Antioxidants and Periodontal Disease2.2.ppt

Powerful New Weapons in the Fight Against

Periodontal Disease

What the latest research tells us.

What it means for your patients.

What it means for you.

Did you know…?

Periodontal disease is now known to be primarily a systemic disease that simply manifests in the oral cavity.

Up to 80% of Americans over the age of 45 have some form of periodontal disease.

Periodontal disease has been linked to many other chronic health conditions such as oral cancer, heart disease, stroke, osteoporosis, pre-term births, diabetes, and respiratory infections.

People with gum disease are twice as likely to have precancerous oral lesions, and have a more than four-fold risk of oral cancer.

Current Clinical Protocols: Up until now, our primary clinical weapons against

periodontal disease have been SRP, antibiotics, and surgery.

Yet we know from clinical research that SRP is ineffective up to 40% of the time.

And when it does work, SRP reduces pocket depths by a little over 1mm on average.

SRP is topical. It does nothing to address the systemic nature of periodontitis.

Surgery may be effective as a last resort, but it is painful and expensive.

Antibiotics help, but they are temporary and ineffective in dealing with long term recurrences.

This new treatment protocol is supported by some of the latest scientific literature; so recent, in fact, that you may not have heard about it.

New Adjunctive Therapy:

Results in about 30 days

Up to 3 times the PD reduction of SRP alone

Dramatic reduction in Bleeding On Probing

Substantial Gingival Index improvement

Works systemically to support the body’s natural immune system. Additional health benefits.

New Clinical Protocols:

The systemic effectiveness of this protocol can be validated simply and effectively in less than 5 minutes right there in your office.

This new protocol is all natural, uses no synthetic chemicals, and is much more cost effective than other adjunctive therapies such as locally applied antibiotics (e.g. Arestin).

Doctors who have used this protocol for years report that their patient referrals to the periodontist have decreased by 90%!

Some things you should know…

Supplementation with high grade antioxidants has been shown to improve periodontal pocket depths by up to 3 times vs. SRP alone.

Much of the damage done to periodontal tissues and supporting bone structure is due to the emission of reactive oxygen species (ROS), or free radicals.

The body’s antioxidant defense system plays a crucial role in fighting inflammatory chronic diseases such as periodontal disease.

Antioxidant deficiencies (both local and systemic) have recently been directly linked to periodontal disease.

Let’s look at the research…

786,916 published studies on the effects of a wide range of vitamins, minerals, herbs, and other ingredients found in high-quality supplements (1966-2003 Medline search, 2/4/2003)

201,658 published studies specifically looking at antioxidants, free radicals, and their relationship to human health and disease (1966-2003 Medline search, 2/4/2003)

What research is there that has linked antioxidants, free radicals, and

periodontitis?

Over 200 studies and clinical trials have clearly established the close relationship between antioxidants, free radicals and periodontal disease. No known studies have been found that contradict findings.

Studies conducted around the world over the past 10 years

Renowned institutions, university dental and medical schools, and private industry

The evidence mounts…

“There is an increasing body of evidence now

available to implicate reactive oxygen species

(free radicals) in the development of a variety of

diseases. Periodontal disease is no exception.”

Dr. R. J. WaddingtonDept. of Basic Dental ScienceUniversity of Wales College of Medicine

The largest research effort to date on this subject…

“Using data collected from over 9,862 subjects, Dr. Grossi’s

team examined serum levels of antioxidant nutrients and

their relationship to periodontal disease. Results showed

that selenium has the strongest association with gum

disease, with low levels increasing the risk by 13-fold. Low

levels of vitamins A and C, a-carotene, and b-crytoxanathin

also increased the risk.”

Article published Summer 1999

University of Buffalo

Archived at www.research.buffalo.edu

The link is confirmed for the first time in 1999.

“Oral biologists from the University of Buffalo’s School of

Dental Medicine have shown for the first time that a diet low

in antioxidant vitamins can increase the risk of developing

gum disease. The findings have implications beyond gum

disease, since bacteria from gum infections have been

shown to play a role in heart disease, lung disease, and

diabetes, in addition to destroying gum tissue and bone.”

Article published Summer 1999University of BuffaloArchived at www.research.buffalo.edu

Low antioxidant levels are a risk factor for perio disease

“What is clear is that low levels of most antioxidants are a

risk factor for periodontal disease and infection. Free

radicals are released as a result of bacteria clearance and

killing. Periodontal tissue depends on natural antioxidants

to overcome this oxidative stress and maintain

homeostasis. When antioxidants are depleted, the ability of

gum tissue to overcome oxidative stress, maintain normal

tissue, and control the bacterial damage appears to be

compromised.”

Sara Grossi, DDSSenior Research ScientistUniversity of Buffalo School of Dentistry and Medicine

People with periodontitis have low antioxidant levels

“People with chronic periodontitis

have low levels of the protective

antioxidant glutathione, reported

researchers in the December 2002

issue of Molecular Pathology.”

“Researchers concluded that

glutathione might be beneficial when

used as a supplement to help

prevent chronic periodontitis and

might be able to assist in the healing

process.”

JADA, Vol. 134, January 2003

Free radicals can destroy perio tissues and facilitate

bone resorption

“In aggressive and chronic forms of periodontitis, the

predominant inflammatory cells within the connective

tissues appear to be functionally activated and exhibit

increased production of free radicals. These molecules are

capable of inducing periodontal tissue destruction, and are

associated with osteoclastic bone resorption.”

Professor I L C ChappleUnit of PeriodontologySchool of Dentistry University of Birmingham

Low antioxidant levels are both local and systemic

“This is the first reported investigation of possible

differences in GCF antioxidant capacity between

periodontal health and disease. The results from this

cross sectional study show that local, GCF total

antioxidant capacity is significantly decreased in patients

with periodontal disease. Furthermore, this local decrease

was reflected systemically by lower mean antioxidant

capacity in plasma from patients with periodontitis.”

Professor I L C ChappleUnit of PeriodontologySchool of Dentistry University of Birmingham

Antioxidant vitamins can counteract free radicals

“Fusobacterium nucleatum (FN) is associated with

periodontal disease. FN strains stimulated neutrophils to

produce a large amount of reactive oxygen species (ROS) or

free radicals. ROS production and lipid peroxidation could

be counteracted by Vitamin E.”

Dr. Maryam Sheikhi, et alDivision of Clinical & Oral Bacteriology

Karolinska Institute Sweden

Catechin compounds from green tea kill P. gingivalis

“Green tea catechin showed a bactericidal effect against P.

gingivalis. In the in vivo experiment, the pocket depth (PD)

and proportion of BPR were markedly decreased. BPR

produce tissue destructive enzymes such as collegenase

and peptidase. These enzymes play a role in destroying the

gingival tissues, in osteoclast breakdown, and in the

progress and development of periodontitis.”

Dr. Masatomo Hirasawa, et alDept. of MicrobiologyNihon University School of Dentistry Japan

Antioxidants Supplements Produce Dramatic Results

A 60-day, double-blind clinical study conducted at Loma Linda University in 2000 gave antioxidant vitamin supplements to subjects with various levels of periodontitis.

After just 30 days, the actual pocket depth (PD) reduction was:

Baseline PD PD Reduction Percentage4mm .934 23.3%5mm 1.705 34.1%6mm 2.807 46.8%7mm 3.125 44.6%

Bleeding virtually stopped.

Gingival Index improved markedly.

Let’s Review the Science:

Periodontal disease is a systemic disease that manifests in the oral cavity.

Periodontal disease has now been linked to oral cancer, heart disease, stroke, lung infections, pre-term and low birth weight babies, osteoporosis, and other chronic diseases.

Free radicals play an important destructive role in the development and progress of periodontitis

Antioxidants neutralize free radicals in body tissues

Patients with periodontitis tend to have lower antioxidant capacity – both locally and systemically

Patients with low levels of certain vitamins and minerals have up to a 13-fold greater risk of periodontitis

Let’s Review the Science:

Antioxidant vitamin supplements that work systemically to support the immune system may help fight the disease and aid in the healing process

Certain natural antioxidant compounds actually kill the bacteria that play an important role in chronic periodontitis

Rapid and dramatic improvements in periodontal tissues is possible through antioxidant vitamin supplementation

How does antioxidant supplementation

compare with antibiotic therapy?

Locally Applied Antibiotics

Arestin is a tetracycline derivative antibiotic product with a 90% market share for locally applied antibiotic (LAA) treatment of periodontal disease.

It does not work systemically.

Temporary effect (14-28 days)

Typical patient cost is $25 to $30 per pocket.

Multiple treatments per site may be necessary.

Antioxidants or Antibiotics?

Mean Pocket Reduction (mm) over 9-month clinical trial

Baseline PD >5mm >6mm >7mm

SRP alone 1.08 1.05 0.98

SRP + Arestin 1.32 1.46 1.99

Antibiotic Impact 0.24mm 0.41mm 1.01mm

Actual Pocket Reduction (mm) in first 30 days of clinical trial

Antioxidantsw/out SRP 1.71mm 2.81mm 3.1mm

% Increase vs.SRP alone 58.3% 167.6% 216.3%

Data compiled from February 2003 issue of Compendium, a peer-reviewed dental industry journal, and Loma Linda University clinical trial press release dated April 2001.

Antioxidants or Antibiotics?

Side-by-side Comparison

Antibiotics Antioxidants

Reported Time Period 9 months 30 days

SRP 1 time None

PD reduction (>5mm) 1.32mm 1.71mm

Percentage over SRP alone 22.2% 58.3%

PD reduction (>6mm) 1.46mm 2.81mm

Percentage over SRP alone 35.2% 167.6%

Mean no. of sites treated / pat. 30.7 (3x) ALL

Total cost of treatment $2,303 + SRP $50-75

Data compiled from February 2003 issue of Compendium, a peer-reviewed dental industry journal, Loma Linda University clinical trial press release dated April 2001, and other sources.

If you were the patient, wouldn’t you want to hear about a lower cost option that could be even more effective and also offer other health benefits?

Listen to what these patients, hygienists and doctors have to say after using natural antioxidant

therapy.

Patient Testimonials“My gums are healthier, and will remain healthier, and I intend to continue with the program indefinitely…. Seeing and feeling such dramatic results in such a short time is a real motivator to wanting to stick with the program. Never have I seen such dramatic results with previous programs…. I have been to many other dentists over the years…and the other doctors’ programs never eliminated my bleeding, receding gums.”

“I am very grateful that someone has discovered a way to eliminate the cause of gum disease, rather than simply waiting for the inevitable to occur and then treating it later.”

--Ms. M. D Pelichy

“Thank you for correcting my gum disease that every Dentist before you never could accomplish.”

--Mr. J. Demore

Doctor Testimonials

“How would I describe the results we’ve been getting? Phenomenal! When patients actually take their supplements, the program is 100% effective. Every dentist and hygienist needs to know about this.”

--Dr. J. Lowe

“Treating over 500 patients from a bacterial and nutritional viewpoint has achieved better results after scaling / root planing on our periodontal patients. This is a very easy program to incorporate into an office. The patients that we helped control their periodontal disease (with no surgery or antibiotics) are very grateful, and tend to complete the rest of their dental work, including cosmetics. They refer more quality patients to our practice than any other group in our practice, thus keeping our practice very busy without doing much outside advertising.”

--Dr. R. Schefdore

How much evidence is enough?

So what should you do?

“More than 90% of systemic diseases reveal signs and symptoms in the mouth. Most patients see their dentist on a regular basis more frequently than they do their physician. We are in a unique position to help our patients. Our mission as general dentists is no longer merely to wipe out dental decay but to correct diseases in the mouth so that the patient’s overall health also benefits.”

David A. Tecosky, DMD, MAGD

General Dentistry, a peer-reviewed Journal of the AGD, Dec. 2002

Recommended new clinical protocol:

For all patients with gingivitis, bleeding gums, bone loss, and early to advanced

chronic periodontitis:

As an adjunctive therapy to be used with SRP, immediately prescribe a pharmaceutical-grade antioxidant supplement with clinically determined proper ratios of vitamins, minerals, bioflavonoids, and a full complement of antioxidant compounds backed by actual scientific clinical studies.

The clinical studies supporting this product should verify the product’s ability to raise antioxidant capacity levels and to reduce lipid peroxidation.

So what antioxidant supplement

products should you recommend?

The The onlyonly product product

clinically proven to clinically proven to raise antioxidant raise antioxidant

levels:levels:

LifePakLifePakTMTM

Why LifePakLifePakTMTM?

Because there’s more at stake here than just treating periodontal

disease.

Why LifePakLifePakTMTM?

The immune system support provided by LifePakTM may have additional health benefits in the battle against heart disease, lung disease, stroke, osteoporosis, diabetes, the aging process, and other chronic diseases.

The antioxidants, vitamins, minerals, flavonoids,

catechins, and extracts found in LifePakTM are all natural, of the highest quality, and scientifically formulated and balanced to ensure maximum absorption and bioavailability.

Why LifePakLifePakTMTM? LifePakTM is the ONLY multi-vitamin supplement of

it’s kind to have 2 double-blind, placebo controlled, clinical trials that show clinically significant improvements in antioxidant capacity and lipid peroxidation.

LifePakTM is the #1 rated comprehensive antioxidant vitamin supplement by the industry watchdog group, Supplement Watch. (www.supplementwatch.com)

LifePakTM is the #1 selling antioxidant vitamin supplement in the world (outside the U.S.)

The science behind

LifePakLifePakTMTM

The first multi-vitamin mineral supplement to show antioxidant and cardiovascular benefits in double-blind studies

424 scientific studies cited in LifePakTM Scientific Product Review for Healthcare Professionals

LifePakTM contains more than 40 antioxidant vitamins, minerals, flavonoids, carotenoids, and other compounds clinically proven to scavenge free radicals

The science behind LifePakLifePakTMTM

(means +/- SD)

42.1 4243.4

50.9

30

35

40

45

50

55

60

65

Baseline Endpoint

PlaceboLifePak

p < 0.001

LDL Protection

(means +/- SD)

331299

335

716

0

200

400

600

800

1000

1200

Baseline Endpoint

PlaceboLifePak

p < 0.001

-Carotene

(means +/- SD)

3.4773.429

6.248

3.305

0

1

2

3

4

5

6

7

8

Baseline Endpoint

PlaceboLifePak

p < 0.001

Vitamin E

LifePak improved antioxidant status and protection of LDL against free radical damage.Smidt CR, Seidehamel RJ, Devaraj S, Jialal I. The Effects of a Nutritionally Complete Dietary Supplement (LifePak®) on Antioxidant Status and LDL-Oxidation in Healthy Non-Smokers. FASEB Journal Vol.13 No.4, p.A546, March 1999.

NSE Market Research Study

(n=234, Dec.2001)

95%

0% 20% 40% 60% 80% 100%

No

Yes

“Do you believe LifePakLifePakTMTM makes a difference in

the way you feel?”

Top three ways cited for how Top three ways cited for how LifePakLifePakTMTM makes a difference in makes a difference in

the way people feel:the way people feel:

More EnergyMore Energy

Stronger Immune System Stronger Immune System

Better SleepBetter Sleep

Oxygen Radical Absorption Capacity

(ORAC)– Measures total antioxidant ability of natural

products– Normal diets have 3 servings of fruits & vegetables

providing 1200-1600 ORAC units/day– Health authorities recommend 5-10 servings of

fruits & vegetables, providing an extra 1000-2500 units to improve health: The “ANTIOXIDANT GAP”

Ronald L. Prior, Ph.D., USDA

How well does your supplement stack up?

0

500

1000

1500

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3500

LifePak fills the antioxidant gap

Antioxidant Capacity (ORAC) of Multivitamin/Mineral Supplements (daily

dosages)

ORAC units from normal diet

Recommended daily ORAC units for optimal health

Why LifePakLifePakTMTM?

LifePakTM costs about $60 per month when purchased on the company’s automatic delivery program (ADP). Every 12 months the company sends you a 4 month’s supply FREE!

Special formulations of LifePakTM for Women, LifePakTM Prime for adults over 40, and Pre-Natal LifePakTM are also available.

Is there a way to accelerate and sustain

the healing process even further?

Yes.(Believe it or not!)

Green Tea as preventive measure for periodontitis.

“Continuous application of green tea catechin

on a daily basis may be a useful and practical

method for the prevention of periodontal

disease.”

Dr. Masatomo Hirasawa, et

alDept. of MicrobiologyNihon University School of

Dentistry Japan

Pharmanex recently submitted applications for 2 patents relating to green tea as a result of collaboration with Purdue University

Pharmanex holds exclusive rights to fields in the richest tea producing region of China

Green tea harvests are processed at Cinogen, Pharmanex’s manufacturing facility in China.

Tegreen 97

Why take Tegreen 97?

Tegreen 97 has high concentrations (97%) of polyphenols known as catechins.

The catechins as a chemical group have significant free-radical scavenging properties and are potent antioxidants.

Clinical trials have shown that catechin compounds are lethal to the primary bacteria that contribute to periodontal disease.

A recent study published in General Dentistry (a peer-reviewed journal of the AGD) green tea polyphenols have been shown to break down and kill oral cancer cells.

Why take Tegreen 97?

Green tea catechins have also been shown to inhibit growth and induce regression of human prostate and breast cancers in animals.

One 250 mg capsule of Tegreen 97 is equivalent to 7 cups

of brewed green tea.

More Testimonials

“I workout every day and try to take good care of myself. You can imagine how surprised I was to find that I had a pretty serious case of periodontal disease. After just 30 days on LifePak and TeGreen, I was very pleased to hear that my 6mm and 4mm pockets were all down to 3mm or less, and the bleeding had completely stopped. My BDS score on the BioPhotonic Scanner went from 22,000 to over 28,000 during that same time. This is incredible.”

--Mr. K. Miller

“The patient presented with generalized 4mm periodontal pockets on the maxillary and mandibular arch, and 6mm pockets with bleeding upon probing on the mandibular right lingual quadrant. At the patient’s latest recare visit there was an overall decrease in 4mm periodontal pockets to normal health, which is 1mm to 3mm. The 6mm periodontal pockets…were reduced to 3 mm. The overall gingival is firm, pink, stippled and very healthy. I attribute this amazing gingival turnaround to proper oral home care and LifePak vitamin supplements.”

--S. Richard, RDH

LifePak augments the entire antioxidant defense system.

The effect can easily be demonstrated using the BioPhotonic Scanner.

LifePakLifePakTMTM + Tegreen 97 works.

You can prove it yourself.

18828

25991

28924

32175

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35000

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0 4 8 12

Time (Weeks)

p < 0.001 p < 0.01 p = 0.23

Clinical Study ResultsChart shows increase in Body Defense Scores as measured by the BioPhotonic Scanner for people taking LifePak daily.

The BioPhotonic Scanner is a practice builder!

The scanner is high tech. It is unique. Patients will talk about it. It sets you apart from all the rest.

The scanner provides patients with a valuable insight into their personal antioxidant network status.

The desire to measure personal progress keeps patients coming back to your practice.

The ability to monitor antioxidant status keeps them on the product long-term.

Why Pharmanex? ONLY Pharmanex has the BioPhotonic Scanner

that can actually measure the levels of certain antioxidants in human tissue.

By obtaining a Body Defense Score (BDS) using the scanner, a consumer can readily discover whether or not his / her immune system is working optimally, and if their supplements are actually doing anything.

Pharmanex was the only supplement company to qualify as an official sponsor of the US Olympic Team. All Pharmanex products had to pass rigorous tests by an independent lab before acceptance.

Why Pharmanex?

Pharmanex offers a 100% Money Back GUARANTEE that LifePak will increase the antioxidant capacity of every individual who takes the product for at least 60 days.

Pharmanex is part of a publicly traded billion dollar company that is profitable, carries a 5A1 Dunn & Bradstreet rating.

Pharmanex offers many other high quality nutritional supplements in addition to LifePak.

Why Pharmanex?

All Pharmanex formulations are based on solid scientific research and clinical trials.

Pharmanex employs over 75 PhD’s who perform ongoing research and clinical trials.

The Scientific Advisory Board at Pharmanex includes some of the world’s leading experts in the fields of nutrition, biology, medicine, and antioxidants.

Dr. Lester Packer, the world’s foremost antioxidant research scientist, received his Ph.D. in Microbiology and Biochemistry from Yale University and has been a Professor and Senior Researcher at the University of California at Berkeley for the past 40 years. Most recently, Dr. Packer has established an additional research laboratory in the Department of Molecular Pharmacology & Toxicology within the School of Pharmacy at the University of Southern California to pursue studies related to the molecular, cellular, and physiological aspects of free radical and antioxidant metabolisms in biological systems.

Dr. Packer is also the recipient of numerous scientific achievement awards and serves on editorial advisory boards for scientific journals related to biochemistry, antioxidant metabolism and nutrition.

Dr. Packer has published over 700 scientific papers and 70 books on every aspect of antioxidants and health.

Lester Packer, Ph.D.

An award-winning organic chemist trained in both Eastern and Western science, Chi-Huey Wong, Ph.D., is Ernest W. Hahn Professor of Chemistry at the Scripps Research Institute, La Jolla, California. Prof. Wong serves Pharmanex Scientific Advisory Boards, not only in the U.S., but also in Taiwan at the Academia Sinica, where he heads the Bioorganic Chemistry lab and holds the title of Distinguished Chair in Chemistry.A native of Taiwan and a graduate of its National University, Prof. Wong holds a Ph.D. from the Massachusetts Institute of Technology and was a postdoctoral fellow at Harvard. His honors include the American Chemical Society Arthur C. Cope Scholar Award, International Carbohydrate Award, Enzyme Engineering Award and the Presidential Young Investigator Award. He recently presented his work at the Nobel Symposium on catalytic asymmetric synthesis. He is the author of more than 400 peer-reviewed scientific papers and holds 60 patents on his discoveries. Dr. Wong's principal research interests are in carbohydrate chemistry and how chemistry can be used to modify enzymes to increase or decrease enzymatic function and create better biologically active compounds. The work of his research group thus has major implications for improving human health with safer and more effective substances, such as natural products of biomedical importance. Dr. Wong was elected April 30, 2002 to the National Academy of Sciences, membership in which is considered one of the highest honors that can be accorded a U.S. scientist or engineer.

Chi-Huey Wong, Ph.D.

Ernest W. Hahn Professor of Chemistry, The Scripps Research Institute

SRP + Antioxidants fight the disease both locally and systemically

What we know:

Patients may receive other health benefits from taking antioxidant supplements

Antioxidant supplementation is safe, cost effective, and supported by a growing body of research.

Patients in clinical trials with quality antioxidants have demonstrated remarkable, and possibly unprecedented periodontal status improvement.

Why you should prescribe antioxidants…

Because your patients deserve the best treatment options clinically available.

Because the scientific literature supports the efficacy of antioxidant therapy protocols as effective adjunctive treatment modalities.

Because SRP alone is ineffective up to 40% of the time. When it does work, it provides marginal clinical improvement. Topical only.

Because antioxidant supplementation works with SRP to battle periodontitis from within.

Because LAA treatment is expensive, temporary, and marginally effective relative to antioxidants.

Why you should prescribe antioxidants…

Because LAA therapy does not address the systemic nature of periodontal disease.

And, because your practice can make money by doing the right thing for your patients.

A lot of money

How much money can there be in prescribing antioxidants?

Primary Assumptions:

Patient scans / day: 4

Acceptance Rate: 75%

ADP Average Order: $62.70 (LP +Tegreen)

Annual Attrition Rate: 50%

Annualized NET in mo. 12: $111,638$111,638

Staff Bonus @ 20%: $22,328$22,328

Practice NET PROFIT: $89,310$89,310

Additional assumptions available upon request. Each practice results will vary according to individual efforts and promotion abilities.

Wait. It gets better . . .

This income stream can continue to grow each year as more and more new and existing patients get on the LifePak program.

Furthermore . . . MINIMAL Doctor time is required. This program works almost entirely through your hygiene dept.

And best of all . . . That income can continue on into your retirement. Imagine that. Being paid for years into the future because you did the right thing for your patients today.

Each practice results will vary according to individual efforts and promotion abilities.