I found a single published case report of someone with recurrent periodontal disease who was studied and found to have a high Epstein-Barr viral load subgingivally. Antiviral treatment with Valtrex for a period of 10 days reduced the virus to the detection limit and the periodontal disease improved dramatically. The condition was stable when checked a year later and the virus was still barely detectable. [PT Sunde, et al. Patient with severe periodontitis and subgingival Epstein-Barr virus treated with antiviral therapy. J Clin Virol 2008 Jun;42(2):176-8.] Viral screening is not done routinely for patients with chronic gingivitis. Was this a meaningful example of what could be achieved readily with a shift in thinking by periodontists to try an antiviral in patients, especially those with severe chronic gum disease?

This is very much the case. The world of medicine, as well as dentistry, remains woefully ignorant of how commonly a chronic smoldering virus brings about symptoms of all kinds, as you have learned, representing 85% of all cases of chronic illness. This is equally true for periodontal disease being viral 80% of the time, and this case study was spot-on in identifying the culprit and using an available antiviral that was effective. That medication might not be a perfect match for all cases of viral-induced gum disease but represents what is possible. The rest is up to human ingenuity to experiment with available options to determine what might work best for individual cases that vary because there could be a variety of different organisms and susceptibilities to a given antiviral.