A Paradigm Shift in Periodontal Disease
Drs. Ian Needleman and Adam Roberts spoke with Dr. Suham Alexander about a new paradigm shift in periodontal disease.
Periodontal disease is a progressive condition associated with bacteria. There has been little in terms of innovation with respect to periodontal disease. Traditional approaches have focused on eliminating bacteria; however, there may be alternative or adjunct treatments which can influence the ecology of the oral cavity.
It is impossible to “sterilize” the oral cavity. This has led to new thinking about the use of probiotics as an adjunct to periodontal disease treatment. Various diseases are linked to dysbiosis in the gut and it has been postulated that the oral microbiome can also be affected by the alteration of gut microflora.
While diet does play a role in periodontal disease, it is one of many factors related to periodontal disease. Nutrition, alone, may or may not have a role in disease progression or development. There is evidence that nutrition can influence inflammatory markers and other biomarkers. The intake of refined sugars and carbohydrate continues to directly impact the microbiota to produce lactic acid, lower the pH and demineralizes enamel surfaces which can lead to caries and the onset of periodontal disease. There is data showing that communities with higher refined sugar diets suffer from various oral diseases. Oral healthcare professionals should discuss nutritional habits and get involved in discussion about weight and obesity with patients or refer patients to the appropriate professionals to help lessen the risk of developing periodontal disease.