Biological Screening: Evaluating immunity and inflammation for predictable outcomes

Dentistry in general has evolved and continues to evolve. No matter what you call it:

Biological, Functional, Integrative, Holistic, or “crunchy granola”. Increasingly, evidence

reveals that immunological readiness and subclinical inflammation are key predictors of

successful osteo-regeneration (bone healing and repair), osteo-integration and long-

term stability and predictability.

Despite impeccable surgical techniques or prosthetic planning, systemic imbalances

(low grade inflammation or metabolic dysfunction), can compromise healing, easy

failures, and lead to long-term complications.

For these reasons, those of us who chose the “why” instead of the “what”- keep

researching and studying the emerging science and intricacies of each individual’s

systemic needs/deficiencies, and aim to support these with the help of other like-

minded specialists.

There is a biological orchestration that is what will determine success in any treatment

plan; because even seemingly “healthy patients”, a hidden systemic inflammation will

affect and/or delay: soft tissue and bone healing, marginal bone loss, impair

regeneration and osteo-integration, and heighten susceptibility to infections and

failures.

Therefore being proactive will minimize complications and negative outcomes. This is

true for not only dentistry, but most anything in life.

We at Pure Dental Naples have been blessed to be a part of the latest research and

protocols, and continue to share outcomes with other practitioners in the US and

Europe, because science changes! Leaders like Dr. S. Ghanaati, Dr. Joseph

Choukroun, who emphasize the importance of preparing the host rather than focusing

solely on the materials or surgical precision, not only makes sense- but in our opinion,

is the only reasonable and pro-individual way to practice for the benefit and best

interest of the patient.

Optimizing a patient’s biological terrain will always enhance outcomes

At Pure Dental Naples Salivary testing is a starting point. Not all salivary testing is the same- trust me- we have experimented with many! We start by seeing what is present: everyone has “ good” and “bad” bacteria- we want to know the amount of cultures; because the good bacteria will take care of or, maintain the bad. For example: just because you have Treponema denticola doesn’t necessarily mean you will “get Alzheimer’s”as I have recently noticed on social media “influencers”. Correlation does NOT imply causation. Once we control and address certain issues, generally speaking, the amount of cultures of Td will go down. So understanding microbiology and the interaction of microbes with each other as well as the whole picture, is what determines the final analysis.

Bloodwork is Important!

Although I repeatedly inform patients that I am NOT a PCP, a baseline is always advisable. A basic blood panel can offer a wealth of information about a patient’s systemic status. We recommend a few core biological markers, and if patient’s are interested, advanced immune and inflammatory testing that look at Immunoglobulin levels, pro-inflammatory cytokines in addition to the microbiome testing we do on a regular basis. All our patients are encouraged to consult with their PCP! We can only suggest and recommend options to consider. Following are a few we like to see in our patients:

• hs-CRP detects chronic low grade inflammation

• Vit D (25-OH) modulates immune and bone response

• HbA1C reflects glycemic control, critical for wound healing

• Ferretin elevated in inflammation; low may reflect poor immunity

• Homocysteine indicator of vascular and methylation status

As always- we highly recommend and encourage our patients to be followed by a PCP, Functional MD/Integrative MD , DO, or other medical specialist of choice since these are only options and recommendations. Collaboration with medical professionals is what should be standard of care.