Erectile dysfunction might be associated with chronic periodontal disease

Erectile dysfunction might be associated with chronic periodontal disease:two ends of the cardiovascular spectrum.

INTRODUCTION: Both chronic periodontal disease (CPD) and erectile dysfunction (ED) are associated with cardiovascular disease and its risk factors, including smoking and diabetes mellitus. However, the association between ED and CPD has never been studied. AIM: To study the association between ED and CPD. MAIN OUTCOME MEASURES. Prevalence of ED, prevalence of CPD, ED severity. METHODS: The study population consisted of 305 men who filled the Sexual Health Inventory for Men (SHIM) questionnaire in order to detect ED and assess its severity, and underwent a pair of standardized posterior dental bitewing radiographs in order to detect CPD. SHIM questionnaire scores 21 or less represented ED. Alveolar bone loss of >or=6 mm represented CPD. RESULTS: The mean age of included men was 39.5 +/- 6.7 years. Overall, 70 (22.9%) men had ED and 13 (4.3%) had CPD. CPD was significantly more prevalent among men with mild ED (P = 0.004) and moderate to severe ED (P = 0.007) in comparison to men without ED. CONCLUSIONS: ED might be associated with CPD. These preliminary findings are consistent with theories that associate these conditions with systemic inflammation, endothelial dysfunction, and atherosclerosis.

J. S. MED 2009 Apr;6(4):1111-6. Epub 2008 Dec 15.

LANAP

AAP Boston

I am at the American Academy of Periodontology annual meeting in Boston. It has been a very interesting meeting. Ray Yukna spoke today after the general assembly on a pannel on lasers along with Dr Greenwell who is also a Lanaper and Dr Romanos. Yesterday Dr. Lloyd Tilt spoke the first Periodontist to have the Periolase he gave his 10 year data. Interesting that they placed him under Inovations in Periodontics. Evan though the specialty is less than 100 years old.

LANAP in the NEWS

This is a video in our local NEWS cast regarding LANAP


LANAP in Los Angeles

Associate member of the American Academy of Periodontology

I have been honored with an Associate membership in the Prestigous AAP American Academy of Periodontics.

AAP Meeting in Boston

At the AAP don't forget to catch Ray Yukna on Saturday 1 pm this is the Corp sponsored program. then again you can see him 2pm.

MILLENNIUM DENTAL TECHNOLOGIES

Outstanding Clinical and Human Histologic

Outcomes with the PerioLase® Nd:YAG Laser

Speaker: Raymond A. Yukna

The Laser-Assisted New Attachment Procedure

(LANAP™) using the Nd:YAG laser in a specific

patented protocol has been evaluated as a single

visit treatment of periodontal pockets with the goal

of obtaining new attachment. Clinical success is

supported by human histology showing new

cementum and new connective tissue attachment.

Then Monday at 10:15.

CTS1: LASER APPLICATIONS: AN EVIDENCEBASED

APPROACH TO CLINICAL PRACTICE

10:15 - 11:45 am

Program Track: Treatment of Inflammatory

Periodontal Diseases

Moderator: Timothy P. Walsh

Speakers: Bobby L. Butler, Henry Greenwell,

George E. Romanos, Raymond A. Yukna

Lasers have been used in dentistry for many years.

Historically, lasers have been shown to be used primarily

for soft tissue procedures. The clinical benefits of lasers

have led to FDA clearance for numerous uses of such in

periodontics and implant dentistry.

Educational Objectives:

• Understand different laser wavelengths and their

interactions with hard and soft tissue, including the

applications of varying wavelengths and treatment

protocols to treat periodontitis.

• Discuss tissue biotypes and case selections for open

and closed crown lengthening.

• Demonstrate long-term success for treating failing

implants with lasers.

Laser Gum Surgery

LANAP at the AAP meeting

I hope you have the oportunity to go to the AAP this year.


lloyd Tilt will be speaking on Sunday he will show his 10 year data.

I guess in Perio 10 years is considered innovative?

IP2: INNOVATIONS IN PERIODONTICS SESSION 2
10:15 - 11:45 am




http://perio.org/meetings/am/2009AdvanceProgram.pdf

Interesting thing about periodontists is all available accounts seem to suggest that Dr. Grace Rogers may have been the first practicing Periodontist in 1914.




You would think 10 years of data would be allot considering periodontics has been existence less than 100 years.

Though, it is still considered INOVATIVE?

Who Was the First Periodontist?

Who Was the First Periodontist?

Many people have wondered, who was the first periodontist? Upon hearing this question, many have wondered, what is a periodontist? Well, we are going to discuss those questions and many more throughout the course of this article, to the best of our abilities concerning the documented evidence.

We know that periodontal disease has been a problem for people all throughout history. You see, as a specialty, periodontics – the study of periodontal disease, periodontitis, et cetera – has a very long and very full history. That history covers the whole of civilization.

There is evidence that even back in prehistoric times, our ancestors had some problems with their teeth. For example, people in the early Egyptian and Middle Eastern cultures had oral health problems. How do we know this? Well, for one thing, there is written evidence and skeletal remains which show the existence of periodontal disease.

In histories pertaining to ancient Chinese and Indian cultures, there exists evidence of periodontal diseases like scurvy. Within those same histories, there were actually pieces of advice pertaining to the importance of cleaning one’s teeth! The evidence piles up through history, from ancient Greek and Roman to Renaissance Europe. The diseases themselves were well described in the records available, as well treatments and methods of prevention.
However, the first periodontist came quite a bit later – not until the early twentieth century, in fact. Now, it stands to reason that periodontists likely existed before this; they simply were not documented. They may have gone by a different title. Around about 1914, however, all available accounts seem to suggest that Dr. Grace Rogers may have been the first practicing periodontist.
Given the long history of documented periodontal diseases and care, however, it only stands to reason that, in the equally long history of dentistry, other people must have practiced periodontology. We simply do not have the records of those possible forebears.
Disclaimer: If you have or think you might have gum disease or any other health problem, please visit your dentist or periodontist for advice, diagnosis and treatment. This article is for information purposes only and does not intend to provide advice, diagnosis or treatment for any health condition.

Periodontal disease a risk marker for stroke

Periodontal disease a risk marker for stroke.

Men with a history of bone loss due to periodontitis run a higher risk of having a stroke, according to a study in the Annals of Neurology (May 28, 2009).

The potential role of periodontitis in the risk of cardiovascular disease has received much attention in the past decade, and evidence of an association between periodontitis and cerebrovascular disease, especially ischemic stroke, has been stronger compared to other types of cardiovascular disease, the study authors noted.

Although the link has been reported before, their research examined the clinical measures of periodontitis as opposed to self-reports or other assessments not involving periodontal probing, lead study author Thomas Dietrich, D.M.D., of the University of Birmingham School of Dentistry said.

The researchers analyzed data from 1,137 men in the Veterans Affairs Normative Aging Study, an ongoing study that began in the 1960s with healthy volunteers from the greater Boston area. Participants underwent medical and dental exams every three years for an average of 24 years.

A trained periodontist conducted the dental exams, including full mouth radiographs and periodontal probing at each tooth. Cerebrovascular disease was defined as a stroke or transient ischemic attack.

Dr. Dietrich and his colleagues evaluated the incidence of cerebrovascular events in relation to mean radiographic alveolar bone loss (a measure of periodontitis history) and cumulative periodontal probing depth (a measure of current periodontal inflammation).

Bone loss key

Overall, 80 incident cases of cerebrovascular disease occurred during a combined 27,506 person-years, and periodontal bone loss was "significantly associated" with an increased hazard rate of cerebrovascular disease, according to the researchers. They found a stronger effect among men younger than 65 compared to older men.

In comparison, periodontal probing depth was not associated with a significantly increased rate of cerebrovascular disease.

The exact mechanism of the association is unclear, said Dr. Dietrich, noting that both causal and noncausal factors may explain it.

There could be direct or indirect effects of the periodontal infection and inflammatory response, or some people may have an increased proinflammatory susceptibility that could contribute to both cerebrovascular disease and periodontal disease, the authors wrote. Current epidemiologic studies are not able to differentiate between these causal and noncausal pathways, even with perfect control of all established cardiovascular risk factors.

And why was periodontal bone loss significantly associated with an increased hazard rate of cerebrovascular disease, while periodontal probing depth was not?

"This is more consistent with a noncausal mechanism, since treatment of periodontitis or tooth loss would not affect the underlying susceptibility to inflammatory disease," Dr. Dietrich said.

A significant link was found between history of periodontitis as measured by alveolar bone loss and incidence of cerebrovascular disease in men, independent of established cardiovascular risk factors, the authors noted. Furthermore, they found evidence for a stronger association between periodontal bone loss and incidence of cerebrovascular disease among younger men.

"Even if this association was predominantly noncausal, periodontitis could be an important marker of risk for cerebrovascular disease, given its relatively high prevalence and the strength of the association," they concluded.

Large epidemiologic studies using molecular and genetic approaches in various populations are necessary to determine the strength of the association between periodontitis and cerebrovascular disease and to elucidate its biologic basis, they added.

Tooth decay, bleeding gums may herald chronic ills

NEW YORK (Reuters Health) - Our modern dental woes have a lot do to with modern whole-body ills like heart disease and diabetes, according to the author of a review of decades' worth of studies on diet and health.

The culprit in both cases? The so-called fermentable carbohydrates forming the foundation of the modern diet, says Dr. Philippe P. Hujoel of the University of Washington School of Dentistry in Seattle. These include sugars and starchy foods that break down into sugars in the mouth, as well as tropical fruits and dried fruits.

Hujoel argues in the Journal of Dental Research that gum disease and tooth decay should be seen as "alarm bells" that signal a person is at risk of heart disease, diabetes and other chronic health problems.

In recent years, Hujoel argues, fat has replaced fermentable carbohydrates as the enemy, which has led to the promotion of heavy carbohydrate consumption-and in turn the need for dental interventions like sealant and fluoride to prevent tooth decay.

Studies have shown development of gum disease within days of a person upping their sugar intake, which then improves within weeks of a person cutting out carbs. If such high-fermentable carbohydrate diets continue, Hujoel argues, their associated chronic illnesses take hold.

"Clearly, the dental alarm bell has an extremely low threshold for activation; the response occurs in days, weeks or, at most, years, as opposed to the decades it takes for systemic (diseases) to become clinically apparent," he writes.

Hujoel calls for research to investigate the question of whether diets that are good for our teeth are also good for our overall health. If the answer is yes, he adds, "dental diseases could become increasingly regarded as the early marker of adverse lifestyle choices," and could also offer clues to understanding other systemic illnesses such as Alzheimer's disease.

SOURCE: Journal of Dental Research, July 1, 2009.

http://www.reuters.com/article/healthNews/idUSTRE56Q4RM20090727

Certain Oral Bacteria Linked To Obesity

Certain Oral Bacteria Linked To Obesity

Investigators at the Forsyth Institute are focusing on the possible role of oral bacteria as a potential direct contributor to obesity. It seems likely that certain bacterial species could serve as biological indicators of a developing overweight condition.

Researchers J.M. Goodson, D. Groppo, S. Halem and E. Carpino measured salivary bacterial populations of overweight women. Saliva was collected from 313 women with a body mass index between 27 and 32, and bacterial populations were measured by DNA probe analysis. Levels in this group were compared with data from a population of 232 healthy individuals from periodontal disease studies. The median percentage difference of seven of the 40 bacterial species measured was greater than 2 percent in the saliva of overweight women. Classification tree analysis of salivary microbiological composition revealed that 98.4 percent of the overweight women could be identified by the presence of a single bacterial species (Selenomonas noxia) at levels greater than 1.05 percent of the total salivary bacteria. Analysis of these data suggests that the composition of salivary bacteria changes in overweight women.

Of even greater interest, and the subject of future research, is the possibility that oral bacteria may participate in the pathology that leads to obesity. The complete research study is published in the June issue of the International and American Associations for Dental Research's Journal of Dental Research.

Source: Journal of Dental Research

Los Angeles Gum Surgery

History Of Periodontitis Linked To Cerebrovascular Disease In Men

History Of Periodontitis Linked To Cerebrovascular Disease In Men

History Of Periodontitis Linked To Cerebrovascular Disease In MenScienceDaily (July 3, 2009) — The potential role of periodontitis, an inflammatory disease of the gums, in the risk of cardiovascular disease, particularly ischemic stroke, has received growing attention during the last decade. A new study is the first prospective cohort study to use clinical measures of periodontitis to evaluate the association between this disease and the risk of cerebrovascular disease.Led by Thomas Dietrich of the University of Birmingham School of Dentistry, and Elizabeth Krall of the Boston VA and the Boston University School of Dental Medicine, the study analyzed data from 1,137 men in the VA Normative Aging and Dental Longitudinal Study, an ongoing study begun in the 1960s with healthy male volunteers from the greater Boston area. A trained periodontist conducted dental exams every three years that included full mouth X-rays and periodontal probing at each tooth. Cerebrovascular disease was defined as a stroke or transient ischemic attack (TIA) and follow-up lasted an average of 24 years.The results showed a significant association between periodontal bone loss and the incidence of stroke or TIA, independent of cardiovascular risk factors. This association was much stronger among men younger than 65 years old.There are several possible pathways that could explain the association found in the study. There could be direct or indirect effects of the periodontal infection and the inflammatory response, or some people may have an increased pro-inflammatory susceptibility that could contribute to both cerebrovascular disease and periodontal disease.The study found that only periodontal bone loss, which would indicate a history of periodontal disease, not probing depth, which would indicate current inflammation, was associated with the incidence of cerebrovascular disease. Also, the stronger association in younger men seen in this and other studies may indicate a pro-inflammatory susceptibility in some men that is reflected in periodontal destruction at a younger age.The authors note that if periodontitis caused cerebrovascular disease, it could be an important risk factor, given its relatively high prevalence and the strength of the association in younger men. It is also possible that people with periodontitis may pay less attention to health in general (e.g., they may not take medications as regularly). The authors conclude: "Large epidemiologic studies using molecular and genetic approaches in various populations are necessary to determine the strength of the association between periodontitis and cerebrovascular disease and to elucidate its biologic basis."This study is published in Annals of Neurology.

AGD panel to discuss perio, heart disease link

AGD panel to discuss perio, heart disease link

The connection between periodontal disease and cardiovascular disease will be the topic of a panel discussion on the growing need for dentists and physicians to collaborate at this week's Academy of General Dentistry (AGD) annual meeting.

Marvin Slepian, M.D., and Neil Gottehrer, D.D.S., will lead an "Oral/Body Inflammation Connection" discussion during the meeting in Baltimore.

"It is critical for all dentists and physicians to collaborate in helping patients reduce inflammation, which can become a target factor for cardiovascular disease," Dr. Slepian stated in a press release.

Information presented during this session will provide dentists with hands-on knowledge regarding how to communicate with physicians to collaborate and create more proactive management periodontal disease treatment plans (including nonsurgical options), which can then improve periodontal and associated physical health by reducing cardiovascular disease.

"This is a landmark course being presented, and I am honored to be holding the discussion with my colleague, Dr. Slepian," Dr. Gottehrer stated in the release. "We hope to provide groundbreaking and useful information to attendees to help them improve the overall health of their patients and to build an increased awareness about the connection between periodontal disease and cardiovascular disease that many, if not most, patients are unaware of."

Along with a panel of seven other doctors, Drs. Gottehrer and Slepian will identify the categories by grade of periodontal disease and the risks of disease to the patient, describe uniform treatment for all stages of both periodontal disease and cardiovascular disease, and suggest a successful hygiene program to improve dental care given to patients.

LANAP Dentist

LANAP in the News

Laser gum surgery Los Angeles

Researchers study link between gum disease and memory loss

Researchers study link between gum disease and memory loss.

The National Institutes of Health (NIH) has awarded a $1.3 million grant to a group of researchers who have found a link between gum disease and memory loss.

The research team includes Richard Crout, D.M.D., Ph.D., an expert on gum disease and the associate dean for research at West Virginia University (WVU) School of Dentistry; gerontologist Bei Wu, Ph.D., a researcher at the University of North Carolina; Brenda Plassman, Ph.D., a specialist in memory research at Duke University; and Jersey Liang, Ph.D., a professor at the University of Michigan.

The team will look at health records of several thousand Americans over many years, according to WVU.

"This could have great implications for health of our aging populations," Dr. Crout stated in a press release. "With rates of Alzheimer's skyrocketing, imagine the benefits of knowing that keeping the mouth free of infection could cut down on cases of dementia."

The research builds on an ongoing study of West Virginians age 70 and older. Working with the WVU School of Medicine, School of Dentistry researchers have given oral exams and memory tests to 270 elderly people in more than a dozen West Virginia counties.

Funded by a $419,000 two-year grant, they've discovered that about 23% of the group suffers from mild to moderate memory loss.

"If you have a gum infection, you'll have an increased level of inflammatory by-products," Dr. Crout noted. "We're looking for markers in the blood that show inflammation to see if there is a link to memory problems. We'd like to go full circle and do an intervention -- to clean up some of the problems in the mouth and then see if the inflammatory markers go down."

Los Angeles Periodontist

Laser periodontal therapy effective alternative to surgery

Laser periodontal therapy effective alternative to surgery

Laser periodontal therapy is an effective alternative to scalpel/suture surgery for treating gum disease, according to a new study in the International Journal of Periodontics & Restorative Dentistry.

Led by Raymond A. Yukna, D.M.D., M.S., the histological split mouth design study looked at twelve single-rooted teeth with moderate to advanced chronic periodontitis. Six teeth were given Laser Assisted New Attachment Procedure (LANAP) using the PerioLase MVP-7 by Millennium Dental Technologies, while the other six received scaling and root planing only.

After three months, all LANAP-treated teeth showed regeneration of root surface (cementum) and new connective tissue attachment (CTA), whereas none of the control teeth effectively showed new attachment or regeneration.

"These positive results support the concept that LANAP can be associated with cementum-mediated new connective tissue attachment and apparent periodontal regeneration of diseased root surfaces in humans,” said Dr. Yukna in a press release. "Recent years have seen major advancements in periodontal technology, and this study is a successful demonstration of using a free-running pulsed Nd:YAG laser applying the specific LANAP protocol."

"The publication of this study addresses many of the concerns held by the dental community," said Michael Minailo, president and CEO of Millennium Dental Technologies. "With growing demand and continued scientific support, we expect to see significant momentum in 2009."

http://www.drbicuspid.com/index.aspx?sec=nws&sub=rad&pag=dis&ItemId=300317

Patients With Moderate To Severe Periodontitis Need Evaluation For Heart Disease Risk

Additional research is called for and patients with moderate to severe periodontitis should receive evaluation and possible treatment to reduce their risk of atherosclerotic cardiovascular disease (CVD), according to a special consensus paper by editors of The American Journal of Cardiology and Journal of Peridontology in the July 1, 2009 issue of The American Journal of Cardiology, published by Elsevier. Periodontitis, a bacterially-induced, localized, chronic inflammatory disease, destroys connective tissue and bone that support the teeth. Periodontitis is common, with mild to moderate forms affecting 30 to 50% of adults and the severe generalized form affecting 5 to 15% of all adults in the USA. In addition, there is now strong evidence that people with periodontitis are at increased risk of atherosclerotic CVD - the accumulation of lipid products within the arterial vascular wall. The explanation for the link between periodontitis and atherosclerotic CVD is not yet clear, but a leading candidate is inflammation caused by the immune system. In recent years the inflammation is now recognized as a significant active participant in many chronic diseases. Other explanations for periodontitis and atherosclerotic CVD are common risk factors such as smoking,Diabetes mellitus, genetics, mentalanxiety, depression, obesity, and physical inactivity. Regardless of the cause, the expert panel believes that the current evidence is strong enough to recommend that doctors assess atherosclerotic CVD in their patients with periodontitis. The research recommends that patients with moderate to severe periodontitis should be informed that there may be an increased risk of atherosclerotic CVD associated with periodontitis, and those patients with one or more known major risk factor for atherosclerotic CVD should consider a medical evaluation if they have not done so in the past 12 months. "This consensus paper is important because it will draw attention to the fact that patients with periodontitis, especially moderate and severe forms of the disease, can have increased risk for coronary disease," commented to David Dionne, Executive Publisher of The American Journal of Cardiology. Notes: The article is "The American Journal of Cardiology and Journal of Periodontology Editors' Consensus: Periodontitis and Atherosclerotic Cardiovascular Disease" by Vincent E. Friedewald, MD, Kenneth S. Kornman, DDS, PhD, James D. Beck, PhD, Robert Genco, DDS, PhD, Allison Goldfine, MD, Peter Libby, MD, Steven Offenbacher, DDS, PhD, MMsc, Paul M. Ridker, MD, MPH, Thomas E. Van Dyke, DDS, PhD and William C. Roberts, MD. It appears in The American Journal of Cardiology, Volume 104, Issue 1 (July 1, 2009) published by Elsevier. Source: Maureen Hunter Elsevier

Gum disease is Contagious

From AAP web site
Families and Periodontal Disease
Periodontal (gum) disease may be passed from parents to children and between a couple
Several recent studies support the association between periodontal (gum) disease and family members:
Periodontal (gum) disease may be passed from parents to children and between a couple, according to an article in the September 1997 issue of the Journal of the American Dental Association. Researchers suggest bacteria that cause periodontal disease pass though saliva. This means that the common contact of saliva in families puts children and couples at risk for contracting the periodontal disease of another family member. Periodontal disease can lead to tooth loss.M
Up to 30% of the population may be genetically susceptible to developing severe periodontal disease, according to a study published in the Journal of Clinical Periodontology. These findings could result in the early identification and treatment of at-risk patients.
Based on this research, The American Academy of Periodontology (AAP) recognizes that treatment of gum disease may involve entire families. If one family member has periodontal disease, the AAP recommends that all family members see a dental professional for a periodontal disease screening.

LANAP in the NEWS

This is Dr Robert Gregg speaking on LANAP with ABC NEWS






LANAP

Brushing teeth boosts sperm count

Brushing teeth boosts sperm count
Mar 2009


Brushing your teeth twice a day can boost your sperm count. That's according to the British Dental Health Foundation (BDHF) who have advised reaching for a toothbrush after research found that infertile men are far more likely to suffer from gum disease. A study of 56 men aged between 23-52 by the Bikur Holim Hospital, Jerusalem, and the Hebrew University Hadassah School of Dental Medicine found that more than half the men with low sperm counts or no sperm at all displayed developed gum disease.

The BDHF will begin its annual National Smile Month campaign on 17 May 2009, highlighting gum disease's links to overall health under the slogan: ‘Look after yourself, brush for health'.Gum disease has been linked to heart disease, diabetes and strokes and now infertility.

Chief executive of the Foundation Dr Nigel Carter said: ‘Brushing your teeth may not sound sexy, but this study shows its importance to male fertility. Factor in the benefits of good oral health for an attractive smile and to stop bad breath and it's time men picked up their toothbrush.' The Israeli study showed that half the men suffered from gingivitis, and two thirds of these men had low sperm counts. Gingivitis causes inflammation characterised by bleeding gums and soreness.One third of the men suffered periodontal disease, which affects the tissues supporting the teeth and can lead to tooth loss. Half of the men with no sperm count had chronic periodontal disease.

LANAP DENTIST

Periodontist and LANAP

This is one of my favorite Videos. This is Tom McCawley a periodontist, past President of Periodontists Society. He was the second author on the Chalie Cob paper that showed lasers burned roots. In Tom's words Charlie falsified the results. Charlie is also the spokes hole for the AAP regarding Lasers and Periodontics. Charlie has been exposed as a liar on Dentaltown.

Gum Disease linked to Dementia

MORGANTOWN, Va., June 24 (UPI) -- Brushing teeth and flossing may not only reduce gum disease and stroke but memory loss, U.S. researchers suggest.

In an ongoing study, researchers at West Virginia University in Morgantown gave oral exams, memory tests and, if subjects agreed, a blood test to 270 people age 70 or older in more than a dozen West Virginia counties.

The researchers found about 23 percent of the group suffers from mild to moderate memory loss".

We're looking for markers in the blood that show inflammation to see if there is a link to memory problems," one study researcher, Dr. Richard Crout, said in a statement.
It is not yet understood whether mouth microorganisms create health problems or whether the body's inflammatory response is to blame. Crout said it may be a combination.
However, the connection between severe dementia and gum disease is already well-known, although clinicians often do not realize gum disease affects memory, Crout said.
"Older people might want to know there's more reason to keep their mouths clean -- to brush and floss -- than ever," Crout said in a statement. "You'll not only be more likely to keep your teeth, but you'll also reduce your risk of heart attack, stroke and memory loss."

Gum disease treatment in Los Angeles

Diabetes: It's Connection to Oral Health

Here is an interesting article. Article

Diabetic patients are at greater risk for tooth decay due to the presence of higher bacteria levels found in saliva when diabetes is not under control. As diabetes can lower resistance to infection, periodontal disease can develop.

A Good Dentist Sees More Than Molars

Here is an interesting article in The Washington Post.

Article

Patient experience with LANAP

This patient relates her experience with Lanap (Laser Assisted New Attachment Procedure).

LANAP DENTIST LOS ANGELES

More than 50% With Rheumatoid Arthritis Have Periodontitis

Over half (56%) of people with rheumatoid arthritis (RA) also have periodontitis (a chronic inflammatory disease of the gum and surrounding ligaments and bones that hold the teeth in place), displaying fewer teeth than healthy matched controls, high prevalence of oral sites presenting dental plaque and advanced attachment loss (the extent of periodontal support that has been destroyed around a tooth) (chi square p<0.05), according to the results of a new study presented today at EULAR 2009, the Annual Congress of the European League Against Rheumatism in Copenhagen, Denmark. In addition, these patients were found to have significantly higher RA disease activity and anti-CCP (cyclic citrullinated peptide) antibody levels than others with RA who did not exhibit periodontitis (r=0.84, p<0.05; r=0.78, p<0.05). The study also showed that, after six months of anti-TNF therapy (prescribed to control RA inflammation and destruction), a statistically significant improvement in periodontal status was seen in 20 (80%) of the 25 participants (mean age 41.5+3.7 years; mean disease duration 7.2+4.8 years), suggesting that the biological therapy may also be able to modulate the inflammatory process in the periodontium (the tissues investing and supporting the teeth, including the cementum, periodontal ligament, alveolar bone, and gingival / gums). Dr Codrina Ancuta of the Grigore T Popa University of Medicine and Pharmacy, Rehabilitation Hospital, Iasi, Romania, who led the study, said: "There is a growing body of evidence to demonstrate an association between periodontal disease and systemic conditions involving inflammatory rheumatic disease (especially RA), cardiovascular disease and diabetes. However, further cross-disciplinary research among rheumatologists and periodontologists is required to fully understand the underlying mechanisms that link RA and periodontitis, and to explore how patients can be managed more holistically using treatments such as anti-TNFs and some lifestyle approached that may simultaneously address both conditions." The prospective observational study compared 25 consecutive RA patients receiving anti-TNFs with 25 systemically healthy individuals matched for age, gender and periodontal status at baseline and six months, assessing both groups for periodontal status (visible plaque scores, marginal bleeding scores, attachment loss, number of present teeth), and the RA patient group in terms of RA parameters (erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), anti-CCP antibodies, disease activity and disability scores). Statistical analysis was conducted in SPSS-14 (a statistical analysis computer programme) p<0.05. Moderate to Severe Periodontitis may be a Risk Factor for Developing RA in Non-Smokers A second study presented at EULAR 2009 showed that, although smoking is an established risk factor for both RA and periodontitis, non-smoking individuals with moderate to severe periodontitis may also be at a greater risk for the development of RA. Those with RA who had moderate to severe periodontitis also developed significantly higher Anti-Citrullinated Peptide Antibody (ACPA) levels than those with no-mild periodontitis. The retrospective study identified 45 RA patients based on their hospital discharge diagnostic codes from a cohort of 6,661 participants of the Atherosclerosis Risk in Communities (ARIC) study, from whom serum was obtained at the time of a detailed periodontal assessment during the period 1996-1998. RA participant sera were assessed for ACPA and rheumatoid factor (RF) positivity using ELISA (enzyme-linked immunosorbent assay). Participants were classified as having incident RA (n=33) if their first hospital discharge code occurred after periodontitis classification. The hazard ratio (HR) of developing RA in subjects with moderate to severe periodontitis (n=27) was found to be 2.6 (95% CI=1.0-6.4, p=0.04), compared to those with no / mild periodontitis (n=6). Among lifetime non-smokers who developed RA, the Hazard Ratio was 8.8 (95% CI=1.1-68.9, p=0.04). Periodontitis severity was not shown to be independently associated with RA incidence among current and former smokers. ACPA levels were significantly higher in participants with moderate to severe periodontitis than in those with no / mild periodontitis (222.5 Units vs. 8.4 Units, p=0.04). These findings indicate that periodontitis may be a risk factor both for the development of RA, and for the development of more severe ACPA-positive disease. Abstract number: FRI0171 & FRI0129 Source:Rory BerrieEuropean League Against Rheumatism

Rheumatoid Arthritis and Periodontal disease

Resopnse to Whoopi Goldburg's Gum Disease

I made a video inviting Whoopi in to have a second opinion on her Gum situation.















Whoopi Goldberg invitation

Published Article on LANAP in Compendium

I recently was published in a a Peer Reviewed article in Compendium.

Here is a link

Laser Surgery article

If you go on the link below you will find videos of the patients that were in the article.


Laser Dental Surgery

Gum Disease Can Kill You

"Gum Disease Will Kill You" "Save your own life" "Your Mouth is Connected to Your entire body" This is what Whoopi Goldberg said on the View.







Periodontal Osseous Surgery

How much pain will I have with Gum Surgery?

Pain is subjective but after doing over 300 LANAP cases I have found that on a scale of 1-10 most patients say it is about a 3 out of 10 the next day and a week after. The most common complaint I have seen is sensitivity to cold after the surgery that usually lasts about 1 month.

Here is a video of a patient that had Traditional Osseous Surgery on his top teeth then Laser Assisted New Attachment Procedure on the bottom teeth. He compares the difference.


Periodontal Surgery

Laser Bacterial Kill

This is a good article that shows the diference between the ND:Yag and the Diode laser where it coresponds to killing P.Gingivalis. A known bacteria in Periodontal disease.

Link to laser article

The take home is "The dfference in therapeudic index between Nd:YAG and diode indicates that the pulsed Nd:YAG has a 16 times greater selectivity for destruction of pigmented oral
pathogens than the diode laser"

Laser Gum Surgery

DISGUSTED WITH THE ADA

Today I resigned from the ADA. The ADA working Group on Lasers headed by Charlie cobb published on the ADA website for public consumption.



http://www.ada.org/prof/resources/po...sers_final.asp



I would like to encourage all LANAP dentists to contact the ADA and express your disappointment in their statement.





John S. Findley, D.D.S., president
American Dental Association
211 East Chicago Ave.
Chicago, IL 60611-2678
312-440-2500

1410 East 14th Street
Plano, Texas 75074-6359
972-423-4595
Fax 972-424-6712
findleyj@ada.org

I am writing about the recent ADA Laser Position Statement now published on the ADA website. I find the ADA’s position to be inaccurate and misleading, especially with regards to LANAP. [As an ADA member] I am disappointed in this final statement that was released without review by the clinicians who developed the LANAP protocol,

Specifically is in not accurate to say, “…the therapy included ‘intrasulcular applications’ to remove ‘sulcular epithelium’.” This study reviewed “moderate to advanced” periodontal disease, and as such periodontal pocket applications of the Nd:YAG were investigated.

The second paragraph on the LANAP protocol appears to be conjecture, opinion, and speculation, and is hardly worthy of an official position statement from the ADA. This paragraph and therefore the ADA’s position statement are seriously flawed. Specifically,

1. This study was, at the time, the 4th largest human histology – with a control group – in the prestigious, peer-reviewed periodontal scientific literature. To call it a “pilot validation” or a small sample size is an attempt to minimize the significance of the findings.
2. It is a completely false representation to state that the “study was not blinded”. The study was blinded to the patient (proximate teeth were treated in all but one case), blinded to the calibrated clinical examiner, and blinded to the histologist.
3. It is disingenuous to state the sample size was small. This was a human histological study that involved the block sectioning of the study along with bone. Human Investigation Review Boards (“IRBs) regard human experimentation very seriously. IRBs regard block section removal of teeth even more rigorously. Consequently, (IRBs) bone block sections of human tooth/bone histology is not performed on the same numbers of patients and teeth, as a clinical study comparing established treatment method and that does not involve intention creation of bony defects
4. The placement of the pre-treatment notches were fully explained in the peer-reviewed manuscript in the December 2007 issue of the International Journal of Periodontics and Restorative Dentistry (IJPRD). Yukna, RA; Carr RL; Evans, GH: Histologic Evaluation of an Nd: YAG Laser-Assisted New Attachment Procedure in Humans. Int J Perio Rest Dent 27(6):577-587, 2007
5. It is absolutely baffling what the Council can possibly mean in the statement regarding extrapolation to early and moderate chronic periodontitis, when considering the beneficial outcomes from advanced periodontitis. This statement is more argumentative than enlightening.
6. Similarly argumentative is the Council’s comments on the creation of a stable fibrin clot (referred to as a “seal” by the Council). If the authors do not understand the benefits of creating a stable fibrin (1st connective tissue) clot, then one must question the expertise of the Council and its members in wound healing 101.

ADA American Dental Association

Free Running Pulsed Laser

More laser physics.

The Periolase is a Free Running Pulsed Laser. What that means is that it is pulsed at microseconds.

A microsecond (abbreviated as μs) is one millionth of a second

The Perioslase pulses at 100 microseconds with a repetition rate (Hz) of 20.

When the laser is pulsing at 100us 20hz it stays off for 49,000+us, the equivalent of the pulse being on for 1 second and off for 8 minutes -- plenty of time for the tissues to cool and not cause collateral coagulation and necrosis. The flashlamp gives the ability to have a duty cycle of 0.2% (the time the laser is on, compared to the time it is off). Each pulse at 100ms and 20hz is around 2000 watts which kills any p. gingivalis (pigmented or not) and lots of other species. Most diodes have a functional duty cycle of about 25% due to the low wattage and don't kill the bacteria for the same reason.

This is why a pulsed laser is needed for soft tissue treatment of periodontal disease -- wattages need to be high, duty cycles need to be low.

LASER PERIODONTAL SURGERY

Dental Lasers Depth of Penetration

Nd represents the Periolase the only laser able to do LANAP you can see the depth of penetration can be up to 4 mm. This allows the laser to penetrate into privileged sites deep in the tissue.

Notice the Er being the Erbium (the Syneron, waterlase, Fotana, or Hoya) the CO2 (Deka) have a very shallow depth of penetration.

Laser dentist

Laser Tissue interaction in Periodontal Surgery

This image shows the different dental lasers on the bottom each in their respective wavelength. The Periolase is an ND:Yag with a wavelength of 1064 nm. The lines on the graph show the absorption in each of the different tissues. Notice that Melanin, Hb (Hemoglobin), and HbO2 (Oxigenated hemoglobin) completely disappear at about 1100 nm. This correlates to the increase in absorption in water once the wavelength is absorbed in water the rest of the tissues stop absorbing the energy. Therefore the ND:Yag is highly absorbed in Melanin. Dark pigmented anaerobic bacteria are full of Melanin. Dark pigmented bacteria have been postulated as being the primary bacteria responsible for Periodontitis.

Laser Periodontist

Laser Gum Surgery the Science of LANAP

Why is it that only the Periolase MVP 7 can do LANAP?



Laser phisics 101



L ight

A mplification by

S timulated

E mission of

R adiation



The Electromagnetic spectrum shows the different wavelengths on a graph.













Notice the visible spectrum between 400 and 700 nm the periolase is the ND;Yag that is 1064 nm.


If a laser dentist says that their laser can do LANAP it kind of like saying Blue is Red or Green is Yellow.

Each of these colors has a diferent wavelength and are absorbed diferently in diferent tissues.

LASER DENTAL SURGERY

Show me the laser that Reverses Gum Disease

This is the Periolase MVP 7 it is the only laser that has the FDA clearence to do LANAP.

Don't be fooled by any other laser!

LASER GUM TREATMENT

Alternative to Periodontal Surgery LANAP

Here is a diagram that show the steps of LANAP.

A. = Take measurements of the Periodontal Pocket.

B. = Removal of inner pocket lining with an ND:Yag laser. The laser decontaminates the area.

C. = Scaling an Root Planing is done to remove Tartar and disrupt the Biofilm.

D. = Second pass with the laser allows for a stable Fibrin Clot ones own Tissue Barrier.

E. = Tissue is re adapted to the tooth NO Sutures are used.

F. = Bite is adjusted.

G. = Regeneration.

Periodontal Alternative Treatment

Laser Gum Surgery LANAP

What is LANAP? It is an acronym for Laser Assisted New Atachement Procedure. The New does not stand for a new procedure but to New Cementum Mediated Atachement to The Root Surface in the Abscence of Long Junctional Epithelium. Basically the FDA clearence says it reverses gum disease.



LANAP

Doubting for 8 years

I admit I was a skeptic.

I first looked at the Periolase. You might even have called me a doubting Thomas.
I referred a patient to my periodontist (one of the best in LA, teaches at USC) I knew this patient needed his teeth removed it was confirmed by the perio that he needed implants, and for all the training I had it was a good recommendation.

But the patient didn’t agree he searched for an alternative and found the creator of the LANAP procedure, & had the LANAP done. That was 10 years ago; those loose teeth that I knew needed to be removed are still there and firm. So every 3 months this guy would come into the office I couldn’t deny it had worked for him.

So I started to look into it, because as you know Periodontitis is the #1 cause of tooth loss in adult Americans. And I being a dentist, by definition a dentist doesn’t exist without a patient, and after asking my patients what they wanted from me, the usual response over and over again was “I WANT TO KEEP MY TEETH”, “I WANT TO KEEP MY TEETH”, “I WANT TO KEEP MY TEETH”, so for me it was a patient driven search.

So my journey took me to Dentaltown an online community where 40,000 dentists are signed up and discuss things like perio. Being a doubting Thomas I searched out “The Guy” you know the one “The guy” who always has something negative to say about every procedure or dental product you know “the guy” who always says “it didn’t work for me”. Well after many years of looking for “The Guy” I still haven’t found him. Still looking.

Fortunately the two knuckleheaded Gp’s that developed the LANAP protocol practice nearby so I would refer my hopeless cases to them every time it got harder and harder to refer, they would always try and sell me a laser, but I DIDN’T WANT A LASER!, I wanted to help my patients keep their teeth.

Then after seeing and understanding Ray Yuknas HUMAN histology, the FDA clearance that says “NEW CEMENTUM MEDIATED ATTACHMENT IN THE ABSENCE OF LONG JUNCTIONAL EPITHELIUM” the CRA 9.7 out of 10, never finding “THE Guy” on DT to say anything negative about the procedure or the laser, not being able to refer to anyone who had the laser, seeing my anecdotal case walk in the door every 3 months, I decided, I too wanted to help people keep their teeth. The rest is history you can go on this site to see my x-rays you would be shocked at what my perio readings are 12mm bleeding suppurating pockets going to 2mm healthy sulci, again INCREDIBLE RESULTS time after time. This is why I have NO problem recommending to my colleges this procedure.


LASER GUM SURGERY

My journey into LANAP

I had a patient that I refered to my Periodontist one of the best in Los Angeles, teaches at USC.

He and I both agreed that my patient should have his teeth removed and Implants placed. For everything I knew that was a good recomendation.

His teeth were loose and he had lost most of the bone around his teeth.

But the patient did not want to get screwed with Titanium and searched out an alternative.

Fortunatly he found the creator of the LANAP procedure and had it done in 1997.

This patient has been coming into my practice faithfully every 3 months to have his teeth cleaned.

To this day over 12 years later he still has all his teeth.

LANAP DENTIST

LANAP has FDA clearence to reverse gum disease!

Here is the actual FDA clearence that says NEW CEMENTUM MEDIATED NEW PERIODONTAL LIGAMENT ATTACHEMENT TO THE ROOT SURFACE IN THE ABSCENCE OF LONG JUNCTIONAL EPITHELIUM"

In other words it reverses gum disease! The # 1 cause of tooth loss!

FDA Clearence

http://www.millenniumdental.com/pdf/k030290.pdf

Gum disease is the #1 cause of tooth loss

Most people who loose their teeth loose them due to Gum disease also known as Periodontitis.

"I want to keep my teeth"

This has been the constant mantra my patients have said to me over the 20 + years of my career.

By definition a dentist does not exist without a patient.

Why I LANAP?

The patient driven technology.

I have been a dentist for over 20 years and I have asked my patients

"What can I do for you?" "How can I help you?" "When you and I sit down here in 20 years what do you want?" "What are your dental goals?"


The constant response has been ...

I want to keep my teeth.

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Why create a new blog?

I decided to share my experiences being a dentist. I have been a dentist since 1988. So I have been around the block a little in the dental field.

First post on New Blog

Hello my name is John McAllister I am a dentist that practices in Los Angeles California.