Improving Your Patients’ Nutritional Status: It’s Important
FOR THE MOST PART, the articles I write in our newsletter are about safer, more effective, and more efficient techniques for shaping and obturating canals. However, today I want to talk about the confluence of technology and science that is making it ever clearer that nutrition as measured by the level of antioxidants in our system is closely associated with our overall general health and has a specific impact on our periodontal health (References 1–4). In fact, the connection between proper nutrition and gingival health has been known for hundreds of years. Just consider the relationship between scurvy and the lack of vitamin C. What we did not have until just recently is a method of quantifying our nutritional status without taking a blood sample, a procedure that would discourage most of us from determining our antioxidant level.
With the advent of the biophotonic scanner (Figure 1), an instrument developed at the University of Utah that uses a blue laser light to detect the carotenoids in our skin, we have a tool that within 90 seconds gives us an accurate measurement of our nutritional status. This tool has been proven to be so effective that the National Institutes of Health gave Yale University a $1,000,000 grant to use it to measure the effectiveness of a diet high in fruits and vegetables; the scanner proved to be far more accurate than all other quantifying systems.
What does this mean for dentists and their patients? Consider a double-blind study from Loma Linda University in which patients with varying degrees of periodontal pocketing were treated with antioxidant vitamin supplements, with scaling and root planing, or with scaling and root planing combined with local antibiotic therapy. After just 30 days, the group whose treatment was limited to antioxidant supplements had a significant reduction in pocket depth compared to the two other treatment modalities. In effect, the local manifestation of a destructive inflammatory condition, pocket formation, was significantly improved by the systemic administration of effective supplements. In fact, this form of treatment surpassed the effectiveness of local therapy. It is reasonable to conclude that what we think of as a local condition, periodontal pockets, is more accurately a local manifestation of a systemic deficiency. That does not mean that local treatment should not be applied, but the superior improvement in the group given antioxidant supplements does mean that at a minimum these conditions should be treated systemically as well as locally (Reference 3).
What we know to date is that a high level of circulating antioxidants will have a profoundly positive effect on preexisting periodontal conditions. In addition, other studies have confirmed an overall correlation of antioxidant status and lifestyle parameters. Another study established that the proper use of nutritional supplements improves the antioxidant status of subjects over a twelve-week period. And a third study established a highly significant correlation between serum carotenoid levels and skin carotenoid levels as assessed by the biophotonic scanner. Perhaps most impressive, another study reconfirmed the excellent correlation between skin scanner scores and blood carotenoids, the currently accepted gold standard in research.
The research has clearly established that a high level of antioxidants is necessary for health (Reference 4). When antioxidants are at a low level, there is a strong correlation with higher incidences of periodontal breakdown that can be dramatically reversed by improving the patient’s antioxidant status. In fact, the research goes way beyond the connection with periodontal disease, including macular degeneration, heart disease, diabetes, cancer, and lung disease (Reference 5).
While this is an interesting subject, what does it have to do with our daily practice of dentistry? First of all, I must say that I asked myself that question when I first learned about the scanner. However, I had myself scanned, and my antioxidant score and came up quite low. Having read the material about the connection between degenerative diseases and low antioxidant levels and knowing that at age 67 I’m primed for degenerative diseases to start manifesting themselves, I was keen to get my antioxidant level higher. Over the last four months, I have improved my numbers from an initial 16,000 to 37,000, based on a score ranging from zero to 100,000. The supplements are all within a safe dosage range, and they are produced at what is called a sigma 6 level, meaning that they are pharma grade in terms of purity and consistency of effectiveness. I believe that I am helping myself stay healthy longer. We may not have the will power to change our lifestyles by eating healthier and exercising more, but taking a regimen of antioxidant supplements that have been proven to be effective in many studies is a step in the right direction.
So the reasons that this scanner and these supplements are tools that we can use in our practice should be self-evident. Given the validity of the science backing both the scanner and the supplements, we can now incorporate these tools to easily and inexpensively assess our patients’ nutritional status, correlate it with their periodontal conditions, and make recommendations for improving that status when it is evident that it needs improving (References 6 and 7).
I very much like the business model. The hygienist or the dental assistant would most likely be the ones doing the antioxidant assessment, leaving the dentist free to do his routine work, and the office would carry no inventory to give to the patient. Any recommended supplements come directly from the company. Each office would have a scanner and charge a small fee for the service, perhaps $20. This amount adds up when it is part of a routine for your patients. For a small fee you are giving patients a service that gives them crucial information regarding their nutritional health, and you are giving them the opportunity to improve their status when it is deficient. Most people would never go for a blood test, and so they would remain uninformed about their potential deficiencies. The sigma 6 pharma grade antioxidant supplements that you are recommending would be fulfilled by the same company that makes the biophotonic scanner, awarding the dental office a 25 percent commission. Yes, it is a business model that rewards those making the recommendations, but those recommendations are based on the solid science of the biophotonic scanner that in turn measures the antioxidant status that has been proven crucial to a person’s overall health.
In short, you are helping yourself by genuinely helping your patients. Just as I would not do endodontic treatment when it is not necessary, I would not recommend antioxidant supplements when they are not necessary. Yet, it has been estimated that something like 75 percent of our population is in a state of poor nutrition, and we can make a positive mark with the biophotonic scanner and the recommendations for these well-designed supplements.
I hope that I have made an effective argument for incorporating this service into your practice. At a minimum, you should be scanned yourself as I was. It does have an impact when it’s personal. If you are interested and wish to know more about it or simply want to be scanned, we are setting up programs to accomplish both these missions. Please call Essential Dental Systems for more information at (201) 487-9090.
- Muñoz CA, Kiger RD, Stephens JA, Kim J, Wilson AC. Effects of a nutritional supplement on periodontal status. Compend Contin Educ Dent. 2001 May;22(5):425-8, 430, 432 passim; quiz 440.
- Waddington RJ, Moseley R, Embery G. Reactive oxygen species: a potential role in the pathogenesis of periodontal disease. Journal of Oral Disease, 2000; 138-151.
- Halliwell B, Gutteridge JMC. IN: “Free radicals in biology and medicine,” 2nd edition. Oxford: Clarendon Press,1989.
- Neiva RF, Steigenga J, Al-Shammari K, Wang H-L. Effects of specific nutrients on periodontal disease onset, progression. and treatment. Journal of Clinical Periodontology, 2003; 30:579-588.
- Chapple ILC. Role of free radicals and antioxidants in the pathogenesis of inflammatory periodontal diseases. Clinical Molecular Pathology, 1996; 49:247-255.
- Sculley N, Langley-Evans S. Salivary antioxidants and periodontal disease. Proceedings of the Nutrition Society, 2002; 61:137-143.
- Vogel RI, Fink RA, Schneider LC, et al. The effect of folic acid on gingival health. Journal of Periodontology,1982; 9:275-280.
July - September 2011.