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Periodontal Health: the
Microbiological Context.
| I would like to convey the great
benefits for the clinician and client which come from the
observation of the microbial environment thanks to the dark field
microscope. A scrupulous exam of my patient's micro flora during the
last twelve years, has allowed me to confirm the important work
conducted by Dr. Trevor Lyon on periodontal diseases. I have even
observed an assorted range of flora according to my clients' many pathological
conditions, whether being cavities, periodontal disease, oral flora
instability, or systemic diseases. |
What I wish to discuss is the precise
extrapolation which can be attained from dark field microscopy, which
opposes everything published to date.
The image of the microscopic
flora is an animated graphic representation bursting with information, as
though the gingival sulcus was revealing all its conditions, colors
and activity.
It is so easy to recognize the bacteria in the form of
shells, in clusters or in a chain, the filaments, the dental plaque
which is considered normal, its evolution in time, and, at the outset
of the pathology, all the different varieties of
spirochetes, of vibrios, of mobile rods, the rare or
common presence of epithelial cells, the types of leucocytes which
vary according to circumstances, the battling neutrophils or the dead
ones which form the oozing pus that too often accumulates at the
bottom of this delicate crevasse.
Without mentioning the ever present
amoeba in periodontal diseases and absent in a healthy sulcus, as well
as worrisome trichomoniasis and typical candidiasis of some
conditions. |
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| Normal dental plaque: coccis,
filaments, epithelial cell, little motility |
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| Gingivitis
plaque: spirochetes and great motility | |
All of this gives us a
very precise view of what is occurring inside the sulcus, and is
very different in a context of periodontal health, periodontal
disease, dental cavities or in the case of general problems.
The
quality as well as the quantity of cells provides information. Even
feverish conditions and important systemic diseases present varying
natures depending on the type of leukocyte found. Without
mentioning the intake of medicine which influences the salivary environment,
the type of flora, etc.
This has persuaded me to offer much
different treatments according to each oral problem, and has brought
me to qualify plaque (like so many of our European counterparts) as:
compatible or incompatible with periodontal health. For my part, I
support Dr. Lyon's studies, which emphasizes the pathogenicity of
oral parasites. As informed professionals, can we let these
parasites reproduce in our patients and fill this active crevasse?
Of course, a scrupulous qualitative bacterial definition by species
and type is necessary and I concur.
However, I know of very few
clinicians who really study in depth the bacterial flora through
analysis, culture, or other |
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| Amoeba
(Endamoeba gingivalis) and leukocyte infection in
periodontitis. |
biochemical tests, and who use this information to conduct their
therapies on a day to day basis. My experience has shown me that
bacteriological exams aren't available, aren't usually used, and are
even not recommended because of problems in carrying microbiological
material across borders to specialized laboratories. If we manage to
do this, the results will be in the form of a document with
percentages that will allow us, clinicians, to make certain
pharmacological decisions and which the patient will only see a
bunch of gobbledygook. |
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| Accretion of white blood cells forming pus. | |
As for microscopy results, I believe they
contain extraordinary information and help achieve therapeutic
success. The regular microbiological surveys of the sulcus flora
through simple and effective antiparasitic pharmacological means,
result in an almost magical clinical condition of the patient within
only a few weeks: ceasing of bleeding, diminishing of mobility,
better breath and an unprecedented increase in general oral comfort.
This adds to the confidence level and creates an important
partnership between clinician and patient. Furthermore, the client
feels he's participating in his own therapy since he sees for
himself the progress of his flora from one week to the next. |
How can I not congratulate a client
for looking forward to seeing his monthly progress and for giving me
the permission to continue his treatment? These regular and rigorous
exams often allow us to use local forms of pharmacotherapeutics
adapted to the client and his progress.
These treatments are also
prescribed according to his systemic health condition. The judicious
use of a systemic treatment can also be appropriate as long as it is
used in accordance with the parasitic, bacterial or fungal condition.
In fact, with an easily accessible non surgical approach, exempt of
any curettage or smoothing, simply by removing tartar debris in a
bloodless environment, we manage to recreate a periodontal
restructuring with an average elimination rate of pathological
crevasses of 85% (author's clinical results).
Of course, regeneration
techniques remain an option and conventional transplants are still
suitable if necessary, especially since they are done in a well
controlled and sterile |
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| Trichomonas tenax, spirochetes and a
few neutrophils. |
environment. However, surgical treatments tend to
produce lesser results and require a much greater effort form both
the patient and practitioner. Finally, a regular microscopic exam
allows to ensure the long term health of the gum as well as
verifying that there isn't any new infections. |
We have inquired within the medical
community and found out that doctors do in fact successfully treat
intestinal parasites. They immediately consider them as pathogenic
from the moment they start feeding off red blood cells. Millions
of cases of vaginal trichomoniasis are also treated each year, while
also treating the partner. However, oral trichomoniasis and our amoeba
are completely overlooked by dentists because fifty years ago, someone
somewhere determined they were non-pathogenic.
Microbiologists who we
have spoken to believe it is rather controversial. Many evoke cross
contamination and disinfection in dentist clinics, all the while
letting partners with nauseating periodontitis continue kissing.
Where do we draw the line? I hear many of my clients, sitting
inches from the microscope screen, ask such feeble questions as to the
epidemiology of this illness while these parasites are feeding off
their white blood cells.
We're not only talking about macrophages.
What type of immunity do we accept before fighting back? Who manages
this flora? Although it is quite visible, who really cares about it?
The use of doctor's methods offer very promising results. History
shows us that the detection of Helicobacter pylori was
immediately followed by treatments of ulcerative stomach conditions
and gave unprecedented results, notably the stop of surgical
treatments.
What are dental professionals waiting for? Our experience
is limited. Too few dentists use the microscope because they are not
usually encouraged to do so by universities, which promote a more
fundamental approach to research. The most disconcerting example is
juvenile periodontosis, in which the flora is completely incompatible
with the periodontal health, and in such a case, returning the flora
to its' normal state provides immediate recovery. |
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| Candidiasis caused by
prolonged antibiotic therapy. |
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| Entamoeba gingivalis
hugging the core of a leukocyte in a case of pregnancy related
periodontitis. |
The presence of periodontal pockets or parasites in a 6
year-old child is abnormal. This is quite humbling to a dentist and
thus requires that the client become responsible for the treatment
of this trivial infection, rather than continuing to receive
comments about his poor brushing method, which is often not bad at
all.
|
Microscopic therapy
has become more and more accessible and utilised by an increasing number
of our colleagues. They are very excited at better understanding the
periodontal phenomena, and they have also observed significant results
and put away their curettes for good. Clear and concise protocols must
however be used to properly view this microbial phenomena. For
example, the present way of collecting flora in the area of the first
inferior molars is a blatant mistake because the affected sulcus is
found on another tooth completely. |
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| Three active amoeba in a chronic
periodontitis. | |
It is time to show the achievements of this
new approach. In 1914 it was already showing potential, although it
was put aside for lack of proper medication. The great Canadian
clinician and researcher, Dr. Trevor Lyon, has consistently
demonstrated the benefits of this approach since 1984. The
understanding of his theories has however been mystified by other schools
of thought. Europe has now shown us the way of active microscopy in
a more general and less rigid approach. The importance is that the
client can observe his condition and his recovery. We believe the
clinician with a microscopy approach has as much right to treat a
patient as one who practices a more traditional bacterial approach. It
is unfortunate how so few modern microbiological laboratories aren't
available to assist us with clinical decisions, and that surgical
treatment has often already begun. |
| These conventional methods largely
exceed our microbial knowledge. Some will say claim that the removal
of oral parasites also destroys pathogenic anaerobic bacteria. Even
though bacteriology remains the central point of view, is there really
a better target that these obvious amoeba?
Realistically, the motivation behind all these schools of thought
has for objective to improve the overall health of the patient and
considers all clinical oral hygiene conditions, the degree of
inflammation, the exact location of bone defects, and the physical
periodontal iatrogenic or accidental environment, etc.
The benefits
of microscopy reside in the unconditional observation of the
periodontal sulcus, of determining the condition and the means
needed to regain a compatible flora. This allows the patient to
actively participate in his/her treatment and the clinician loses a |
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| Ameba nest progressing rapidly
in the periodontal cavity. |
little of his magic healing powers and becomes
rather a compassionate facilitator. The client can chose to see for
himself his pus filled infected sulcus, and therefore chose to
restore a flora and thus better periodontal health. The choice in
treatment must jointly be established in all chemotherapeutic shapes
and forms which today's medical community offers. |
For information, please contact
:
 International Institute of Periodontology
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IIP (Canada)
5775,
Jean XXIII Blvd., Office 100
Trois-Rivières, Quebec
CANADA, G8Z 4J2
Tel.:(819) 691-2652
Fax : (819) 691-1771
Toll free (Canada) : 1-866-GENCIVE (436-2483)
|
IIP (Europa)
Le Nice 1er
455 Promenade des Anglais
06000, Nice, France
For Europa: Tel: 04 93 71 40 65
Europa Fax: 04 93 71 40 32
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E-Mail: info@parodontite.com
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