Say No to Ginger Vitis and her friend Perry O'

Ginger Vitis and Perry O' are not friends to invite to your next party, and- even worse!- unfortunately, they're having their own shindig under your gums!  Ginger and Perry have to go!  I need to write a children's book with these two characters as villains.  Don't they sound ominous?  Yes, they are quite dastardly.  I rather picture them similar to Natasha and Boris from the Rocky and Bullwinkle Show (for those old enough to remember.)   

Natasha and Boris or Ginger and Perry

Let's review what gingivitis and periodontitis infections really are, and why they matter to your entire body!  

I know I've written about gingivitis before but with new research out on how bad it really is for you and your health, thought I'd add an update.  Grab your coffee, I don't normally write so much but this time there's lots to address so please, sit down, relax and read on! 

Gingivitis ~ What the heck is it and how's it different from periodontitis?  

gum infection = gingivitis

Gingivitis is an infection exclusively in the gum tissue.  It is, for the most part, reversible.  It's mainly caused by bacterial/fungal biofilm living at and under your gumline (from, as we say in the biz, "poor oral hygiene").  Most of the bacteria in our mouth and body are there to help us, but there are a handful that are destructive.  Gingivitis does not hurt, so most folks ignore it.  Patients often say "oh, my gums always bleed."  Boy, if only they heard the alarm bells ringing in my head when I see gingivitis and hear that!  

The commercials on television make gingivitis seem benign, and even many dental professionals may blow it off as un-important, non-serious.  They all couldn't be further from the truth.  Gingivitis is actually the gatekeeper to future jawbone loss and gum disease infections (periodontal disease).  In addition to that, patients with gingivitis pockets (the area around the necks of the teeth) of only three millimeters (one to three millimeters is considered "okay" by dental professionals) have an elevated risk of vascular disease.  Gingivitis causes a low grade inflammatory response in the gum tissues.  Many of the bad bacteria found in periodontitis are also found in gingivitis.  These same bad bacteria also inhabit your nose and sinuses and can contribute to pneumonia, sinus infections and ear infections.  Not so benign?!

Note red rolled gums, swollen tissue between the teeth, and bleeding

    Gingivitis differs from periodontitis- perio- in that periodontitis infects and liquefies the bone.  It is a chronic inflammatory disease.  The bone literally dissolves, which is why tooth loss can occur.  The bacteria that cause periodontal disease trigger your body's immune system to produce enzymes and it's these enzymes that cause your jawbone to dissolve.  It's your body's way of trying to protect you from the bacteria.  
A bacteria named Porphyromonas gingivalis (P.g. for short) is one of the baddest of bad guys.  P.g. is present in gingivitis as well as periodontal disease - he's what's termed a Keystone Pathogen.  He opens the door for other bad guys to come flooding into your body, not just in your mouth.  He even encourages the good bacteria to turn bad- he hijacks white blood cells and turns them into bacterial transport cars!  That should cause you pause!

How Gingivitis becomes Periodontitis

Progression from Gingivitis to Periodontitis

This inflammation in the gums acts as a switch, igniting your DNA and causing the deeper, more chronic periodontitis infection to take off like a rocket if there are enough bad bacteria  AND (the key here) if you are genetically susceptible. When your genes say your immune system is more sensitive to the bacteria then we call that a "hyper-responder."    

A slight tangent: Our genetic profile - our unique DNA - is the root of all chronic diseases within each of us.  Your DNA influences your susceptibility.  With the advancements made in gene testing, we can now peer into our future and literally change our history!  What incredible times we live in!!  We no longer need to guess why disease is there, we can look at our genetics and be proactive.  You can have a low genetic risk level and still get periodontal disease by overriding your immune system with activities such as smoking cigarettes or cannabis, poor oral hygiene, diabetes, and high biofilm bacterial/ fungal loads to name but a few.
 (So if your genetic markers don't point directly to periodontal disease susceptibility, you still can't be lazy.)

 Ideally, you learn your genetic tenancies now, before you have an infection or bone loss, while you are healthy.  Folks that are genetically positive are what are termed "hyper-responders" and are much more sensitive to the bad pathogens.  Dentistry can now test for this susceptibility.  The test we use is called Celsus One and is by Oral DNA.  Know now and be proactive! You only need to do this test once- your genes won't change.  Then you'll know if you are genetically susceptible to the gum disease bacteria.

Genetic testing may be even more valuable for your children.  Know what their risk levels are for cardiovascular disease, diabetes, and periodontal disease while they're still young.  You can guide their lifestyles to help them make wise choices and live longer healthy lives.  With the costs of health care going up, prevention is vital!

Back to specifically periodontitis: With the infection already starting in your gums, the pathogenic bacteria reproduce in a matter of hours.  Even if you had gum therapy yesterday, but didn't do your homecare last night, the bacterial population is heading back up to pre-therapy levels within three to seven days.  Fighting this battle is a daily thing.  

I've talked before about the need for professional, advanced hygiene care (Why Do My Gums Need Therapy).  If you have plaque and tartar buildup, you're just barely treading water, and you'll be sinking fast if all you're doing is brushing your teeth. (Read my post about cleaning in-between your teeth while you're at it.) Your fabulous dental hygienist is expertly trained to get that plaque/tartar out from under your gumline.  That starts the healing process - getting your mouth primed for recovery.   However, some of the bad gum disease pathogens are immune to deep scaling and gum therapy.  
Work with your dental team, and then do. your. homework.  
Learn what's going on in your mouth. Test, Treat and Re-test.  Know with whom and with what you are dealing.  Creating customized homecare instructions that address your individual situation, and knowing your risk factors (I.E. your genetic risk levels), you can take control of your oral and systemic health.  When things like stress, nutrition imbalances, or kissing a new partner who has periodontal disease come into your life, you have a better chance of maintaining your dental health.



                                                            ***IMPORTANT***

 Prevention! Need to Test the Bacteria Levels

Perio pathogen testing by Oral DNA -

Test, Treat and Retest

 Any dental office can and should offer to do this.  Salivary testing gives us a more definitive look at the bacteria - both variety and quantity.  I love knowing what's there, especially BEFORE infection and damage occurs.  Then we can be especially proactive.  I'd love if everyone took this test, because it really is extremely vital knowledge.  I've come across information that says patients with exceptional homecare can mask active inflammation occurring below the surface. You can still have a high bacterial levels and if you are a hyper-responder the rest of your body is also hypersensitive to the bacteria. Inflammation can then occur throughout your entire body ( for example: think Rheumatoid arthritis).  Just because we can't detect inflammation with our current visual diagnostics does not mean it's not there.  We need to "up" our tools, so I offer this test to all my patients, especially now that I understand the genetic connection to be so vital.  I also love that it tells us which antibiotics will address these pathogens.  I suggest antibiotics sparingly and judiciously, but I like having this option if/when needed.  The standard, typical antibiotic regimes for treating periodontal disease only work in killing the bacteria 30% of the time, so knowing exactly what pathogens you have and customizing the proper antibiotics is vital to eradicating the infection.  Still, antibiotics alone can not work against this disease, it can not penetrate the biofilm.  After treatment it is vital to re-test and be totally sure you've succeeded.  If the test for pathogens is still positive then you go back to the drawing board.  As you'll see below, you cannot ignore this disease- it will resurface within the body and can be destructive.  Destroy it.  If you do not have the pathogen, you do not have the disease.  Plain and simple.


Dr. Dan Sindelar, past president of the American  Academy of Oral Systemic Health (AAOSH) summed it up:

The bad bacteria associated with both periodontal disease and systemic disease -- Treponema denticola, Porphyromonas gingivalis, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, and Tannerella forsythia -- can be tested for in any dental office with salivary diagnostics. A surprisingly large portion of our population is above threshold* for these bacteria. When you see how many people are above threshold, it becomes apparent how big an impact this can have on health.

• 40% of those under 30 years old are above threshold
• 61% between 30-40 years are above threshold
• 70% between 40-50 years are above threshold
• 77% between 50-60 years are above threshold
• 83% over 80 years old are above threshold

Cortisol and stress play a key role

**Threshold: “Pathogen Load Threshold”- The concentration above which patients are generally at increased risk of attachment loss/disease progression.

The Oral -Systemic Link  -  Gum Disease's Long Reach Beyond the Mouth: Here's why Ginger and Perry should not be invited to any more parties! 

When I first started looking at what effect oral infections had on the rest of the body, my list had eight oral-systemic health connections.  Now, 25 years later, that list is exploding with amazing new research almost monthly.  Poor oral health is linked to some very serious medical conditions.  The mouth is the window to your body.  Time to close that window!  Hold on to your hats and take a look!  

• Cardiovascular diseases:
• Heart attack,                        published April 2016, February 2016
• Stroke  published 2016       published 2012
• Atherosclerosis,                   published May 2016  , May 2016
•  Vascular diseases                          published 2006, published 2010
• Alzheimer's disease                       published September 2015
• Pancreatic Cancer                         published May-June 2014
• Breast Cancer                                published 2015
• Kidney Disease                              published February 2016   
• Respiratory Infections                   published October 2014       
• Esophageal cancer                         published January 2016
• HIV activation due to Periodontal Disease-  published 2014
• Prostate Disease                             published February 2015
• Rheumatoid Arthritis                     published 2013
• Diabetes                                         published February 2015
• Still Birth                                       published 2010
• Preterm & Low Birth Weight        published 2010
• Colorectal Cancer                          published February 2015
• Oral Cancer                                   published 2012
• Stomach Ulcers                             published 2002
• Stomach Cancer                            published February 2016
• Diabetes                                         published Oct/Dec 2014
• Lung Cancer                                  published  April 2016

These are strong connections, but much research still needs to be done.  This is all truly cutting edge information and it's exciting to be in on the ground floor.

It really is time to attack oral diseases like your life depends on it, because as you can see - it does!  That bloody cleaning is a sign, a giant sign with neon lights flashing, yelling at you that things are unhealthy, and it's really only the tip of the iceberg.  Dentistry must work with the rest of your medical team, and be an integral part of your wellness plan.  Medicine now recognizes periodontal disease as a medical disease, rather than just a tooth issue.  It's time to beat these infection-causing pathogens and get the proper tools to help you help yourself  have a truly healthy mouth - which leads to a healthy body!  Never, ever ignore gingivitis!  Send Perry O' and Ginger Vitis packing! 

For more information on how I attack and go to war against periodontal disease and gingivitis read my blog posts and other articles:
      It's a Small, Small, Extra Small World 

My Second Orkos Award 

      Meet the Bugs
      Beat the Bugs
      Nutritious Nuggets
      Perio Protect Trays - read about what hydrogen peroxide can do to heal your gums!
      Mouth Breathing and gum disease - you'll never beat gum disease if you mouth breath. 

I have lots more information but these posts/articles sum up my treatments well.

The Money, Honey

You are ultimately in charge of your own health, so let's talk about the cost of all this.  Insurance- yes, dentistry is insurance driven.  For so many folks, if insurance doesn't cover it, they won't do it.  Hmm, I think, "penny wise/pound foolish".  Treating dental disease is really a long term investment in yourself, your total body health and well being, as well as your family's health (remember, it's contagious!!).  Look at that list above again.  All those diseases and the treatment for them costs so much more than gum therapy in terms of dollars, stress, heartbreak and, sadly, possible early mortality.  So, yes, it does cost money and yes, it comes out of your pocket.  But, as with all health issues, look at the insurance deductible and rethink prevention.  In the long run, you'll be money ahead.  The most precious thing you own is your health, and all the money in the world can't buy it back for you later.  Invest wisely.  Be healthy. and of course, keep smiling!  Remember, Ginger and Perry aren't your friends.

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Thank you all for reading this blog.  I am so excited to report we are closing in on almost 49,000 page views.   I'm honored and so pleased to have you stop by!

Hugs to all of you,

Barbara Tritz RDH, BS
Specialist in Myofunctional Therapy