Beat the Bugs- Conquering Periodontal Disease

Here's the follow up to my latest post:  "Gum Disease: Meet the Bugs".  Now that you know how nasty these little buggers are, you need the tools and know-how to finally conquer and beat them!  This post is a little long but filled with a ton of information.

First, a little review:

Gum Disease

*Gum disease really matters.  It's an INFECTION of your gum tissues.

*Gum disease does not hurt (until the final stages).

*Half the population of the USA over age 30 has periodontal disease- that's advanced stage gum disease.

*Periodontal disease is the number one cause of tooth loss in adults.

*Gingivitis- the early stage of gum disease is the gateway to bone loss - and 50 to 90% of adults world wide have gingivitis.
                                 
*This infection is connected to an incredible number of diseases in the body.
                             
*If your gums bleed with brushing, flossing, tooth picking or eating, you may have a gum infection, which means GUM DISEASE.   Bleeding gums, even during a dental hygiene appointment mean infection, and is not a healthy sign.

Step ONE: The Basics 

The key is to get that plaque biofilm outta there!

#1. Get an electric toothbrush.  Really!  It does a way better job than your ancient, old manual brush. Believe me when I say I can always tell which patients use an electric versus a manual brush.  It shows.  It's well worth the money it costs.  Yes, I know they're "expensive."  However, when you see the list of diseases associated with gum infection, an electric brush is a trifle compared to what damage gum disease inflicts on our bodies.
Once you own it, use it at least twice a day, for at least three minutes each time.  As I've said before, plaque's sticky and really likes living under your gums and between your teeth.  It actually takes that long with the electric brush to get if off your teeth.  It takes much longer with a manual brush.

It cleans better 

#2. Clean in-between.  Most folks hate floss, so if you hate it, don't floss.  Stop with the guilt already and use something like soft picks, and piksters, or the good old rubber tip stimulator.  What I'm looking for is not massaging the gums, but rather a way to reach in between your teeth and under the gumline to disrupt and disturb the plaque.  AND, this is the really important part - mix up some baking soda and peroxide, or baking soda and your favorite mouthwash, and work that underneath the gums and between your teeth with your picks. The baking soda acts as an antibacterial agent.  (And it's cheap!)  And, yes, I'm aware it tastes less than stellar, but it works and (did I say?) it's cheap!

#3. Scrape your tongue- twice daily.  The amount of plaque-biofilm on your tongue is substantial.  It needs to go.  Be sure your children also use a tongue scraper.  I taught my then five year old to do that and it's now a part of her daily routine, just like brushing.  Still working on the flossing/cleaning in-between part though...

Step TWO: Because Brushing and Flossing really are NOT enough

You need to disinfect.  The bad guys need to get washed down the drain.  But, here's where we can get creative.  I have several options, so find one system that'll work for you.  The best tools are the ones that work best FOR YOU. 

Option 1. Water pik or Hydrofloss irrigation.  I recommend my patients use either baking soda (about a heaping spoonful) and warm water, or bleach water  (one part  6% bleach to 25 parts water) or Therasol  (concentrated solution is diluted one part to eight parts water).   All those bad mama jama pathogens can't survive that flushing.  Use a full tank of warm water, outline your gums with the pointiest irrigation tip you can find.  Each company has one.  Go around your mouth up and down, tongue side and lip side at least three times.  Keep your head over the sink and do not turn the machine on unless the tip is pointed in the sink or in your mouth or it can get messy.  And, FYI- there's always a little cold water left in the tubing.
There are shower -flosser models for those interested in doing all this in the shower.

Once a day is great, twice is incredible.

OR

Option 2.  Ozone oil and piksters- dip the pikster into the oil and work that under the gumline and in-between the teeth.  I recommend  PurO3 Tooth and Gum Support with peppermint and Stevia--tastes the best. (While you're there, they have a new Bug Bite Relief.  Ozone stops the itch of mosquitoes almost instantly- you'll thank me later. )

  Worldwide you can order ozone oils from GreyCellSales - they take payment in US dollars, UK pounds and Euros.  I love what ozone oils can do to help healing.

OR

Option 3.  Perio Protect Trays - custom made trays that you wear with special 1.7% hydrogen peroxide gel, gentle to your tissues, yet strong enough to breakdown the bacterial biofilm.  Peroxide releases oxygen - which kills the bacteria that lives in your oxygen-less gum pockets.  It also debrides the bacterial cell wall.  The specially made trays are the key to holding the peroxide into the pockets and on gum tissues, and allowing the gel to kill the pathogens.  You start out six times a day for 15 minutes, with the idea you will eventually get to twice a day for 15 minutes.  Takes about two months to transition to the twice daily routine.  And, as a great side benefit, you'll have whiter, cleaner, decay free teeth!   I have many patients using this routine and love the results they have obtained!   Here's a video I took of a patient who's been using her trays - the slide's empty!  That's what I love to see. 

OR

Option 4.  PerioSciences Antioxidant Gel and Rinse - I've just started using this product myself, and like the taste.  I've heard good things about these products from people I respect but in truth, I have not had any patients try this yet so can not vouch as to its long term results.  Check back.  For now I'm trying it on myself, working the gel in-between my teeth with piksters or rubber tips.

OR

Option 5. Izun Oral Care's Perio Patch and Rinse - new, new products that heal from the outside in.  They have a unique intra-oral barrier that absorbs wound exudate (pus) and promotes gum healing.  Still learning about this but love what I'm reading!

AND

This is really not optional:
Monitoring the bacteria.  As I've mentioned before, I use a chairside phase contrast microscope to constantly monitor the gum disease bacteria.  It's quick, inexpensive to the patient, and gives us a "look see" to life under the gumline.  Click here to read an excellent article by another dental hygienist who also uses one!  I recommend my patients return frequently to monitor the bacteria and see if they are being successful in their homecare routines. If not, it's time to regroup or change things up, get deeper where the bad guys live.

And One More Thing!

Periostat - Low dose doxycycline - stops bone loss.  This is a sub-antibiotic dose of doxycycline so it does not kill bacteria, instead it alters the host (that's you) response to the pathogens (the bad guys).  The periodontal bacteria cause your body to produce enzymes and it's these enzymes that cause your bone to dissolve.  Periostat helps stop bone loss by inhibiting and suppressing those enzymes.  It's taken twice daily, am and pm, about one hour before meals.  Taking this medication is a commitment and may well be a long term thing, but isn't it good to know there are so many options to stopping bone loss and preserving your teeth!?!


That's seven different ways you can choose from to disinfect your mouth and save your teeth!   Pick one or two!  If you don't like it, try another!  Find one that works for you, and stick with it to save your teeth.

And to make sure you actually do kill them: check on the microscope.


                                                        

Step 3: The Rest of the Story

Diet - it's time to look at what you're eating, and get serious about healthy, nutritious food.  Stop eating sugar and just about anything white.  I have a patient that had a very bad case of periodontal infection  she just couldn't control until she stopped all sugar.  The transition was just about miraculous, it made me even more a believer in the healing power of healthy food.  Sugar causes inflammation. 

Nutritional supplements - In addition to a nutritious diet, vitamins and supplements are important.  I have an entire post on what supplements to include to support a healthy oral immune system.  Add Vitamin D3, Vitamin C Vitamin K 2, Co Q 10, Magnesium and Omega 3's  to your shopping list.  Look on my post for quantities.  

Mouth breathing - Close your mouth and breathe through your nose - all the time.  Folks that mouth breathe have red, swollen infected gum tissues, in addition to a whole host of other issues.  If you have sinus problems that won't allow you to breathe through your nose, consider having a physical- you might just have acid reflux that's causing your clogged sinuses.  It's all related.  Close your mouth, breathe through your nose.  Sleep apnea and any other airway issues are  important to address as well.   I do have another post or two on mouth breathing/nasal breathing.  Athletes, if you want to improve your performances, then it's time to really learn about nasal breathing  ;) 

Probiotics -  As we change the oral flora by eliminating the bad guys, we need to replace them with good guys!  Brand new research published May 25, 2016 says this improves oral health.  They recommend probiotics with Lactobacillus species.  There are new probiotics out for gum health.  Look at Evorapro, Venus Smile Probiotic mints, or Periobalance.  Suck on one tablet in the morning and one after dinner, or whatever their instructions recommend.  These will all have to be ordered online. 

Family - gum infection bacteria are contagious so it would behoove you to have the entire family be proactive and all work on oral health together.  It's your immune system's reaction to the bacteria (i.e. the family gene pool) and viruses that cause bone loss, and you all share the same DNA, so be healthy.  Prevention and learning good oral health habits benefits the entire family!

And then there's the value of good sleep, stress management, and exercise.

Speed Bumps to Recovery: 

Dry Mouth - Many medications change the quality and quantity of your saliva.  Your mouth may not feel "dry" but if you are taking two or more prescription medications, then you can be assured the quality of your saliva is not as healthy either.  Good, healthy saliva flowing in your mouth is a vital part of maintaining a disease free mouth.  And, of course I have a post on products to help keep your mouth moist.  Let me know which products work best for you.   

Smoking and Drugs - Sorry to say, but smokers have an uphill battle to have a healthy mouth.  Drugs are no better.  I hope to do an entire post on this in the near future.   

Other Health Issues- If bleeding continues after doing therapy for a month, it may well be time for a physical and possibly a referral to a specialist.  Look at BMI, family history, gut microbiome, antioxidant levels, diet, autoimmune issues, blood disorders, and other compounding risk factors.  If you have a chronic inflammatory disease and no clue as to its cause(s) then how can you treat it?  Your medical doctor should be part of your wellness team.  More on this in a future post.  

Being Lazy:

Yup, we all are... Make a promise to yourself to get healthy and stick to it.  There's nothing you can't do if you get the habits right.  It's not quick or easy but it is possible- I wrote a post on dental habit development - click here to refresh your memory!  My one suggestion today is to not wait until bedtime to "do your teeth."  Find a way to take care of them in the morning or other time(s) during the day.  Bed time just won't work, even I might be tempted to skip doing my oral care (gasp) when I'm tired and just want to crawl into bed after a long day.

Gum infection, tooth decay in-between the teeth, and heavy grinding all in one picture! 

Hopefully I've inspired and encouraged you with new information, new products and new ideas on gum disease prevention, and on how to achieve a healthy mouth.  You have the knowledge and it's time to fight this infection with all the determination, fire power and ammo you can get your hands on!  Hopefully I've provided you with a bazooka or two for your artillery!   You can win this war!  


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Any time you see a highlighted word, click on it to go to my research.  I appreciate your questions and comments.  And, thank you all for reading. We've hit 36,000 page views!! 
Til next time, 
Keep Smiling!


Barbara RDH

Oral-Systemic Periodontal Therapist
Specialist in Orofacial Myofunctional Therapy