But what causes periodontal disease? Did you say plaque? If so, you are atleast partially correct. Through recent research conducted in Philadelphia and Boston, it has been discovered that many different types of bacteria (including NON-PLAQUE) bacteria can cause the loss of teeth. These NON-PLAQUE bacteria, unlike plaque bacteria, are usually tissue-invasive (they live INSIDE the gum tissue itself). What does this mean? It means that flossing, brushing and frequent cleanings cannot always assure that you will have your teeth for the rest of your life.

How do we get rid of these NON-plaque bacteria? First, we take a BACTERIAL CULTURE of the pockets to find out exactly what bacteria are causing the periodontal infection. Then antibiotics are used to kill them. Antibiotics alone, however, do NOT eliminate the need for conventional periodontal therapy (for example: scaling and root planing or periodontal surgery).If irreversible bone damage has already been done, the resulting pockets still MUST be eliminated to help prevent the return of these "bad bugs".

If you have already had conventional periodontal therapy, (especially surgery) and the SURGERY HAS FAILED, a bacterial culture can often reveal the presence of a bad bug; that was not killed by the surgery. Thus, the disease will again resume post- surgically and continue to cause more bone loss and the reoccurence of pocketing; you will soon be right back where you started from.

How do we get these so-called bad bugs. A recent article in U.S. News and World Today (November 1993) revealed that we can catch them from each other (for example, KISSING). If you have well water that is bad, the Enteric bacteria (E. coli is one type) can enter your mouth and gum tissue through drinking water and cause havoc (severe bone breakdown) in a very short period of time. Many Third World countries routinely have this bacteria in their public drinking water.If you have dental implants, they can cause them to fail within a year (I have seen them fail in as little as two months). The people who died from eating bad food at Jack-In-The-Box restaurant in Seattle had the E.Coli bacteria. If YOU CAN DIE FROM THESE BACTERIA, you can understand how much damage it can do to your periodontal (bone) tissues that hold your teeth in your jaw.

If you have these bad bugs, can you sometimes ELIMINATE THE NEED FOR PERIODONTAL SURGERY? If you catch them early enough, yes.

I find that their destruction can atleast eliminate the need for more complex procedures, such as bone grafts or reduce the amount of surgical procedures required. Also, in several instances I have been able to save the teeth of some patients who were about to have ALL their teeth extracted. Nothing is guaranteed and each person reacts differently to even the same bacteria; this is referred to as RESISTANCE (similar to why some people get colds more than others in the Winter).

Just what is a bacterial culture? It consists of two tests, one being an actual culture where the bacteria taken from the periodontal pocket is grown in a Petri dish. It takes up to two weeks for some of them to grow. Then they are identified by their color and shape with the naked eye. In addition, a DNA probe is taken; this is very accurate and can identify some of the bacteria by their DNA characteristics, similar to how O.J.Simpson's blood was identified. It is very accurate esp. since LIVING bacteria are not needed.