 McArdle's disease is a rare genetic disorder caused by a deficiency of the enzyme alanine amino transferase ALT, which leads to difficulty exercising due to muscle pain and weakness. Periodontal disease is a chronic inflammatory condition affecting the gums and surrounding structures of the teeth. It is caused by bacterial biofilms, which are composed of bacteria and other substances that stick together and form a protective layer around the teeth. Patients with McArdle's disease may be more susceptible to periodontal disease because of their impaired immune systems. This case report describes a woman with McArdle's disease who developed periodontal disease. She was treated with a combination of oral hygiene instructions, probiotics, and debriement using D-Biot-E-C-H. After 60 days, her periodontal status improved significantly, with fewer pockets with probing pocket depth, PPD, greater than or equal to 4 mm, and fewer pockets with PPD greater than or equal to 5 mm. Her full mouth bleeding score, FMBS, also decreased from 48%. This article was authored by Salvatore Konitsoro, Carolina Mayrani, Andrea Scribant, and others. We are article.tv, links in the description below.