By: Dr. Amy Doneen

Medicine and dentistry have historically been placed in healthcare silos. This segmented approach continues to allow cardiovascular disease to remain the top cause of death in the United States. The BaleDoneen Method™ is a collaborative, science-based approach to preventing, detecting, and treating cardiovascular disease (CVD) by targeting the underlying causes of arterial plaque formation. It goes beyond traditional risk factor management (high blood pressure or high cholesterol) by identifying and mitigating the root causes of arterial disease. The BaleDoneen Method™ advocates that arterial disease and inflammation be meticulously monitored in each patient at regular intervals. The method aims to achieve “arterial wellness,” meaning patients have healthy, plaque-free and stable arteries less likely to cause heart attacks, strokes, or other chronic disease of aging such as vascular dementia, chronic kidney disease, macular degeneration, erectile dysfunction and peripheral arterial disease.

A key aspect of the method is its emphasis on a personalized approach to evaluation and treatment. Each patient’s unique genetic, lifestyle, and health profile are assessed to determine root causes of arterial inflammation and the best interventions for that individual. The method utilizes advanced diagnostic tools, such as carotid intima-media thickness (CIMT) ultrasound imaging, coronary artery calcium scoring (CACS), and genetic testing, to assess the health of the arteries and detect hidden risks. These tools help identify both the presence of arterial disease and the level of inflammation in the body, which can be a major driver of plaque formation. Inflammatory markers include high-sensitivity C-reactive protein (hs-CRP), Lp-PLA2 (lipoprotein-associated phospholipase A2), and myeloperoxidase (MPO), to better gauge the inflammation in a patient’s arteries. By targeting inflammation, which is now understood to be a core factor in plaque rupture and clot formation, the method aims to minimize the likelihood of plaque-related cardiovascular events.

Management of arterial disease also involves lifestyle modifications with personalized recommendations in diet, exercise, sleep, and stress management to lower inflammation and improve vascular health. Medications and supplements are used when necessary to mitigate the root causes of arterial disease and arterial inflammation. Additionally, the recognition of periodontal health is a key factor to the success of the BaleDoneen Method™.

Atherosclerosis is primarily driven by oxidative stress, which ultimately causes the trapping of cholesterol in the arterial wall.² It’s important to recognize risk factors for atherosclerosis such as age, high cholesterol, hypertension, smoking and diabetes. It is also extremely important to recognize and treat high-risk periodontal pathogens, as this infection is a significant contributor as well. Approximately 65 million adults in the United States (US) have periodontitis, and 6 million have severe periodontal disease.³ Chronic periodontitis occurs in 68% of US adults ≥ 65 years of age.⁴

The pathogens associated with periodontal disease include Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia, which are often referred to as the “red complex” bacteria due to their high pathogenic potential. These pathogens are linked to severe forms of periodontal disease, which is an inflammatory condition affecting the supporting structures of the teeth. Inflammation from periodontal disease can release bacteria and inflammatory mediators into the bloodstream, allowing these pathogens to spread beyond the oral cavity. The inflammatory response triggered by periodontal pathogens is a significant contributor to the progression of atherosclerosis. The inflammatory mediators produced as part of the body’s immune response to these pathogens include cytokines, C-reactive protein (CRP), and other pro-inflammatory molecules, all of which are implicated in atherogenesis. Treating periodontal disease can reduce systemic inflammation and thereby lower cardiovascular risk.

It is critical medical providers, particularly those involved in cardiovascular prevention, recognize the necessary partnership between medicine and dentistry. This integrative approach provides the healthcare consumer with the opportunity to achieve optimal health. We need to advocate all patients, particularly those with cardiovascular disease, are evaluated for high-risk periodontal pathogens and periodontal disease. Managing periodontal disease is an essential component of cardiovascular disease prevention strategies. The BaleDoneen Method™ has been proven to stabilize and regress atherosclerosis.5 This success is possible because of the respect for and partnership with our dental colleagues.

Dr. Amy Doneen, DNP, is co-founder of the BaleDoneen Method, Owner and Medical Director of The Prevention Center for Heart & Brain Health, and co-author of two best-selling books – ‘Beat the Heart Attack Gene’ (2017) and ‘Healthy Heart, Healthy Brain’ (2021).

REFERENCES

1. Bale BF, Doneen AL, Vigerust DJ. High-risk periodontal pathogens contribute to the pathogenesis of atherosclerosis. Postgrad Med J. 2017 Apr;93(1098):215-220.
2. Bale BF, Doneen AL, Leimgruber PP, Vigerust DJ. The critical issue linking lipids and inflammation: Clinical utility of stopping oxidative stress. Front Cardiovasc Med. 2022 Nov 9;9:1042729.
3. Eke PI, Dye BA, Wei L, Slade GD, Thornton-Evans GO, Borgnakke WS, et al. Update on prevalence of periodontitis in adults in the United States: NHANES 2009 to 2012. J Periodontol. (2015) 86:611–22.
4. Eke PI, Wei L, Borgnakke WS, Thornton-Evans G, Zhang X, Lu H, et al. Periodontitis prevalence in adults ≥ 65 years of age, in the USA. Periodontol 2000. (2016) 72:76–95.
5. Cheng HG, Patel BS, Martin SS, Blaha M, Doneen A, Bale B, Jones SR. Effect of comprehensive cardiovascular disease risk management on longitudinal changes in carotid artery intima-media thickness in a community-based prevention clinic. Arch Med Sci. 2016 Aug 1;12(4):728-35.