Functional Periodontics

What is Functional Periodontics? It is a term coined by my colleague Dr. Thomas Lewis when I became his Oral Health Consultant. It began as Periodontal Biologics, which also has a nice ring to it. But with either name, the definition is the same.

I believe in both Western and Eastern modalities since they both have valid approaches to treatment. I think that when we talk about health, one shouldn’t exist without the other and if used properly, they will compliment each other. Health has many categories, including trauma, infections, and acute and chronic diseases. While many believe that health is determined solely by genetics, we are seeing that this just is not the case.

I believe in evidence-based principles. I want to stay as open-minded as possible and learn as much as I can about integrative therapies. I want to be able to provide different modalities for healing. Healing from surgical therapy in the oral cavity is surprisingly predictable in most situations. There are techniques that are more atraumatic than others, but in most people (barring pharmaceutical therapy, systemic disease, non-compliance, etc), they will heal well after extractions and periodontal surgery. But what about those people that have deficiencies that can affect healing? Are there methods that will improve healing? Are there nutrients that can be taken pre and postop to improve the outcome? What about those patients that are allergic or can’t tolerate most antibiotics or conventional pain medications? What about systemic conditions that manifest in the mouth and contribute to a poor quality of life due to pain (where pharmaceuticals aren’t helpful). What about those patients that are treated conventionally for periodontal disease and aren’t stabilizing? Are there other tools in the toolbelt that can help heal these patients? This is where learning about and recommending integrative therapies shines.

While continuing to improve on surgical techniques and skills, another aspect is to choose materials that may not be as toxic to the patient. Or to use materials that are treated in less toxic media. Everyone reacts differently to materials and medications, but choosing a local anesthetic that has less carcinogenic activity is an example of a material substitution that is advantageous to every patient.

Functional Periodontics is also knowing more about people’s medications (and their side effects), their role in oral disease, and being able to confidently discuss topics that many patients now are experts on such as supplementation, epigenetics, nutrition, and lifestyle medicine.

My traditional surgical training has been second to none, along with continued education and 20 years of experience. With time, what is logistically possible continues to flourish. A steady hand and patient technique allows for optimal healing. Adding new techniques, materials and protocols is the goal at all times, as well as, working with the patient to respect their personal choices. We have patients that prefer not to use pharmaceuticals, and while I may recommend one, I will help them find other ways. We have patients that want to learn more and want to try out new things. This pushes me to learn and adapt as well.

While sometimes we can’t save an ailing tooth (conventionally or with another modality), we still have wonderful options for reconstruction. I hope to impart the importance of having an open mind and not being afraid to learn something new. The world is constantly changing and we have to, as a profession and as human beings, learn to grow together. I look forward to this journey with you.