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    Treating periodontal disease does reduce heart disease. Identifying high-risk periodontal pathogens in high-risk patients does extend life and significantly reduce health care expenditures. Knowing inflammatory and genetic risk factors makes outcomes more predictable. Engaging in an oral systemic dental practice will add value to the practice... and your life. Join the movement, it matters!

Predictable guidelines, standards, and principles to implement a pathogen based oral systemic health
platform is available to dental teams in our '13 Steps to Transform Dental Hygiene' training manual.

Purchase a 12 Step Implementation Manual

  • Manual cover

    Purchase your copy of this complete manual and transform your dental hygiene program to a new standard of care. This manual includes all references needed for background of presented material and methods, sample forms, simple to follow instructions, and sample presentation language.

  • heart logo Most comprehensive pathogen based oral systemic
    implementation guide available to dentistry.

    heart logo The complete guide to oral pathogen initiated systemic
    inflammatory disease and mitigation of the causative
    biome and translocated micro-biomes.

    heart logo A compelling conviction to transform traditional
    dental hygiene delivery based on current science.

    heart logo Easy to follow steps to evaluate, diagnose, and treat
    high-risk pathogens in high-risk patients.

    heart logo Discover the intersection of high-risk periodontal
    pathogens, inflammation, and genetics in a medical history.

    heart logo An antibiotic stewardship guide for treating high-risk
    patients with translocated high-risk bacteria in place the
    moment they enter your practice.

    heart logo A business model for delivering oral systemic health that
    will transform the financial performance of the
    dental practice at every level.

    heart logo Full color graphics and a resource section to connect
    the practice with every product and service required to
    diagnose, treat, and manage high-risk
    periodontal pathogens.

    heart logo Over 100 current evidence based references to support
    diagnostic and treatment recommendations.

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    Resources for dental teams and patients
    Oral systemic health maintenance at home

    Oral hygiene education and instruction, with effective home care products, is important to the success of the therapy completed in the dental office.

    The high-risk pathogens at work initiating gum disease, and systemically promoting heart disease, in high-risk patients, are constantly reproducing in the oral biofilm; it is a colony of ever growing bacteria that restarts the moment it is removed.

    A key to maintain oral systemic health is to keep this biofilm from completely establishing. This is best done by using products that are formulated to do just that.

    To our dental teams- your primary periodontal treatment is complete. A patient has had mechanical debridement with some variation of targeted adjunctive antimicrobial therapy. They need to be instructed on how to mitigate biofilm.

    This resource is a great place to start.

    To patients and consumers looking for solutions- many have not yet found a dental team practicing oral systemic health principles and seek products that can effectively reduce the risk or high-risk oral pathogens. This resource will give you the confidence that daily use of one of these products is significantly reducing oral bacteria populations. We advise you to find a doctor who embraces these ideals to support your oral health.

    There is no real evidence that ranks the antimicrobial products against each other as most effective. There is a lot of research showing that each of the products listed is effective or very effective at mitigating high-risk pathogens and/or disrupting an oral biofilm. All of the products listed are used by dentists and hygienists engaged in oral systemic health care delivery.

    Hygiene team

    gums image
    Brushing, flossing, and traditional dental cleaning
    do NOT kill high-risk oral bacteria
    These do!

    Professionally formulated antibacterial rinses for daily use-

    CTx4 by CariFree- A dilute flavored solution of sodium hypochlorite, xylitol, and fluoride, at an alkaline pH. Very effective and not acidic. May be the most effective and preferred product that is ideal for resistant periodontal cases, smokers, and diabetics. For routine periodontal maintenance; use two months after primary care, then switch to Profresh, Therasol, Trilogy, Listerine, or Crest Pro-health. Dentists and patients can order direct from or

    Therasol by OraTec- Product is composed of 2 compounds; alkyl dimethyl amine oxide and alkyl dimethyl glycine. These synergistic compounds are classified as amphoteric, quaternary surfactants. Tests have shown Therasol's antimicrobial activity to be close to equivalent to a 0.5% chlorohexidine solution and capable of maintaining its activity for up to six hours. Dentists can order online at, patients go through dental offices.

    ProFresh- A rinse formulation with chlorine dioxide. Effective for daily maintenance for patients with non-aggressive periodontal disease, patients completing two months of CTx4 therapy, or simply any non-periodontal patient. Order online at or

    Triology- A proprietary blend of biologic ingredients and carbamide peroxide. Order or contact at

    OraVital rinses- A number of proprietary rinses are available for certain aspects and timing of periodontal therapy. They are formulated with antibiotics relative to a patient's specific pathogen screening. Not available to patients directly, and dentists are encouraged to take OraVital's proprietary training. Refer to their web-site at .

    Hydrogen peroxide gel, 1.7% -PerioGel- Is being used in the oral systemic delivery of biofilm control both as primary biofilm removal protocol and/or as a daily biofilm disruptor and pathogen mitigation after primary periodontal therapy is complete. Hydrogen peroxide is an effective antimicrobial agent when held in contact with the pathogens or biofilm with a professionally fabricated tray. Patients can acquire them from dental offices only. Dentists can acquire PerioGel at, and get tray information at

    Over the counter effective antimicrobial rinses for daily use

    Listerine is an effective over-the-counter product to reduce oral high-risk pathogens. Its antimicrobial formulation is based on four essential oils. It is available with and without alcohol.

    Crest Pro-Health with CSP, a chlorine molecule formulation, is effective, similar to Listerine as a daily antimicrobial.

    Home-made effective antimicrobial rinse

    The following recipe is public knowledge and is based on the Slots' research several years ago on the use of sodium hypochlorite [ NaClO- bleach] for biofilm mitigation at a low cost. Note that the CTx4 product above is based on a sodium hypochlorite formulation. Should any patient elect to use a formulation like this, it must be done while periodontal disease and/or bleeding gums are being supervised, and managed by a trained dental team. Patients would take care to avoid children access to this... or any oral rinse dedicated to reduce high-risk oral pathogens.

    First read the label on the sodium hypochlorite in hand, or that will be purchased for this purpose. Patient must know if they have a solution that is 5.25% NaClO or 8.5% NaClO.

    For 5.25% NaClO- mix 20 parts water with 1 part bleach. You can add 1 teaspon of Xylitol and a drop of peppermint or orange oil for flavor. Rinse for 1 minute and spit, 2x weekly, do not brush for an hour, or rinse after you brush.

    For the 8.5% NaClO- mix 32 parts water with one part bleach. Same additional instructions as noted above for the 5.25% solution. Rinse for 1 minute and spit, 2x weekly, do not brush for an hour, or rinse after you brush.

    Dentist photo

    All periodontal therapy must be evaluated,

    diagnosed, treated, and supervised

    by trained dental teams.

    Oral systemic training matters!

    Effective methods to deliver daily antimicrobials

    Waterpik- Waterpik Aquarius Professional Water Flosser or the Cordless Water Flossers by Waterpik. The delivery of any antimicrobial agent is most effective when the product can get under the gum margin and into 'pocket' areas. All the above rinse products work well with a waterpik except Listerine. Other companies make similar products for antimicrobial delivery. Waterpiks can be ordered direct at or

    Philips Sonicare- a popular power tooth brush that uses ultrasonic wave technology to clean under gum margins and to some degree, into pockets. A power tooth brush is not as effective as a waterpik, but is better than nothing for a non-compliant patient. The patient simply fills mouth with the rinse product and uses the sonic brush to potentially 'drive' the product under gum margins and into pockets. Can be ordered at, or

    Oral-B power brush- same appropriate discussion as noted for sonicare power brushes. Oral-B power brushes are based on a different technology than the above, but are very effective in reaching below the gum line to certain depths. Can be ordered direct at, or