Dr. Duane Keller Inventor of Perio Protect

Monday, November 25, 2013

KMOV Channel 4 Interview of Dr. Keller

Tuesday, November 5, 2013

Pages

Periodontal Disease is Managed

The Perio Protect Method has been demonstrated through independent research (University Park Research) to successfully decrease periodontal pockets and decrease bleeding. This trial compared the Perio Protect Method with scaling and root planing and demonstrated the Perio Protect Method was superior.

Patients can control the cause of the periodontal disease and when they kill the bacteria responsible for periodontal disease, they also control the bacteria responsible for decay. Controlling the cause of these disease is easier, simpler and less costly than treating the effects.

Controlling the bacteria in the mouth when viewed in conjunction with the 2013 J Am Heart Assoc. article (showing periodontal treatments decreased cardiovascular events) can provide positive benefits for patients general heart health as well.

Perio Protect Orkos Award | AAOSH Connect - Connecting the world of oral systemic healthcare

Perio Protect Connecting the world of oral systemic healthcare

Initial Study of the Perio ProtectTM Treatment for Periodontal Disease

*1164 Initial Study of the Perio Protect^TM Treatment for Periodontal Disease*
L.E. WENTZ¹, A.M. BLAKE¹, D.C. KELLER², and B.J. SINDELAR², ¹Ohio University, Athens, USA, ²Keller Professional Group PC, St. Louis, MO, USAA new treatment regimen, Perio Protect Method^TM, is being used to treat all stages of periodontal disease. While subjective clinical response has been positive, no studies have systematically examined this method that uses prescription trays to direct medications into the gingival sulcus. Objective: To evaluate outcomes of the Perio Protect Method^TM. Methods: A retrospective analysis compared pre-treatment and six months post-treatment records for 11 patients with periodontal disease and 2 with gingivitis (56.2±10.1 years; 8 females, 3 males; 5 smokers =39%). Sequential subjects with at least one molar in all quadrants and no standard periodontal treatment for 6 months pre-study were chosen to complete 6 months of the Perio Protect^TM program. Disease severity was assessed by probing pocket depth (PPD) and bleeding and established treatment frequency and duration. Teeth exhibiting the worst symptoms of periodontal disease (PPD=5.7±1.8; range= 4-9) and those with the least evidence of disease (PPD=1) were considered in the subsequent analysis. Data was analyzed using paired t-tests. Results: Nine patients exhibited bleeding pre-treatment (20.7±14.0 sites). A significant decrease occurred post-treatment with only three patients exhibiting bleeding (2.7±4.4 sites; p=0.002). No patients developed any new bleeding sites post-treatment. A significant change in PPD occurred in the most severely diseased teeth with post-treatment PPD of 3.0±2.1 (p<0.0001). The percentage of closed pockets (PPD≤3 mm) in this group post-treatment was 70.8%. All teeth in the least severe range stayed within the normal range post-treatment (PPD≤3 mm). Conclusions: Treatment outcomes indicate the Perio Protect Method^TM is effective in treating periodontal disease. Further studies are necessary to examine its effect on different patient populations over longer treatment times and to compare it to gold standard treatments.
Seq #142 - Periodontal Therapy and Prevention 2:00 PM-3:00 PM, Friday, 10 March 2006 Dolphin Hotel Pacific Hall
Back to the Periodontal Research - Therapy Program Back to the ADEA/AADR/CADR Meeting & Exhibition (March 8-11, 2006)

The Journal of the American Heart Association 2013:2:3000254 recently published a study that demonstrated periodontal disease and cardiovascular disease (CVD) and atherosclerosis are related. Improvements in periodontal treatment (clinical and microbiological) were related to a decreased rate of carotid artery CCA-IMT progression at 3-year follow-up.

This longitudinal study is a result of the Oral Infection and Vascular Disease Epidemiology Study (INVEST) that was specifically designed to evaluate whether periodontal infections predispose patient to CVD or atherosclerosis. They found a decrease in the number of bacteria was associated with a decrease in the periodontal status, which was associated with a decrease in CCA-IMT. They found an increase in the number of bacteria was associated with an increased periodontal status, which was also associated with an increase in CCA-IMT.

This is extremely important for patients using the Perio Protect Method (PPM), which was shown to decrease both bacteria and periodontal disease in the J Clin Dent 2011 and 2012. If you treat the periodontal disease you decrease your risk of CVD.

Tuesday, November 20, 2012

How Gum Disease Bacteria Get Into the Blood Stream

How Mouth Bacteria Can Cause General Health Problems:

Saint Louis Dental Article - gum disease linked to general health.

Before it is possible to learn what is abnormal it is essential to know what is normal, so it is possible to appreciate what are the problems and then how can these problems be addressed. Many people question how it is possible for bacteria that are involved with gum infections to also be the cause of general or systemic health problems. This blog is going to first show you what is normal, then we will discuss how gum disease begins and how this starts to affect the infection process. This blog will first show how the bacteria grow in infected gum tissues and then get into the blood stream. Other parts of this blog will deal with how the bacteria once in the blood stream can cause general health concerns or inflammation.

A healthy smile is no accident and the health of the mouth is something that most people do not appreciate but take for granted. Health is essential to maintain, for if there is a loss of health this is replaced with disease. The health of these person's mouths are maintained on a daily basis because they uses the Perio Protect Method that enables them to control the bacteria that cause disease.

Healthy gum tissue is demonstrated in this picture. There is a small valley or sulcus around each tooth that should be about 1 to 2 mm deep when the tissues are healthy. The cells of this region make a fluid that flushes out this valley to keep food and bacteria under control and this fluid continues to "flush" out this region about every minute or so when it is healthy. There are bacteria present in this region, but they are ones that live in a good relationship with the tissues and don't cause any inflammation or damage. These first bacteria are few in number and live in an oxygen rich environment as the valley is still small.

We need to briefly discuss the bacteria as we just don't appreciate how significant they are in our health and the part they play in disease. First bacteria are extremely small, much smaller than we may have been taught to appreciate. Here we are looking at the head of a pin under a microscope. Even with the microscope it is not possible to see most of the bacteria as you can place between 1,000,000 and 10,000,000 million bacteria on the head of a pin, so we can begin to appreciate how many bacteria there may be in our mouth!

Looked at under higher magnification we see the bacteria that are sitting on the head of this pin. They don't just sit there, but they actually attach to the surface wherever they live. If conditions (food and water) are plentiful they begin to make proteins (quorum sensing) and other substances that stimulate growth and other bacteria join the group to live in a community (biofilm). What one bacteria makes as a waste product the next bacteria can use as food. The more food that is present helps determine how well the bacteria grow and help determine the size of the community.

The community of bacteria is called a biofilm, a term coined by one of my good friends (now deceased) Dr. Bill Costerton. Bill was a unique individual that realized we do not have all of the answers and owe it to those who follow us to look at everything with an open mind. Bill realized that Robert Koch was only been partially correct with his Koch's Postulate that one bacteria causes disease and he was tenacious in his search for the truth that the community of bacteria is what is really responsible for disease, not the individual bacteria.

A biofilm is a community of bacteria that live in an environment as a group. In the mouth, which is an ideal incubator for bacteria, one bacteria can grow and when challenged it can divide about every 20 minutes. One bacteria dividing every 20 minutes can result in 5,000 billion, billion bacteria in one hour. The bacteria are so small, they attach to their surface and they grow so fast. It is not possible for most people to control these bacteria with just brushing, flossing and using oral rinses, which cannot get into the valley where the bacteria live.

If we don't have health we have disease. The World Health Organization studied the status of oral health in 144,000 individuals and the graph at the right shows that less than 5% of the people living in North America were healthy without disease. This can best be explained by understanding how the bacteria live and realizing that brushing and flossing and oral rinses are just not enough to control the bacteria. This first damages the tissues around the teeth, but the damage does not remain there as the bacteria invade the host blood stream and are carried anywhere in the body in just minutes.

This artist’s representation shows the gum tissue and bone to the left of the tooth. Bacteria begin to grow on the surface of the tooth at the top of the valley or sulcus. These early growers are bacteria that live quite well in an oxygen rich environment and the bacteria and their waste products don't cause much local damage. However, as the bacteria community grows, other bacteria grow that don’t need oxygen and these bacteria can live off of the fluid that is made to flush the area clean, or off of the waste products of the early colonizers These later bacteria cause much more of the damage seen in advancing gum disease.

Looking at the gum tissue in this representation from Scientific American (by permission) we begin to see that gum disease is actually a wound or small ulcer that occurs in the tissue. We don't see this broken down tissue because it is found under that flap of gum tissue, but if we brush or floss the region it results in bleeding because the blood vessels (capillaries) are exposed at the bottom of the ulceration. Bacteria from the gum infection is therefore able to gain immediate access to the blood stream because of these ulcerations. This ulcerated tissue (inflammation) is a response to the bacteria and this is the portal of entry and explains how the bacteria can get into the blood stream.

The slide of the periodontal or gum pocket (Georgio Simasoni by permission) is pictured to the left and the arrow shows the bottom of the pocket where the bacteria are stained brown. The blood capillary is seen just one to two cells from the edge of the tooth root,but the bacteria cause the loss of these cells. Where the gum disease exists there are no cells between these bacteria and the host blood stream. This is why research finds that chewing on infected gum tissue causes a 4-fold increase in the bacteria poisons that enter the blood stream. It also explains why there is over a 75% to 85% increase in bacteria in the blood stream if this region is scaled or root planed during routine dental cleaning before the bacteria are controlled.

These bacteria are both bacteria called Pg (Porphyromonas gingivalis). The slide on the left shows the lipopolysaccharides (LPS) that serve as poisons or toxins that arise from the surface of the bacteria and remain on the bacteria surface or are released into the environment. These toxins can be made when the bacteria grows in an environment where there is oxygen and serve to protect the bacteria from being eaten. The slide on the right shows similar LPS poisons or toxins that can be made when the bacteria grows in an area without oxygen. The purpose of these poisons is self protection for the bacteria. The stronger the poisons, the more the bacteria are protected from being digested by white blood cells, but the toxins made by the bacteria when they grow in the presence of oxygen is not as caustic as the toxins made by the bacteria when growing in the absence of oxygen.

The human body has multiple white blood cells that are responsible for recognizing bacteria and which are designed to move to the bacteria, swallow it and digest it. The picture shows one of these bacteria being approached by the white blood cells (PMN or polymorphonuclear leukocyte). The PMN moves to the bacteria, engulfs it and digests it, so that should be the end of the problem. Well it is not.

If you go back to the picture of the bacteria above to the right you will see the poisons in the form of clumps on the outside and also within the bacteria. Once digested by the PMN we do not have enzymes to digest the LPS toxins, so they are released into the environment and this can cause localized inflammation. But it doesn't stop here!

The LPS are joined to binding proteins and these combined toxin/protein are recognized and taken in by other white blood cells called macrophages that are part of our immune system. Once the LPS are inside the macrophage, the cell begins to make a series of proteins (called a protein cascade) that can help bind to the LPS and these are released from the cell,.
Two major problems exist. The proteins that are made cause inflammation and once inside the macrophage, the toxins (LPS) remain for over 60 days, causing these cells to continue to develop and release the inflammatory proteins. The photograph on the left shows the presence of these toxins (LPS) in macrophages 60 days after they were first ingested, stimulating these cells to continue to make and release proteins that cause inflammation. Forestier C. et al. Lysosomal Accumulation and Recycling of Lipopolysaccharide to the Cell Surface of Murine Macrophages, an In Vitro and In Vivo Study J Immun 1999;162(11) 6784-91

Inflammation is what causes most of the local problems and/or the general or systemic problems. Viewed here we can begin to see the damage that occurs to the gum tissue around the tooth. The products of this inflammation cause the gum tissue to breakdown, cause the loss of bone supporting the teeth and if the cause of disease is not corrected these conditions will result in the loss of the teeth. This causes swelling and pain as the body attempts to control the bacteria that live in a region that is extremely difficult to reach and control. Brushing and flossing and oral rinses are just not enough. This inflammation starts in infected gum tissue but it doesn't stay in just the gum tissue if the infection is allowed to continue.

It is possible to control the bacteria that cause gum disease with the Perio Protect Method. The infected gum tissue above has been restored to health by controlling the bacteria that caused the disease. The patient uses her Perio Protect Method once or twice a day for 10 to 15 minutes where she directs medication in the valley around the teeth so the bacteria that cause disease can never regrow and she can keep her teeth and improve her health.

Bacteria from gum disease have been associated with many of the general systemic problems. It is important to understand the relationships between oral bacteria and systemic disease because gum disease can now be treated by stopping the cause (bacteria) and not getting the response (gum infection) or systemic involvement. It is important to control the bacteria in the mouth, which is possible with the Perio Protect Method that has been shown to kill 99.98% of the oral bacteria. Controlling a disease by controlling the source of the disease is better than dealing with all of the effects that may occur if the bacteria pass from the gum tissue into the blood stream and cause systemic inflammation and disease.

Monday, October 8, 2012

Conventional Methods Fail To Help Patients as CDC says 50% of Patients Have Gum Disease.

Results from the 2009 - 2010 National Health and Nutrition Examination Survey (NHANES) confirm that more adults have periodontal disease than previously thought. Over 64 million Americans have gum disease, or said another way: CONVENTIONAL TREATMENTS HAVE FAILED TO CONTROL THE CAUSE OF GUM DISEASE FOR 64 MILLION PEOPLE.

It doesn't have to be that way. The Perio Protect Method was evaluated by independent researchers (Putt MS, Proskin HM. J Clin Dent 2012;23:48-56) and found to be superior to conventional scaling and root planing (which is the present gold standard of care). The gold standard should be the best way to treat the cause of disease, which is precisely what the Perio Protect Method does; it delivers doctor selected medication directly to the periodontal pocket and the medications have been shown (USC Dental School, Journal of Dental Research 2007) to kill 99.98% of the bacteria that cause disease. If you treat the cause of disease you do not have the effects.

Patients can now use a simple, safe and reliable method to deliver medications to the source of the disease. Patient's need to know they have an option and failure to treat the cause of disease seems like an ineffective method, especially if 50% of the population still has the disease.

Tuesday, September 25, 2012

Watch Dr. Duane Keller on the Wellness Hour and Learn About the Gentle Alternative to Tradional Gum Surgery !

Do you or someone you know struggle with gum disease? Watch this video and learn how you can treat gum disease in a less invasive manner, and you can even do it in the privacy of your home.

Monday, December 19, 2011

Do you or someone you know have Periodontal Disease?

Forget Conventional Surgery.

Try the Perio Protect Method!

http://www.dentalmastermindgroup.com/dental-education/dr-duane-keller.html

Find A Perio Protect Provider Near you!

http://www.perioprotect.com/locator.asp

Monday, December 12, 2011

Before/After Pictures Of Diseased Mouth

This Patient Presents with Severe Gingivitis. Pictures shows calcified Tarter/Calculus on and around all teeth. Tarter or Calculus can be as hard as bone. Patient did not have any type of surgery. Patient did wear customized Perio Protect Trays followed by several appointments for professional removal of biofilm and calculus. Perio Protect Trays have customized seals around each tooth, this seal is in direct correlation with patients periodontal readings. If the patient has a 6mm pocket on the distal lingual of #30, then the seal that covers the distal lingual of #30 reaches down 6mm to hold the medication in the pocket. Patient did have a normal cleaning after wearing Perio Protect Trays. For more information visit www.perioprotect.com

Before Perio Protect Method

After Perio Protect Method

Wednesday, December 7, 2011

DentalMaster.com interviewed Dr. Duane Keller, inventor of the Perio Protect Method

Click on the link below to watch this short video.

http://www.dentalmastermindgroup.com/dental-products/perioprotect.html

Monday, November 28, 2011

What doctors, hygienists and patients are saying about Perio Protect:

“This is by far the best perio treatment out there.”
- Dr. Robert Nisson, Henderson, NV
“This is a revolutionary treatment!!!”
- Dr. Owen Waldman, Scottsdale, AZ
“In my thirty-five years of dentistry, I have never seen anything like this. It does the same for perio that fluoride does for cavities.” -Dr. Terry Spahl, St. Paul, MN

“I have had amazing results with the Perio Protect Method! My personal patients have seen pocket reductions from 8 to 2mm. This morning I had a patient who saw me on May 8, 2007 and today on a follow up recall that same pocket which was an 8mm pocket is now at 3mm. It represents a 1mm per month reduction! FANTASTIC!! We have repeated these results over and over and over again.”
- Dr. Randolph Sun, Lakeport, CA

“In my 32 years as a dental hygienist, I’ve never come across anything that works this well..”
- Linda Schowengerdt, RDH, Nevada, MO
“The results we have seen with the use of Perio Protect in my practice have been just short of miraculous. Nothing I have ever tried has been as successful in reducing inflammation and pocket depths as the Perio Protect technique.”
- Dr. Jack Fifield, McKee, KY
“This is a great service for patients. In over 30 years of practice, I have never seen anything work like this.”
- Dr. Allen Sprinkle, Arlington, TX
“I have seen a remarkable improvement over the last year using the Perio Protect Method for patients that I have treated for twenty or thirty years without the success that I now have. I can also confirm the improvement by the reduction in harmful bacteria that I see using my phase contrast microscope. This is becoming more important with patients who have heart problems or a stroke.”
- Dr. Ronald Cohen, Brooklyn, NY
“These trays will reduce the need for osseous surgery by more than 50%. These are revolutionary!”
- Dr. Gary Wiele, Clayton, MO
“We have been using Perio Protect for virtually all our perio patients for several years. We treat all our patients with PerioProtect except those who are very advanced and will definitely require significant surgery. These are referred to a superb periodontist. It is extremely powerful. Results are astonishing.”
- Dr. Steve Ross, Wappingers Falls, NY
“I started 10 patients the first month, 15 the second. About 30% of my patients need this Perio Protect system”
-D. Allinson DDS, Kirksville, MO

“I just got back from the Periodontist and he was amazed and wanted to know what I had done to correct the condition. I told him about using the Perio Protect system. He told me that my condition is great. He said he wouldn’t need to see me for a year and then only for a check up!”
-Patient: S.O., Elizabeth, AR
“I always felt I was failing my perio patients who did what I asked and still had problems. I used your method and the bleeding was GONE within one to two weeks. Now we have a way that works to help them.”
-T. Loughary, DDS, Jacksonville, IL

“I was surprised at the Perio Protect system results. No, not surprised, AMAZED! I was a 'Doubting Thomas,' but no longer. Perio Protect works just like you told us it would.”
-T. Deeter, DDS, Bismark, ND

“My bleeding gums stopped bleeding in two days! And the bleeding hasn't come back. That was over two years ago. I feel healthier now and my teeth are whiter. This is a totally painless and easy method that I use every day. My teeth feel as clean as if I just had a professional teeth cleaning every time I use the trays. ”
-D.N.D., St. Louis, MO

"Love IT! Love IT! Patients Need it! I have helped so many patients keep their smile and confidence and we are changing their health status ... healthier hearts and minds! I have over 20 patients actively using Perio Protect.
- Careen McNeil, RDH, Canada

Saturday, November 12, 2011

5 Major Health Threats That Your Dentist Can Predict

Click Here To View

Tuesday, November 1, 2011

Hidden Dangers of Gum Disease

Headline making news today on Yahoo's home page. Gum disease is a serious disease that is getting world wide attention.... which is long over due!

The Perio Protect Method not only can help maintain oral health, but can kill 99.9% of bacteria every single day!

Click Here to Read About the Hidden Dangers of Gum Disease

Monday, October 31, 2011

Our Latest Publication In The Journal of Clinical Dentistry

The Journal of Clinical Dentistry

THE INTERNATIONAL JOURNAL OF APPLIED DENTAL RESEARCH

Subgingival Delivery of Oral Debriding Agents:

A Proof of Concept

Click Here to View the Article from the Journal of Clinical Dentistry

Saturday, October 22, 2011

Oral Bacteria can effect your heart, or even your unborn child.

According to the Mayo Clinic, a full menu of diseases can result from poor dental care, including endocarditis (an infection of the inner lining of the heart), cardiovascular disease (clogged arteries and stroke may be linked to oral bacteria), and premature birth and low birth weight babies, to name a few.

Oral bacteria causing infections in gum tissue may threaten more than your teeth and gums. Research has established associations between oral bacteria and systemic diseases including:

Type 2 Diabetes
Heart Disease
Respiratory Disease
Blood Clots
Strokes
Preterm and Low Birth Weight Babies
Chronic Inflammation

Image of biofilm from a periodontal pocket.

The theories linking oral bacteria to other diseases explain that the mouth may be a portal for bacteria to spread to the rest of your body.
If you have been diagnosed with gum disease for example, pathogenic bacteria are likely forming colonies that cause localized inflammation and damage in your gum tissue. Those bacteria may enter the blood stream through small ulcers in your gum tissue.

The growth of bacteria in periodontal pockets occurs in three stages. After the first stage of attachment, the bacteria form a colony with a filmy or slimy protective covering. The most advanced stage of bacterial growth involves clumps of bacteria detaching from the colony to form new infections.

The bacterial infection, like the colony growing on the tooth surface in this illustration, spreads when small clumps of bacteria detach in a “seeding” effect to form new infections. Left unchecked, bacteria growing in the protective colonies in periodontal pockets can lead to the destruction of teeth and eventually the bone supporting the teeth. Because the bacteria may spread through your body to threaten more than your teeth and gums, it is important to talk to your doctor about your risk factors and treat any infected areas of your mouth.

ASSESSING YOUR RISK FACTORS FOR DISEASE
People who have a family history of disease may be genetically predisposed and need to discuss ways to protect their health with their doctor. It is important for everyone to eat right, not smoke, and take care of their oral health.
Heart Disease, Stroke, Hardening of the Arteries (atherosclerosis)
Once oral bacteria enter the body, they may cause inflammation, which in combination with fat deposits can lead to a build up of plaque clogging blood flow and to a build up of blood platelets causing blood clots. These conditions may be responsible for heart attacks, strokes, and other dangerous health conditions.
Diabetes
Controlling gum disease has a positive effect in controlling diabetes. Diabetic patients with gum disease have a higher blood sugar level and require more medication to manage their diabetes. When the gum disease was treated, the blood sugar levels decreased and stayed lower for 3 months.
Respiratory Disease
The bacteria present in gum disease have also been located in lung tissue in patients with lung abscesses. Biopsies of the diseased lung tissue found the same bacteria that are present in the gum disease.
Alzheimer’s Disease
The bacteria associated with Alzheimer’s Disease have been isolated in the periodontal pockets and along the nerves from the teeth to the brain tissue. When these bacteria are introduced into brain cultures, beta amyloid is formed, which is the substance that is a cause of Alzheimer’s Disease.
Pre-term and Low Birth Weight Babies
Pregnant women also have an increased incidence of gum disease. It has been demonstrated that an inflammatory product caused by the bacterial gum infection can cause a woman’s uterus to contract. Pregnant women with gum disease have a 57% incidence of low birth weight babies and a 50% greater incidence of preterm deliveries. Researchers continue to examine these correlations to determine the relationship between gum disease and pregnancy.
As research continues, it is important to understand that oral bacterial infections are serious and that they should be treated. Please talk to your doctor about the best treatment options for you.

Wednesday, October 12, 2011

To The 85% Of The Population Who Have Some Form Of Gum Disease

Keller Professional Group

3955 Bayless Ave. Suite 100

St. Louis, MO 63125

314-638-4190

As you are aware, dental treatments have advanced significantly in the last thirty years. However, one of the remaining challenges for oral medicine in the 21^st century is the effective treatment of periodontal disease. Periodontal disease is the most common cause of bad breath, bleeding gums, receding gums, loss of the bone supporting the teeth and eventually the loss of teeth.

We are now offering a revolutionary method that will bring periodontal treatment to new levels of effectiveness. It is revolutionary in a small, but important way - it provides the missing piece for delivering “tried and true” medications to an infected gingival sulcus (perio pocket) around the tooth. The Perio Protect Method™ for treating periodontal disease features a very comfortable appliance worn over your teeth just minutes a day at home or work (or in your car), which brings medicine for healing your gums and restoring your oral health. The appliance is clear and flexible and easy to use. Unlike traditional periodontal surgery, the Perio Protect Method™ involves no lost time from work for recovery and costs considerably less. And the best news of all: it is very effective.

This is what the “perio tray” looks like. In the photograph you will see the small seal around the top of the tray that serves to gently guide the medications to the source of the infection. These are easy to use; will make your brushing and flossing more effective and wearing them can reverse disease symptoms in a matter of days. Now is the time for you to take control of your health in a way that was not available before.

Please do not hesitate to call if you have any questions in the future. Thank you for coming into our office, and we look forward to working with you to reach your optimal oral health.

Sincerely,

Duane C. Keller D.M.D.

Tuesday, September 20, 2011

Are Patients To Blame for Their Gum Disease?

I think it is important for readers to understand that you may not be at fault for your gum disease (unless you don't at least try to brush and floss). The following are exact excerpts from the dental literature that demonstrate even if you follow the directions of your dentist you may not be able to adequately control the cause of gum disease that is also associated with a host of systemic complications.

This first one is an excerpt from a professional journal. Every possible treatment was done and they evaluated the bacterial (cause) results at one year. No one is going to do all of these steps, but even with this the bacteria that cause the disease are prevalent at one year. How can people be responsible if we (the dental profession) don’t give the patient the tools to control the disease.

ž Conventional Care:

Shiloah J, Patters MR, Dean JW 3rd, Bland P, Toledo G J Periodontol. 1998 Dec;69(12):1364-72

The prevalence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Bacteroides forsythus in humans 1 year after 4 randomized treatment modalities. 1) scaling and root planing; 2) pocket reduction through osseous surgery and apically-positioned flap; 3) modified Widman flap; and 4) modified Widman flap and topical application of saturated citric acid at pH 1 for 3 minutes.

Patients rinsed with 0.12% chlorhexidine for the first 3 months postoperatively and received a prophylaxis every 3 months.

The choice of treatment modality did not affect the prevalence of the target species at 1 year post-treatment. These results suggest that prevalence of microbial pathogens negatively affects the 1 year outcome of periodontal surgical and nonsurgical therapy.

This second one was the results from the University of Florida that was presented at one of the major research meetings. The bacteria (cause of gum disease) were found to be the same in the periodontal pocket before and after professional (gold standard scaling and root planing) cleaning. How can the patient control the disease if we the profession leave the cause in place?

Conventional Care:

Differences between Biofilm Growth Before and After Periodontal Therapy

Resposo S et al. University of Florida, Gainesville, FL

Objective: The purpose of this study was to evaluate in vitro subgingival biofilm growth from plaque samples collected before and after scaling and root planing (SRP). Methods: Subgingival samples were collected before and after SRP from a 5mm pocket or greater with bleeding, along with 5ml of saliva from 9 patients diagnosed with chronic periodontitis. Calcium hydroxyapatite discs were coated with 10% filtered sterilized saliva for 2hrs, placed in 5ml of Trypticase Soy Broth (TSB) and innoculated with 100ul of dispersed subgingival plaque. Biofilms were grown anerobically at 37ºC for up to 10 days with transfer to fresh medium at 48 hour intervals. Biofilms were then processed at specific intervals for total viable counts and the species present were evaluated and semi-quantified by DNA-DNA hybridization. Biofilm composition was also analysed by Scanning Electron Microscopy (SEM). Results: Samples taken before SRP harbored more bacteria than after SRP (10⁷ versus 10⁶, p=0.004). However, both sets of biofilms grew at a similar rate, reaching a peak CFU of ~10⁸ cells as early as day 3 (p>0.05). Samples taken after SRP presented the same species as those samples taken previous to the procedure, but in less quantity (p<0.001). Greater amounts of red complex bacteria and A.actinomycetencomitans (~10⁴) were found both before and after SRP when compared to other species (~10²). SEM analysis showed growth of a complex structure comprised of rods, cocci,fusiforms and filaments in both sets of mature biofilms.

Conclusion: Subgingival biofilms before and after SRP treatment present the same composition of bacterial flora and are able to grow similarly if given proper conditions. Therefore, subgingival bacteria that remains after SRP therapy has the potential to recolonize to pretreatment levels if not properly maintained.

If you the patient do what we (dental profession) tell you and you still suffer a deterioration of the disease over time it is because you were not compliant? A patient has to be compliant, but you also have to be shown a method that works!

J Clin Periodontol. 2003;30 Suppl 5:4-6.

Improving oral health: current considerations.

Ciancio S.

School of Dental Medicine, University of Buffalo, SUNY, Buffalo, NY 14214, USA.

The high incidence of periodontal disease among adults in the Western world indicates that in most cases, routine dental care could be considerably improved. The progressive effect of the disease suggests that improvements in oral cleanliness are mandatory if large numbers of adults are to retain their teeth into old age. Data show that periodontal disease can be minimized through effective plaque control, and that a combination of brushing, interdental cleaning, and chemotherapeutic agents (e.g. mouthwash) is beneficial to patients with plaque control problems. The vast majority of adults do not follow an adequate home-care routine. Average brushing times are low, and only a minority of patients regularly floss. In addition, in those patients who do regularly brush and floss, a deterioration of plaque control occurs over time, suggesting that compliance is a major issue. The principal challenge for dental professionals is to identify how best to elicit an improvement

I do agree with his last sentence that we have to find a way to elicit an improvement.

Our research published in the Journal of Dental Research 2007, Vol 86 show we kill 99.98% of the bacteria in 17 days that are in the periodontal pocket (the same bacteria left in the first two articles). Perhaps patients do not need to beat themselves up, but realize they now have a choice which works.

Later I will post some excerpts that illustrate just how related these bacteria relate to cardiovascular disease, pre-term low birth weight, Alzheimer’s disease, arthritis, cancer, stroke, etc.

Duane Keller DMD

Tuesday, September 13, 2011

What is Perio Protect?

Bacteria divide every 15-20 minutes in the mouth. 1 bacteria in 24 hours will = 5,000 Billion, Billion. Unless..... YOU DON"T LET THEM!!!!

The goal of the Perio Protect Method™ is to promote lasting oral health without requiring repetitive invasive procedures.

What about the bacteria under the gum tissue? Mouth rinse can't kill the bacteria under the gum tissue, and mouth rinse only kills bacteria while you are rinsing.

In 2003 the World Health Organization published a comprehensive report on oral health showing that more than 80% of adults in the U.S. have some form of gum disease. Unfortunately most of these people don't know it.

How does the disease start? click on the following link http://www.perioprotect.com/serious.asp

Perio Protect® is a comprehensive method that is customized for individual patients to help manage biofilms, communities of bacteria, growing in the spaces or pockets between teeth and gum tissue. The overall goal of the Perio Protect Method™ is to manage oral biofilm with minimally invasive dentistry for lasting oral health.

The Method is a combination of treatments, including a non-invasive chemical debriding therapy used in conjunction with traditional mechanical debriding procedures. The chemical therapy involves a tray delivery of doctor-prescribed solutions to chemically debride biofilm from the periodontal pocket and alter the pocket's microbiological environment to disrupt biofilm growth.

The standard cleaning procedures in dental offices (e.g. scaling and root planing) help remove plaque and tartar and help reduce bacteria, but unfortunately bacteria reproduce quickly and biofilms regenerate very easily, so it is difficult to control them between office visits.

With the Perio Protect Method, you can place prescribed solutions into periodontal pockets with an appropriately formed, customized dental tray between office visits to help manage biofilm. Although a dentist must choose the most appropriate solution for individual patients, the most commonly prescribed solution with the Method has oxidizing and oxygenating agents. Oxidizing agents debride (chemically remove) the slimy protective coating of a biofilm and its underlying layers and also cleanse the oral wounds.

Dentists may choose to treat the oral wounds with the chemical debriding and cleansing agents before mechanical debriding procedures to help reduce bacterial populations and thus reduce the risk of introducing bacteria into the bloodstream during mechanical debridement.

For most people following the Perio Protect Method, the placement of prescribed solutions into a periodontal pocket via a customized prescription tray requires only minutes each day. Patients describe the tray delivery as comfortable and appreciate its non-invasive technology.

The actual combination of mechanical treatment, chemical therapies, and prescribed treatment plan is determined by a dentist evaluating your specific conditions. To Learn more about the Perio Protect Method click on the following link http://perioprotect.com/.

Want to know if you have gum disease? Come on in for a free consultation normally valued at $265.00! Just call 314-638-4190. (offer only valid at Dr. Duane Keller's dental practice)