This past March I referenced a study linking gum disease to Alzheimer’s and concluded that I would just go ahead and get a followup MyPerioPath test done again.
I first came across MyPerioPath when I was exploring the links between gum disease, high cholesterol, and an elevated Lp-PLA2. As a quick review, the MyPerioPath test is a way to sample the DNA of the oral biome. It’s a painless test. Go to the dentist, swish around some saline solution in your mouth for 30 seconds, and spit it out into a test tube. The test tube gets shipped off and about a week later, you get the results.
The reason you’d want to know the consistency of your oral biome is because there have been many disease associated with certain virulant organisms, and understanding whether or not you have those strains, and to what degree you have them can help direct your treatment.
In fact, the most painful part of the whole process is that it’s not covered by insurance so it’s all out of pocket, all $180 of it. On top of that, they charge a $20 collection fee. This last $20 is probably what incensed me most about the whole thing, after all wasn’t I the one doing all the work by swishing and spitting and getting drool all over myself?
In retrospect, now that I’m writing this 3 months later and my indignation has subsided, $20 seems reasonable since it probably covers the cost of shipping biohazardous material across the country, but at the time I was pretty annoyed by the charge.
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Here is a graphic the dental office provided me when I got the test the last time:
Results
Here is the report I received. You can click on the images to see larger versions of them.
I’ve included the pathogen graphic from the previous report for easier comparison, but if you’d like to see the prior complete report, you can go here.
April 2016:
Result: Pathogenic Bacteria Detected, 2 Above Threshold
Bacterial Risk: HIGH – Very strong evidence of increased risk for attachment loss
July 2015
Result: POSITIVE – 4 Pathogenic Bacteria Reported Above Threshold
Bacterial Risk: HIGH – Very strong evidence of increased risk for attachment loss
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You can see just by comparing the graphics that while I still have populations of the big baddy, Aggregatibacter actinomycetecomitans, the amount is far less than before, previously 10^7 and now 10^4, which makes it just above threshold.
I still have high levels of Capnocytophaga species, but it’s labeled as a low risk pathogen. My moderate risk pathogens have all decreased below threshold which is good, although now have a new population of Eubacteriam nodatum.
What Am I Going To Do About This?
After receiving the results and getting cleaned by the hygienist, the hygienist recommended that I get deep cleanings in all four quadrants of my mouth, antibiotics applied to certain teeth, laser treatment, and a repeat MyPerioPath after everything.
Here is the cost breakdown she provided:
TOTAL COST: $2,355.00
Spending over two grand on this is definitely out of my budget, so after the initial sticker shock, I politely declined. Part of me wondered if she would be receiving some sort of commission or incentive for pushing this. I show up for a routine cleaning and a MyPerioPath, and walk away with a recommendation for over $2000 worth of treatment… which just didn’t smell right to me. I’ve never been told I needed deep cleaning before so I was a skeptical, especially since this was coming from the hygienist and not the dentist.
After doing some research it seems that dentists paying hygienists based on commission and offering bonuses for services they recommend is a thing:
…some deep cleanings are necessary to treat gum disease, but adds that some medical consulting firms advise dentists to offer deep cleanings to improve their bottom line. He says hygienists also perform deep cleanings, freeing the dentist to do more complex, and expensive, procedures. But Lim says practices that pay hygienists on commission, or offer bonuses for services they recommend, encourage unnecessary treatment. “Monetary incentives influence [hygienists] to overtreat,” Lim says.
At this point, I’ll just continue with what I’ve been doing:
- Brushing at my gum line with my Oral B electric brush
- Using Oxyfresh Mouthwash
- Flossing (Dr. Tung’s Smartfloss is now my favorite floss)
- Brushing with these angled go between brushes
Now that I’m out here on the West Coast, I’ll need to find a new dentist which will give me the chance for a second opinion.
*Image taken from here
I’m curious if you have tried either oil pulling w/ coconut oil. Or using coconut oil -you can brush with it. http://articles.mercola.com/sites/articles/archive/2015/04/25/coconut-oil-toothpaste.aspx OR you should check out earthclinic.com for other natural treatments.
Oil pulling would seem like a smart and cheap experiment. Pull for a couple of months and retest.
I was doing it for a big, then lost momentum with the move. I think you’re right in that it would be a good thing to try out again.
And read entire page for others remedies. http://www.earthclinic.com/cures/gum_disease5.html
You’re right! There ARE a lot of natural remedies. I think I’ll add in some oil pulling into my daily regimen.
Have you tried looking for a biological dentist? https://iaomt.org/
Just checked out the site, and unfortunately none in my neck of the woods!
A couple other thoughts. They sell something called Periogen on Amazon, may be of interest.
Also, some tips, one from my dental hygienist, after brushing, take a Soft tooth brush and gently massage your gums for a couple minutes each day. Helps me greatly.
Another from a tip given on TV. Before flossing, or whatever you use between teeth, take a tiny bit of tooth paste between your fingers and rub floss through it before flossing. You get tooth paste Between teeth that way. Keeps things cleaner.
I am just stumbled upon your posy which you did a bit ago. But as far as my periopath ,I dont know if you have learned about other options besides or in addition to scaling and rot planning which is costly. Oral probiotics, certain foods, dental self exams and rinses to help lower bad bacteria are also tools you can use that are effective. Love to learn more about your perio health journey
I understand that your post is 3 years old now but as a hygienist by profession I felt compelled to leave my feedback. I firstly want you to understand that by you going to an office that actually takes the time to address the root of the periodontal disease is incredible and uncommon. I want to give two thumbs up to your hygienist and the dental office. I also want you to know that I know MANY hygienists: 36 that I graduated hygiene school with plus many more over the years of working. Not one of them is paid off of commission OR do they get bonuses for meeting goals. Most of us are paid hourly. I would agree whole heartedly with what your hygienist recommended. I would have recommended the exact same thing. At our office we do the saliva testing because we understand and properly educate our patients about whole health and the correlation between the mouth and the entire body. I will ALWAYS recommend what is in the best interest of the patient regardless of finances. At the end of the day I understand that I have given my patients the knowledge and if they are not willing to complete treatment that is on them. I just do not appreciate your post commenting that your hygienist was probably making commission off of this. I believe she was recommending the proper and standard of care. You will always find an office that will do a “simple” cleaning but I am afraid that is not helping you out at all. In fact when scaling and root planing is needed and you have a “simple” cleaning completed instead you are actually making the disease progress even more. At the end of the day most hygienists are not paid on commission nor do we get bonuses. We are recommending the best treatment for you. The dna testing cannot lie! Maybe you can find a hygiene school in your area, they offer much more affordable scaling and root planing. Best regards.
Thank you so much for your feedback and clarification. It’s just strange to reconcile when one dental office recommends a procedure that’s hundreds to thousands of dollars while a second and third office say it’s something I don’t need at all. Perhaps it all just comes down to the ‘art’ of medicine. Since the writing of this post I’ve gotten regular dental checkups and my oral health has been improved from prior with improving pockets etc, although no followup MyPerioPaths have been done.
That being said, my most recent followup showed worsened pockets and they found some areas in my molars that needed deep cleaning… so maybe that first office was right after all. Or maybe this stuff developed afterwards.
In any case I scheduled an appointment for the deep cleaning… and then COVID struck, and now everything has been postponed indefinitely.
It’s good to know that hygienists aren’t commission based. I’ve just seen enough areas in medicine where the financial incentives are not entirely aligned with patient care that my perspective has become a little jaded.
I’m glad there are good folks like you out there to set me straight!
Hi Caveman, I came across your post researching to write a blog post about periodontal disease and I thought I’d add my 2 cents.
I am a natural/ holistic dentist in Phoenix and a member of IAOMT. I’m impressed that you have educated yourself about the importance of gum health. It’s a challenge in my practice to get people to understand the importance of investing in their periodontal health. I’m a big proponent in taking care of the chronic inflammatory infection in the mouth that is periodontal disease. I see my patients with chronic health issues such as diabetes, heart disease, Lupus improve, and even thrive after addressing their gum disease and committing to periodontal health. The tools I use besides the MyPerioPath test, deep cleanings with laser degranulation (only a dentist can initiate the laser to curette diseased tissue) and localized antibiotic gel therapy are custom-designed trays loaded with hydrogen peroxide gel. The course of therapy is three months wearing trays three to four times per day for 5 to 15 minutes. After that, the trays are worn once for 15 minutes each day.
Why are these trays successful in the long term treatment of the periodontal disease? The bacteria in the mouth that is hostile to our bodies are anaerobic. They die in the presence of oxygen. All of the bacteria on your MyPerioPath report are anaerobic. Hydrogen peroxide breaks down into water and oxygen. The custom-designed trays express hydrogen peroxide gel into areas with periodontal pockets. The effect is the oxygenation of deep, oxygen-poor periodontal pockets, killing the anaerobic, disease-causing bacteria. Rinsing with mouthwashes or bottled hydrogen peroxide cannot reach the pockets, not does the effect stick around. Rinsing with bottled hydrogen peroxide is damaging as high concentrations will break down tissue in the mouth. Over time, the makeup of one’s oral cavity can be altered away from the inflammatory, disease-causing anaerobic bacteria to a more symbiotic aerobic (oxygen loving) microbiome.
My clientele, as a holistic dentist, prefers natural solutions. These trays are antibiotic-free and kill the offending bacteria not all bacteria, as do antibiotics. I use them for my mother who suffers from dementia, along with deep cleanings, laser curettage, and gingival irrigation with essential oils. I’m not a physician so I cannot grade her dementia. Anecdotally, she is far better than her mother was at her current age.
Find a dentist who can diagnose and prescribe these trays for you. Two labs who fabricate them are PerioRestore through DenMat and PerioProtect. I think you will find that you can affect your oral microbiome is a positive manner and improve your oral health as well as your systemic health.
Jennifer Ebner, DDS MS