Dentists and Lyme Disease: Ushering in a New Era of Treatment

Biological dentistry or natural dentistry highlights dental health and treatment from a holistic perspective. As part of our work, we are trained to help identify patients who might have Lyme disease (LD). This experience is critical because it impacts the patient’s oral health and how we treat you should the Lyme bacteria be present.

In the rest of this article, we discuss what Lyme disease is, symptoms of infection, and its link to dentistry. We also address our management approach to patients with this infection and offer the best solutions available to maintain your dental health when faced with this disease.

What Is Lyme Disease?

Reported in many countries worldwide, Lyme disease often has dire health effects on its victims, with symptoms appearing in three to 30 days after being bitten. As such, Lyme borreliosis or Lyme disease is the body’s response to being bitten by infected ticks that carry the spirochete bacterium (Borrelia burgdorferi).

Although the spirochete itself does not cause direct harm, the host often has an aggressive response to its presence or experiences few to no symptoms. But an aggressive response comes with widespread inflammation.

The results can affect the body’s outer layer (exocrine), joints, muscular, cardiovascular and neurological systems, and/or the mouth and teeth. This impact may be particularly severe when the immune system is compromised by stress, poor nutrition, and other elements.

General Clinical Manifestation Phases

The development of Lyme disease typically takes place in three phases:

• Early localized phase
• Early disseminated phase
• Late persistent phase

If diagnosed early, the patient can receive successful treatment to resolve the symptoms. However, symptoms may persist or be stubborn to treat no matter what the stage of the disease. Many patients experience re-occurring symptoms or are subject to new infections following recovery and some never recover. Still, early diagnosis and treatment frequently leads to full recovery.

Early Localized Phase

Most but not all people will have the well-known bull’s eye rash (erythema migrant) after being bitten by a tick infected with Lyme disease. This typical bulls-eye rash is due to a target lesion with a central papule (small, raised area of about 3/8 inch) at the center of a growing circle of inflammation.

However, victims may notice a papule with little or no surrounding inflammation or a macule (flat) bite mark that is warm around the edges. Other evidence of bites include a vesicle (a fluid filled sac) or a bite area with a necrotic center because the surface tissue in the area is dying.

Without treatment, localized inflammation can spread up to 12 inches and remain for days or weeks.

Early symptoms during this stage include:

• High temperature
• Stiff neck
• Swollen glands
• Conjunctivitis
• Joint pain
• Fatigue
• Problems focusing
• Light sensitivity

Early Disseminated Phase

The burgdorferi spirochete can spread into the bloodstream and settle in various areas of the body within weeks or months after the initial infection. When this happens, the victim may notice several small rashes in circular formations on the body.  These lesions are generally smaller in diameter than the first bulls’ eye rash if this was present at all.

Symptoms in this stage are more severe and can include:

• Lyme carditis (light-headed arduous breathing chest pains palpitations fainting)
• Facial nerve palsy
• Acute lymphocytic meningitis
• Neck stiffness
• Myalgia
• Radiating, burning, and shooting pain on the skin
• Moving pain in the bone, joint, and muscle
• Fatigue
• Iris and optic nerve inflammation or damage

Late Persistent Phase

Post Treatment Lyme Disease Syndrome (PTLDS) is the third phase, which occurs within months or years after the initial infection. This phase can include the following symptoms:

• Nerve damage
• Muscle weakness
• Arthritis and similar joint and bone problems
• Inflammation of the tendons
• TMJ pain
• Widespread nervous system damage
• Brain inflammation

An overlap of physical symptoms occurs across the last two phases, often leading to mistaken diagnoses. Because LD mimics other physical diseases, it is essential to find a dentist who is knowledgeable about Lyme disease and its presence in the mouth and facial area.

Orofacial Symptoms

Orofacial symptoms occur in the face, mouth and general head area and are of specific concern to dentists. Some of these symptoms involve temporomandibular disorders (TMDs). These disorders frequently involve pain in jaw bones and problems with the muscles that affect opening and closing the mouth.

People can experience pain in the face and teeth and even facial nerve palsy. Unexplained burning or tingling sensations, and an altered sense of taste or dry mouth (xerostomia) are other common issues that patients exhibit.

Further orofacial symptoms include headaches, peripheral neuropathy involving tingling or pain in the lips, tongue, and face, and acute parotitis. Inflammation, obstructions in ducts, and infectious organisms are often behind the development of acute parotitis. Additionally, patients report having headaches, elevated temperatures, and facial swelling with acute parotitis.

Patients may present with halitosis (bad breath), despite excellent oral hygiene. Sensitive teeth, pulpitis (dental pulp inflammation) and acidic oral pH are further typical dental symptoms linked with Lyme disease.

Dental Link to Lyme Disease

Lyme disease is exacerbated by root canals and dental extractions, often living in the teeth rather than the enamel. Similarly, this disease appears to flourish in the dentin and tiny tubules of the teeth which can extend to three miles, giving these organisms plenty of space to multiply and spread. As such, the Borrelia burgdorferi bacteria and related organisms pose a unique threat to dentistry patients before and after root canals or tooth extractions.

Because of this threat, it is vital that anyone with Lyme disease or who suspects they have contracted this disease consult an experienced dentist. Likewise, it is important that they consult with dentists who are familiar with non-traditional or green dentistry methods. These methods are often preferred over mainstream medical or dental treatments as they place less stress on patients’ immune systems.

How Green Dentistry Approaches Possible LD Patients

If you or we suspect that you have Lyme disease, we may recommend a serological test. The first test seeks to identify B. burgdorferi antibodies with a sensitive enzyme immunoassay (EIA) or an immunofluorescent assay (IFA). If these results are negative, no further tests are required.

If the test is positive, a western immunoblot essay test follows. This test is administered to determine the presence of Immunoglobulin G (IgG) and Immunoglobin M (IgM) antibodies indicating the presence of B. burgdorferi.

Alternatively, a second EIA can be done. It is often necessary to do a second test as these organisms can go undetected for two to six weeks after exposure and stay in the bloodstream after treatment, producing false-positive test results, which affects diagnosis and treatment.

The GREEN DENTISTRY Solution

If our patients or we suspect the presence of LD based on medical history and symptoms, we might suggest a serological test. Beyond this, we offer biological dentistry solutions that consider your systemic health within the parameters of holistic health and the treatment disease.

If this sounds like the medical care that you’ve been searching for, book a consultation with us today. After meeting you, we will recommend the optimum course of natural treatment that works for you.

BOOK YOUR APPOINTMENT ONLINE TODAY or CALL US at (415) 918-6783.

References

1. Gwenn L. Skar; Kari A. Simonsen. Lyme Disease. National Library of Medicine. 2024, September 1.
2. G M Heir, L A Fein. Lyme Disease: Considerations for Dentistry. National Library of Medicine. 1996 Winter;10(1):74-86.
3. Isabel Mello, DDS, MSc, PhD, FRCD(C). Dentistry and Lyme Disease: What We Currently Know Based on the Available Evidence. European Society of Medicine. 2024, May 21.
4. Sharmila Baliga, Sangeeta Muglia, and Rahul Kale. Salivary pH: A Diagnostic Biomarker. National Library of Medicine. 2013 Jul-Aug; 17(4): 461–465.
5. Saudi J Anapest. Exacerbation of Chronic Pain After Dental Extractions in a Patient With Post-Treatment Lyme Disease Syndrome. National Library of Medicine. 2018 Jan-Mar; 12(1): 112–114.
6. Paul Mead, MD1; Jeannine Petersen, PhD1; Alison Hinckley, PhD. Updated CDC Recommendation for Serologic Diagnosis of Lyme Disease. CDC. 2019, August 16, / 68(32);703.