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Historically our perio treatments have focused on the bacterial origins of periodontal disease, and we have developed and utilized a wide array of treatments and adjunctive therapies combating the bugs that cause perio disease. I have spent years preaching this in my educational presentations around the country. This is still vitally important. It is now understood and accepted that perio disease is a bacterial infection starting with oral biofilm, and that periodontal tissue destruction is primarily the result of the body's inflammatory response. Agents that address the immuno-inflammatory response will become more numerous in the near term, enabling us to more effectively reduce the damage to the periodontium. Research has recently revealed that the same inflammatory mediators are operating in several diseases including perio disease, cardiovascular disease, rheumatoid arthritis and adverse pregnancy events. Understanding the effect of the inflammatory burden on the entire body, not just the oral cavity is so important because we are treating people. Identifying and managing patient risk factors, susceptibility and the effect of inflammation on the entire body will help us address the person in our chair, not just their mouth.
Richard H. Nagelberg, DDS
Every patient, every time, any amount of perio disease

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Comment by Richard H. Nagelberg on September 13, 2009 at 5:55pm
That first word was supposed to be Bravo!!
Comment by Richard H. Nagelberg on September 13, 2009 at 5:53pm
Brave Juli and thank you for your kind words about the blog post. It seems pretty clear that so many of the factors that increase inflammation are conscious choices. Your post makes it clear that dietary choices and sedentary lifestyle choices exact a price on our health. Obviously periodontal disese also substantially involves behavioral choices that have consequences as well. I applaud your on going efforts to persuade us to get moving. Thank you again for your excellent input. Richard H. Nagelberg, DDS
Comment by Juli Kagan, M.Ed. on September 12, 2009 at 6:54pm
Dr. Nagelberg:
Thank you so much for reminding us of the consequences of inflammation in the body, as well as the oral cavity. As an exercise enthusiast and health advocate, I wanted to expound on your thoughts.

It's vital to understand that chronic inflammation puts the body in a constant state of crisis. Inflammation to the body is akin to weeds in a garden. The suffocating toxins, threats of injury, and challenged immune response jeopardize our seemingly effortless body functions.

An unhealthy diet and lifestyle only intensifies the inflammatory response. Red meat, omega-6 fatty acids, trans-fats, and high fructose corn syrup, all part of the typical American diet, actually encourages inflammation. These foods in fact trigger chemical pathways that cause a chronic inflammatory situation. Even obesity significantly contributes to a low-grade condition of chronic inflammation. Adipose cells release inflammatory proteins into the bloodstream, which increase the risk of cardiovascular disease. Obesity is also linked to higher C-reactive protein levels, produced by the liver.

Fortunately inflammation is reversible because diet and lifestyle are, for the most part, risk factors under our control. Eating foods that are unprocessed, substituting fish for meat, using olive oil or vegetable spread instead of butter, and consuming nuts and beans, which in fact have anti-inflammatory effects, is a start. Green tea, red wine, and many fruits and vegetables, especially berries, broccoli, tomatoes, and spinach all have anti-inflammatory properties.

It is important to treat any inflammatory conditions, especially those that are chronic.

Some suggestions:
Take care of yourself; manage your stress more carefully; get your blood pressure below 120/80; keep your HDL high and your LDL low; and find out your CRP levels.

Lastly, studies show regular exercise may help reduce inflammatory proteins. So GET MOVING! (Would you expect I say anything differently?)

Your body works hard all day trying hard to maintain a state of health. Eat well and live life fully. Your body will thank you.

Juli Kagan, RDH, M.Ed.
Author, Speaker, Educator
JuliKagan.com
MindYourBodyBook.com

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