Hi. I’m Suzanne Roelofs, I’m a dentist and nutritional therapist and I run the BOST clinic in London, where I combine complementary and conventional treatments for patients suffering from gum disease.
I see the mouth as part of the whole and understand the importance of a healthy mouth to support a healthy body and vice versa. I place great emphasis on preventative dentistry as a way of maintaining good health - generally and after treatment. This holistic approach to gum care can help allow the mouth to heal itself naturally. My goal is for you to keep your teeth.
I am one of only five dentists worldwide who practice the treatment in which I specialise: Bone One Session Treatment or BOST for short. BOST is a safer, quicker, less invasive, less expensive, health conscious alternative to extractions and implants. Performed without surgery, BOST is a fast, comfortable, and reliable treatment which eliminates periodontal disease at its source: under the gums and in the bone supporting the teeth.
Please do browse the various sections of this website where will find all the information you need on how and why BOST works.
Holistic Gum Care at the BOST Clinic
- I have been a dentist for over 13 years during which time I have treated a huge variety of patients.
- I studied postgraduate aesthetic dentistry in Australia and New York.
- Holistic gum treatment at the Bost Clinic can provide a great alternative to extractions and implants for people suffering from gum disease, allowing the mouth to heal itself naturally.
- BOST is a unique combination of non-surgical treatments which help the body to recover naturally from the bleeding gums, loose teeth, pain and bad breath caused by periodontal gum disease.
- In a single half-day session, the gums are gently stretched under local anaesthetic to clean out the debris, bacteria and other toxins that cause this distressing form of gum infection - no harsh chemicals and no surgery.
- Because the whole mouth is cleaned in one treatment, there is no chance of re-infection. The body is allowed to heal naturally, almost always avoiding the extractions and implants so often recommended by others.
- The practice is limited to gum treatment only. Please contact the General Dental Council, if you would like to have details of dental practices close by offering general dentistry.
- I am based at the Hale Clinic, where the philosophy is to combine and integrate the principles of conventional and complementary medicine.
- If you would like to make an appointment please telephone or email the practice and we will be pleased to arrange a convenient time for you. All welcome.
- GDC registration (2003)
- Dentist MSC (Netherlands 2002).
- Postgraduate CertClinDent in Aesthetics (Australia 2003)
- Dento-facial Aesthetics (NYU New York 2009/10)
- Nutritional Therapist (CNM London 2011)
"Having been told that I would have to have three of my front teeth removed, I was absolutely delighted to find that after BOST treatment this was no longer necessary. Not only was it a huge saving in cost but also wonderful relief not to have to undergo an uncomfortable and invasive proceedure."
"I have just seen [my usual dentist] for a follow-up appointment and I am delighted to tell you that the major problems he identified to my health from my teeth are no longer an issue! He was very impressed that your treatment had such a big impact... he felt that at this stage the difference was quite remarkable."
"I really want to say thank you so much for saving my gums and I am really glad that I found you before my situation had worsened... I think my body is doing great recovery so far."
"I have to say Suzanne that it’s sure good to prove these doctors wrong! There is a cure to periodontal disease. It is your method + nutrition + personal oral hygiene + diligence over time. Thanks, Suzanne! :)"
“My gums and my teeth finally feel (after 20 years of gum disease) manageable and clean. My breath smells normal again (I would know as my kids would have no problem telling me if my breath was not ok!)... Altogether, I cannot believe that magic does happen and I thank heavens every day for having chosen to come to you!”
"Just returned from my dentist and he can’t believe that my gums have responded so well to your treatment. Thank you so much!"
Healthy gums do not bleed, are light pink, firm, resistant to movement and have a smooth appearance. The gums normally form a 'ditchʼor 'sulcus' that goes completely around the tooth; this is a shallow groove 1-3mm deep at the edge of the gum where the gum is not attached to the tooth.
In a healthy condition, the gums have a strong attachment to the root and underlying bone. The roots of all teeth are sturdily attached to the bone and the gums by many tiny, but very strong ligaments called the periodontal ligaments. They allow minimal movement of the teeth in any direction.
In a healthy person there are many different microorganisms in the mouth. The bacteria are not destructive to our tissues, but live in harmony with us and actually help our digestive processes.
Periodontal gum disease
Periodontal gum disease is an infection of the periodontal tissues around the tooth: the gums, the ligaments, and the bone. This happens when the balance between the ‘good’ bacteria and the destructive bacteria is disturbed. Pockets of infection form between the teeth and gums, out of reach of normal dental hygiene. They accumulate and form plaque and tartar. Buried deep under the gums, aggressive bacteria produce chemicals that attack tissue and bone. They initiate an immune response and erode the connection between the gum and the roots of teeth. The aggressive bacteria involved are mostly ʻanaerobicʼ, meaning they live in low-oxygen environments away from air. The immune system tries to attack these bacteria but is not always able to fight back completely. As the gums' ligaments detach from the teeth and bone is lost, the infection can spread and go deeper, creating more pockets and worsening the condition. As time passes the pockets deepen, bacteria levels increase, and chemicals contaminate the bone and the root surface. The gum disease then spreads into the underlying bone supporting the teeth causing them to loosen. If the gum disease is not treated early enough, the patient can lose their teeth.
Risk factors for gum disease
Considerations which can modify the onset or aggressiveness of the disease are called ʻrisk factors'. Periodontal gum disease starts when bacteria encounter a weak immune response from an individual. The general state of the immune system is therefore an important factor in the onset of periodontal disease. The immune system’s efficiency is linked to a number of factors. These factors include a person’s level of stress, fatigue, hormonal changes, general health and a number of life-style factors such as diet, exercise, and smoking. Diabetics for example tend to have a higher risk of periodontal disease. Often gum disease progresses silently and flares up in times of stress or other circumstances that suppress the immune system.
Besides this, the type of bacteria present in a patient’s mouth, and how much, brings another risk factor. There are pathogenic bacteria associated with periodontitis.
Genetics can also play a role in making some people more susceptible than others. Studies have provided evidence that hormones, heredity, and other host factors influence periodontal disease incidence and severity.
Symptoms of gum disease:
- Bleeding while brushing, flossing, or eating hard food
- Soft, puffy, swollen gums
- Receding gums (gingival recession) resulting in apparent lengthening of teeth. (Heavy handed brushing or using a toothbrush that is too hard may also cause this.)
- Painful or tender gums
- Occasional gum swellings
- Loose teeth / moving teeth
- Pain when chewing
- Deep pockets between the teeth and the gums, where the attachment has been lost
- Pus between your gums and teeth.Pus appears when you put pressure on the tooth
- Toothache when the bacteria reach the nerve at the tip/apex of the root of the tooth
- Sores in your mouth
- Bad breath that is not related to food and does not go away
- Persistent metallic / bad taste in the mouth
- A change in the way your teeth fit together when you bite
- A change in the fit of partial dentures
- Lost teeth
Periodontal disease is often silent, this means that symptoms may not appear until an advanced stage of the disease.
Gum disease & general health concerns
Gum disease has been strongly related to other health problems such as and and recent medical research has linked periodontal bacteria to other serious health problems, which include:
- Heart disease
- Respiratory and sinus infections
- Digestive problems
- Alzheimerʼs disease
- Premature birth
Problems with conventional treatment
Traditional treatments involve potentially harmful disinfectants and even surgery. With conventional treatment there is firstly a non-surgical stage, which is executed in sessions (i.e. closed field curettage). After this there is often a second stage, which is surgical and involves cutting the gum, 'flapping' it (opening up the gum, peeling it from the teeth and bone), root scaling, osteoplasty (remodelling/cutting the bone), removal of excessive wound healing tissue (granulation tissue), soft tissue grafts, bone grafts etc. The gums get stitched back around the teeth, which makes it sore to clean after. Post-operative pain and discomfort is a major drawback. Also it is virtually impossible to do the surgical stage in one go. Therefore re-infection from the untreated side can happen. Only a few people have the courage to endure four sessions of treatment and the subsequent weeks in pain. On top of all this, the gums, which are usually already receded to begin with, recede even more as a result of the surgery. As the gums recede, obviously the pockets get shallower, but the aesthetics are impaired. The extra exposure of the root can also give extra sensitivity. Instead of supporting the bodyʼs natural healing processes, surgery removes infected tissue and bone, leaving one with much lower, more receded, gums.
The main problem with the mainstream approach is that the treatment is done over two or more sessions, giving bacteria in the untreated side of the mouth every chance to re-infect the treated side. Patients who have the full mouth treated within 24 hours, have much better results than the standard protocol of 2-4 sessions a few weeks apart. Treatment in one session is hugely beneficial, regardless if the treatment is surgical or not.
Another major problem with mainstream treatment is a high rate of relapse. The main reason for this may be that after the deep cleaning of the pockets (with re-infection from opposite sides later on) the gums re-adhere at the margin first, locking in the remaining bacteria deep down in the pocket. This creates a hidden chronic infection deep down in the pocket, waiting for the immune system is under pressure (stress or any other factors). This chronic infection can flare up and this means a new acute phase, so the gums detach, and a new pocket opens.
Dr Hoisington who developed BOST treatment explained what happens to the bone: Most periodontists are mainly concerned with how to defeat the bacteria and reduce pockets, but orthopaedic surgeons look at bone as something you should heal if it is broken. Dr Hoisington started looking at damaged periodontal bone as being broken rather than just being infected. This gave him an insight into treating periodontal disease more like a medical problem than a purely dental problem. He set up a protocol of treating the whole mouth in one session rather than in sessions, where re-infection is an obvious problem. Besides this he found that when you do an open flap procedure to get periodontal access to the bone, you cut off the circulation to the bone, which dries it out and you actually kill the superficial bone cells. This greatly contributes to the failure of grafting and any other kind of procedure you are trying to do on the bone.
Holistic gum treatment at the Bost Clinic consists of 4 parts:
- Bacterial DNA testing
- BOST treatment
- Aerobic oral hygiene regime
- Adequate and appropriate nutrition
1. Bacterial DNA Test
Modern periodontal treatment starts by determining which bacteria are present in a periodontal gum infection and how many. Using the bacterial DNA test, we are able to identify exactly which bacteria are causing the periodontal infection. In the majority of cases, the DNA test will reveal that the type of bacteria present in the gums can be eliminated without the use of antibiotics. In these cases, it is preferable to avoid antibiotics in order to prevent a drop in the immune system.
However, because some species of bacteria are very resilient they cannot be brought under control using the treatment alone. Actinobacillus actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) are aggressive species of bacteria that fall into this category. If the test shows that these bacteria are present, then appropriate antibiotics are usually added to the treatment in order to produce complete healing.
The bacterial DNA test is done, by putting a paper point under the gum tissue for about 15 seconds. It is safe, quick and a painless procedure. Bacteria thrive in the plaque (biofilm) that covers the tooth roots down at the level of attachment. Once the bacteria are collected on the paper point, the test gets send off to a laboratory where the bacteria will be identified by comparing their DNA with DNA profiles held in the labʼs reference database. It is very interesting for dentists as it gives you a list of the main periodontal anaerobic pathogens present (causing the infection), which helps with the formulation of the treatment plan. Compared to culturing the bacteria, bacterial DNA-testing offers much greater accuracy as well as reduced cost. It tells you exactly what's there.
Why is a DNA test necessary?
The bacterial DNA test provides a scientifically accurate way of knowing which bacteria are causing the infection. Without the test, there is only one chance out of ten of choosing the right antibiotic combination to fight the bacteria under the gums. When invasive bacteria are inside the tissue, on the roots and the bone, the BOST treatment can’t reach them and antibiotics are needed to clear them out. Without the focus given by the test, we are more likely producing resistant strains than good treatment results. Most patients find that it is very reassuring to know whether or not they have aggressive strains of bacteria in their gums. If the Aa and Pg are not present, patients feel relieved immediately. Patients who test positive for the aggressive strains of bacteria, on the other hand, gain a better understanding of why they have had such a difficult time with periodontal problems in the past. They can feel hopeful for the future because they know that they will receive properly targeted antibiotics in addition to effective local treatment.
Who should take the bacterial DNA test?
- People who have symptoms of gum disease
- Prior to orthodontic treatment: With braces, force will be put on the bone and oral hygiene will be more difficult. Aerobic hygiene is also important to help prevent common post-orthodontic problems like gum recession as well as gingivitis during treatment
- As part of a fertility program. Periodontal disease has been linked to infertility, low birth weight and premature birth. Before entering the reproductive years a bacterial DNA test is a great tool to help with prevention and/or treatment. If any aggressive bacteria are present, treatment and aerobic oral hygiene is recommended. It is vital not to pass aggressive bacteria on to the newborn baby.
- Before implants. The test tells you what bacteria are there, which is great because it is essential that the mouth is correctly prepared before the implants. When implants are placed without knowing what kind of bacteria are in the mouth, peri-implantitis (gum infection around the implants) can occur. This infection around implants is notoriously difficult to get rid of.
- For patients who have (a family history of) Heart disease/stroke, Diabetes, Arthritis, Recurrent respiratory infections (sinus/lung), Digestive problems, Alzheimerʼs disease, Mouth ulcers. Periodontal bacteria are linked to these disorders.
BOST - keep your own teeth as much as possible
BOST (Bone One Session Treatment) is a non-surgical solution that supports the bodyʼs natural healing processes, helping to fight periodontal disease at its source: under the gums, and in the bone. It starts with a simple DNA test to identify the exact form of bacteria involved and their quantities. When the bacterial DNA tests became available, a DNA test was done immediately before and after treatment. The results showed that 99% of the bacteria could be removed with the BOST gum treatment.
The treatment involves (under local anaesthetic where required), gentle stretching of the gums back from the teeth (where attachment was lost already), to expose the infected areas. This lets Suzanne clean out the infection, even at the level of the bone. She cleans the whole mouth in one go, so thereʼs no chance of re-infection (which happens when treatment is spread out over multiple appointments). Only three simple dental instruments are needed. To do the whole mouth takes around four hours in total, but youʼre not stuck in a traditional dentistʼs chair. Instead, you lie on a specially designed bed – and you can take as many breaks as you need.
There's no invasive surgery, and no chemical disinfectants. In BOST treatment we stretch the gum tissue to get access down to the surface of the bone and are able to smooth it and remove the granulation tissue and the anaerobic bacteria trapped in the porosities of the bone. In fact, we found that stretching gives nearly as good an access to the root surfaces as a flap and is much faster and doesn't require stitching. Suzanne can even splint loose teeth to keep them firm while the mouth recovers. Splinting is great for improvement of aesthetics especially where teeth affected by gum disease have moved.
BOST creates the right circumstances to allow our body to do the healing
After the treatment you follow a simple oral hygiene regime, using a product called 'Perio-aid', which helps the gums re-attach naturally to the teeth and form a strong, healthy bond. The treatment is done to try and keep your own teeth as much as possible, usually without the need for implants. BOST treatment is a great alternative to implants.
Advantages of BOST
- We check what bacteria are present and how many, this is to personalise treatment.
- BOST treatment gives the body a chance to heal itself.
- Aerobic treatment, NO surgery.
- Drainage of toxins from pockets.
- Perio-aid: prevents early attachment and re-infections. Helps to create sturdy attachment of the gums to the teeth.
- Patients do not experience much discomfort during or after the treatment.
- Long-term success.
- Quick (1/2 day appointment) single session.
- Helps improve aesthetics / oral health / general health / function / confidence.
- Keep your own teeth as much as possible.
- Helps reduce burden on the immune system.
- Huge reduction of aggressive bacteria, which is good for general health too.
- Removal of toxins and tartar build up from under the gums.
- Great alternative to implants.
- Cost-effective solution.
3. Oral hygiene regime
Oral health and dentistry have their place in the overall health of patients. Aggressive bacteria from the mouth can become localized in other areas of the body affecting the normal functioning of other bodily systems. Gum disease has been related to heart disease, diabetes, infertility and a host of other conditions. With BOST, patients are shown a new simple oral hygiene routine with the Perio-Aid, that helps keep their gums and healthy for years to come, and thus improving their overall health.
4. Good nutrition to help the immune system
Healing is achieved by creating the right circumstances in the body, the right circumstances in turn, allows our body to heal itself. This is a holistic view. A deficient diet may well have contributed to the initial periodontal problems. Therefore we give nutrition advice with the BOST treatment because a healthy functioning immune system helps to keep the gums and teeth healthy.
Healing from the inside out
A list of beneficial foods is given with the treatment and what foods are best avoided to keep gums and teeth healthy. For example sugar ʻfeedsʼ the bacteria related to gum disease and increases plaque formation, so best to exclude, whereas black berries might be able to fight off aggressive bacteria related to gum disease. If a patient needs extensive nutrition advice, or if there are many underlying factors / systemic problems they might be referred to a GP or nutritionist, who can look at underlying factors. As we have seen before, gum disease is multi-factorial and we sometimes need to explore / exclude systemic underlying problems.
Good nutrition and a healthy gastrointestinal tract are the seeds to life, and it all starts in the mouth.