Evidence & Limitations
What we know. What we don't. Where our scope ends.
We publish this page because most "oral-systemic" and "longevity dentistry" marketing conflates three very different categories of evidence. We do not.
Established
High-confidence findings.
- — Periodontitis is a chronic inflammatory disease driven by a dysbiotic subgingival microbiome. Treatment reduces local inflammation and improves clinical periodontal outcomes.
- — Periodontal treatment improves surrogate markers of systemic inflammation in multiple randomized trials.
- — Specific pathogens (P. gingivalis, T. denticola, T. forsythia, A. actinomycetemcomitans, among others) are causally involved in periodontal tissue destruction.
- — Untreated periodontitis is a risk factor for tooth loss, implant failure, and worsened glycemic control in diabetes.
Associational
Real, but not proven causal.
We treat these findings as strong reasons to take periodontal disease seriously in a longevity context. We do not claim treating your gums will prevent a heart attack or Alzheimer's.
- — Periodontitis is associated with roughly 3.5× higher risk of atherosclerotic cardiovascular disease and 1.7× higher risk of Alzheimer's disease in epidemiologic data.
- — Oral pathogens, including P. gingivalis, have been identified in atherosclerotic plaques and in postmortem Alzheimer's brain tissue.
- — Periodontal treatment has not been shown in randomized trials to reduce hard cardiovascular endpoints (myocardial infarction, stroke, cardiovascular death). The PAVE trial, for example, was negative on that endpoint.
Outside our scope
Where our lane ends.
- — Systemic cardiovascular, cognitive, and metabolic risk management belongs to your physician.
- — ApoE genotyping, systemic genetic testing, and pharmacogenomics belong to your physician.
- — Supplement, peptide, hormone, and IV therapy belong to your physician.
- — We interpret your systemic labs only in the context of your oral findings. We do not duplicate, replace, or override your physician's interpretation.
How we handle uncertainty
If we can't cite it, we don't claim it.
If a claim is associational, we say so. If a test has Breakthrough Device designation but is not FDA-cleared, we say so. If a treatment has not been shown to change hard endpoints, we say so. This is what a specialist partner looks like.