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The Role of Nutrition in Periodontitis

July 13, 2020

The Role of Nutrition in Periodontitis

Alvin H. Danenberg, DDS


Marty Klein: Welcome to Dentistry for the New Millennium. I’m Marty Klein, Training Manager at the Institute for Advanced Laser Dentistry. My guest today is Dr. Al Danenberg, a periodontist in Johns Island, South Carolina. Doctor Al, as his patients call him, received his dental degree from the Baltimore College of Dental Surgery and a specialty certificate in periodontics from the University of Maryland. Today, we’ll talk about how he got started with LANAP, how it became a career defining paradigm shift, and the relationship between diet and nutrition with periodontitis. Dr. Danenberg, thanks so much for joining me today.

Dr. Al Danenberg:  It’s a pleasure. Thanks for the opportunity.

MK: Certainly. Let’s start with how you first got on board with the PerioLase and LANAP. How did you hear about it? And what motivated you to give it a shot?

AD: You know, it’s a long time ago, I’m not exactly sure how I learned about it. I believe that I read some clinical articles to start with that made sense to me. I’m kind of geeky with the science, and when I saw the information about regeneration, of course, that’s what all periodontists wish for. We had all these modalities in those days that never really did the job, and those modalities were not necessarily patient friendly. Then when I learned that this type of technology would not only be more patient friendly, but actually could develop true regeneration, it just blew me away. So I pursued it, did a little research, signed up for the program, and it changed my practice life. I mean the results that I started to get from doing the PerioLase surgery compared to periodontal surgery, using bone grafting material and membranes and suturing and the aftermath of the sequelae of healing… It was like night and day. So mainly the research and the science behind the regeneration, they made me change.

MK: I did read that it was the regenerative properties and the fact that LANAP is minimally invasive that drew you to the protocol.

AD: Without a doubt! I had patients that after I did the LANAP procedure, would literally go back to work the next day, almost never needed medication. And previous to LANAP, they were out of work for days, they needed medication for pain. They were relatively miserable, and the
end result was far inferior to the result with LANAP. I was extremely successful with LANAP on my patients.

MK: So this has been about a decade that you have been doing LANAP. There’s a statement on your website which really struck me and that you define your career in two sections: before and after the laser.

AD: Yes.

MK: Tell me more about what you mean by that.

AD: Well, it’s just that the patient-friendly aspect, as well as the regenerative results, which were far superior than the regeneration that I was able to create with the therapy I was using previously was night and day. It just changed periodontal surgery for me. Since I started LANAP, I did not do any flap periodontal osseous surgery that could be done by LANAP. It just wasn’t part of my protocol any longer.

MK: You mentioned at least some patients that would go back to work the next day…

AD:  Yes, absolutely! I don’t think that any patient would not be able to go back the next day, maybe the day after, unless they wanted to stay out of work for some reason, but medically, there was no reason for them to stay out.

MK: Now you’ve done a lot of work and research on the relationship between nutrition and periodontitis. How long has that been an interest of yours? And is there a connection to the laser with that?

AD: Absolutely. As a matter of fact, in the beginning, I was not into the nutrition part (basically a primal nutrition, primal lifestyle and the support of the gut microbiome and its effect on overall periodontal disease and the immune system). So prior to that, and I guess that was starting maybe 2013-2014 or so, and then I was doing that on a regular basis until I literally stopped seeing clinical patients in 2018.

Nutrition was a huge factor because the whole concept of periodontal disease needs to be considered with the requirement of a strong immune system and a control of the bacteria in the gut, which actually controls the bacteria in the mouth. It’s not vice versa, even though many people think the bacteria in the mouth is the only critical element. Actually, the dysbiosis in the gut starts the dysbiosis in the mouth, and then there’s cross talk back and forth after that. So you need to get a healthy gut and healthy immune system, and that it can only be created if you understand using specific types of probiotics to get the gut healthy and a specific diet that’s not inflammatory. The concept of using antibiotics with LANAP I stopped completely, because that destroys the gut microbiome. So I used some herbal type of products that supported the immune system, prebiotics and probiotics that supported the gut microbiome, and changing my patients’ diet to an anti-inflammatory diet. I got significantly better results with patients that had accepted those modalities. Now, of course, not everybody wants to make life changes like that so maybe 5% of the patients that I saw with LANAP wanted to do all the other things that I thought would be helpful for their overall health and healing. But those that did the nutrition and got their guts healthy and supported their immune system and diet did extremely better than the ones that did not, and overall health improves too, of course.

So here’s the science behind gum disease:  The gut bacteria becomes unbalanced for a variety of reasons, and sometimes it’s diet, but it could be stress. It could be poor sleep. It could be poor exercise patterns. It could be the toxic elements that are in food and air and the things that we do to our body. But whatever changes the gut microbiome affects the bacteria in the mouth, and creates dysbiosis in the mouth that is exacerbated by poor diet and poor lifestyle choices. Even though it starts in the gut, when it is in the mouth, that’s generally the first clinical observation that there’s a problem. So the dentist has this wonderful platform to see infection in the mouth that really is related to the gut. When the dentist can understand that and treats the active gum disease, which pours into the bloodstream just like active gut dysbiosis pours into the bloodstream (called a leaky gut), by treating both factors, the gut as well as the active periodontal disease, with LANAP can create a significantly healthier environment, reduce chronic systemic inflammation that obviously affects every organ system in the body. Just by treating the mouth with LANAP and understanding how to treat the gut dysbiosis, or the imbalance of the bacteria, overall health will be achieved. And that’s an exciting opportunity for dentists because physicians really don’t know anything about this, and the dentist has this opportunity and platform to see it in the mouth.

MK: Speaking of opportunities along this line, I understand that you have a certification course available for dentists to become a certified biological nutritional dental professional. Can you tell me a little more about how that works and why have dentists should take that class?

AD: Absolutely well, actually, the International Academy of Biological Dentistry Medicine got in touch with me and wanted me to be represented as a periodontist on their board. They wanted something unique and different to help with the concept of this type of nutrition and biological concepts for overall health, in the dental practitioners’ world. So I created, I wrote and recorded, this approximately eight hour or six hour course in sections that is offered by IABDM that will offer the designation of Certified Biological Nutritional Dental Professional. And why that’s important is that for the whole concept of overall health and the dentist being the most active health care professional that has the opportunity to look in the mouth and see the problems, now to understand that they can change the problems in the mouth as well as the gut. By improving nutrition and understanding the biology of system, they can actually create an overall wellness that has not been actually accomplished up to this point.

I do believe, also, that if we work to address the gut problems, the immune problems, the diet issues, lifestyle changes, the chronic diseases that exist in society today – and 60% of U.S. adults, according to the CDC, have chronic diseases, and 70% of all deaths in the United States are a result of a chronic disease – if we can change this biology and nutritional protocols, we can either reduce or even prevent chronic diseases. It takes a lot to motivate a person or have a person motivate themselves to make these changes, but it is absolutely possible. These days – now that we’re dealing with a Coronavirus – our immune systems, and people that are susceptible and at risk are getting the virus in a more unhealthy progression, if we can improve our immune systems, we may be able to be stronger in preventing these diseases to become as virulent as they have been in the recent time.

MK: Thank you. This is all great information. I would like to plug your website, because there’s lots on there. You have a blog that is updated all the time. There’s your book that could be ordered to your website, through Amazon as well, called Crazy-Good Living!: Healthy Gums, Healthy Gut, Healthy Life. You wrote an extensive paper, “Your Gut is Killing You”, and there are many more things on your website, it’s actually very well put together. That’s I’d also like to invite all of our listeners here to subscribe to this podcast for a new interview each Monday, wherever you download your podcasts or at Dr. Danenberg thanks so much for joining me and sharing your unique perspectives.

AD: Thanks for the opportunity, Marty. I appreciate it, too.

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