Welcome everyone to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health. 

I love meeting people with similar philosophies about health and wellness. This past week I had the privilege of sitting down and talking to Dr. Susan Creech, a local dentist in our area, about how oral health leads to overall health. What an interesting conversation! From her early practice of (traditional) drill and fill dentistry, Dr. Creech saw an opportunity to help prevent disease. Adding salivary testing and wellness scans to her practice, she not only looks for abnormal tissue in the mouth, but also tests for bacteria that could put your body at risk for disease. Note: Oral cancer is becoming more and more common. 

We don’t talk enough about oral health. As Dr. Creech said in our conversation, “Your mouth is a window into your body”. I agree 100%, therefore I want to pass along some of the insights I gained from our visit. Hopefully, she will come back and do a “Part 2”!    

Let’s dive in. 


What are the Health Risks of Oral Bacteria? 


Bacteria in your mouth is both good and bad. Your mouth needs good bacteria. These germs break down food and kill the bad bacteria that can lead to oral health problems. But balance is key. If uncontrolled, bacteria in the mouth can multiply and enter the bloodstream affecting other parts of the body. Note: Patients with a heart valve problem, who are getting their teeth cleaned, should probably prophylax with an antibiotic (maybe even patients who are pregnant). 

What are some of the dangers of oral bacteria? Here are a few statistics: 

  • There are up to 50% of heart attacks and strokes that are triggered by oral pathogens or bad bacteria. 
  • 70% are most likely to develop Alzheimer’s disease in people who suffer from gum disease for over 10 years. 
  • There are 7 times the increased risk of adverse pregnancy outcomes, including preterm deliveries and low birth rate due to oral pathogens.
  • 12% higher risk of premature death in women who have a history of periodontal disease.
  • 50% greater risk of developing cancer (oral cancer, esophageal cancer, colon cancer, breast cancer, pancreatic cancer). Note: With breast cancer there is an abnormal response to treatment when there are high levels of the aggressive bacteria found. 
  • 95% of Americans with diabetes also have periodontal disease. 

These are big percentages!


How Do You Test for Oral Bacteria? 


Traditionally, periodontal disease was diagnosed with a stainless-steel metal probe (invented in 1936 by periodontist Charles H.M. Williams). Dentists would probe around the teeth in search of deep pockets that would indicate the patient has periodontal disease. To keep the mouth healthy, dentists recommended a deep cleaning, a good toothbrush and water floss for regular home use. The problem, according to Dr. Creech, is that some people would respond well to that treatment and others would not. Frustrating for both patient and provider. The question was “why”? 

Salivary testing has improved treatment outcomes in Dr. Creech’s practice. Note: I actually took the HR5 Saliva Test during our conversation! My results will be revealed in a future follow up podcast! 

The HR5 Saliva Test is a simple, affordable, and highly accurate saliva test that will tell you the exact levels of each of the following bacteria in your mouth:  

  1. Aggregatibacter actinomycetemcomitans (Aa)
  2. Porphyromonas gingivalis (Pg)
  3. Treponema denticola (Td)
  4. Tannerella forsythia (Tf)
  5. Fusobacterium nucleatum (Fn)

Each of those bacteria have a list of diseases that are correlated. Diseases like Alzheimer’s, and Rheumatoid Arthritis have high levels of all of the five, or at least 1 or 2 of these aggressive bacterias. Porphyromonas gingivalis, for example is associated with: 

  • Heart Attacks 
  • Strokes
  • Arterial Plaque 
  • Pregnancy Complications 

Note: High levels of Pg in pregnant patients can contribute to low birth weight and preterm delivery, high blood pressure in a pregnant patient (preeclampsia), and kidney failure. 

The prep and process is easy: 

  • Don’t eat or drink anything for 15 minutes (minimum) prior to taking the test. 
  • Spit into the tube, saliva filling up to the red line (bubbles don’t count).
  • Your dentist will send it off to be tested, and you will get a report of any bacteria noted within a couple of days. 


What is the Treatment for Oral Bacteria?


If the results show that you have one of the five, aggressive bacteria (listed above), there are a few different options: 

  • Oral antibiotics (Amoxicillin, Metronidazole, Moxifloxacin)  
  • Mechanical treatment (SRP, Laser, Perio surgery)
  • Antimicrobial (molecular iodine, chlorhexidine)
  • Natural products (Periosciences, Xylitol based products)
  • Home care (electric toothbrush, water flosser)
  • Probiotics (long term) Note: Long term probiotics contribute to the natural flora. It changes the bacteria.

After the treatment, you RETEST to see if the bacteria is gone. Dr. Creech recommends this test annually.


Healthy Mouth, Healthy Body 


In closing, here are a few tips from Dr. Creech, that will keep your mouth (and body) healthy: 

Avoid mouthwash. It destroys good bacteria, and masks clinical symptoms (redness, bleeding, inflammation). The masking could give the dentist (and patient) a false reading of how healthy their mouth is. If you do want to use mouthwash, Dr. Creech recommends a particular line of mouth rinses called Periosciences. It has essential oils and is Xylitol based (which is key). 

Avoid toothpaste with Sodium Lauryl Sulfate (SLS). These can cause dry mouth and/or ulcers and canker sores. 

Pay attention to your tongue. If someone has a geographic tongue, Dr. Creech will ask if you have any type of burning symptoms. An enlarged tongue can sometimes suggest that there are other things going on (i.e., the liver). 

Take notice of any bleeding. Even a little bit of bleeding is NOT okay. That is inflammation! Every time you swallow (600 times a day), that bacteria is getting into the bloodstream. It’s getting into the tissues of all the other organs! 

There are SO many correlations between what you see in the mouth and what is occurring in the rest of the body. Oral health IS IMPORTANT! 

“Our mouth is connected to our face. Our face connected to our head. And our head is connected to our body. It all works together”. – Susan B. Creech, DDS. 

Till next week.