Dr. Mercola Discusses Root Canals (Transcribed)

See Dr. Vinograd’s remarks next week here: Root Canals (commentary) & Podcast on the subject Episode 3: Root Canal.

Hello, this is Dr. Mercola, and it’s always been surprising to me how even physicians fail to appreciate how important the mouth is and the health of our teeth is to our total health.  If you’ve been following this site for a while, you know we’ve been placing great importance on the dangers of mercury in dentistry and how it should be avoided.  In fact, there is now way, I think, it should ever be used.  You just need to avoid it like the plague because it is a potent neurotoxin.

It’s a potent biohazard and should not be available, but is this the only problem with having proper dental health?  Unfortunately, the answer is no because if you suffer with a chronic disease, it’s really important to understand there’s a factor in your illness that could be a result of root canal surgery.  That is because every year in the United States along, 25 million root canals are done, and nearly every dentist and physician is oblivious to the potential health risk that this operation produces.

I’m going to discuss the challenges with root canals.  This is somewhat controversial, but I believe it’s important.  I’ve known about this information for 20 years because it’s really vital to understand that over 95% of all dentists and physicians do not understand this issue because they have avoided this research that been available literally for over 100 years.

Fortunately, because I was educated about the dangers of root canal, I have been able to avoid of them my entire life.  Interestingly, after I learned about, I wound up having an infected tooth that was seriously infected that had to be surgically removed.  Now, traditional dentistry would have recommended root canal, now the interesting this is that I was about 40 years old during that time.  During my entire adult life, up to that point, I suffered from severe acne, chronic severe cystic acne that I tried everything for, and it wasn’t getting any better.  The moment, I had that tooth removed, the acne disappeared.  It was just like a miracle, which is pretty interesting.  For me, it made a very remarkable change in my own health.

Now, you might be wondering, “Well, Dr. Mercola, how did you get an infected tooth?”  Well, the challenge is, and really, if you’re a parent, you have to understand this, the reason that you get infected teeth or the beginning of that is because of your diet.  Dr. Price found that in his extensive research is all of that.  If you’re eating a healthy diet that’s essentially avoids sugars and grains, full of good vegetables, and healthy foods, and you’re avoiding the toxins, you just are aren’t going to get cavities.  If you look at cultures that are eating ideal types of diets, you’ll see that cavities are almost non-existent in that culture.  That’s what happens here.  So, parents, you have to be good with your kid and teach them these principles, so they can avoid these problems and complications in life.

Getting back to my own experience, I have two additional teeth removed since.  What I did initially with the first tooth is I had a partial put in, and then it was switched to a bridge.  So, I had two bridges, and I’m in a transition now to have an implant.  It’s actually a very special metal called zirconium, which I believe is far better than titanium.

Fortunately, I’ve had early mentors in this area, Dr. Tom Stone and Dr. Douglas Cook who was a biological dentist in northern Wisconsin.  They taught me this information about 20 years ago so I’ve been able to apply it to my own health personally and avoid root canals and recommend all my friends and family to avoid them, and I recommend you to consider avoiding it, too.

I’m going to provide you with the information, the material, the knowledge that you need to make that informed choice.  The pioneer in this work, in the toxicity of root canals, was actually done by Mayo Clinic and Dr. Weston Price.  They did this jointly back in 1910, over a century ago.  Now, Dr. Weston Price was known as the world’s greatest dentist.  He was a diligent researcher, and his work was revered by both the dental and medical professions.  His work took him around the world where he studied the teeth, diet, and bones of the populations without the benefit of living with modern food and avoiding the processed food.  He did 25 careful and impeccable researches, and he actually led a team of 90 researchers where their findings mark up there with the greatest medical discoveries of the 20th century.  Unfortunately, his information and the information he found out has been largely suppressed.

This all started because around 1900, Dr. Price had been treating root canal infections He became suspicious that these root canal teeth always remained infectious even though he treated them like all the other dental physicians did.  That thought kept preying on his mind, haunting him each time a patient consulted him for some serious debilitating disease for which the medical profession had no answer.

Then, one day, he recommended that a woman, who had been wheelchair bound for six years, have her root canal tooth extracted even though it looked find.  He then removed the tooth from the woman and implanted in under the skin of the rabbit.  Interestingly, the rabbit developed this similar, crippling arthritis, and in 10 days, the rabbit died.  Even more profoundly important is that the patient has spontaneous remission, and her crippling arthritis resolved, which was really quite profound.

So, Dr. Price came to learn that many chronic degenerative diseases can originate from root filled teeth, and the most frequent that he found were heart and circulatory diseases.  He also found 16 different bacterial agents that can contribute to that.

In Dr. Price’s time, it was not that easy to culture and identify these bacteria (they were anaerobes) because the technology did not exist in the 1920s.  Most of the bacteria that were recorded by organized dentistry during that time were of unknown origin, but today, there are far more sophisticated techniques like DNA analysis.  So, these bacteria can actually be very specifically identified.

The second most common diseases were those of the joints, arthritis and rheumatism.  In third place, almost tied for second, were diseases of the brain and nervous systems such as MS.  After that, any disease that you can name might have actually had a cause from root canal-filled teeth.  There may be the actual position of the tooth and the acupuncture meridian it occupies.  So, root canal tooth in one area may cause one symptom where, in another area, another area of the jaw would cause another symptom.

So, Dr. Price learned that primitive tribes with ideal nutrition, avoiding all processed foods, had perfect teeth without cavities or gum disease.  As soon as these natives, though, started adapting to the Western advanced types of diets of the advanced nations, their teeth became deformed, full of cavities.  They had gingivitis.  They started getting diabetes and all the other diseases of Western nations.  So, it was obvious to him that human degenerative diseases where fundamentally a nutritional problem.

So, he discovered, that it is mechanically impossible through this process to sterilize a root canal tooth which most dentists believe, that you can physically sterilize.  Dr. Price learned that it is impossible, and I’ll tell you why.  No matter what material or technique Dr. Price used, the root filling shrinks minutely and even microscopically, but it does shrink.  This shrinking prevents the inner canals from being sterilized.  So, this is the key:  Because of the bulk of the solid-appearing tooth, called the dentin, which consists of miles of tiny tubules.  This is what we believe now, but what’s taught in most dental schools and what most dentists believe is the tooth has only one to four major canals.  What they don’t appreciate and what’s not taught in dental school and is never really mention is these accessory canals.  Dr. Price identified as many as 75 accessory canals in a single tooth.

Now, this is the where the issue is because these microscopic organisms, typically aerobic bacteria reside in these tubules, and they fail to become sterilized because there’s essentially three miles of these tubules.  If you lay them end to end, there’s three miles of them.

When the tooth is sterilize is the root canal is formed, you create a different environment, and this environment is actually isolated from the normal environment of the body.  As a result of the oxygen presence, these bacteria which require oxygen actually mutate and morph to these dangerous anaerobes.  It’s bad enough that you have these mutated bacteria, but what happens is that these bacteria produce toxins.  These toxins can be released every time you chew.

So, what many people fail to realize is that a root canal tooth has no fluid circulating through it, but the maze of these tubules, these three mile tubules, remains.  So, these anaerobic bacteria that live there are remarkably safe from antibiotics.  You cannot kill them even with IV antibiotics because there’s no way for these antibiotics to reach them.  The bacteria migrate out into the surrounding tissues where they can hitchhike to other tissues in the body, and the new location can be any organ, gland, or tissue.  A colony will be set up which serves as a focus for chronic infections.

One of the things that makes it difficult to understand is that there is a large amount of relatively harmless bacteria common to the mouth.  They change.  They actually morph, and they adapt to these new conditions.  So, they shrink in size in these crammed quarters.  They don’t have the normal oxygen supply, and they morph.  They learn to exist and thrive with little food and little oxygen.  So, that need oxygen, these aerobic bacteria mutate, and they are able to get along without it, essentially changing into these anaerobic bacteria.  In the process of adapting, these formerly friendly normal organisms, become pathogenic, capable of producing disease bacteria, and they become more virulent and produce potentially very serious, potent toxins.

Now, Dr. Price’s important research completely alters the way we must now think how diseases develop and disappear.  Now, these root canal teeth don’t affect everyone.  This is a concept that I want you to understand because if you have a strong immune system, you may remain in perfect health for many years, even decades after root canal surgery.  Dr. Price learned that if you have a strong immune system, it’s capable of engulfing the bacteria in infection so that they are stabilized and are prevented from entering other sites.  However, once your immune system becomes compromised because of a severe accident, stress, or infection, your immune system can become so compromised that it can develop a degenerative disease because it is unable to control these pathogenic bacteria.

Interestingly, there’s no other area in medicine where a dead body part is kept in your body.  If you have your appendix, the surgery preserve it and keep it in there.  It surgically excises it and removes it.  God forbid, you were to have frostbite in one of your digits, in your finger or toes, we certainly want them to keep that toe or finger, but that’s not what happens.  If there is severe infection, it is amputated.  So, once a body dies, no matter how important it is, it is typically removed from the body except for your tooth because the standard of care in dentistry is to keep and preserve tooth structure.  There’s an important component to that because we definitely want to keep our teeth.

If you remove a tooth, you have to do something to address that because there will be a mechanical dysfunction that results from an absence of a tooth, but you don’t want to keep a dead tooth in your body, largely because the anaerobic bacteria in root canal teeth are flushed into your blood stream every time you bite down.  The start looking for a new home.  As I said, if you have a healthy immune system, this is not an issue, but the moment your immune system becomes compromised, look out.  You’re going to have a potential problem.

So, you create this permanent abscess in your body with this root canal operation, and it sets you up for some potentially serious degenerative diseases.  Whether these diseases occur shortly after root canal surgery or if they occur much later in life depends, again, on the health of your system.

Dr. Price wrote to incisive books in 1922, and they were nearly 1200 pages long about this research.  It covered not only this research but human health and dental conditions that were important enough, so much so that he should have won a Nobel Prize, but unfortunately, he didn’t.  Unfortunately, also, the American Dental Association denies his findings and claims that they have proven root canals to be safe.  However, they have no published data or actual research on this.  So, his work seems to have been deliberately buried, unread, and unappreciated for about 70 years.

At that time, there was an endodontist, a root canal surgeon, by the name of Dr. George Meinig.  Dr. Meinig was actually born in my hometown, Chicago, and he was born nearly 100 years ago.  He moved on and eventually became a captain of the United States Army during World War II then moved to California, Hollywood and became a dentist to the stars.  He practiced root canal therapy there, in Hollywood, and he actually taught this subject to others in the dental profession.  He eventually became one of the founding members of the American Association of Endodontists, and that’s the professional association for root canal therapists.

However, in the early 1990s, Dr. Meinig, in development with the Price Pottenger Nutrition Foundation, spent 18 months of intensive study of the meticulous 25 year root canal research that he found in Dr. Price’s book on dental infection.  In June 1993, Dr. Meinig published the book Root Canal Cover-up.  This book is still available on Amazon today.  If you want to pursue this topic in more detail, I strongly recommend that you pick up a copy of that book because it has all this information and goes into much more detail that I can on this video.

So, if you’re convinced, let me just say that I strongly recommend that you not have root canal therapy.  If you have one, let me caution you that there are specific areas that you need to be concerned about before you remove a root canal because you can make it worse.  As I said, I don’t believe anyone should ever get a root canal, but if you are considering one, you have to do your homework on this issue.  You can listen to this video again.  You can get Dr. Meinig’s Root Canal Cover-up, or you can go back to Dr. Price’s original research.

So, if you have one, you’ll still consider removing it because, remember, the immune system starts to crash, the likelihood that you’re going to potentially encounter some degenerative diseases increases.  You options, if you’re going to remove it, are quite simple.  You can either have a partial denture made, and that’s a little tooth that you place in and out.  That’s a partial because it’s not a full denture, and it would contain however many teeth were the root canal teeth.  There’s an upper and lower one you would use.  That’s the least expensive, and it’s also the least convenient.

The other option you can have is called a bridge.  Bridges are considerably more expensive. They typically destroy the adjacent teeth and create this bridge which looks like a normal tooth but there’s a space underneath between it and your gum.  Then, you have to regularly floss with it.

The last approach that you can use is an implant.  There’s some potential problems with implants.  The typical one uses titanium.  One of the concerns is that you have multiple types of metals in your mouth.  So, if you have titanium, and you have metal or a crown or a filling, that metal can form a battery between the two dissimilar metals and that cause a current that exceeds the current in your brain.  You want to be careful about putting that.  That’s why my favorite is the zirconium, but you really need to see a dentist to understand who’s knowledgeable, who’s trained in this.  Certainly, all dentists are trained in the therapy, but they’re not trained about the specifics of root canal danger.  So, you need to see someone who’s concerned about biological dentistry.  We’ll have some links for you on this page to find those dentists.

Remember, just pulling the toot is not enough.  Another interesting thing that Dr. Price found is that the bacteria in the tissues adjacent to the root canal can also be a problem because they just don’t reside on the tooth.  They permeate around the immediate tissue.  So, dentists are generally taught to remove a tooth and leave the periodontal ligament in the socket in a procedure similar to delivering a baby and leaving the placenta in the uterus.

Most experts now recommend slow drilling with a burr to remove one millimeter of the entire boney socket so you can get rid of those bacteria because there’s a risk that that bacteria can actually develop a cavitational necrosis.  The purpose of this is to move the periodontal ligament, which seems to always be infected with these toxins and the bacteria.  It is typically a Streptococcus that is living in these dental tubules.  So, again, the first millimeter is typically removed with a slow drill.

So, this is in direct contrast to what most dentist learn in dental school, which is to save the teeth, to perform a root canal to save the structure.  They really do think that they are doing the best they can for you, but they are unaware of the research that Dr. Price did.  If they are aware of it, they’re convinced that the American Dental Association knows better and has disproven this when they haven’t.

It’s really an important topic.  When I was practicing medicine, if a person came in, we would routinely look for anyone who’s had a root canal.  It didn’t mean that they had to remove it at that time, but it was always a factor that we would consider that could be a hidden variable that we weren’t aware of that would prevent the person from achieving their highest level of health.

So, it’s really an important information to have.  Most people are not aware of this.  Hopefully, this information will start to spread.  People will be knowledgeable that this could be one of the hidden factors that may be contributing to any degenerative disease that they’re having because it’s the paying attention to details that we need to have to find out the mysteries so that we can truly take control of our health.

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Inflammation and Oral Systemic Connection P3

Some of your patients are already at risk for developing diabetes.  They may be type II diabetics already, or they may be prediabetics.  I learned a couple of years ago from Dr. Bale that diabetes just didn’t happen.  He tells a story, and I’ll say this very quickly.  Dr. Bale tells a story prior to the Bale/Doneen method that went to the hospital, had a heart attack, recovered from the heart attack, came back home, and in describing his experience at the hospital as fine, but said, “Guess what?  While I was in the hospital, I was developing diabetes.”  It happens all the time, but what Dr. Bale will tell you that you don’t develop diabetes in the hospital.  This is a 10-20 year evolution.

Some of our patients are prediabetic or already diabetic.  If you know what to look at in your patients’ oral health, you can diagnose 73% accuracy prediabetes or diabetes looking at the right parameters by doing a good oral health exam.  We’ll explain what that is, probably 5 minutes to be that accurate.  One simple test at that, you as a health practitioner can accurately diagnose with a 92% accuracy prediabetes or diabetes.  This is incredible information.  It has now been published, and we need to know about it.

So, how about your patient’s attitude?  How will this change your practice?  Will I have time for this?  Will it help my practice?  Will it hurt my practice?  Let me show you that these studies have already been done.  Patients that have gone through this screening, in other words, medical screening in a dental setting both in the private dental world and in the educational institutions, patients’ attitudes when dentists get involved in general health is extremely positive.  We’ll discuss what patients said. We’ll discuss what the literature clearly says about the powerful positive impact of bringing this kind of information to practice.  It grows your practice, and it also grows your reputation as a health care provider in the entire community to our practice.  Very positive there.

The last slide that I will show you is don’t forget yourself because your lifetime risk is the same as everyone else.  All of us, as human beings, have a lifetime risk of developing coronary heart disease.  If you’re a male and you’re 40 years or older, your lifetime risk of developing coronary heart disease is almost 50%.  You have a 1 in 2 chance of developing some kind of coronary disease.  I will tell you this, though, that Dr. Bale will tell you that this is preventable if you know what to do and you are looking at the right things and you are in the right position.

If you are a female, you have about a 32% risk of developing coronary heart disease.  Just looking at that risk that should be motivating for all of us to determine what our level of risk is because risk factors are equivalent to greater risks.  Risk factors like diabetes don’t just occur suddenly.  They occur in younger individuals, and it’s only once we get into our 40s and 50s decades that these risk factors ultimately culminate into the event.  That’s what we want to prevent.

So, in this course, you’re going to learn from two experts that deal with heart attacks and strokes and diabetes on a daily basis.  You’re going to look at your own health and determine if you are at risk.  You’re going to look at the health of your spouse, the health of your children, the health of your parents, and the health of your whole extended family.  So, please come to this course for your own personal reasons.  Also, please come to the course to learn about how you can protect your friends that are your patients.

It’s been a great privilege for me to be a part of Dr. Bale and Ms. Doneen’s work, and I guarantee you that this will be the most important course that you have ever attended. So, thank you Dr. Bale for your work and nurse practitioner Doneen, and thank you also Crown Council for the wonderful work that you guys are doing.  Please consider adding this important work to the causes that you are so good at doing.  Thank you.

Dr. Bale:              Dr. Nabors, thanks.  Amy and I feel indebted to Dr. Nabors because we’ve been aware of the connection for a lot of years, working with our patients to maintain oral health, but we ran into Dr. Nabors because he was able to really objectify the bacterial burden with the testing he brought to the United States with the salivary diagnostics.  So, that move we were doing went on to a much more solid platform of objectivity for our work to prevent heart attacks.

I’m going to fly through the next four slides because I want to leave a full 15 minutes for Q&A and basically just say I’m very excited about the potential for more oral medicine specialists in this country.  We need them.  We deliver a two-day course for medical providers and dental health providers come to that, and they’ve always been pleased when it happens.  That’s why I come to San Antonio now.  We have medical providers that will be attending our two-day course coming up.  After they go through our course, then they’re much more aware of the oral systemic connection, and they need to partner oral medicine specialists.  I had a patient who needed to find an oral medicine specialist to partner with, and he lives in Phoenix, Arizona.  We found somebody who wants to leave where they’re working.  They’re celebrating, testing.  We need more fighters out there.

Anybody coming to the November 2nd course is going to leave that course being able to call themselves an oral medicine specialist, and medical providers who through another course will certainly need to collaborate around the country with you in the effort to maintain cardiovascular wellness.

So, we do need to rewrite the American Heart Association impact goals for the current decade.  Ideal cardiovascular health equals the absence of clinically manifested disease and optimal control of oral health.  So thanks again for being in on the call.  I’m excited about what you’re doing.  I appreciate all your help in preventing cardiovascular events in this country.  So, thank you.

Caller 1:               I have a few questions.  The first one is, how do you suggest that periodontal disease should be defined?  Please address active versus inactive periodontal disease, controlled versus uncontrolled.

Dr. Bale:              Dr. Nabors, do you want to take that?

Dr. Nabors:         Well, I would certainly love to, but I would say that those who are listening may think I’m biased.  So, Dr. Bale actually has case studies that show the relevance of what we’re trying to do together.  So, I would actually ask you Dr. Bale to answer that question.

Dr. Bale:              Yeah.  I think any definition of periodontal disease certainly has to include bacterial burden and certainly the bacteria we currently know that carries a huge risks such as the Porphyromonas gingivalis, Tannerella forsynthensis.  We know these periodontal Gram-negative bacteria can drive arterial inflammation, and they could do it in several ways.  Certainly, one of the ways that’s well-defined at this point is through the lipopolysaccharides that are created by these Gram-negative germs, and they stimulate toll-like receptor forms, toll-like receptor 2, which are critical drivers of the inflammation in our arteries.

In addition to that, several of these bacteria have been shown to increase the permeability of the inside lining of the artery, as you know, called the endothelium.  When you increase the permeability of the endothelium, you’re opening up the wall of the artery for injury.  So, I think any definition of periodontal disease has to address bacterial burden, and we do have excellent tests for that now.  The bacteria are clinical, and they could certainly be sub-clinical.  I do have a case I’ll be talking about in our course where he had subclinical periodontal disease in term of attachment loss and pocket depth.  You would give him a gold star, but the more sophisticated salivary test showed that he had a very significant bacterial burden, and he had arterial inflammation.  He’s a very high-risk patient not only for heart attack but also for ischemic stroke.  A critical part of getting his artery cooled off was addressing his periodontal bacterial burden.

Dr. Nabors:         May I add to that, too, Dr. Bale?  I think we certainly want to encourage any practitioner to follow the ADA guidelines as well in defining periodontal disease, especially on bleeding and pocket depth.  Unfortunately, we don’t have a perfect way of diagnosing periodontal disease.  We do have a classification system, not a diagnostic system.  The classification system must involve the ADA I, II, III, IV, V or the AAP classification.  Either one works.  Most of us use the ADA but bother are important.

What Dr. Bale is saying is that when you add the bacterial burden to it simply increases the level of risk, most for bone loss, and certainly, the level of risk for us that may be at risk for heart disease.

Caller 1:               What is the best way to teach this information to a patient who doesn’t feel or see any impact of periodontal disease?

Dr. Bale:              Now, let me take that.  We will be addressing that in a big way in our November 2nd course.  My partner, Amy Doneen, will spend a whole hour addressing how you communicate with patients the potential cardiovascular risk.  We have ways where we’re going to talk about how you can educate the patient.  We have an acronym or a method called EDRA, and the E stands for education.  So, we have great terminology, and Dr. Nabors has developed the terminology along with us that you will be able to utilize that the patient will understand.

For example, at the endothelium we’re talking about, the inside lining of the artery, you let them know that’s the tennis court, and how hot it is and permeable it is, is the most important thing you can know about your cardiovascular health.  We have ways of identifying subclinical plaque in the wall of the artery.  Actually, some of that testing will be available at the course for individuals.

If you want to find out about your own potential risk, whenever we’re addressing an audience that we’re teaching, we always let them know they’re the most important people in there, not the patients, because if they don’t take care of themselves they’re not going to be taking care of any patient.

So, a lot of people that come to our courses inadvertently find out, “Hey, you know, I got a little risk, but at least I found out before I had an event.”  We’re actually going to do two simulated visits as part of the course, as part of the CE we applied for.  We’re going to have a patient visiting a dental professional, a patient visiting a medical professional, and how you communicate to the patient and how the dental provider communicates with the medical provider and how the medical provider communicates with the dental provider.  All that communication.  Whoever has the communication, they’re right on the money.  If you don’t know how to educate, you don’t know how to communicate.  That’s your death.

Dr. Nabors:         May I add something to those wonderful comments, and that is our own Steve Anderson will be there as well.  At the end of programs, Steve is going to talk to us about implementation and how we can discuss this in terms our patients can understand.  So, we’re really looking forward to him being there.

I would also like to add that if I understand the question and that is sometimes our patient may be reluctant to do a test, we certainly understand that because testing is very routine in the world of general medicine and not as routine in our world, but Dr. Bale and Ms. Doneen are going to present some unique cases wherein they not only use serum risk factors where they were looking at specific markers that indicate risk.  They also discover from using the salivary test.  Sometimes, it’s actually the bacterial burden that tips them off.  Is that not right Dr. Bale?

Sometimes, there’s cases where the salivary test actually help to find what you’re treatment is going to be, right?

Dr. Bale:              Absolutely.  The patient I saw yesterday that flew in from Phoenix to see me has got a periodontal issue, and we discovered it.  That’s why I had to find a dentist quickly, an oral medicine specialist in the Phoenix, Arizona area, and we were able to do that.  He flew back yesterday, and he’s probably calling the office right now to make an appointment.

Caller 1:             I have a question about that.  May I ask if you may talk a little bit about where the access is to doing the saliva test.  My members want to know if that’s available to them, and can you talk about that?

Steve:                   I’ll weigh in on that.  Dr. Nabors pioneered one of the earliest salivary tests today in the brand Oral DNA, and you can go on the internet, just search for Oral DNA.  The supply’s ordered through Henry Schneid.  The supplies, you take the salivary sample, send in your oral DNA, and then the results are provided online.  So, Dr. Nabors has been very closely involved with Oral DNA for several years, founded it and developed the whole system.  I believe, Dr. Nabors, that would be considered the standard but not the most-widely used salivary diagnostic test?

Dr. Nabors:         Yes, that is correct, and thank you Steve for doing that.  Please be aware, too, that everything is HIPAA compliant.  The laboratory’s completely [1:00:36], and Steve said they’re very easy to get and start doing that.

If you have questions, you can e-mail me at TNabors@baledoneen.com. Even though I’m not associated directly on day-to-day basis, I’m certainly very interested in learning how you can add value to the dental experience.

Steve:                   If I could just weigh in on how you raise patient awareness.  I’ll just give this one quick tip that I would say to the vast majority in the Crown Council.  For years, we passed a hurdle when you diagnosed periodontal disease in a new patient, you would simply ask, “How long have you had this infection?”  The response from the patient will always be, “What infection?”  When you show them, they commonly respond to this, “It doesn’t hurt.”  Your response to that is, I’m always amazed, “An infection this serious doesn’t hurt until it’s too late.”  Then, the next step in that, where medicine and dentistry come together, is to ask the patient who they know that heart disease or has high cholesterol, high blood sugar.

Of course, everyone know someone that has one or more of those conditions.  The response to that is periodontal disease is similar to those except they don’t hurt until it’s too late.  That’s why when we see the signs of it, we get very concerned, and want to get it treated before it’s too late.  Most people can relate to that because they’re very familiar with the other conditions.  When you frame it in that way, it makes more sense.  That’s a short answer to an obviously more-involved way of presenting things, but for those that may not be familiar with that, that’s a quick introduction and quick review.

Listen, Dr. Bales, Dr. Nabors.  Thank you again for sharing.  You accomplished the near impossible.  I asked the two of you to cram two days into one hour.  I appreciate you completing the task and making everyone aware of the resources that are available in your course that you’ll do November 2 in Las Vegas.  If you would like to know more, it is definitely a direction that dentistry is going rapidly.  We appreciate your pioneering work in educating all of us in how to take care your practice in that direction to better serve our patients.  So, thank you again for being with us today, and thanks for all the Crown Council members for being here in our webinar today.  We wish you a great day.

Thank you!

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Dr. Vinograd’s 3rd Lecture on Holistic Dentistry at The Gerson Institute

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Inflammation and Oral Systemic Connection P2

So, there is evidence that periodontal disease can actually trigger cardiovascular events.  Well, there’s a wealth of information out there.  I’m just going to bring up one brief study that I think is simple to explain and has a huge impact.  They looked at 628 at Pima Indians, and they used the Pima Indians because there’s a very low rate of cigarette smoking in that tribe.  They wanted to see if periodontal disease has any risk on these individuals dying of cardiovascular disease over a period of time.  Within 11 years, about a third of those individuals dropped dead; 204 died.

They sorted out the cardiorenal deaths, which was a majority of the deaths, and what they found was a bit shocking.  If the patient had no or mild periodontal disease, no Pima Indians suffered a cardiorenal death, none.  There were zero deaths if that was the case.  If they had severe periodontal disease, they were three times more likely to suffer a cardiorenal death.  Again, they made multiple adjustments for other potential risk factors.  That’s a very impressive study that periodontal disease is associated with the risk of cardiovascular events.  We’ll, of course, present additional evidence in that regard.

Do we have any evidence that periodontal treatment can actually impact cardiovascular risk?  There’s a wealth of that information as well.  The one study to talk about today deals with type II diabetics, 371 of them, and about half of them received excellent treatment for periodontal disease.  The others did not get treated, and they looked to see if it had any impact on the overall sugar control, the A1c.  The ones that had treatment had a very significant drop in the hemoglobin A1c of 0.4%, demonstrating much better glycemic control, which is related to cardiovascular risk.  In our course in November, we’ll talk about additional evidence in that regard.

So, what did the American Heart Association conclude in that highly publicized paper in April?  It was published in an excellent journal.  They had several huge conclusions.  One, there’s level A evidence that periodontal disease is independently associated with arterial disease.  That’s a huge conclusion.  Level A evidence is extremely difficult to obtain.  It was published in our journal JAMA several ago that the cardiovascular guideline, the vast majority of those are based on less than Level A evidence; 20% or less of the guideline’s actually Level A.  So, that’s very impressive that there’s Level A evidence, and independent means it’s been adjusted for the several risk factors.  Periodontal disease is still associated with arterial disease.  That’s a huge statement.  They also concluded that the evidence that’s out there looking at periodontal treatment does show a trend for cardiovascular risk

As you know, the unfortunate additional conclusion that got most of the press was, periodontal disease doesn’t cause arterial disease.  They weren’t able to prove that periodontal disease causes arterial disease.  Of course, that’s what the press latched on to, and crazy statements started flying around.  “Periodontal health doesn’t matter for cardiovascular health.”  That’s ridiculous.

In order to show causality, it’s extremely, extremely difficult to do that.  Number one, you have to have a definition that is extremely objective for pediondontal disease before you can show causality.  We believe that should include burden of bacteria.  Certain items at all aren’t subjective.  So, that’s a hurdle that has to be overcome before you’re going to show causality.  Another hurdle is in the studies, they’re trying to show that the treatment protocols have to be very objective and have to have objective points to prove that the treatments were effective, and again, probably including something showing effectively  that yes, we eradicated the bacterial burden.  Then, there are numerous known risk factors for cardiovascular disease.  Those are confounding.  Number four, to prove causality, all of those have to be controlled.  You have to have baseline from the control group to the treatment group.  You have to be matched where there’s no significant difference in the two groups of baseline.  By the end of the study, there can still be no significant difference in the known risk factors.  That’s a huge hurdle to overcome.

We do now know, and we’ll talk about this in our course in November, but most of the time, when there’s a plaque “rupture” where you’re going to get an event that blocks the flow of blood, a clot, that causes heart attack or ischemic stroke, we now know most of those “events” are not symptomatic.  The vast majority of them are asymptomatic.  You get small damages that, overtime, can lead to heart failure or dementia.  Sometimes, it just simply heals over, and the plaque on the wall of the artery continues to grow.

So, if you’re going to do a study to show causality, any study that’s going to include cardiovascular disease, in the future, are going to include being able to measure those asymptomatic events.  So, causality is going to be very tough to prove.  It’s going to take time and an extremely well-designed study and a better definition.

The fortunate thing is that causality is not a pre-requisite for including periodontal disease assessment and management in a cardiovascular wellness program.  If we had to show causality before we included things in our program, we would hardly be doing anything.  Few things have been show to actually have causality.  That’s not necessary.  Simply having Level A evidence, which is extremely difficult to accumulate, having Level A evidence that periodontal disease is independently associated with arterial disease along with evidence of therapy reducing that risk is plenty of information to demand that any cardiovascular wellness program include oral health and assessment of periodontal disease and managing that disease in their program to maintain cardiovascular wellness.

So, I look forward to hearing Dr. Nabors now.  He’s got a few more slides to go through with you.  I’ll just say a few more things in the end, but I really appreciate you being on-call.  We have to have your help to reduce the number of heart attacks and ischemic strokes in this country.  Periodontal disease is at the root of a lot of those.  Thanks.

Dr. Nabors:         Thank you so much, Dr. Bale, and I believe the listeners today can truly hear in the voice Dr. Bale how dedicated he is to preventing heart attacks and stroke and also his partner Amy Doneen.  These two individuals are very unique, and I think you can hear that in their voice and in the presentation that Dr. Bale just made.  I’ll tell you that Dr. Bale and Ms. Doneen’s speaking for 2 day programs about [30:58], and I’m always fascinated with their ability to keep the audience on the edge of their seats and providing new information every time they speak.

We mentioned here, and I’m privileged to be a part of what Dr. Bale’s doing and what Amy Doneen is doing.  I think all of us should have the privilege to look into our patients, not just our ill patients, but as our friends and family, that we now have a greater responsibility to help determine if our patients may be at risk for heart disease or ischemic stroke or diabetes.

I was also privileged to be a part of their time in writing this CE course called Inculpatory Evidence:  Periodontal Disease Assessment and Treatment is an Essential Element in Cardiovascular Wellness Programs.  That is being published by Pinwell and will be in Dental Economics this month.  We should see that publication in a matter of days.  So, please look at Dental Economics, and look at your web-based Dental Economics material.  You can take a 2-hour CE course perhaps, prior to coming to Las Vegas.

As Dr. Bale said earlier said today, as we look at our responsibility as health care providers, we really emphasize the prevalence of cardiovascular disease and the causes of cardiovascular disease.  He also helps us understand the important role that chronic infections play, and, in particular, the chronic infection that is called periodontal disease plays as an independent risk for factor for vascular events.  He also says, in that slide, that dentists can also play a role as screeners and as monitors and educators for our patient bases in helping them live longer.

This particular slide here is from a study that was done in 2002 by the Columbia University Columbia School of Dental Medicine.  There have been about five studies that have been done since 2002, one concluding in 2010, that clearly show that dentists can play an important role in systemic health.  Certainly, by observation and treatment of periodontal disease and being able to define periodontal disease more accurately by looking at more accurate parameters of periodontal disease risk.  It clearly shows, too, that dentists need to take a more proactive role in looking at health histories and looking at a number of issues.

In 1999, this goes back 13 years, the Journal of the American Medical Association said thatdentists can have a large impact on vascular diseases and diabetes in three areas.  Number one, as screeners; number two, as educators; number three, as monitors of risk factors.  We will be discussing all three of these areas in our course so that when you leave, you’ll know what it means to be a screener, an educator, and monitor of risk factors.

I’ll say this.  It’s not going to change the amount of time that you spend with the patients significantly. I realize what our training is, and that is to make sure the oral health is as good as we can possibly get.  It may require just a few more minutes to look at these very specific elements that you can learn in this course so that you can help advise your patients that may be at risk because you discovered their risk and save their life.  You know that this is happening today.  As we continue to look at this study in the Journal of the American Heart Association, we understand what we can do and what we need to know.

While we’ve been talking about the systemic connection for a number of years, I would also say that many of us have not changed our practice significantly.  I would also suggest that we can change it significantly, continue to do the things that we do and do well but also add this as a very important aspect of general health and well-being of our patient bases.  So, what we will learn at this course will be, we will help define our patients at risk for diabetes or cardiovascular diseases.  In other words, you will be able to look at your patients based on their medical history.  What are the real significant findings in the questionnaire that you are already getting?  We’ll offer maybe a revised version of the medical history.  In order words, the same medical history that Dr. Bale and nurse practitioner Doneen use in their review to determine from medical history, what risk may lie unnoticed in the medical history?

Blood pressure’s significantly important here.  Many of you are already taking blood pressure, and I will tell you from what I learned from Dr. Bale and Ms. Doneen is that blood pressure is a big deal.  We were taught primarily to use blood pressure to educate our patients, but we want to know if our patient is safe at the time that we are doing our dental procedures.  We have a responsibility to do that.  We can take our knowledge based on blood pressure where it is, and we can help educate our patients.  I will tell you that we will learn in this course that pre-hypertension is dangerous and that hypertension is ultimately a killer.  We need to know which of our patients are pre-hypertensive or which of our patients are in fact hypertensive.

Also in oral health, there are a significant things we can look in our patient’s mouth by just doing a good clinical exam.  I will also suggest to you that we will learn by using salivary diagnostics.  We can do an improved oral health exam, and we can help identify individuals that may be at risk for systemic disease based on our oral health findings.

Then, lastly, we really do need to understand risk factors.  It’s been about 2.5 years that I have been sitting at the [38:22] of Dr. Bale and Ms. Doneen, and I can tell you, I have a much higher regard for risk factors than I ever had before because we can look at risk factors.  You can look at your patients and the risk factors associated with the medical history, their blood pressure, and their oral health.  Then, you can add numerous risk factors that you will learn at this course, and you can know very, very quickly which of your patients are at extreme danger.

One such report that was published just in November 2011, is that if you know what to look for during an oral health exam, you can identify individuals that have a 63% increase risk for heart attack with no other test.  We are certainly advising that you learn what tests are available as you are working with your physician colleagues in your community, but this is striking news.  You can look at oral health and come up with this type of figure for your patient that may be at risk for heart attack.

I mentioned blood pressure, and the things that we will be looking at more closely as we listen and learn from Dr. Bale and Ms. Doneen, these two studies were published this month in [39:51], which came out of Europe, which was a perspective urban and rural epidemiology study.  It was published online September 5th of this year.  Then, also we have our CDC study that was published September 11th of this year.  They are in agreement that there is approximately 40% of the world population, including US population that are pre-hypertensive or hypertensive.  That’s a huge number.

For those of us in the dental setting, this is particularly important because we see our patients every six months or every three months based on their oral health status.   Approximately 50% of those who are pre-hypertensive or hypertensive are undiagnosed.  So, if you’re taking blood pressure of your patients, this is incredibly important to the health of your patient to be able to determine if they are pre-hypertensive of hypertensive.  As Dr. Bale stated, this is one of the leading causes and major causes that he and nurse practitioner Doneen are fighting today.  We can be a part of that fight just by understand the role of blood pressure, how important that is, and how important our role can be by taking blood pressure on every one of our patients.

Why is that important?  Blood pressure screening can prevent 46,000 deaths per year in the United States alone.  For those of us in the oral health profession, we’ll join with general health practitioners as a team, and that’s what the CDC was saying.  Clearly, when there’s a team effort, we discover more pre-hypertensive patients and hypertensive patients when everyone understands the significant risk factor associated with deaths in the United States.

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Inflammation and Oral Systemic Connection

 

We’re going to get started here in about five minutes, and for those that are early, thank you for being on time.  I’m just going to run through housekeeping items as the group assembles here.

First, a few calendar items.  We’re going to be talking today about really fascinating medical science that has to do with periodontal disease and overall health.  A lot of just fascinating information today.  On the calendar, let me just mention a couple things.  One, the end of this month, September 28 and 29, is the Nomar Hygiene Seminar featuring Tommy Nabors and myself and members of the Tops team.  That will be in Nashville.  In December, we are looking forward to our year-end roundtable, and if you’ve never attended a Tops Crown Council Roundtable event, it is a must-do, and you can get more information about that by calling the toll-free service (877) 399-8677.  So, that is the first Saturday, the end of November to December.  We’re really looking forward to the Crown Council annual event, January 24-26, 2013, in Nashville as well.  This appears to be the biggest annual even ever, and great enthusiasm.  The enrollment is over-the-top.  We’re very excited.  If you have not signed up for that, contact the Crown Council office today because hotel space is very limited now at this point.  There will be never-done-before and maybe never-done-again events at this one.

Of course, everyone is aware we’re going to kick off the annual event Thursday with a big event at the Ryman Theater, home of the country music and the Country Music Hall of Fame. It’s the mother church of country music with an All Star lineup of some of the biggest names in country music.  Celebrate smiles for life, and we’re very excited about that.

Speaking of smiles for life, we just wrapped up the 2012 Smiles for Life campaign.  Total money raised was $1.3, and thanks to everyone who participated and made that really a continuing miracle.  Over the last 13 years, we’ve raised over $31,250,000 dollars for children’s charities.  So, thanks for everything you do every year to make that possible and make a difference in children’s lives.

For those that are anxiously awaiting the checks for your local charity, they are being mailed today.  The check is literally in the mail.  They are being mailed to the doctor.  Just a reminder, the reason why we send the Smiles for Life checks to the doctor in the name of the local charity is so that you can organize a check presentation ceremony where you can make that official, instead of dropping it in the mail.  We hope that you’ll use the check opportunity as a way to get additional publicity for your office and your community.

A few housekeeping items.  For those of you that may not have joined us before on a webinar, we have record attendance today, and we are very excited about that.  There is a high degree of interest in this topic.  So, you are aware, you are in listen only mode.  You can hear us, but cannot hear you so we can have a clear broadcast and everyone can hear our guests today.  There is, in your control panel, on your computer screen, there is a question box.  You’re welcome to submit questions anytime during the presentation.  We will have a question an answer period near the end of the hour, and we will take those questions on a first come, first serve basis.  Again, you’re welcome to submit those at any time, and we will address those on a first come, first serve basis and hopefully get through all of the questions.

With that, let me introduce today’s topic.  I am very excited about this. This webinar today has been long in the making.  I sat down several years ago, here in Dallas, with Dr. Tom Nabors whom everyone knows as dentistry’s expert when it comes to periodontal disease and bacterial testing.  He is the pioneer in the industry in bacterial testing.  If I’m overstating, Tom, I’m sorry, but he has done the whole industry in America a whole lot of good.  He’s with us today, and we’ll be presenting along with Dr. Bradley F. Bale.

Dr. Bale who is an MD, it would take me a half hour to read you his biography of everything he has done in the medical world.  So, I’m going to sum it up with this:  This is a man who is constantly presenting to medicine and health care professionals all over the world.  He is one of the most sought out experts in terms of heart disease and the topic we’re going to talk about today.  He is the only physician that we know of in America who guarantees his patients that they will not have a heart attack if they remain under his care.  We don’t know of anyone else that does that.  He talks about it.  He just shrugs his shoulders, “Of course.  I don’t know why everyone shouldn’t do that.”  When you understand the science of what he talks about today, it really becomes pretty common sense.

So, I’m very excited to have the two of them today to share this joint venture between dentistry and medicine and how the two professions can work better together in helping cure one of the prevalent diseases in chemistry and to be able to screen for one of the most prevalent problems we have in healthcare and medicine.  With that, welcome Dr. Bale, Dr. Nabors.  Thank you for being our guests for today for our Crown Council webinar.

Dr. Bale:              Thanks, Steve.  Dr. Nabors, why do you go ahead and say a few words first.  Then, I’ll take over.

Dr. Nabors:         Sure.  Let me thank Steve and Greg Anderson.  Thank you so much for the good works that you have done in the dental profession.  Let me also thank the Crown Council listeners.  This is a special brew, and we are so proud to be a part of this presentation today, so privileged to be a part of the Crown Council on continuing education. Congratulations on all of the good works that you continue to do.  With that, I’ll turn it over to Dr. Bale.

Dr. Bale:              Okay.  Great.  I appreciate the opportunity, Steve, to address your Council because I know addressing oral medicine individuals who realize the important of maintaining excellent oral in terms of also maintaining cardiovascular health.  It’s always been a pleasure to address and share information with individuals who we can partner with in our efforts to keep people from heart attacks and ischemic strokes.

So, I just want to give you the overall outline of what we’re going to cover today.  The first thing we’re going to do is give you a sense of the overall burden of cardiovascular disease and periodontal disease.  Then, we want to share with you some of the information that links periodontal disease with cardiovascular disease.  We’ll a bit about the recent American Heart Association conclusions about the systemic connection.  Then, we’ll tell you about a course that’s available now in dental economics that I have a pleasure of creating along with Dr. Nabors and my partner, Amy Doneen.  I should mention, Amy knows this subject as well or better than I do.  She’s sorry she can’t be on this webinar, but she’s traveling to San Antonio where I am right now because we’re getting ready to give a two-day course to health care providers.  So, she gives you her best, and hopefully you’ll get to meet her sometime.

Then, we will end with a bit about a course that we’re going to deliver November 2nd in regards to the oral systemic connection.

So, in terms of periodontal disease incidents, we have excellent, very recently published information published online on August 30th.  That’s pretty hot off the press, and it was the best assessment that’s ever been done for the incidents of periodontal disease in the United States.  They actually did full mouth exams that’s never been done before.  They based the definition of periodontal disease on attachment loss and pocket depth.  What they found was shocking to some people, that’s for sure.  I don’t think I was that shocked because Dr. Nabors already informed me how prevalent periodontal disease is in this country.

This study shows that basically half of Americans aged 30 or older have periodontal disease, and about 60% of that periodontal disease was classified as moderate.  About 20% is mild, and about 20% is severe.  Individuals 65 years of age or older, 70% of Americans have periodontal disease.  That’s huge.  I mean it’s got to be ranked up there as the top chronic disease in the United States, and as you know, it’s highly associated with cardiovascular risks as well as type II diabetes.  A lot of individuals with periodontal disease are not aware of it.

In terms of cardiovascular disease, it remains the number 1 killer in this country.  Every 39 seconds, someone dies of cardiovascular disease, and that’s an endpoint nobody can argue with.  In terms of the age for cardiovascular death, about 150,000 in this country die of cardiovascular disease for the age 65, which robs the mat least 13 years of life.

So, the issue is huge with cardiovascular disease as it is with periodontal disease.  A study was published in July looked to see is an adult more likely to have a noncardiovascular death or are they more likely to have a cardiovascular death, fatal or nonfatal?  The study showed that American adults are 2 to 3 times more likely to suffer cardiovascular death, fatal or nonfatal, than to have a fatal noncardiovascular death.

So, we need to enlist the help of all health care providers, certainly the dental community needs to be very involved in the effort to eradicate this unacceptable cardiovascular risk to the American population.

In the year 2009, the American cardiologists along with the American periodontists certainly recognized this issue, and they confirmed the connection between cardiovascular disease and periodontal disease.  They have outlined the known mechanisms by which they are related, and they specified some treatments that could be delivered.  They called for the collaboration of the two fields of health care to work on reducing cardiovascular risk.

In 2010, the European Society of Cardiology basically stated the same thing that oral health does influence cardiovascular health and that we have to start working together in order to reduce the unacceptable risk.

Our method, the Bale/Doneen method in which we do guarantee our results, and I should mention the guarantee may shock you.  Our patients understand it.  It carries no malpractice connotation.  So, we just feel we have evolved to the point where you can, with reasonable assurance, make a guarantee that the patient won’t have a heart attack.  We haven’t had a patient have a heart attack in over 10 years, but if you’re going to do that, you’re going to have a comprehensive approach.  That approach certainly has to include oral health.

We now have Level A evidence showing independent association between periodontal disease and cardiovascular risk.  So, all prevention programs for cardiovascular disease have to include the oral/systemic connection.

So what is the evidence that periodontal disease could impact cardiovascular risk factors?  Well, there are numerous risk factors we know about periodontal disease.  The impacts I’m just going to share with you.  In one study published not long ago, they looked at over 650 healthy subjects who were 35 or older, and they were tested for periodontal bacteria, the four bacteria that are known to carry significant cardiovascular risk.  That’s A.a, Porphyromonas gingivalis, Tannerella forsynthensis, and Trepnoma denticola.

What they found was very interesting:  The individuals who had the highest tertile of burden of these bacteria had significantly higher blood pressure, 9 mmHg for the systole and 5 mmHg for the diastole.  That increase in blood pressure creates very significant increase risk for ischemic stroke and heart attack.  They found the patients in that highest tertile were three times more likely to be hypertensive, and they did make a lot of adjustments before they came up with that figure.

So, the study was interesting in that it was a concentration of bacteria as opposed to the clinical diagnosis of periodontal disease that carried the risk of increased blood pressure.  So, this is certainly evidence that subclinical periodontal disease can have significant cardiovascular impact, and perhaps we need to think of a diagnosis of periodontal disease that includes bacterial burden.

There are lots of other known cardiovascular risk factors periodontal disease is associated with such as the cholesterol issues, the blood sugar involved in type II diabetics, and, in particular, associations with biomarkers that we know indicate arterial inflammation.  If you come to the course we’re going to deliver in November, we’ll be showing the recently published data published in the journal Lancet that actually demonstrates inflammation is causal of cardiovascular disease.  That’s a huge statement.  To show something that’s causal is difficult, but this data indicates that indeed arterial inflammation is involved in the formation of build-up of plaque along the walls of the artery.  It’s involved in the triggering of events, the heart attacks and the ischemic strokes.  We do have evidence that periodontal disease impacts, in an unfavorable way, all of the biomarkers we use in our work to tell if the artery’s hot, if it’s inflamed.  If it’s inflamed, the patient is in peril.

We’re also going to be discussing toll-like receptors in the course, which gets into the nitty-gritty science about how the inflammation is triggered, and we’ll relate that to periodontal disease.  So, there is evidence that periodontal disease is associated with the formation of disease in the wall of the artery.

In 2008, the United States Services Task Force certainly concluded that was the case.  They did a very extensive review of the literature, excellent studies, and concluded that periodontal disease is an independent risk factor for coronary heart disease.  There are lots of other evidence in that regard, and we’ll be presenting a lot of that data in our course in November.  Certainly, it’s fascinating that the data about their demonstrating the presence of these periodontal pathogens within the plaque that’s in the wall of the arteries.  We’ll answer that question, how can it happen, how can it get in there.  We’ll talk about that in our November course.

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Common Diseases Caused By Bacteria In Our Mouths P4

Later, we’ll show you a study where we took out the proteins.  Look at this.  This is the albumin levels in humans, and this is where it runs.  In this one that is toxic, look at this albumin.  It’s running very abnormally.  It doesn’t run like regular albumin.  When we go to jawbone cavitation material, there’s a lot of people that do osteonecrosis or cavitation surgery, and they send it in.  Almost all the protein that’s in those cavitations, it’s almost all albumin, and it’s albumin that’s linked to other albumin molecules like it’s been to a place where there’s a lot of rigorous chemical activity.  At the same time, that material will be very high in mercury, silver, cadmium, iron, etc.  So, those jawbone cavitation materials are toxic.  They’re high in metals.  They don’t have normal cell proteins.  They have proteins that look like they’ve been char-broiled.

So, we want to study the small molecule toxicants associated with avital teeth and osteonecrotic materials.  It’s important to remember that this site contains both small molecule toxicants and proteins, and we can separate these rather easily.  Doing so proves that the toxins produced by oral anaerobes are small molecules like hydrogen sulfide and methyl thiol.

Here’s the second step we do.  When you send your tooth in, we take that third wash, from the tooth extract, and we put it in what we call a centricone.  There’s a filter.  Here, then it filters out all the proteins, and you put it in the centrifugation.  You spin it down.  What you get is a protein-free ultrafiltrate of a tooth extract containing just small molecules.  Big molecules don’t go through this.  you can’t find any protein in this material.

This is what we test.  We do this for several reasons, one of them being that we look at the literature about pathogenic bacteria, we found out that the toxins in there were not proteins, not endotoxins, the things that cause other cells to die are small molecules.  This is how we set up our test.  We took all of these proteins, phosphoglycerate mutase, pyruvate kinase, phosphoglycerate kinase, creatinine kinase, [40:54] and a synthetic fibroblast growth factor.

The reason these were selected is they all bound to ATP. They have different molecular weights, so we can separate them on the gel and look at the effect of the toxins and proteins at one time.  At this one we screen them by doing this.  We did nothing or we added hydrogen sulfide, which we know is very toxic at high levels, 2 millimolars.  That’s how high it is in a periodontal pocket.  You can see, it totally inhibited every one of these enzymes.  Hydrogen sulfide is lethal.  It will kill you.  If you go near an oil or a gas refinery, you’ll see these little sticks out there.  They’re measuring hydrogen sulfide because if it builds up, it will kill the population.  So, they have warnings for these.  It is an incredible toxin, and it is produced in your mouth, as we’ll show later.

This T is the toxin from the tooth.  So, here’s with nothing.  Here’s with the tooth extract, and here’s with hydrogen sulfide.  You can see these toxins are as every bit toxic as hydrogen sulfide, but I’m here to tell you it’s not hydrogen sulfide.  When we use hydrogen sulfide, it smells like rotten eggs.  If I were to open it up, a vial, 2 millimolar, and set it here with the top open, everybody in the room would be complaining about the small.

These teeth, they have a smell.  Trust me, they’ll turn you green, but they don’t smell like hydrogen sulfide.  Some of them that are toxic, they don’t have a smell at all.  So, we’re dealing with a compendium of toxins that we don’t fully understand.  One of them we know about is called gliatoxin, and it’s at the end of my talk if I get there.  It doesn’t smell, but it’s more toxic than the rest of them put together.  It’s produced by Candida.  So, what we can say is that the toxicity extracted from teeth are not large proteins but rather small molecules.

Also, this toxicity is most absorbed by charcoal but not by cation or anion exchange resins.  What does this tell you?  I know a lot of you guys carry charcoal tablet when you go to Mexico, and when you start feeling a little sick you take them.  Why do they work?  They soak up the toxins produced by the bacteria that have infected your intestinal tract.  They also soak up vitamins so don’t take them too long.  This tells you that these toxins penetrate.  They’re hydrophobic.  Things that bind to charcoal are more or less hydrophobic.  In other words, they would penetrate the hydrophobic tissues in your body very effectively.  They would go through cell membranes, and they cause a lot of problems.

We’ve talked about a compound I’m making, and this is part of the rationale behind getting something that would go in there and pick up these toxicities.  What we’ve shown here is that the presence of this type of toxicity of hydrogen sulfide and similar compounds can be detected in a radiodiagnostic assay using binding to viable enzymes.  This is nothing but hardcore science.  I mean, this irritates a lot people, as you might imagined, but they haven’t done this and said I’m wrong.  This has been now 12 years.

Here’s the study as we do it today:  We have these enzymes that we use that are abbreviated here.  We can see there are no other proteins here because we filtered them out.  Everything we’re looking at in these studies is just nothing but small molecule soluble protein.  We have two controls, and these are the proteins we add.  These are the enzymes we add to the mixture.  Then we can compare three root canals.

Everything you see here, they’re all root canals.  They’re the same color because they’re from the same mouth.  These three are all from the same person.  Ca means cavitations, and we’ve got a control (+) and a control (-), which is where we have to show what we get without toxin and what we get hydrogen sulfide.  When we evaluate this, what we can see.  The two outside lanes are our controls.  You can see that these proteins interact and become radioactive very quickly.  If you have root canals like these three here, this first one here is not nearly as toxic as the other two next to it.  The two green ones, the outside one is incredibly toxic, and the one next to it isn’t toxic at all.  The person in the light color here, he had the least toxic of the root canals in his mouth.  Now, why is that?  The type of infection, and possibly the person who had this root canal probably practiced really good oral hygiene.  Probably gargled with hydrogen peroxide and treated his mouth carefully.  Probably didn’t eat a lot of sugars, etc. There’s a lot of variability in somebody’s root canal and how much toxins it will produce.

We’re doing an experiment now with one of my people that has a periodontal site, a very nice one that I can get into with microbrush, and he can get into it.  He tested it himself.  It’s amazing how the level of toxin production changes with what he eats.  It’s just a one-person thing, but hopefully it will bring up some interesting information someday.  That pocket is incredibly toxic, and the next day it’s not depending on what he eats.

Let us talk about cavitation materials.  We have tested people who do jawbone cavitation.  We’ve never found one that wasn’t reasonably toxic, if not incredibly toxic.  I would tell the people here that might get attacked on this.  I represented or was an expert witness, and helped a dentist that was being attacked for doing jawbone surgery.  We took nine of his samples, and I did mass spectrometry on every protein that spread out on a gel like this.  Every protein that we tested turned out to be human serum albumin.  Even if it were a higher molecular weight or a lower molecular weight.  You break it down in mass spectrometry, and what it says is the material that you get out of the jawbones that are infected is you’ve had a lot of inflammatory processes.  Albumin’s been rushed to that area, and that place for jawbone surgery totally disrupts cross links and breaks down protein albumin.  We could hardly find.

We found a lot of blood clotting proteins there also.  It was blood clotting proteins and albumin were the major proteins that we identified in the cavitational material from this person.  That eliminated the argument that the person from Temple Dental School was saying that he was removing normal tissue.  It’s not normal tissue.  We also took that same tissue and did ICP mass spectrometry to identify the metals.  What you find when you do that is the metals aren’t consistent with it being normal tissue either.  It’s high and heavy metal such as mercury, iron, silver, copper, and other compounds similar to that.

The material in these jawbones, it’s not normal tissue.  There’s probably something that needs to be removed.  I think it’s something that we need to consider.  I think 12 years from now, if I’m still here alive and talking, this will be something accepted such as the focal point theory. This is the bottom line:  Osteonecrotic materials do not have the metal content of normal tissues nor do they have the normal proteins.  To back up the chemistry, and just to show you where the products come from and a lot of the studies we haven’t done.  When we look at the breakdown of L-cysteine, desulfhydrase is the enzyme that’s in these anaerobic bacteria.  Why did they produce hydrogen sulfide, and why, if you don’t brush your mouth regularly, you start stinking.

We look at this.  It produces hydrogen sulfide.  It also produces ammonia.  What we’re finding is maybe the hydrogen sulfide plus the ammonia together are what perhaps make these sites so toxic and so susceptible to breakdown of the tissue.

This tooth was sent to me by Hal Huggins.  There as a time in my life when I found Hal Huggins a major pain in the rear end.  There’s some things about him that I like and some things I don’t like.  You can’t talk about his intensity.  When he found out I was visiting you guys and talking about mercury toxicity, he sent me some teeth, called me, wrote me.  In general, he harassed the living daylights out of me until I said, “We’ve got to do something for this guy so I can shut him up.”  I thought he was wrong, just to be blunt.  I didn’t believe that a tooth could be as toxic as mercury.

This tooth came from him and it was extracted from a person with multiple sclerosis.  We did the same things that we talked about.   We washed his tooth three times, let it set there, and after the 3000 microLiters, we started adding.  This is a pretty homogenous, by the way, labeled with ATP.  Here’s what happened after we added 5 microLiters of that last thousand microLiter wash.  It just totally abolished the activity of the proteins in the brain.  This was something coming out of a well-washed tooth that had been extracted from a person who was sick.  Now, I am not saying that infected teeth cause multiple sclerosis.  It might be that these people have a lower immune system, and their teeth just become infected.  The person with the tooth needs some dentistry, some good advice.  We need to be studying this area.  There’s absolutely no doubt that this tooth is more toxic than hydrogen sulfide. It might be because of the ammonia that’s in it also.  It might be because of the toxins. We don’t have the answers, but we need to be pushing our government and the National Institutes of Dental Research to have research in this area and not have people from Brazil, Chile, Japan, Sweden, Germany, and every place else do research that we could probably do better and more effective in this country.

To say these teeth do not have an effect on human health, whether this game after or before this person developed multiple sclerosis, it shouldn’t be in their mouth, not this level of toxicity.  This is incredible toxicity.  I give full credit for Hal Huggins for pushing this issue.  I also say Dr. George Manning because coming to one of your talks, I didn’t listen to Al very much until I listened to Dr. George Manning give a talk on root canal coverup.  When I listened to him, it was sensible science he was talking about.  Sensible science is what wins this game.  That’s the reason the academy today is winning the fight with dental amalgams.  Show me sensible science.  Go back to Mike Ziff’s mantra.

So, if we say, “Is there anything else that ties this together?”  This is the research that some of you know brought me into this fight.  This is a polyacrylamide gel.  We’ve separated proteins after grinding up the brain of a normal person and treating it.  We see what goes down in the pellet and what stays soluble.  In normal brain, like here on the side, here’s a pellet and here’s a supernatant.  Tubulin stays in the soluble aspect, and I would point out in a normal brain, tubulin, creatine kinase, and glutamine synthetase all stay soluble.  If you do the same thing with an AD brain, certain tubulin and creatine kinase all go down in the pellet.  It’s an abnormal partitioning that anyone can observe.

People have said I’m right, but it’s ignored.  What makes tubulin and creatine kinase soluble proteins, go down in the pellet?  It’s because they’re abnormally affected by some toxicant in the brain, which renders them to bind to particular material.  If we take a soup and a pellet with no treatment, we look at the supernatant.  There’s the tubulin.  As we increase the addition of the toxic material, that’s 2.5 micromolar, 5, 10, and 20.  If you go across here, when we get to the grey end, here, it’s gone. If we go here, you can see that the tubulin has gone down in the pelette fraction , and you can see that it’s gone here.  Not effected.  So, hydrogen sulfide does not cause the apparent biochemistry that we see in an AD brain, but an extract from an infected tooth does.

I think that this is something that’s very important.  Even if you don’t want to say it causes Alzheimer’s disease, would you want something floating in your blood stream that cause your tubulin to abnormally partition that was very hydrophobic?  The things that do cross into the blood brain barrier and cross into the brain are hydrophobic materials primarily.  If we look at the photolabeling activity, the hydrogen sulfide does not seem to have much effect on brain tubulin, but this toxic material from this tooth with multiple sclerosis and other things totally abolishes the photolabeling and has no effect on this protein.  This is exactly what you see in Alzheimer’s Disease.  That’s exactly the profile.

So, we can say that Alzheimer’s Disease probably has something to do with toxicities coming out of the oral cavity as well as anything else.  So, these were the results.  These were also observed in Alzheimer’s Disease brain and brain tissue exposed to mercury.  This has been published a long time, and nobody has said I’m wrong about it.  They just ignore it.  This is the same situation that’s in your mouth just looking at your mouth by a chemist.

That’s what you have, amalgam fillings that release elemental, as well as Hg2+.  You can have an avital tooth, doesn’t have to be the same tooth, that releases hydrogen sulfide plus methyl thiol plus other compounds.  When these compounds react with mercury, you get the HgS.  You can even get silver sulfide, but this is what precipitates in the tissue.

This is what causes an amalgam tattoo.  If you don’t believe me, excise it from one of the gums of your patient, send it to doctors and have the measure the mercury content or the metal content.  It will be sulfides and other heavy metals in amalgams.  It’s probably not all that toxic to that tissue although it’s ugly.  If you look at this, hydrogen sulfide and you make this from the thiamine, these two organic mercury compounds.  We made them in our laboratory.  We tested them, and what we can tell you is they’re incredibly toxic. The toxicity of mercury compounds is based on their hydrophobic ability or their ability to penetrate cells.

Hg2+ is toxic to the kidney, but it’s not to toxic to the central nervous system because it can’t get it.  Methyl mercury and dimethyl mercury are incredibly toxic to the central nervous system because they’re hydrophobic and they partition into the fat layers, the fat tissues, and they penetrate the body.  They can get into places where we don’t expect, and we can talk about toxicity. We can talk about the synergistic toxicity, and we can say this is a major problem.  We have to look at the ability.

Getting amalgams out for no reason to prevent them from reacting to periodontal disease toxins which we’re not going to stop is a good argument.  You are manufacturing toxic organic mercury compounds in your own mouth if you amalgams and periodontal disease.

Mr. H.B. Wallace, who funded a lot of my research is now dead.  He was the son of the vice president of the United States, Senator Truman.  He was a person who though his father and other people suffered from mercury toxicity .  I have to say I steal a lot of it from people, but on this one particle talk, Weston Price, I read all of his work.  I listened to Dr. George Manning talk, and of course, HHal Huggins was the tack that I had to sit on.  I have a lot of friends in the IAOMT.  A lot of you guys, I can’t tell you how many times I’ve sat and talked with you and how much dentistry I’ve learned and the problems you have.  I really appreciate that.  Like every husband, I’m hard to put up with.  I’m very intense, and I have a very tolerant wife.

I would like to present the Ziff Memorial Plaque to Dr. Boyd Haley.  In Michael’s honor, I’d like to thank you for your research.  He really appreciated your research on the dental mercury issue.  Thank you very much.

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Common Diseases Caused By Bacteria In Our Mouths P3

This one is an Evaluation of the Incidence of Periodontitis-associated Bacteria in the Atherosclerotic Plaque of Coronary Blood Vessels.  Again, published in 2007, General Periodontology, not done in the United States. “In patients with the severe form of chronic periodontitis, it seems that clinical attachment loss is not associated with bacterial permeability into coronary vessels.  What is important is the presence of an active inflammatory process expressed by a significantly higher bleeding index in those patients in whom the examined bacterial species were found.” I think the more that you have toxic response around the capillaries that surround a tooth in the gum line, the more likely it is to bleed.

I think this is one of the more important ones.  This is the Correlation Between Atherosclerosis and Periodontal Putative Pathogenic Bacterial Infections in Coronary and Internal Mammary Arteries.  What they did was they looked at the effect and the infection levels in the mammary arteries versus the coronary arteries.  The conclusion was, “The absence of putative pathogenic bacteria in internal mammary arteries, which are known to be affected rarely by atherosclerotic changes, and their presence in a high percentage of atherosclerotic coronary arteries support the concept that periodontal organisms are associated with the development and progression of atherosclerosis.”  In general, what they’re saying is mammary arteries don’t become infected with periodontal bacteria.  Those in the coronary arteries do, and that’s where you get the atherosclerotic plaques build up.

The pressure in your blood system is more near the heart.  If you look at it, almost all the plaques that you’ll see there build up are where the heart pumps and you have bending in the artery, and that’s where you have the major blockages with the formation of atherosclerotic plaques.  So, it makes sense that the pressure of the heart beating as we age and other problems we might have, if we form a break in the artery, if we have bacteria floating around from our mouth, they set up housekeeping in that site.  They prevent that site from repairing normally because of the toxins they’ve produced.

This is Antimicrobial Prophylaxis in Oral Surgery and Dental Procedures.  It talks about “transient bacteremia is a known risk factor following oral surgery and invasive dental procedures in patients with altered immune system response and those with a susceptible site of infection like patients with heart valve prostheses or recent joint replacements.”  Essentially what they found in here was that anaerobic bacteria were found in 64% of the blood cultures, and they found it also in the plaques that they were looking at this time.

This is Osteomyelities with Proliferative Periostitis, an Unusual Case.  This was a single person.  They said, “We present and unusual case of chronic osteomyelitis with proliferative periostitis affecting the mandible of a 12-year-old patient.  This source of infection was related to the developing lower left third molar which had apparently no communication with the oral cavity.” So, I would wonder, where would the lower third molar get a bacterial infection if it had no communication with the oral cavity? How would the bacteria can into that and get into the jawbone of this patient?  That’s something that I think if any of the dentists had an answer for this I’d sure like to hear it because this was one that really confused me, a paper that I did not understand.  It does point out that all bacteria get into the mandible of certain patients and create a severe problem which someone might call cavitations or jaw bone infections.

Now, we get into the part that I think is different than a heart disease, which is being studied quite a bit.  It’s the Evidence of Periopathogenic Microorganisms in Placentas of Women with Preeclampsia. For those of you who don’t know this, “Preeclampsia is a pregnancy-specific hypertensive disorder that often leads to maternal morbidity and mortality.”  It is not to be taken lightly.  The conclusion is  “the significant presence of periopathogenic microorganisms of their products in human placentas of women with preeclampsia may suggest a possible contribution of periopathogenic bacteria to the pathogenesis of this syndrome.”  I would go back and say this is classic academic double talk, may suggest and sometimes they say may possibly suggest, or possibly, may possibly suggest.   There’s a time when you say there’s no reason why you should have pathogenic bacteria in the placenta of a mother carrying a child.  It just shouldn’t be there, and it doesn’t may suggest.  It does suggest.  As a matter of fact, some people would say that it would prove there’s a definite problem with this person if it doesn’t exist in the placenta of people who don’t have this problem.

Taking it a step further, the Isolation of Commensal Bacteria from Umbilical Cord Blood of Healthy Neonates Born by Caesarian Section.  Again, this was not done in the United States.  This study suggests “that term fetuses are not completely sterile, and that a mother-to-child efflux of commensal bacteria may exist.”

They isolated bacteria from the breast milk of a healthy woman, E. faecium, and they injected this into mice, I think intrapatellar.  The labeled chain could be isolated in polymerase chain reaction detected from the amniotic fluid of the inoculated animals.  In other words, they could take bacteria  that went from a mother’s mouth into her breast milk.  They isolate that.  They amplify it.  They inject it into a mouse.  They find out that when they injected it into the mice who are pregnant that that bacteria ends up in the baby mice, the ones that are in utero at that time.  So, these bacteria have the ability to spread throughout the body without any help. Even if they’re not killing the animal, they can do it.  In contrast, it could not be detected in samples obtained from a non-inoculated control group.

When people tell you that bacteria from the mouth can’t get, by injection, into the bloodstream, affect certain organs or get into the babies or into the uterus, etc., or into the blood, they’re totally wrong.  The research says they’re wrong.  This was a very complete study.  Again, it’s referenced here.  This was done in 2005.

This is something that should be of interest to all the medical doctors here.  Is Periodontal Infection Behind the Failure of Antibiotics to Prevent Coronary Events?  This was published in 2007 and in atherosclerosis.  It’s a complex study, but you can read it in detail and you can read the rest of it.  It says, “This paper presents the hypothesis that periodontitis is behind the failure of antibiotics to prevent coronary events.  We discuss the systemic effects of periodontal infection and consider studies to test our hypothesis, which offers a novel viewpoint for discussion of antibiotics in coronary-disease prevention.”  I want to tell you how novel this is.  If you read Weston Price back in the 1920, is he saying this?  There were things, and you cannot cure somebody of certain infection as long as you keep an infected tooth in that person’s mouth.  This is hardly novel, but it is novel for people today, perhaps.

What they’re saying is no matter how much the antibiotics would enhance the killing of a bacteria that’s in the heart tissue and save that person, if you are reinfecting that person with bacteria that are coming out of dead tooth or severe periodontal disease where the antibiotic doesn’t work, it’s because it doesn’t get there.  You’re just beating a dead horse.  You may help the person for a time, but if you don’t tie medicine and dentistry together, join them at the hips so they can’t be separated, you will not cure these people, none of the infections that cause these illnesses.

I’m not going to go through this much, but it says, “The bacteria recovered from these infections are often of oral origin and involved mixed aerobic-anaerobic oral flora.”  This is another one.  I’m going to skip this, but you can read.  It talks about the influence of an endotoxin on mice, but the “experiments indicate that the pathogenicity of a mixed gingival flora may depend on the decrease of the local and systemic disease mechanisms induced by endotoxins derived from Gram-negative oral bacteria.”  I believe this.  Endotoxins would do this to you, but they are totally ignoring the fact that these pathogenic bacteria make chemical toxins that are relatively lethal.

This is one that might be of interested to the mothers.  Distribution of 10 Periodontal Bacteria in Saliva Samples from Japanese Children and Their Mothers.  If we read this, “Our results indicate a correlation between the presence of periodontal bacteria in children and their mothers, while the presence of red complex bacteria (this is the bad set of bacteria for periodontal disease) in children was highly associated with that in their mothers.”  In other words, mother who kiss their children, who feed their children from the same spoon are actually infecting their children with the same microorganisms.  For those of you guys that like to make out with strange ladies, you’re getting the same treatment.

So, the thing is that these infections do transfer, and there is something that you really need to take into account.  What we’ve come down to is we need a study of the toxicants with avital teeth and osetonecrotic materials.  If periodontal disease causes any systemic illnesses, then teeth harboring microbes should also contain potent toxins.  This is where I think my research has come into play, and it’s not novel with me.

Long ago, they would talk about people with bad breath.  If you have death breath, you had periodontal disease.  You’re producing hydrogen sulfide, methylphile, putrescene, cadaverin, a lot of small chemical toxins.  I would almost tell you that the entire dental community with the except ion 0.01% of researchers, are totally ignoring the effect of these toxins on human health.  I want to show you the results of what we’ve done.  I would like to point out that I started doing this because of the people that are sitting in this audience.  There were a whole load of you that would talk about the problems that came along with this.

This is research that we did in my department in my research lab to start with.  It’s now done.  For those of you who send us toxic teeth, we send them back and tell you the tooth extracted was toxic.  This is how it’s done.  We take the tooth, we add 1 mL of water.  Then, we shake it for one hour.  We remove that extract and save it.  We don’t do anything with it.  We then put it in another mL.  We stick it again for another hour, and we remove that.  We don’t do anything with it except research.  Then, we do the third one.  We take this 1 mL extract.  For those of you keeping context, a mL is 1000 microLiters.  It’s a 3000 microLiter wash in three sequential things.  That’s what an analytical chemist does.  Three washes gets almost everything, and this is not just on the outside.  This one has to be coming through.  We’ll show you the amount of protein and the amount of toxin that comes through.

This is where we do the work.  We don’t do it over here.  We do it over here.  Most of the teeth we test would be toxic.  With this one, we find out about 20-25% of the teeth don’t display toxicity.  So, it allows us to put things in a scale of quarters.  Very toxic, moderately toxic, slightly toxic, and nontoxic.  You just saw that we did.  You see several here.  They’re all underlined.  If they’re underlined, this is the number of washes, the first wash, the second wash, the third wash.  Put it in between.

This is the first wash.  See how toxic, how much protein, albumin is out here?  If you go to the second wash, it decreases. If you go to the third wash, it’s minor, but there’s still some proteins there.  If we look at this, and here’s really an infected tooth.  Keep this in mind because when you do the topaz when you’re doing the blue color, you look at the protein level.  You look at the level here versus the level over here, and which one of these teeth is the most toxic? We’ll show you in just a second how this tooth, the toxins in this tooth, totally inhibit the photolabeling of these four enzymes that we have here, and that washing it from the first to the second to the third, we get the proteins down dramatically.  This is early research.

This is not what we do today, and we have new technology.  There’s no way I could explain this technology.  It’s called nucleotide photolabeling.   Suffice it to say, the NIH funded me to develop this for 25 or more straight years.  Let’s take this tooth.  This one has the most protein, and I’ll just go back a second.  We’re going to be talking about this one and the three washes that go along with it and compare it to the others over here that have less protein.

Here’s the control protein.  Here’s the one you should be looking at the saying, “Here’s the level.”  If you go over here, that first wash, which is incredibly toxic, wipes it out.  Even the second wash wipes out most of it.  The third wash does less because we’ve diluted the toxins that are associated with that, but if you look at all the proteins here, you’ll see that there’s an increase of protein.  When we have an increase of protein, we generally have a big increase of toxicity.

The concept of this is as these bacteria that invade this site release toxins, your body fights it.  It’s similar to when you get a spot of poison ivy.  You get that liquid blister.  That’s because you’re getting all of these inflammatory proteins such as serum albumin rushing into that site.  The water follows it.  You get the swelling, but the proteins will bind the toxin to prevent it from going into your body causing the destruction elsewhere.  You can see that this one was really toxic and wiped it out.

Over here where we have the less toxic tooth, there’s the first wash, second wash, and third wash.  You can see that while the protein is still there, it’s toxic because there’s the decrease in the activity of the enzyme.  The less intense the black , the more toxic, the more the proteins are in here.

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Common Diseases Caused By Bacteria In Our Mouths P2

So, there are a net where the bacterial growth was detected, and 87% of the periondontally diseased teeth, 59% of the teeth containing bacteria in the pulp sample indicating that the outside from the periodontal had gone into the tooth.  This was done quite a bit.  You can look at the number 259 to 7000 times greater than the concentration of the corresponding layers from healthy teeth.

So, what we can say is that radicular structures like these serve as bacterial reservoirs from which bacteria colonization of the mechanically-treated root surfaces can occur.  In other words, if you’re planning a tooth and you’re doing tooth planning and scaling, you’re opening up that colony, that periodontal pocket to bacteria to come out of the tooth to come back into periodontal pocket.

So, we have a problem here.  You definitely need to clean up the tooth, but at the same time, you’re increasing the risk that the bacteria can come back out of the tooth and reinfect that pocket that is treated.  So, we have to have intels and probes to treating this type of situation.  So, we can address several major questions.  This isn’t all of them, but bacteria can come from the periodontal diseased pockets enter the blood stream.

I’m going to show you a publication later where they treat people with heart disease. They treat them with antibiotics, and these people improve.  They take away the antibiotics, the infection comes back.  That seems to be a normal situation, and what I would propose and something that we said many years ago along with Weston Price is that you cannot stop infection, periodontally infected tooth, you cannot get the antibiotics in there to clean that infection.  The antibiotics do not get into the dentine tubules and eliminate that infection.

So, we can ask other questions.  Do bacteria cause systemic infection and relevant diseases?  We’re going to discuss these and give several examples of recent publications that indicate that.  Do infected and vital endodontically treated teeth lead to blood bacteremia similar as proposed for periodontal disease?  I can’t believe they don’t think that.  It will be up to your decision to make that.  We can look at this like this:  Do periodontal disease and infected teeth lead to jawbone osteonecrosis, and does jawbone osteonecrosis lead to other systemic illnesses?  This is the big argument now with regard to cavitations, etc.

So, what happened? This was an area of argument that seemed to be tested by microbiology and the techniques most of you know about, but about 20 years, new technologies came in.  It’s very difficult to detect anaerobic bacteria because they die.  If you expose them a little bit to air, they don’t culture very well.  So, you have this problem.  If you try to show the bacteria in your root canal ended up in your liver, it’s very difficult to isolate that and culture.

As a matter of fact, it’s almost impossible, but they had this new technique.  It’s called polymerase chain reaction or PCR.  For those of you that don’t follow, that’s when you watch CSI, and when they get a very small drop of blood from a sample.  Then, they go back and say, “This DNA came from Joe Smith.  So, he’s the killer.”  What they do is they have a technique where they amplify the nucleic acid, and that nucleic acid will identify either the human subject or the bacterial species that put the DNA there.

So, what this allows us to do is it allows us to go into a person who has an infected site, pull out that bacteria, even if it dies.  We can isolate the DNA, RNA from that bacteria, amplify it, and say, “This belongs to this specific species of bacteria.”

We can then go into the hard tissue, the atherosclerotic plaques, the placenta.  We can translate the bacteria fraction from that, take the DNA, amplify it, and say the bacteria from the mouth ended up in this lady’s placenta.  Isn’t that interesting when we say is that bacteria toxic?  Does it produce toxins?  We’re going to show you, yes, that’s probably the way it works.

This was published in Dental Economics, The Perio/Systemic Link, and you can read this.  It’s in your handout, but I think the bottom line here, which is in red, is the consensus in the medical and dental professions at this time is that there is an association between the mouth and the body.  2007.  They were finally getting it.  I think Weston Price died in 1930 or something like that.  The level of causality is still up for debate among some researchers and clinicians.  This kind of comment is what led me to tell people who make the comment that I felt like I was in an eight-year argument with the Count Drunk [16:32] with regards to certain things in dentistry.

I mean, you can always have a difference of opinion.  I mean, me and my hunting dog disagree every now and then, but I think that that doesn’t really prove much of anything.  I think we can now look at this and say what’s the research showing?  The point I’m making is that almost all the data I’m going to talk about now was published before this gentleman wrote this article.  This was in Oral Microbiology and Immunology, 2006.  They’re not in the same order as you have them because I tried to concentrate a little bit on heart versus the other diseases.  It says here that ”the present study shows that maintenance of inflammation may be enhanced by the presence of periodontopathic bacteria.”  Again, they’re looking at things in atherosclerosis.  Much of this research will show you that if have atherosclerotic plaques, one thing that you will find there is a bacteria that invariably came out of the mouth.  It’s hard to imagine swallowing that and getting in.  It’s going through the blood, through the periodontal disease, or through some other problem.

Again, they take about Bacterial Diversity in Aortic Aneurysms Determined by 16S Ribosomal RNA Gene Analysis.  That’s where they use the PCR to amplify this gene and identify what bacteria is in the aortic aneurysm.  “A wide variety of bacteria, including oral bacteria, was found to colonize aortic aneurysms and may play a role in their development.” I don’t think I have to explain to you what happens in aneurysm if you have it in your aorta.  Once the system gets weakened, the production of toxins at this site by these bacteria would prevent this injury that might have started from being repaired.

Another one here is Serum Antibody Response to Periodontal Pathogens and Herpes Simplex Virus in Relation to Classic Risk Factors of Cardiovascular Disease.  Again, not done in the United States, and when we go down here, it says, “The infectious burden comprising HSV and periodontitis may increase the risk for CVD by clearly decreasing HDL cholesterol concentrations.” HDL is supposed to be the high density or the healthy cholesterol.  Whether you want to believe that or not, I don’t know, but it does point out the bacteria are involved in this particular disease response.

Periodontal Disease in Patients with Ischemic Coronary Atherosclerosis at a University Hospital done in Brazil, not in the United States.  If you look at this, it says, “Periodontal disease was very prevalent in the groups studied with a higher degree of severity in those with ischemic heart diseases.  The elevated prevalence of risk factors found indicates that intervention strategies are required.”  I think this is something that’s a good take-home lesson for people in dentistry.  You have to attack the problem with periodontitis because you not just saving the person’s tooth, you’re enhancing the health.  You’re enhancing this person’s ability to live to reach the average age that most of us die.  If they don’t have that, they’re going to have severe problems, and they’re going to die early.  They’re going to be a burden on the medical industry and our insurance premiums and everything else.

Bacterial Profile and Burden of Periodontal Infection in Subjects with a Diagnosis of Acute Coronary Syndrome, again not done in the United States.  It says, “Is it possible that the stimulation of host responses to oral infections may result in vascular damage in the inducement of blood clotting?”  The conclusion of this:  “The oral bacterial load of S. intermedius, S. sanguis, Streptococcus anginosus, T. forsythensis, T. denticola, and P. gingivalis may be concomitant risk factors in the development of ACS.” I think all the works we’re looking at, I haven’t yet read a paper where they didn’t find this.  When does something become so overwhelming and the data become so overwhelming that you begin to believe it.

Again, this is 2005.  Early Carotid Atherosclerosis in Subjects with Periodontal Diseases.  “The present results in indicate that periodontal disease is associated with the development of early atherosclerotic carotid lesions.” The problem that you have when your scientists when you’re proposing that oral bacteria cause a problem, the one question that you have to ask is what else could do it.  Is there evidence that that what else exists there.  That’s what I would propose to you and for you to propose to the people who think that periodontal disease and infected teeth aren’t involved.  What else does it, and what’s your proof?  There comes a time when you have to stop and say that there is nothing else that does this.  What else could be causing this infection and the tissue breakdown at this site?

This, here, is the Evaluation of the Incidence of Periodontitis-Associated Bacteria in the Atherosclerotic Plaque of Coronary Blood Vessels.  Very distinct.  Again, not done in the United States.  What they were looking at, unstable atherosclerotic plaque is a dangerous condition, and I think we all know that.  I don’t know what they mean by unstable atherosclerotic plaque, but I think they’re talking about plaque that breaks off and can clog arteries.  They come to a conclusion:  “What is important is the presence of an active inflammatory process expressed by a significantly higher bleeding index in those patients in whom the examined bacterial species were found in atherosclerotic plaque.” I would tell you, when you start breaking down tissue, the bacteria present there is not an energetic thing going out.  It’s chemistry.  Do the pathogenic bacteria release toxins that cause the tissue to start breaking down when the tissue and the cells start dying?  The body responds with an inflammatory response reaction, washing certain types of proteins called inflammatory proteins into that site.  Later on we’ll show you what those proteins are.

This one involves Antibodies to Periodontal Pathogens and Stroke Risk.  They say the “evidence on the association between periodontal pathogens and stroke is lacking.”  That means that they haven’t done the research.  It probably will not get funded by the NIH.  The conclusions:  “The present prospective study provides serological evidence that an infection caused by major periodontal pathogens is associated with future stroke.” In other words, if you’re putting toxin-producing bacteria into your bloodstream, if they settle in the wrong places, you are susceptible to stroke.  I think all of you know how important stroke is to the elderly or people in this country.

Here’s another one, Endotoxemia, Immune Response to Periodontal Pathogens, and Systemic Inflammation Associated with Incident Cardiovascular Disease Events.  Again, not done in the United States.  It says, “In periodontitis, overgrowth of Gram-negative bacteria may caus endotoxemia and systemic inflammation leading to cardiovascular diseases.”  Their conclusions:  “Our results suggest that the exposure to periodonatal pathogens or endotoxin induces systemic inflammation leading to increased risk for CVD.”  I put this on for one thing because they talk about endotoxins.  These are lipopolysaccharides, etc.  What I’m going to show you, the most severe toxins produced by bacteria, anaerobic bacteria, are small toxic molecules that can go wherever they want.  They pass into the hydrophobic aspects of the body and can cause very severe breakdown of the tissue.  So, while I believe in endotoxins and I know what they are.  I know they’re very toxic, I think because you can buy antibodies and most labs can measure this, they don’t want to talk about hydrogen sulfide metaphile and other compounds because they’re a little more difficult to work with because they’re so small.

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Dr. Daniel Vinograd, DDS |
10450 Friars Rd, San Diego, CA 92120 |
Phone: 619-630-7174    •    Dr. Vinograd, DDS, is a Dentist in San Diego, CA, offering services as a periodontist, and providing teeth whitening, dental crowns, invisalign, implants, lumineers, dentures, root canals, holistic, family and cosmetic dentistry.


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