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, regular professional cleanings, addressing bite problems, smoking cessation, considering anti-inflammatory medications when necessary, having good blood sugar control (nutrition), 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 and an Oral-B sonic toothbrush for general self cleansing.  We have found this combination of home care tools to be most beneficial for daily removal of biofilm more effectively.

Recently, an innovative product which claims to dissolve calculus (tarter) below the gumline has captured our attention.   This product, called Periogen by Global Tonic, is an easy to use powder dissolved in water.  Periogen is used with a water pik and/or an irrigator for deeper pockets.  While this may be a tremendous breakthrough, these claims have not been substantiated yet with studies.  However, it has been our experience that regular use of this product “seems to” change the nature of the calculus, making it easier to remove during maintenance cleanings.   Again, this has not been proven with research and is merely anecdotal information. While Periogen may have benefit in loosening or dissolving some calculus between cleanings it may also be helpful in keeping areas clean and healthy which may be more challanging for any type of periodontal treatment to help repair, ie, advanced furcations (advanced bone loss between roots), which may be considered to have a poor prognosis long term.

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 multifactoral medical condition and requires a very comprehensive, multifaceted, and definitive professional treatment approach. 

For more information for any of these products check out these links:

Host response modulation: 

For many individuals good home care along will not be enough to maintain optimal periodontal health.   Genetic tendancies will often dictate the progression of periodontal disease.  We now know that 1/3 of the population have a genetic tendancy 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 of 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 therapeutic use.

Recently at PerioPeak, a natural approach fora type of host modulated therapy has been discovered.  We feel this is a very exciting breakthrough to help chronic and destructive gum inflammation.  To learn more about this natural alternative go to

Learn more about genetic periodontal disease and host modulated therapy

Nutrition and Supplementation:

One important host factor for healthy gums, which can be controlled by the individual, is diet and nutrition.  We have uncovered numerous research papers supporting this statement.  A diet high in antioxidants and natural anti-inflammatories, 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, Calcium, Co-enzyme Q10, and Omega three fatty acids.  We recommend a comprehensive physical examination once a year with a physician or naturopath to determine nutritional needs, and to identify any health concerns which could be contributing to periodontal disease.