New interest shown for top-of-the-line gum disease treatment

dr-greg.jpgBY NICK DIAMANTIDES
Staff Writer

Several years ago, Dr. Robert Gregg, a Cerritos dental surgeon, and his colleague Delwin K. McCarthy developed a breakthrough procedure for treating gum disease— laser periodontal therapy (LPT). According to peer-reviewed journals their technique has a documented 90-percent success rate compared to a 70-percent failure rate for the old scalpel and suture method. In spite of the new technique’s success, the dental establishment in the United States is, for the most part, treating Gregg’s technique as an unproven, experimental method.
LPT thoroughly kills the bacteria embedded deep in the gums and removes the infected tissue. The other and more common alternative to laser treatment requires scraping out the diseased tissue with a surgeon’s scalpel and stitching the gums back together afterwards. The recovery time for scalpel and suture method is about two to three weeks and often requires doses of codeine or other narcotic pain medication for at least a few days. In addition, the old method removes gum tissue, thus exposing the root surface, making the tooth more vulnerable to new cavities and making it more sensitive to hot and cold temperatures.
LPT, on the other hand, requires no stitches, has about a one-week recovery time and the patient’s discomfort can usually be treated with prescription-strength ibuprofen. In addition, LPT actually stimulates new growth in the jawbone where the teeth are connected. Gregg noted that gum disease causes a loss of bone mass around the tooth. Laser treatment stimulates bone growth.
Gregg and McCarthy started working with lasers in 1990. “There really weren’t a lot of known benefits at that time other than the prospect that lasers could offer less side effects than conventional instrumentation,” he said. “There was some hope that the fiber-optic delivery system would allow us to access areas like root canals and sterilize those as well as possibly disinfect the periodontal pockets.”
“In 1990, I noticed that I was actually seeing patients dramatically improving on their X-rays. The level of bone that had previously not been there was starting to return,” Gregg said. “In my training 25 years ago, they taught us that once the bone goes away from gum disease, it never returns.”
He noted that nowadays dentists use bone-grafting techniques and artificial membranes they use to create some bone regeneration for a single tooth, but in the early 90s, he was seeing full mouth regeneration in the patients he treated with laser therapy.
“When I started seeing that, I was a little bit shocked and curious and concerned.” he said. “I didn’t know what all the ramifications or consequences would be.”
Gregg and McCarthy began using a particular fiber optic that delivered a laser with an attraction to dark pigment. That wavelength (Nd:YAG) was widely used to remove tattoos, but the germs that cause gum disease are dark pigmented too, making that wavelength ideal for their purposes.
After years of trial and error, in 1997, the two dentists received a patent for LPT. Three years later, they developed PerioLase, a customized laser designed specifically for LPT. The Food and Drug Administration approved that machine in 2001.
Gregg noted that “cold steel, sunshine and stitches” do not really address the nature of periodontal disease.
“I think it’s more of a syndrome than a disease, because if it was simply an infectious disease, we could cure it with antibiotics or a vaccine,” he said. “But it’s a much more stubborn and problematic state of pathology.” He stressed that there are many factors at play in gum disease, but the bacteria are by far the most problematic. “The laser was designed to attack those germs that are involved in 90 percent of the most aggressive types of gum disease.”
He noted that recent studies show a 70-percent failure rate of conventional treatments within three to five years. And he found that to be true when he was using the old method.
“Once we started using a specific type of laser, those patients that were problematic stopped being problematic,” he said. “I probably have a 90-percent success rate over the long term.”
Nevertheless, LPT has yet to gain widespread acceptance from the dental establishment.
“There are books written about those who have discovered new and novel treatments to things that go back many hundreds of years and the innovators were not necessarily treated kindly in the beginning,” Gregg said. “I’m still not treated kindly in some circles. The news is slow to arrive. Even here in the United States, there are pockets where the information doesn’t get through to those who are educators in universities, largely because of institutional bias or fear or greed or alternative agendas.”
He explained that, in his observation, two things make people most upset in this world: a challenge to their power base and a threat to their monetary income.
“Implants, for example are all the rage today. Not that implants are not useful. But I’ve seen a number of teeth that could have been saved, taken out in order to place expensive implants,” he said. “That’s a multi-billion-dollar-a-year industry with a lot of vested interests, and we are essentially coming along and saying, ‘you don’t need an implant — you can save that tooth.’
He added that there are other examples how LPT could be impacting someone’s financial bottom line, but he was not thinking about economic impact when he began developing the treatment.
“I was thinking about how I could offer a better treatment outcome to my patients who were suffering from a disease that was episodic and recurring and had a predictable decline in the survivability of their teeth, and a predictable decline in the state of health in the mouth,” he said.He noted that gum disease not only leads to a loss of teeth but it also negatively impacts other parts of body like heart, lungs, pancreas, and the bloodstream in general.
He said that extracting a tooth and replacing it with an implant does not cure the periodontal disease in the gums, which can lead to a host of more serious diseases.
“The infection can still reside in the bones and tissues, “ he said. “I treat cases of failed implants. Why are they failing if they are the answer to gum disease?”
Gregg and McCarthy own Millennium Dental Technologies- the company that manufactures the PerioLase. They also own an affiliate company- the Institute for Advanced Laser Dentistry- that trains dentists on how to use the laser machines.
“Having control over the companies gives us maximum control over patient safety and patient efficacy,” he said. “We continue to see good results in the patients treated by us or by the dentists we train.”
The Institute for Advanced Laser Dentistry has trained over 600 dentists throughout the U.S., as well as from other countries.
To find out if LPT can help you with your gum disease, phone (562) 860-6587.

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