Goal 1: Address the bacterial infection. Here’s my daily routine
Step 1: Chlorhexidine irrigation & flossing
Nobody was prescribing this stuff for some reason despite it being repeatedly referred to in the literature as the gold standard for eradicating subgingival bacteria and disrupting biofilms, so I bought this veterinary solution that comes at 4%, and dilute it down to .2%. It doesn’t taste great (and has a bit of detergent in it), so I mix in some therasol to improve the taste.
I loaded that juice into a cordless waterpik with a plaque seeker tip and thoroughly irrigated into the gumline and between teeth every day for the first couple months, then gradually reduced down to a couple times a month.
I find it helps to floss even on days I’m doing the waterpik, and on days I’m not using the waterpik I put a little of the chlorhexidine solution in a small dish and dip extra thick/absorbant floss into the solution between each tooth. That way I’m delivering the solution closest to where I need it while limiting its exposure to the rest of my teeth & mouth
Step 2. Regular brushing
Next I rinse with antimicrobial Therasol mouthwash, and I brush lightly with a soft-bristled sonic toothbrush while holding the solution in my mouth to help get it into any pocket openings that the vibrations might effect.
Step 3: Ultrasound & arginine treatment
Next I do a final round of "brushing" with a genuine ultrasound (not "sonic") toothbrush, to disrupt subgingival biofilms that I may not be able to reach chemically, including any infection that may have moved into the bone, and to help stimulate gum tissue regeneration.
The ultrasound toothbrush I use is the Emmi-Dent from Germany. You don’t really brush with it, just hold it over each area for a few seconds while it does its ultrasound thing. I do it for about 5 minutes total each day, spending extra time on problem areas.
To prepare the ultrasound brush for use, I apply an arginine-containing toothpaste, which helps stimulate regeneration of both gum tissue and tooth surface.
I stumbled onto ultrasound around 2 or 3 months in to my rehab program, and discovered arginine toothpaste around 6 months in, and both of these discoveries mark major turning points in my recovery. I consider these two elements to be critical.
Step 4: Oral probiotics
I like to follow up this daily bacterial assault by re-introducing some beneficial bacteria. Oral probiotics have been shown to discourage colonization by pathogenic bacteria and decrease pocket probe depth (ref). Here’s one that should be pretty good.
Goal 2: Control and regulate inflammation
The literature is clear in depicting periodontitis as a dual problem of bacterial infection and dysregulated inflammatory response.
To this end, I eat an anti-inflammatory paleo / lectin avoidance diet. Details on this can be found in the book The Plant Paradox by Steven Gundry, MD. I also eat as infrequently as possible (currently fasting for 16-20 hours each day (ref), and eat as low carb as possible (ref).
Exercise is also helpful, particularly HIIT (ref).
A number of supplements have been shown effective for improving periodontitis and general oral health: