often dictate the progression of periodontal disease. We now know that 1/3 of the population have a genetic tendency to develop advanced periodontal disease through no fault of their own. This can be described as an allergy, or “hyper-inflammatory” response to plaque bacteria. In the literature these individuals are referred to as “hyper-responders”, with an immune system that actually up-regulates itself even in the presence of very little plaque bacteria. A lot of research is being conducted in this area of periodontal pathogenesis and how to address it. Periodontal specialists are now discovering the need for more proactive and aggressive treatment with these individuals including the use of “host modulated therapy”. The most successful form of host modulated therapy is the addition of a medication called PerioStat, also known as SDD (sub-antimicrobial dose doxycycline 20mg), for the purpose of addressing the hyper- inflammatory mechanisms internally. Few individuals may not be able to tolerate this medication either due to allergy or side effects (this is rare). Others may not be able to get the prescription necessary to obtain this effective medication. Unfortunately, few dental professionals are educated in it’s powerful therapeutic use. It may be more productive to talk to a medical provider about this medical approach to treat chronic periodontitis more proactively. Periostat actually promotes regeneration of all periodontal tissues if used properly with precise periodontal therapy (RPE).
Learn more about genetic periodontal disease and host modulated therapy
Nutrition and Supplementation:
One of the most important modifiable risk factors for healthy gums is diet and nutrition. A diet high in antioxidants and healthy fats, and low in refined carbohydrates, is a good start.
We also highly recommend supplementation with these key vitamins for improved periodontal and overall health: Vitamins B12, C, D, E, Magnesium, Co-enzyme Q10, and Omega three fatty acids. We recommend a comprehensive physical examination with blood work at least once a year with a physician or functional medicine provider to determine nutritional needs, and to identify any health concerns which could be contributing to periodontal disease. Including deficiencies and/or leaky gut or gut biome issues.