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[While I'm relatively scarce around these parts for the next 2-3 weeks due to a trial, I will occasionally post articles that I have permission to republish and that seem likely to be of interest. This one, taken from Daily Kos, and written by a man I don't ever recall meeting online or otherwise seems very interesting -- if it holds up, it's even possibly life-saving. - GAD]
“Don’t Let Them Pull Out Your Teeth,” by James Hepburn
I’ve been putting off sharing this story for months now because I’m not wild about discussing a personal medical condition publicly. But the information I am about to tell you could have a monumental impact on millions of people’s lives. If that sounds exaggerated to you, read further and you will see why.
And if you, or anyone you know, suffers from gum disease (according to the Center for Disease Control, half of all Americans do – some studies put that number up to 75%) then you need to send them this story. It will probably save them their teeth, a lot of money, and a huge amount of suffering.
A few years ago I was diagnosed with an advanced case of gum disease. I was showing pocket depths of 9s and 10s. Many of my teeth were actually loose. And it had become painful to eat certain foods.
My periodontist told me that in order to stop it from getting worse, I had to have as many as seven teeth pulled. Seven teeth! And, even with my insurance, it was going to cost many thousands of dollars.
The implications of this were devastating to me. Life-changing in some respects. As anyone with false teeth will tell you, it’s not a happy situation. From limiting what foods you eat, to actually altering your social behavior – including the way you smile – losing your teeth is no small affair.
Curiously, during one of my many consultations, it was explained to me that gum disease is actually the result of a bacterial infection. So my first thought was, surely, there must be an antibiotic treatment. But my periodontist said no. Sometimes they use a topical antibiotic, like a gel, to help arrest the spread of infection, but there was no pill you could take like you would for, say, strep throat.
So, I sought a second opinion. Then another. All had the same bad news. ‘There is no antibiotic treatment and we’re going to have to rip out your teeth with pliar-like things and charge you big bucks to do it.’ Or something to that effect.
I was incredulous. What century is this? How, in this day and age, could we be condemned to such barbary? Don’t we have antibiotics for everything? Surely someone was at least working on it. So I decided to search scientific journals for “antibiotic treatment for gum disease.”
Immediately, I found this: The nonsurgical treatment of patients with gum disease: results after five years. by Walter J. Loesche et al. (link)
I am not exaggerating when I say my heart jumped a beat. Could there be hope? I clicked on the link and saw this:
AbstractBACKGROUND: In a previous study involving patients seen at the dental clinic of the Detroit Receiving Hospital, the authors found that 87 percent of teeth initially recommended for surgery or extraction were spared those treatments by a combination of debridement [cleaning] and short-term usage of antimicrobial agents. The objective of the present study was to determine how long the surgery-sparing benefits of less invasive treatment would persist.
METHODS: Ninety of these patients were scheduled for maintenance therapy at three-month intervals over a five-year period. They were evaluated periodically for surgical needs by a clinician who was not aware of the nonsurgical gum treatment the patient had received.
RESULTS: The initial treatment benefits were sustained, as the number of teeth needing periodontal surgery or extraction was 0.06 teeth per patient after 1.1 year, 0.22 after 2.3 years, 0.51 after 3.6 years and 0.86 after 5.1 years.
CONCLUSIONS: A noninvasive treatment regimen for an anaerobic infection in teeth seriously compromised by gum disease resulted in a reduced need for surgery or tooth extraction for at least five years after completion of the initial treatment. [Emphasis added]
Could this be true? And who is this Walter Loesche guy? And if it really works, how come three different periodontists didn’t appear to have heard of him or his work? So I looked him up. According to his bio at the University of Michigan:
He received his B.A. from Yale University in 1957, his D.M.D. from Harvard School of Dental Medicine in 1961, a periodontal certificate from Harvard-Forsyth in 1964, and his Ph.D. from Massachusetts Institute of Technology in 1967….
He has published three textbooks, over 170 peer-reviewed articles, and over 50 chapters and invited reviews. He has “served on the editorial boards of the Journal of Periodontal Research, Clinical Microbiology, the Journal of Oral Microbiology and Immunology, and Anaerobe and served as president of the.
I’ve since learned that
“he was appointed the Marcus L Ward Professor in Dentistry and received honorary degrees from the University of Goteborg, Sweden, the University of Ghent, Belgium and the University of Turku, Finland. In 1988 Dr. Loesche served as the president of the American Association of Dental Research and received the Distinguished Scientist Award in 1994.”
The more I learned about Dr. Loesche, the more I realized that he wasn’t some obscure researcher, but one of the most renowned scientists in his field. And the more I learned about his published work, the more bizarre it became that none of my periodontists were familiar with his antibiotic approach to treatment of gum disease.
As I said, one of my periodontists told me that gum disease was the result of a bacterial infection. But, it actually turns out, that my periodontist probably knew that because of the work of Walter Loesche. He was the one who, more than any other, led this field of research in identifying gum disease as a bacterial infection and pioneered its treatment as such.
Regardless, I can’t express how much hope this gave me. Here was a scientist with bona fides out the yahoo who claimed that he had successfully treated gum disease with drugs. I emailed Dr. Loesche at once. I explained my situation, and asked if he could recommend a drug treatment. This is what he told me to do:
* Get your teeth cleaned (in my case this involved a full scaling which I had already had done).
* Then get your Dr. to prescribe Azithromycin 500mg.
* Take one a day for 3 days. Then stop for 4 days. Then resume for 3 more days.
So I called periodontist #3 and told her about the Loesche treatment, sent her supporting documents from the Journal of the American Dental Association, among others, and her response was very positive. “I’ll try anything.” she said. So she wrote the script and scheduled me to return in thirty days for a progress report.
“It’s a miracle!” Those were her exact words. “I’ve never seen this before.”
As I write this, two years have passed since contacting Walter Loesche and taking Azithromycin. On my last regular checkup my dentist informed me I have no signs of active gum disease. I still have all my teeth. My pocket depths went from 9s and 10s down to 3s and 4s (still not great, but not in crisis either). My teeth are no longer remotely loose or sore. And I can eat anything I want.
This is Where it Gets Political
I find it simply impossible to believe that the periodontal establishment is unaware of the breakthrough of antibiotic treatment following the work of Dr. Loesche and others. The groundbreaking study I linked to above, which proved the superior effectiveness of antibiotic treatment, was published in 2002. There were other such studies, published in top journals, showing similar results going back into the early 1990s.
And yet, yesterday, in preparing to write this post, I contacted eight periodontists’ offices in my area. In each, I spoke to the senior hygienist on staff. And each denied ever hearing of systemic antibiotic treatment.
I personally was was quoted roughly $12,000 to get my teeth extracted. [Edit: As a commenter pointed out, you can get teeth pulled for a lot cheaper. I called my periodonist's office and his assistant suggested that price probably included bone grafts to prepare for implants and may have included some bridge work.].
My antibiotic treatment cost me $15.
Is this why none of the periodontists I saw knew about antibiotic treatment? The tooth extraction business is big bucks. So is the tooth replacement business. Depending on which study you cite, Americans alone spend tens of billions of dollars on periodontal treatment each year – most of that getting teeth extracted and replaced with dentures etc.
Walter Loesche, in one of his papers, spoke of not just an alternative treatment, but a new paradigm – one that replaces the barbaric method of removing patients’ teeth with one that treats the underlying cause.
What Dr. Loesche didn’t mention, however, was that this new paradigm threatens to practically collapse a multibillion dollar industry. If gum disease can be caught in the early stages, and treated with antibiotics prescribed by a normal dentist (which it can), then why do we even periodontists?
So while I’m not suggesting that there’s some plot among the periodontal establishment to suppress the use of antibiotic treatment, there certainly appears to be little incentive for them to embrace it.
As such, perhaps it will take the power of the internet to inform patients that there’s an antibiotic treatment to gum disease. And while there’s no guarantee that everyone’s treatment will be as successful as mine has been, everyone should at least have the opportunity to try it first. Pulling out someone’s teeth should be an absolute last resort after all other treatments have been applied.
So, again, if you know someone with gum disease, and you almost certainly do, please send them this article, have them talk it over with their dentist, periodontist, or doctor, and help them save their teeth. The periodontal industry can find another way to make money.
For further information on the work of Walter Loesche and colleagues at his U. Michigan page, go here and click on the lefthand menu “Publications.”
Here is a groundbreaking paper from 2001 that is not behind a paywall. According to Google Scholar it has been cited 192 times.
Similarly, a normal Google search for “Walter Loesche” without the quotes will also immerse you in a sea of useful information.