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Previous postings have discussed the importance of preventing the development of periodontitis since it requires a lifetime of disease management and contributes to the total inflammatory burden in the body. A recent white paper by heart surgeon Dwight Lundell, MD puts an exclamation point on this issue. Dr. Lundell states that decades of knowledge, recommendations and treatments focused on elevated blood cholesterol as the cause of heart disease is completely inaccurate. The only accepted therapies were cholesterol lowering medications such as statins, and a diet severely restricting fat intake. This protocol also turns out to be inaccurate. He states that, “These recommendations are no longer scientifically or morally defensible”. [“The dietary recommendations have created epidemics of obesity and diabetes”]. The real cause of heart disease is inflammation in artery walls. He further indicates that despite widespread use of statins and reduced dietary fat intake, more Americans will die of heart disease this year than ever before. “Without inflammation, cholesterol would move freely through the body as nature intended”.

Dr. Lundell states, “Regardless of where the inflammatory process occurs, externally or
internally, it is the same”. It is the body’s inflammatory response that damages blood vessels, leading ultimately to heart disease. Periodontitis is a bacterial infection that leads to a chronic inflammatory response, not limited to the oral cavity, but occurring throughout the body. Preventing the inflammatory response by preventing the development of gum disease would be ideal. Preventing the progression of gingivitis to full blown perio disease is vitally important for the person we are treating, not just for their oral health. Treating periodontitis and providing proper maintenance is crucial for every individual who sits in our dental chair and asks us to provide care. We need to be mindful of the affect of the inflammatory response beyond the oral cavity.

In my opinion, as dental professionals, we are focused on procedures, technology and all the other issues that we face daily, all of which are important. Stopping for a moment to focus on the bottom line of what we are doing is importance as well. We are trying to prevent and treat disease, to maintain or return people to health. Dentistry is a procedure and treatment heavy profession. Disease prevention and aggressively addressing early disease states such as gingivitis should be given at least the same level of attention. As always, all comments are welcomed.
Richard H. Nagelberg, DDS.
Every patient, every time, any level of gum disease

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Comment by Mary Jane RDH BS on December 11, 2009 at 8:08am
We address these issues every day. I feel we now need to challenge more physicians to follow through and support this oral cavity/body connection. Every other day I need to deal with an "old wife's tale" from an OBGYN telling my patient that a fetus has a direct impact on her teeth. It is so frustrating. Didn't they have to go to school for this?

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