Positive Health Online

The object of this article is not to alarm people but supply up to date relevant information about dental infections and their possible consequences so that informed decisions concerning health can be made. The information is based on the published science and illustrated by examples from our own practice. The fact that dental infections can affect systemic health was admitted by the governing body of dentists in the UK, the General Dental Council, as a result of my last (and fifth) appearance before them in 2017.  Dentistry as a whole is coming around to the idea that chronic gum infections, periodontitis, is associated with heart disease and diabetes but the harm caused by dental infections goes well beyond this.

This idea of ‘Focal Infections’ where an infection in one part of the body can cause disease in another part of the body is still resisted because if accepted, some of dentistry’s most sacred tenets (and money earners) would have to be scrapped. The idea of dental infections causing disease elsewhere in the body is not new. Babylonian clay tablets describe it and examples appear in the literature from 1815 onward. Dental focal infection received credibility due to the work of Weston Price, Frank Billings and Edward Rosenow in the 1920s and 30s but dentistry as a whole, without any scientific reason, refused to accept it then as now. The latest text book on the Oral-Systemic Health connections claims, falsely, that focal infection is a discredited theory whilst admitting to the connection between gum disease and heart disease. The methods of Price etc. are criticized but their research is still valid. However, what is omitted is the new data on Polymerase Chain Reaction, PCR, which gained the discoverer a Nobel Prize. This shows unequivocally that bacteria from dental infections such as gum disease and root fillings cause infections in different organs such as the heart and even in foetuses.

Infections are acute or chronic. Acute dental infections show the classic signs of inflammation, pain, redness, heat, swelling and occasionally pus formation. A dental abscess causing a swollen painful face is a typical example. These are of short duration and demand immediate treatment. Chronic dental infections are another story altogether. Chronic infections are, in the main, silent or pain free and that’s the rub; often the patient does not know they exist and seldom is an association made between the silent infection and any disease.

Periodontitis, root filled and dead teeth and cavitation infections in the bone, usually from poorly healed extractions, are examples of chronic dental infection. NICO – Neuralgia Inducing Cavitational Osteitis – is a chronic infection in the bone that can cause intense pain but a typical cavitation infection wreaks its havoc on health silently.

The type of health problem caused by chronic dental infections depends on the genetics of the individual, the toxic load that causes heart disease in one person may cause neurological problems in another. This is why it has been so hard for medicine to get to grips with chronic infections. This is basis for our book, Toxic Dentistry Exposed.

The two symptoms most commonly found with chronic dental infections are fatigue and joint pains. Different joints can be affected at different times. Chronic dental infections cause problems due to chronic inflammation markers, the spread of the bacteria, the release of bacterial exotoxins and breakdown products from bacteria cell walls. The offending culprits are in the main anaerobic, they live without oxygen, some are fungal and some are cell wall deficient. The chronic inflammation markers are cytokine messengers such as Rantes or CCL5  and they are associated with cancer and autoimmune conditions (MS) as well as cardiovascular disease, trigeminal neuralgia[1,2,3] and arthritis. Bacterial exotoxins are very potent toxins. Botox is an example of an exotoxin. Very small amounts of exotoxins can cause serious health problems. As Weston Price said, “the amount of toxin is out of all proportion to its effect”. The bacteria or its exotoxin are held in a reservoir in the bone or root filled tooth and released into the body. If they end up in the body in an area of low pH or poor circulation in someone already genetically predisposed to the toxins, then that is the area of the body that the health problem will manifest.

Since nearly all medical doctors have no idea about dental infections the real cause of the presenting symptom goes unnoticed. There can be a time delay or days, weeks, months or even years between the development of the chronic dental infection and any symptoms which makes diagnosis of cause and effect very difficult.

The probability of coronary heart disease is increased by a factor of 3 for someone with a chronic dental infection[4] similarly for stroke[5] and pneumonia.[6] The risk of developing diabetes, obesity and rheumatoid arthritis are increased too.[7]Even the chance of developing cancer increases by 14%[8]  if a chronic dental infection is present.

Periodontitis

This is gum disease and is the most prevalent disease in adults worldwide.  Bacteria collect around the necks of the teeth and emit toxins, the gum tissue, trying to distance itself from the pathogens toxins, dissolves away. Over time, many years, enough bone is destroyed so that the teeth are eventually lost. It is a gradual pain free process, however, the bacteria that cause the problem are anaerobic and constantly release exotoxins and dentistry is slowly waking up to the fact that these toxins cause a multitude of systemic health problems. The good part about this is that periodontitis is treatable if it is not too advanced. In practice we found that the Calcium Therapy Institute protocols were a good starting place to treat periodontitis. In brief the therapy was to remove the bacteria around the teeth, raise the pH of the dental pocket, have a good oral hygiene and a proper nutritional regime. Done correctly, such a therapy can stop the disease and actually lead to reattachment of the membrane that attaches the bone to the tooth. This is the periodontal membrane which is why gum disease is called periodontitis. Reservoirs of infection have to be found and eliminated too otherwise the gum constantly re-infects itself and the periodontitis never fully resolves.

The most common reservoir of infection is root filled teeth.

Typical infected root filled tooth

Typical Infected Root Filled Tooth

Root fillings

When the nerve inside a tooth dies usually due to decay or trauma it can go from an acute pain phase to a chronic silent phase. Dentistry’s answer to this is to remove what remains of the nerve and fill the nerve space with various root filling compounds. This ‘saves’ the tooth but at the expense of the patient’s health. Root filling or endodontics is a specialty within dentistry. The book Root Canal Cover Up by George Meinig, an endodontist himself, is a good resource for information about root fillings..

The three assertions that underpin endodontic treatment are wrong. These assertions are:

1. The root filled tooth is sterile or at least does not have not enough bacteria in it to cause a problem.
2. The insides of the root can be filled completely.
3. Nothing leaks from a root filled tooth.

A “successful” root treatment is, for an endodontist, one that is pain free and where an x-ray shows that the root filling material has reached the tip or apex of the tooth with the presumption that any infection shown on the x-ray will resolve itself.

Firstly the tooth is never sterile after treatment. There are always bacteria present in the root as the tooth root has literally miles of small tubules in it which can never cleaned out. This makes the root filled tooth a reservoir of infection to constantly re-infect the gum and is a frequent reason for unresolved periodontitis.

The second assertion is that the space where the nerve was is filled or obdurated. Again this is not true. The root tip is not a single canal but looks like the root of a tree with side branches going in all directions. It is a physical impossibility to fill these side or lateral canals which always contain bacteria. The third assertion that nothing leaks out of a root filled tooth is just patent nonsense. It is well supported in the literature that para-formaldehyde from some root filling material can leak out into surrounding tissue causing a litany of problems, so much so that the American Association of Endodontists have issued a warning against using such materials.

“Extensive scientific research has proven unequivocally that para-formaldehyde-containing filling materials and sealers can cause irreversible damage to tissues near the root canal system including the following: destruction of connective tissue and bone; intractable pain; paraesthesia and dysthesia of the mandibular and maxillary nerves; and chronic infections of the maxillary sinus. Moreover, scientific evidence has demonstrated that the damage from para-formaldehyde-containing filling materials and sealers is not necessarily confined to tissues near the root canal. The active ingredients of these filling materials and sealers have been found to travel throughout the body and have been shown to infiltrate the blood, lymph nodes, adrenal glands, kidney, spleen, liver and brain”.

The interesting part here is that they admit it is proven that material from root canals can travel far into the body and cause damage. Exotoxins from bacteria lodged in the root, even the bacteria themselves can travel too causing problems where they eventually end up. They can travel along nerve pathways too directly into the brain like mercury can from amalgam fillings. Other root filling materials come with an advisory that care must be taken in disposing of waste as even small amounts can contaminate water supplies.

What other ‘health’ profession advocates keeping necrotic tissue contaminated with toxic chemicals (root filled tooth) a few centimetres from the brain?

To put it in perspective, the bacteria found in root canals are the ones that cause gangrene.

The exotoxins released from the bacteria at the root surface get swept upwards and outward into the mouth by the crevicular fluid. This fluid is produced constantly and is a protective measure employed by the tooth to prevent bacteria from burrowing down into the root. The degree of toxicity of the exotoxins is measurable using the Orotox test developed by Prof. Haley. It is a simple test, a paper point is soaked with the crevicular fluid and stained. The degree of toxicity can be measured. Anything above 0.2 is highly toxic.

Reading from root-filled tooth (Left), X-Ray of the same tooth (Right)

The vast majority of dentists will say that the x-ray is fine with no pathology present. (We would disagree but that’s another matter).

Microbes in #8 Root Canal Tooth

These were the bacteria present in the tooth when tested. Most of the readings indicate a serious risk to health. These results are from a young man who had no specific diagnosis, was functional but who just “never felt 100%”.

NICO - Neuralgia Inducing Cavitational Osteitis / Cavitations

Cavitation infections seldom cause pain. They develop when infective material is not removed after an extraction or when the blood supply to part of the jaw is reduced. They can occur in any bone of the body not just jaw bone. Sometimes named Ratner lesions they are areas of chronic inflammation filled with fatty lumps and clear fluid or occasionally empty with the bacteria collected in a “slime” around the edge. NICO lesions cause facial pain[9]and the pain is often referred to another tooth in the mouth or to Trigeminal Neuralgia. This can make it very difficult for the dentist trying to track down the origin of the severe debilitating pain.

The most frequent place to find cavitation infections are wisdom teeth extraction sites. Cavitations are not found in children; however, in young adults especially in combination with glandular fever or other viral infections, cavitation infections can be completely devastating to health.

If any adult tooth is removed and part of the infection around the tooth remains in the bone usually from the membrane that holds the tooth in place, the bone grows around this infected focus and a space or cavitation occurs in the bone. Cavitations can be seen on x-ray with educated eyes but the vast majority of dentists are untrained to see them. This is because the conventional view is that cavitations do not exist despite being frequently mentioned in the literature from 1917 onwards and even make into the standard American textbook.[10] Most oral surgeons have never seen one because in their eyes cavitations do not exist. In practice we saw them on daily basis. Cavitations produce Rantes or CCL5 from the fatty lumps and research has established an association between elevated Rantes and breast cancer.[11]

Fatty Lump Content (Left) and X-Ray of a Cavitation

The X-Ray is normal to conventional eyes but to us actually shows a large cavitation behind the wisdom tooth. The cavitation was cleaned out and the tooth extracted as the infection had spread to the neighbouring tooth.

Microbes in #1 Root Canal Tooth

Analysis of bacteria found within the cavitation. No surprise that cavitations make people sick!

Accurate diagnosis of cavitations depends on the experience of the dentist and it’s a rare skill. Thermography can assist diagnosis as can certain types of ultrasound. In a lot of cases the connective tissue in the gum grows over the thinnest part of the bone which can be identified. A surgical probe can then be pushed easily through the gum into the bone and an oily fluid exudes out showing the operator where to start cleaning the bone. Usually we did not need to drill the bone at all but just fell into the hole. The largest one we ever did stretched ¾ of the way around a lower jaw. The patient’s chronic iritis (an incurable condition) which has severely affected her eyesight disappeared within 5 days.

Implants

We saw a lot of implants placed into cavitation infections. This serves only to spread the infection further into the bone. Implants by themselves are a risk for chronic dental infection because they have no gingival cuff or crevicular fluid to stop bacteria penetrating the bone. A successful implant is one that has 60% of the surface integrated with the bone. None are fully integrated and in this space between implant and bone, bacteria can grow. Most implants we tested on the Orotox test were highly toxic and when you add problems with the toxicity of the materials used in the implants we think that implants are going to be the next dental amalgam in terms of future health problems from a dental procedure. Immediate placement of implants directly after an extraction can seal infection into the bone and quickly become a chronic dental infection. If an implant is to be considered, at least 12-18 months must pass to properly heal the bone before placement.

The concept of Focal Infection fell out of favour as it did not suit the financial needs of the dentist or the restorative dental paradigms of the times. It led to wholesale tooth removal often without discernible health improvements. This was due in the main, we believe, to incorrect surgical techniques in not removing all the infected bone as well as the fact that a lot of conditions are multi-factorial and while dental infections play an important role in many conditions, they are not the whole story.

We do not advocate removal of teeth or any surgery without good cause and any extraction or surgical intervention will need experienced hands to be successful in not creating further chronic dental infections.

Treating any chronic dental infection cannot be done with antibiotics as there is reduced blood supply to these areas. Even drilling holes in the area to inject ozone only provides a temporary reduction of the bacteria and injecting homeopathic nosodes is completely ineffective. Complete surgical removal and cleaning out infected bone is the only way to treat these infections followed by injecting ozone into the surgical site and rinsing with Dr Pierre Delbet’s magnesium chloride solution. Also crucial are high dose intravenous vitamin c infusions either during the OP or as soon afterwards as possible.

It is difficult to know if a root treated tooth is behind any symptom you may have or if you have a cavitation infection or not. Careful consideration and research are needed before embarking on any surgical procedure including whether to replace any extracted tooth and how that is to be done.

We have retired from active practice and there are very few experienced dentists who can do this work and have the courage to face the wrath of their colleagues. Hopefully as the science becomes slowly accepted, the position will change. Medicine cannot help you, it has not got the skill set, but educated dentists can.

On a personal note, neither of us would have a tooth root filled, keep a dead tooth in the mouth or have an implant. Dr Fischer wrote in his book Death and Dentistry in 1940, “Better to sacrifice the tooth than sacrifice the patient” which is our view too with over 40+ years experience.

References

1. Evidence-Based Complementary and Alternative Medicine Volume 2015 (2015), Article ID 582520, 9 pages. 2015.

2. http://dx.doi.org/10.1155/2015/582520

3. Peripheral Neuropathic Facial/Trigeminal Pain and RANTES/CCL5 in Jawbone Cavitation Johann Lechner and Volker von Baehr

4. Humphrey L, Fu R, Buckley D et al, “Periodontal disease and coronary heart disease incidence: a systemic review and meta-analysis,” Journal of General Internal Medicine, 23:2079-2086. PMID: 18807098. 2008.
Kshirsagar A, Craig R, Moss K et al, “Periodontal disease adversely affects the survival of patients with end-stage renal disease,” Kidney International 75:746-751. PMID: 19165177. 2009.
Dorn J, Genco R, Grossi S et al, “Periodontal disease and recurrent cardiovascular events in survivors of myocardial infarction MI: the Western New York Acute MI Study,” Journal of Periodontology 81:502-511. PMID: 20367093. 2010.
Ameet M, Avneesh H, Babita R, Pramod P, “The relationship between periodontitis and systemic diseases—hype or hope?” Journal of Clinical and Diagnostic Research 7:758-762. PMID: 23730671. 2013.
Hanaoka Y, Soejima H, Yasuda O et al, “Level of serum antibody against a periodontal pathogen is associated with atherosclerosis and hypertension,”Hypertension Research 36:829-833. PMID: 23676848. 2013.
Kodovazenitis G, Pitsavos C, Papadimitriou L et al, “Association between periodontitis and acute myocardial infarction: a case-control study of a nondiabetic population,” Journal of Periodontal Research 49:246-252. PMID: 23713486. 2014.
Barilli AL, Passos AD, Marin-Neto JA, Franco LJ, “Periodontal disease in patients with ischemic coronary atherosclerosis at a University Hospital, Arq Bras Cardiol.;87(6):695-700. PMID: 17262105. Dec 2006.
Tonetti MS, “Periodontitis and risk for atherosclerosis: an update on intervention trials,” J Clin Periodontol, 36 Suppl 10:15-9. PMID: 19432627. Jul 2009.

5. Slowik J, Wnuk M, Grzech K et al, “Periodontitis affects neurological deficit in acute stroke,” Journal of the Neurological Sciences 297:82-84. PMID: 20723913. 2010.

6. Shiota Y, Taniguchi A, Yuzurio S et al, “Septic pulmonary embolism induced by dental infection,” Acta Medica Okayama 67:253-258. PMID: 23970324. 2013.

7.Ogrendik M, “Rheumatoid arthritis is an autoimmune disease caused byperiodontal pathogens,” International Journal of General Medicine 6:383-386. PMID: 23737674. 2013.
Mikuls T, Payne J, Yu F et al, “Periodontitis and Porphyromonas gingivalis inpatients with rheumatoid arthritis,” Arthritis and Rheumatism,. PMID:24403127. 8 Jan 2014.

8. Wen B, Tsai C, Lin C et al, “Cancer risk among gingivitis and periodontitis patients: a nationwide cohort study,” QJM 107:283-290. PMID: 24336850. 2014.

9. Face the Pain by Dr Wes Shankland

10. Oral & Maxillofacial Pathology. Neville/Damm/Allen/Bouquot

11. Breast Cancer: Basicand Clinical Research 2014:8  Hyperactivated Signaling Pathways of Chemokine RANTES/CCL5 in Osteopathies of Jawbone in Breast Cancer Patients—Case Report and Research Johann Lechner and Volker von Baehr