The Inflammation Triad: The Truth About Plaque
0: 00 An Introduction to the Inflammation Triad
02:14 On Plaque’s Role
04:54 Smaller Areas of Plaque Are More Dangerous
The inflammation triad is this three-pronged component that we are looking at the airway, understanding that that's connected to these anaerobic pathogens, which are the ones that can cross over the linings of the body and they formulate these plaques. When we collaborate and we use these better measures and we're looking at this Inflammation Triad, we can get better outcomes for our patients.
When we see this decrease in oxygenation, what happened is occurring in the mouth is that we're not only becoming more acidic, but we're moving from an aerobic and oxygen loving environment to a non oxygen loving environment, which is anaerobic. We are more acidic. When pH changes, we grow anaerobic pathogens, the ones that do not need higher level of oxygenation. When we have more pathogens show up, it wipes out healthy bacteria. They take the food and the space and we lose these most important healthy bacteria called our nitrate reducers.
If we lose our nitrate reducers, we lose the ability to make these levels of nitric oxide. When we cannot make that nitric oxide, we have an increased permeability or leakiness, so to speak. This leads to inflammation. We have more inflammation.
We want to start with our end goal in mind and that is we'll focus on plaque because cardiovascular disease is the number one killer. A heart attack is occurring every 30-40 seconds and strokes about the same rate, and strokes are the number one disabilitating chronic disease in America. But with this information, all of us can feel confident that we're going to live out our future without a heart attack or stroke.
What is plaque exactly? It is this laying down of debris. Lipids are involved: cholesterol, bad cholesterol, LDL particles, but it's debris as our body is trying to get rid of toxins. We get these little lesions on the wall of the artery. Oral bacteria are circulating in the bloodstream and they penetrate into the vessel wall and trigger these events.
We've talked about looking at carotid arteries with ultrasound, with CAT scan technology, and artificial intelligence software. We can also look at the heart arteries now to see exactly where we stand in terms of plaque. We want to know about blood vessels that are like the one we see in the bottom right, where we've taken a cross section. You can see that there's plenty of room for blood flow but there's a dangerous type of plaque in the artery wall. That's likely to disrupt or rupture and cause this person to have a heart attack. Some call it necrotic core, lipid rich. We can see that on CAT scan technology.
There's no way to stabilize and keep someone from experiencing a heart attack if we find this kind of plaque, unless we find out if they're oxygenating well, all day and night, and if they have oral pathogens or not, we have to eradicate those bacterial pathogens in order to stabilize a lesion like this.
This is just an example on the left of the carotid ultrasound, this small area of plaque. Remember me telling you, I was sending patients home every day saying, "Don't worry about that small area of plaque. You've got plenty of blood flow." We now know nothing could be further from the truth.
Small areas of plaque are the ones that are more likely to rupture and cause a heart attack. Once they get discharged from the hospital, that's when the detective work begins and the time begins to save their life by finding all the root causes.
What Lora is pointing to there is plaque formation, and that's a moderately risky plaque. It has the capability to either become scar tissue, low risk plaque that is not going to cause a problem, or it has the capability to become a more dangerous type of plaque if we don't eradicate bacterial pathogens and treat airway issues.
The body can beautifully push that plaque into the wall of the artery and help keep your arteries dilated to maintain blood flow for as long as possible. The mechanisms of the body to create health for you and save your life are amazing. It brings us back to what Lora has just described to us about nitric oxide.
One of the key molecules is nitric oxide in order for our arteries to be elastic and to be able to dilate and to be able to keep this plaque in the wall of the artery and maintain blood flow. That's just one example of how this airway component, the oral pathogen component, contributes directly to plaque formation and our ability to resolve the plaque formation, to transform plaque or reverse cardiovascular disease.
It's possible. People say, "You can't really reverse cardiovascular disease." Okay, the plaque will always be there, but you can reverse the dangerous nature of it and transform it into scar tissue that will never cause a heart attack.
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