In previous posts I tried to define a process called oxidative stress, which occurs when our cells are exposed to more oxidizing agents than they can detoxify. Fortifying our cells against this process, and even increasing healing is the premise behind the use of topical anti-oxidants. We have numerous studies that have shown that wound healing is diminished in the presence of oxidzing agents. In addition these studies have shown that the addition of a combination of anti-oxidants topically reverses the cell damage process and even encourages wound healing. From these original studies clinical research was completed. there are a variety of conditions on which the use of topical anti-oxidants has been shown to have a positive effect:
The link between periodontal disease and systemic disease has been clarified, and we are still uncovering new relationships that confirm he importance of maintaining periodontal health. For example inadequately controlled moderate to severe periodontal disease increases the systemic inflammatory load on our bodies. This increased inflammatory load may increase our risk of cardiovascular disease. It has been shown that patient’s who are diagnosed with periodontal disease in their early adult years have a four-fold risk of developing Alzheimer’s disease. There has also been a positive link confirmed between periodontal disease and obesity, as well as the known link with Diabetes. Active period therapy decreases the amount of systemic inflammatory cytokines, which are directly related to insulin resistance and stabilizing blood sugar in diabetic patients. This is important information that we can share with our patients, to help them understand the whole body value of a healthy periodontium.
I recently had the opportunity to watch a one hour video from the Seattle Study Club Annual Symposium of Dr. pat Allen. His presentation looked at the relationship between anti-oxidants, periodontal disease and oral healing. The data presented left me compelled to try the use of topical anti-oxidants in my practice as an adjunct to our periodontal therapy regimen. I will keep you posted on the results I see, but wanted to share the incredible information. Before we can look at the role of anti-oxidants therapeutically we need to understand the process called oxidative stress.
I have to admit that over the years I have had a love hate relationship with Chlorhexidine. I love it because of the positive impact I have seen it have on gingival health in my patients. I hate it because along with all of the positives come a host of negative sequela, all of which add up to patients not being able to benefit from its’ effects long term. Chlorhexidine has been around since 1954, and was introduced into dentistry in the 1970′s when it was observed to inhibit the formation of plaque. The research clearly shows that when used as an adjunct to periodontal therapy it significantly improves therapeutic outcomes. There are multiple modes of action that make Chlorhexidine effective.
The connections between periodontal disease and health have been widely documented and I have patients who come in concerned about their risk of cardiac problems due to a diagnosis of periodontal disease.
We know that there is a two-way relationship between periodontal disease and diabetes. When diabetes in uncontrolled the risk of periodontal disease goes up. For years we have believed that in patients who have untreated periodontitis it is more difficult to control their blood sugar.