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How does one go about becoming familiar with an avenue of health improvement that we have in the past paid little or no attention to, at least on a professional level, yet has major impact on our patient’s oral health? I am referring to the nutritional status of our patients (and ourselves) and the implications it has on our general health.
The central question is whether or not there is adequate validity in the quantification of our nutritional status as a measure of our health to apply it to our patients. Secondarily, but of obvious clinical importance, is whether or not the technology exists that would allow us to make quantitative measurements.
In terms of answering the first question, one of the first studies that caught my attention was Munoz et al in a paper titled, “Effects of a Nutritional Supplement on Periodontal Status,” published in the May 2001 issue of Compendium. Researchers at Loma Linda University studied the impact of an antioxidant-rich oral supplement on 63 patients ranging in age from 20 to 70 years and diagnosed with gingivitis and Type II periodontal disease during a 60-day double-blind trial.
The participants were randomly assigned to two groups — the experimental group, which took two tablets each day of the proprietary blend of antioxidants, and the control group, which took a similar-looking placebo.
Results of the study showed significant improvement in the clinical parameters and measurements of gingival inflammation, bleeding on probing, pocket depth and attachment levels.
“At the 60-day evaluation point, all subjects receiving the experimental treatment had significant reduction in the gingival index, pocket depth and bleeding index.” Treatment with this proprietary nutriceutical appeared to offer patients a noninvasive, systemic, adjunctive protocol to potentiate in-office therapies.
In a second double-blind study also conducted at Loma Linda, pocket depth measurements were made within three groups of patients. The groups consisted of those who were limited to the nutritional supplements, those who had scaling and root planning and those who had local antibiotics added to their scaling and root planning procedures. At 30 days, the pocket depth and gingival index were measured for the three groups with those receiving the nutritional supplements without any further treatment showing a significantly reduced pocket depth compared to the two other groups.
Double-blind studies represent the highest form of proof in evidence-based research and the conclusions must include the following:
- The proper nutritional supplements improve the health status of the periodontium.
- The improvement must be systemic in nature since no local remedies were applied and where they were applied in the two other groups the results were not as successful.
- Given the systemic improvement in what we traditionally treat as a local problem, we have to assume that the local manifestation of a compromised periodontium is at least in part caused by systemic conditions.
- We must consider the probability that many diseases are at least partially exacerbated if not caused by a lack of proper nutrition.
In addition to the two studies presented here, there are literally hundreds of other studies showing the effect of nutritional status on health as it relates to macular degeneration, diabetes, cancer, heart disease, lung disease as well as the general state of aging.
While much of this is known, there is little compliance among the general population to take the necessary blood tests to determine one’s nutritional status. One can know what the proper thing is to do, but for a large segment of the population, avoiding needles will trump the common sense of drawing blood. And, as a result, we remain uninformed.
Today, however, technology allows the nutritional status of a patient to be determined non-invasively in less than 90 seconds using a blue laser light directed at the skin in the hand. This technology, called Raman spectroscopy, led to the development of the biophotonic scanner that accurately measures the carotenoids in the skin.
Carotenoids have been shown to be a measure of nutritional health from a plethora of studies. Carotenoids are an accurate reflection of a patient’s overall antioxidant status, and antioxidants have, in turn, been shown to be the protectors of our organs on both the cellular and DNA level.
Basically, our degenerative aging process is thought to result from an accumulation of damage done to our DNA and cells by the continuous attacks of free radicals (reactive oxygen species). They are called free radicals because they are missing an election in their outer shell and will attack any other atom or molecule to get one, damaging (oxidizing) it in the process. Antioxidants, as the name suggests, prevents this oxidation by contributing electrons to these free radicals, neutralizing their destructive behavior in the process. Now, life is a balance. We do produce many of our own antioxidants, but not all. Some must come from exogenous sources such as fruits and vegetables.
Many of these antioxidants come from the various highly colored fruits we eat, such as carrots, red and yellow peppers, and the greater their concentration in our blood, the more protection they offer both as antioxidants in their own right, but also as protectors of the endogenous antioxidants we produce ourselves.
To sum up, at this point we have strong correlation between one’s nutritional status and the level of carotenoids in our skin as measured by the biophotonic scanner. We also now have a tool that we can use to determine whether or not the supplements we may be taking are effective. How many of us have taken one nutritional supplement after another without a clue to their effectiveness and than we just switch to another supplement that garners attention in the news or simply drop what we had been taking?
I will tell you from personal experience that one can be quite cavalier about one’s nutritional status until you take the scanner test and get a low score. Knowing the correlation between low antioxidant levels and the increased propensity for degenerative diseases to express themselves, it is logical that most of us would want to change that status as rapidly as possible, especially after we have passed the stage where we still think we are immortal. It is unlikely that most of us have the discipline to instantaneously make a major change in diet and life style. More likely to produce the sought-after results is the use of supplements as recommended by the nutritional company that developed the scanner to aid us in attaining a better nutritional status, one that can be measured periodically by the same biophotonic scanner that told us of our deficiencies.
That is exactly the route I have taken, and during the past three months, my nutritional score has tripled. I am still not where I want to be, but I am on a road that shows continuous progress. Of equal importance, the biophotonic scanner is a motivator for maintaining good nutritional status. I have also noticed that over time, at least with me, it is a tool that produces behavioral modifications. I find myself eating more fruit and vegetables, less fried food and consuming far less sugar. So far, each time I have been scanned, my scores have gone up.
We all wear several hats in the course of our lives. One hat I wear in addition to being an endodontist is a producer of innovative dental products, particularly in the field of endodontics. However, I cannot help but see the advantages to any dental practice that would incorporate the biophotonic scanner as an initial means of determining the nutritional status of their patients. If you see a patient who displays periodontal disease4 and that patient correlates with a low nutritional score, both you and the patient will gain from a regimen of supplements that research has clearly shown to improve these conditions even without local therapy being initiated.
As an added motivator, research has clearly shown that damage to the same gene can adversely effect one’s periodontal state as well as one’s cardiac health. With the knowledge that free radicals damage the genes comprising our DNA, we may be doing much more for the patient than we realize. We are certainly doing no harm.
Data has shown that our patients are far more likely to visit us than a physician. It has also been stated that more than 90 percent of the diseases that affect us display oral signs and symptoms.[5-7] We can take advantage of the technological advances that now allow us to determine our patients’ level of antioxidants to make recommendations to them for an improvement of their nutritional status and to monitor them for the improvements that are sure to come.
There is so much more to this story, but if this short article stirs some interest in you, please contact Victoria Reina at email@example.com for more information and, if so desired, a biophotonic scan for yourself. That’s where it started for me, and I want to extend these benefits to as many people as possible. I hope every dentist who reads this article sees the great possibilities for doing good, both for your patients and yourself.
Note: This article was originally published in Implant Tribune U.S. Edition, Vol. 6 No. 8, August 2011. A complete list of references is available from the publisher.
About the author
Dr. Barry Lee Musikant is a partner in the largest endodontic practice in Manhattan, and his 35-plus years of practice experience have established him as one of the top authorities in endodontics.
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