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on 4/25/06 2:06 PM, Mike Rethman wrote:
Re: polymorphonuclear
leukocytes appear to play a key role in   maintenance of periodontal health as they line the junctional
epithelium and try to wall off the underlying tissues from the destructive pathogens.

Rethman: PMNs play this role (short term wall-off function) everywhere there is a break in the
epithilium,  skin, bowel, nose... anywhere. The periodontal sulcus is no exception. - Mike  Rethman

From Paul Keyes,

  As WBCs migrate through the periodontal tissues they release collagenase which
  breaks down collagen fibers. Over time this loosens teeth and leads to their
  exfoliation. This may be considered a defense mechanism in response to highly
  infected foreign bodies (tooth surfaces). After WBCs migrate into circumradicular
  spaces, they often face a battle they can not win: that produced by millions
  of organized spirochetes rippling together in organized metracronal activity.
  With a phase-contrast microscope it is not unusual to see spirochetes attacking
  WBCs. It is my opinion that WBCs in periodontal pockets are impotent

From: Lynne H. Slim
Sent: Friday, April 28, 2006 10:39 PM
Subject: Re: [periotherapist] Re: Spirochetes

  Dr. Keyes, This information is supported
  by current research, too. I just finished reading a piece on spirochetes by
  Richard Ellen at the U of Toronto. Here's the scoop and what he and his colleagues
  have to say: Treponemes (spirochetes) are at the forefront of established
  periodontal infections. Whether they contribute to the cause of the initial
  injury is a moot point. Once they emerge in the microflora, perhaps due to their
  nutritional requirements, treponemes probably join other omplexes to exacerbate
  and prolong injury to the epithelium. Treponemes have the capacity to induce
  abscesses; to contribute to necrotive ulcerative lesions and to trigger a wide
  range of degrading mechanisms of innate immunity pathways.

  I don't know too much about the immune
  system but I do know that our human bodies keep pathogens at bay by destroying
  them and neutralizing their virulence factors. This defense mechanism is an
  ancient one and is referred to as the innate immune system.

  Richard Ellen, et al advocate suppression of oral spirochetes as one measurable goal
  of therapy and prevention of recurrent episodes of periodontitis.

  I don't know about the rest of you folks, but this information makes perfect sense to
  me and that is why I spend so much   time educating my patients in trying to teach
  my peridontitis patients how to prevent recurrent disease.

Lynne H. Slim RDH, BSDH, MSDH
Sent: Sunday, April 30, 2006 11:17 AM
Subject: Re: [periotherapist] Re: Spirochetes

Dear Sandy, I am sure that you perform an oral examination
before using the microscope so I am wondering, what other clinical signs do
you observe with children that harbor spirochetes?  - Steve Ury

In a message dated 4/30/2006 10:19:25 A.M. Eastern Daylight Time,

  I couldn't agree more. This is why I rely so heavily on the microscope. We are
  seeing spirochetes in children, picked up from their parents. Stopping the infection
  early would save a lot of people a lot of grief. Sandy Sheffler

From Paul Keyes,
Sent: Monday, May 01, 2006 8:44 PM
Subject: Re: [periotherapist] Re: Spirochetes

  I have found spirochetes in a 6 yr old boy whose mother was badly infected.
  He just happened to be with her when she came in for an examination. Can you
  get the teenagers you see to brush carefully with Mentadent and baking soda?
  If so, it should be very beneficial. BTW what do you advise them to do for their

Sandy Sheffler wrote: Usually the children we test have parents   who exhibit high bacterial
counts. I am testing teenagers who have fair or worse   homecare. We're starting younger and
younger because we're finding bacteria -   Sandy

  Hi Dr. Keyes. I irrigate their mouth with   Therasol. Sometimes my dentist prescribes a
  z-pack (with the consent of the   pediatrician) and I try to get them on baking soda in some
  capacity, rubber   tip, toothbrush etc. The Mothers tell me they have never brushed this much
  since   seeing their bacteria. I tell the teenagers, be careful who you kiss. This is
  motivation in the best form. Sandy

Sent: Monday, May 01, 2006 11:05 PM
subject: Re: [periotherapist] Re: Spirochetes
Dear Sandy, Maybe you didn't understand my original question. Let me try a different slant.
You say, Usually the children we test have parents who exhibit high bacterial counts.Is the
'testing' you speak of microscopic examination of sulcular samples? Do you perform a clinical
examination on patients (young or old) before proceeding with a microscopic
evaluation? Also, is the testing of children predicated on the parents bacterial assay?
-  Steve Ury

Usually the children we test have parents who exhibit high bacterial counts. I am testing teenagers
who have fair or worse homecare. We're starting younger and younger because we're finding bacteria.
-  Sandy

  Yes, yes and yes. The practice where I work is mostly an adult practice. If the children are
  already patients, they   are microscopically tested at their recare appt. if their parents are
  already   perio pts or have high bacteria counts. Teenagers today have mouths like sewers!,
  I have found. I test all new pt. adults or children during their appt. Everyone
  has an exam. We are a very thorough office. Periodontal pockets are not the
  criteria I use to test bacteria. By the time there are pocket depths of 5mm
  or more, the disease has been there for a long time. Thanks for asking - SandySheffler RDH

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