When more supporting bone was lost and the pyorrhea pockets became deeper, the overall conditions and outlook changed remarkably. The surprise was the number of systemic body changes found to take place. Among them were the considerable amount of absorption of bone; the occurrence or non-occurrence of dental caries (cavities); changes in the uric acid level; and, in addition, changes in the blood and saliva of the ionic calcium level, and its urea nitrogen content.
In time it became apparent the presence or absence of of gum infections was directly related to the patient's calcium metabolism. When the ionic level of calcium in the blood was higher than normal, the supporting gum and bone tended to be absorbed away more easily in the presence of irritation.
At the same time, studies of saliva revealed it to be more alkaline than usual when periodontal disease was active. Another big surprise occurred when the contents of the pus pockets were found to be very alkaline, having a pH as high as 7.7, when dentists would assume it be acid. The pH of the blood and saliva when normal is 7.4.
One would think that when teeth affected by periodontal disease are extracted there would be some difficulties with healing. Quite the contrary, sockets developed good blood clots and healed rapidly, without pain or the development of a dry socket.On the other hand, those cases marked by the formation of the dense bone of condensing osteitis below the tooth's root end proved to be painful, healed slowly, they developed blood clots that easily broke down, and many of these cases developed the dreaded dry socket. An analysis of the saliva of such patients showed it to be lower in alkalinity and the blood lower in ionic calcium.
It should be more apparent now that the cases mentioned involve two distinct types of individuals. This was borne out even more dramatically when two different types of extraction sockets were examined under a microscope. Here, too, the disparity proved so definite as to be of diagnostic value.
The Sockets of teeth extracted because of pyorrhea were found to contain primarily polymorphonuclear white blood cells having several lobes. Many granules (granulocytes) were seen under the microscope and these cells showed rapid movements. The white cells were seen to be doing their work of engulfing the bacteria, and only a few of the organisms escaped entrapment.
Sockets of teeth extracted for root end infections when condensing osteitis was present had only a few white blood cells(leucocytes) and granules,but large numbers of organisms outside these cells.
These research efforts demonstrated that as alkalinity went down,ionic calcium level went up. Such cases were accompanied by acute inflammatory reactions to irritation agents with destruction of gum attachments and absorption of alveolar bone.
Dentists looked upon pyorrhea as being primarily an infectious disease at the time of the Price studies, and many still do today. You can see from the data that, although bacteria are present, pyorrhea is not due to a specific infection but, rather, involves definite systemic body conditions. The factors were found to be related to a person's specific susceptibility and biological inheritance; that is, they are connected in a very difinite way to one's own biological defense and ability of the immune system.
