Oral Health, COVID-19, and Systemic Considerations

Ron Schefdore, DMD, Ryan Schefdore, Allie Spaw
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INTRODUCTION
With COVID-19 lingering for the past year, keeping a strong immune system is more important than ever. However, researchers tell us that a large portion of Americans fall short of the necessary requirements of essential nutrients from food alone. The obesity epidemic in the United States proves that many people have a below-average or poor diet. Additionally, as we age, nutrient absorption declines, and medications reduce or even stop the absorption of essential nutrients. According to health.gov, 75% of Americans have diets that are entirely too low in fruits, vegetables, and/or nutritious oils. Furthermore, the organization found that more than 50% eat far too many grains, proteins, and carbohydrates.1

These malnourished patients will never obtain great oral health no matter how much they brush and floss! Dentists and hygienists who recommend dental nutraceuticals report that these patients see improvements in healing time after invasive treatments and less bleeding and lower pocket depth scores on recare visits. You can see these findings by visiting Pharmaden Nutraceuticals at pharmaden.net.

Is this evidence simply anecdotal, or is there a credible study on the results of patients with periodontal disease after using nutraceuticals? Yes, a double-blind study was completed at Loma Linda University, showing the effects of incorporating the nutraceutical Periotherapy by Pharmaden Nutraceuticals. In this study, 63 patients with 4- to 7-mm pockets were assessed after 60 days in order to illustrate the effectiveness of the supplement. These results were peer-reviewed and published in Compendium as far back as 2001 (which you can find at pharmaden.net).

The goal of this clinical trial was to measure the improvement in the patients’ pocket depths, gingival plaque, and bleeding without performing any treatments or changing their home care routines. The average pocket depth was reduced by 1.37 mm! The bleeding and plaque indices were also significantly reduced. The Periotherapy nutraceutical offers patients a noninvasive, systemic adjunct to treatment that delivers verifiable results.

These findings have caused a stir in the dental industry, even resulting in praise from Dentistry Today as a “Top Product.” Pharmaden nutraceuticals are manufactured within the United States in an FDA-approved facility designed for pharmaceuticals. Their fine powder, natural nutrients, and black pepper further aid in their increased absorption rates.

BONE REMINERALIZATION AND OSTEOPOROSIS PROTECTION
Bone health is paramount in dentistry. Two essential elements in bone development are calcium and vitamin D. However, the question remains: How much of each of these elements does the body require? Dr. Walter Willett from Harvard and other current researchers recommend going lower on calcium and higher on vitamin D than the old guidelines suggest. The current recommendations are for 500 to 700 mg per day of calcium and 800 to 1,000 IU per day of vitamin D.2

Recent studies show that taking vitamin D and calcium did not significantly decrease bone fractures. However, adding vitamin K2 (MK4/MK7) was found to substantially lower bone fractures.3 MK4 stopped and reversed bone loss, grew stronger bones, and reduced fractures by more than 80%.4 Research on K1 and K2 supports their use for osteoporosis. K2 research also supports its use for the prevention of coronary calcification and cardiovascular disease.

Another study showed that MK7 not only reduces fractures but also maintains bone density. In addition, K2-7 safely directs calcium to bones instead of arteries (so arteries do not harden). In a study of 4,807 people, death rate, severe aortic calcification, and heart disease were lowest in the group that had the highest intake of K2.5

The portmanteau “nutraceutical” (nutrient and pharmaceutical) was coined in 1989 by Stephen De Felice, founder and chairman of the Foundation for Innovation in Medicine, an American organization that encourages medical health research. He defined a nutraceutical as a “food, or parts of a food, that provide medical or health benefits, including the prevention and treatment of disease.”6

Vitamins are different than nutraceuticals. According to the Dietary Supplement Health and Education Act of 1994, a dietary supplement (vitamin) is a product other than tobacco “intended to supplement the diet that bears or contains one or more of the following dietary ingredients: a vitamin, an amino acid, a mineral, an herb or other botanical.”7 Many times, vitamins are synthetically made in a lab, not coming from a food source. To date, the author is not aware of any vitamin that has a double-blind study on periodontal patients showing improvements in bleeding, pocket depth, and plaque.

Before the advent and implementation of nutraceuticals as an adjunct to dental procedures, the only kind of “systemic care” a patient could receive was with antibiotics targeting bacteria and the enzyme collagenase, which causes the body to destroy tissue. Unfortunately, the prolonged use of antibiotics has been shown to severely impede the immune system, and the scope of prescribed antibiotics is far too narrow. Antibiotics definitely have their place, but the overuse of antibiotics in dentistry is starting to gain some traction in the media. A recently published article titled “Antibiotics prescribed by dentists may contribute to the growing problem of Clostridium difficile (C. diff)” is just one example. According to a survey conducted by the Minnesota Department of Health, “36% of dentists prescribed antibiotics in situations that are generally not recommended by the American Dental Association.”8 Incorporating a nutraceutical as an adjunct to their home care would be a safer and more conservative alternative in these situations.

Unlike antibiotics, nutraceuticals inhibit the release of multiple enzymes, including collagenase. Research shows that they effectively assist in reducing plaque buildup, strengthening the host’s immune system, and enhancing soft-tissue healing.

Recently, Pharmaden Nutraceuticals conducted a survey of dentists and hygienists who use its product line. The hygienists reported an improvement in their patients’ tissue health (bleeding, pocket depth, and plaque) on recare visits. Dentists said they like using them when doing implant placement, perio surgery, orthodontics, and extractions. They feel healing is faster and more predictable when they included the nutraceuticals as an adjunct to treatment.

Hygienists who do not incorporate nutraceuticals tell me that typically 30% to 50% (depending on their geographic areas) redo scaling/root planing 1 to 3 years after treatment, even though they had adequate home care. What can be the cause? Dentists and hygienists are taught that many people fall short on essential nutrients, yet essential nutrients are essential to maintain good oral health. They are not given any direction regarding which supplement to use or why. For the most part, store-bought vitamins have no studies, low absorption rates, and inexpensive synthetic ingredients and are often packaged in unregulated facilities. Hence, most obstetricians typically do not recommend off-the-shelf prenatal vitamins.

CONCLUSION
Patients today are reading new studies on nutraceuticals online. Due to the coronavirus pandemic, they’re seeking out healthcare professionals who will incorporate more preventive care to maintain good health and a strong immune system. The same vitamins recommended to help relieve coronavirus symptoms are the same ones recommended to maintain oral health, particularly zinc and vitamins B, C, and D. People today want health professionals on their teams who practice prevention while using fewer antibiotics and less medicine and perform fewer surgeries.

Always consult the patient’s physician before advising a patient to take an antibiotic or a supplement. Nutraceuticals are not intended to diagnose, treat, cure, or prevent disease.


References

1. Health.gov. Dietary guidelines 2015-2020. https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/chapter-2/current-eating-patterns-in-the-united-states/#figure-2-1
2. Askdrk.com. How much calcium do I really need? Accessed March 12, 2021. https://www.askdoctork.com/how-much-calcium-do-i-really-need-201512038614
3. Cockayne S, Adamson J, Lanham-New S, et al. Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. Arch Intern Med. 2006;166:1256-1261.
4. Geleijnse JM, Vermeer C, Grobbee DE, et al. Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease: the Rotterdam Study. J Nutr. 2004;134:3100-3105.
5. Cheung AM, Tile L, Lee Y, et al. Vitamin K supplementation in postmenopausal women with osteopenia (ECKO trial): a randomized controlled trial. PLoS Med. 2008;5:e196.
6. Zeisel SH. Regulation of “nutraceuticals.” Science. 1999;285:1853-1855.
7. US Department of Health and Human Services. National Institutes of Health. Dietary Supplement Health and Education Act of 1994. Accessed October 23, 2020. https://ods.od.nih.gov/About/DSHEA_Wording.aspx
8. Infectious Diseases Society of America. Antibiotics for dental procedures linked to superbug infection. Science Daily. October 6, 2017. Accessed October 23, 2020. https://www.sciencedaily.com/releases/2017/10/171006164847.htm


Dr. Schefdore graduated in 1983 from the Southern Illinois University School of Dental Medicine and recently retired from full-time clinical dentistry after 37 years. He authored the book Better Service, Better Dentistry, Better Income and more than 50 articles. He has been recognized for 10 years as one of Dentistry Today’s Leaders in CE. He is the president of Pharmaden Nutraceuticals and a coach for dentists who want to be insurance-free. He can be reached via email at ronalddmd1@gmail.com.

Mr. Schefdore is one of the industry’s leading healthcare ghostwriters, formulating whitepapers, blog articles, webinars, and more for some of the top names in dentistry throughout the Midwest. Today, Mr. Schefdore assists medical professionals (especially dental hygienists) in building additional revenue streams for their practices. He can be reached at ryanschefdore@gmail.com.

Ms. Spaw is a leading marketing and business development specialist who has spent the last 6 years growing dental practices and cultivating regional healthcare brands. After graduating from the Fisher College of Business via The Ohio State University, she became the vice president of Pharmaden LLC, an industry-leading nutraceutical company, leveraging their unique market niche as the only provider of medical-grade nutritional adjuncts to dental treatment. She can be reached at allie@pharmaden.net.

Disclosure: Dr. Schefdore is president, Pharmaden Nutraceuticals. Ms. Spaw is vice president of Pharmaden Nutraceuticals.

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