A few weeks ago I wrote about the relationship between gum disease, cholesterol, and inflammation which motivated me to go to the dentist for a long overdue visit. This week I want to go over the results of the MyPerioPath test.
The reason I wanted to get the MyPerioPath was to have a better understanding of what’s happening with my oral biome. I wanted to know if I had any bacteria that could potentially explain my elevated cholesterol and Lp-PLA2. I also wanted to know if there were organisms that were putting me at risk for other diseases.
When I spoke to the dentist about this, he was impressed with my understanding of the matter, and explained that what usually happens with the MyPerioPath is that we first get a baseline test. Then, we try out an intervention and test again in 6-8 weeks to see if there has been any change in the biome. If not, then we try another intervention that is more aggressive, like a mouthwash that contains bleach or chlorhexidine, or possibly even antibiotics. Then we test again after 6-8 weeks.
I should also mention that the cost of the exam isn’t cheap! It comes out to around $200 which includes the test itself and the collection fee. AND it’s not covered by dental insurance. So yeah. Just something to keep in mind.
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Results
You can click on the images to make them bigger in case the font is too small to read.
Result: Positive – 4 pathogenic bacteria reported above threshold
Bacterial Risk: High – Very strong evidence of increased risk for attachment loss
Looks like my oral biome isn’t looking too hot and colonized by a lot of strange sounding critters that I’ve never heard of.
The dentist actually provided me with an extra handout detailing the disease these organisms are associated with:
So it looks like my mouth is putting me at risk for infective endocarditis, brain abscesses, coronary artery plaques, aneurysms, pre-term births, pre-eclampsia, respiratory disease, and diabetes.
Well… at least we can cross off pre-term birth and pre-eclampsia from the list on account of my not having a uterus… but still, it doesn’t look pretty.
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Treatment Considerations
In the MyPerioPath report there is also a nice section describing the treatment possibilities
- Office periodontal therapy: protocols to disrupt biofilm and reduce pathogens
- Check!
- Systemic antibiotic option to augment therapy at clinician’s discretion – including a Chlorehexidine mouthwash, local antibiotic like Arestin, or oral antibiotics like Amoxicillin AND Metronidazole.
- No thank you! This will definitely be a last resort for me.
- Home care which currently includes:
- Brushing at my gum line with my Oral B electric brush
- Using Oxyfresh Mouthwash
- Flossing
- Brushing with these angled go between brushes
Final Thoughts
I’m not entirely sure if I’m going to do a repeat MyPerioPath or not, mostly due to the cost of the test AND the cost of the dentist who doesn’t accept insurance.
I mean, if I continue with my home regimen and there isn’t anymore bleeding at the gums to indicate biofilm re-accumulation, I’m thinking I can wait at least until my next dental visit to reasses my gums.
If my gum health has improved, then ok, no point in retesting. If not, then ok, there might be a good reason to retest.
I also plan to recheck my cholesterol and Lp-PLA2. If those numbers improve then ok, I probably don’t need to test again, if not then maybe I should.
I guess I still have another 4-6 weeks to decide.
What do you think?
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I would just check ApoB1/ApoA, LDL-P, hsCRP and HbA1C.
I’m not convinced that Lp-PLA2 is necessary.
BTW – have you checked out this package
Stroke, Vascular, Heart Rhythm with Osteoporosis
http://www.lifelinescreening.com/What-We-Do/Screening-Packages
I haven’t checked out those packages yet, but looking them over it seems like over kill for me at this point. Have you gotten one of those packages done yet?
I would follow Lp-PLA2 levels. It should track with what’s going on in your mouth. It may also take up to a year for it to level down based on your treatment regimen. So repeating the myperiopath in 6-12 months makes sense. You may also want to try using some regular xylitol products to help with the biofilm. I recommend –>http://www.zellies.com/
Thanks for the recommendation! I’ll definitely check it out.
I know the oxyfresh has xylitol in it too, but you’re right, chewing some gum throughout the day would probably help!
I would give the brushing and flossing a solid go first! Seems too expensive otherwise. I use a Philips Sonicare toothbrush that my dentist recommended and would never switch back to anything else, It is much better than the Oral-B.
Thanks!
What is it about the Sonicare that you like better?
The big advantage of the Oral-B is that it’s sold in Costco….
BJJ-C: Thought this might be useful to you and other folks with periodontal issues.
I have severe periodontal issues (smoking, Latte habits of yester years). Had Osseus surgery done 6 years ago.
After researching a lot.. found Ultrasonic tooth brush (that dentists/periodontist are so “naive” about and ask me why can’t I use the Sonicaire…Trust me…this technology is light years ahead of the mechanical rotation based Sonicaire etc that I had used for a decade that are marginally better than manual brushes IMO as I had little to show for…).
This really worked wonders (besides quitting smoking) for me. In fact my dentist mentions I’m probably his most successful patient in keeping periodontal issues under control successfully (Though he never gives credit for the brush unfortunately…not even partial).
Crux of it is …the ultrasonic brushes are effective at killing the bacteria (it seems). There is really no mechanical action in these brushes. Takes a week to get used to but you can clearly feel (felt by the touch of your tongue over teeth…) the unbelievable effectiveness (rather stable gum lines and the bacteria eating away my gums/bones substantially reduced. My dentist expected me to lose several teeth in 5+ years but so far the ultrasonic brush worked really great and teeth are much brighter too).
Another key factor is your ability to keep the rather hard-to reach areas of the teeth super clean…(something you couldn’t do effectively with a motorized mechanical brushes such as Sonicaire much less with a manual brush. )
But IMHO it’s really really worth it – compared to the painful ossueus surgeries and downtime.
One of the best investments I ever made.
Brands:
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1) Emmi-dent: (German firm with a long history of ultrasonic tech). Amazon sells it. I directly order through their dealer (Oratec in Virgina).
– Brush base+charger => $150
– Brush head => $7
(Lasts a quarter. @ 15 mins/day brush time).
– Proprietary tooth paste => $7/tube (lasts a month).
2) Smilex: (Japanese). Same concept as Emmident. But, they claim you don’t need the proprietary tooth paste and can use any tooth paste. But, in my experience using emmi-dent tooth paste (with Smilex brush) is far superior to any other tooth pastes – in terms of cleaning effect you could feel. Minor price to pay.
Price about the same as emmi-dent. But, if you get a life-time warranty …sort of pay half the price for the replacement if original is broken. Not bad.
I use both emmi-dent and Smilex. They are really comparable. One big difference is the smaller size of Smilex brush heads (Japanese size I guess) that are nimbler than emmi-dent’s slightly larger brush heads.
Misc:
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I also use
– Therasol tartar dissolver powder (Oratec has them)
– Therasol mouth rinse (specific formulated for periodontal issues.).
– I also use the Dento-tape (CVS has a store brand that works great) floss with a much larger surface (about 3-4x the width of usual floss). This also helps me a lot…
I couldn’t tell how effective these are but my gut feel it’s keeping mouth clean (as measured by how long it takes for the mouth to deteriorate from the fresh condition – Not very scientific..but empirical observation.)
Wow, this is fantastic. I just added it to my wishlist. I went a little nuts with my most recent black friday and cyber monday shopping… and so will need to wait a bit before picking up a new $$ gadget.
I definitely want to try it out though!
Why did you end up picking up both the Smilex and Emmident?
If you could use your optimal combination would it be Smilex brush + Emmident paste? Or Emmident brush + Emmident paste?