Classic Periodontal Disease

By: Brenda Dunlop, BS, RDH

July 16, 2021

The Challenge:

A new patient with poor home care and lack of dental attention presented wanting whiter teeth along with a cleaning.

The Background:

  • Age: 40
  • Sex: M
  • Medical History: No medical conditions or medications; generally healthy (BP 118/79).
  • Last Dental Exam: 3/8/2017
  • Chief Complaint: Whiter teeth
  • Clinical Assessment: Severe wear on anterior teeth and decay on #19.
  • Periodontal Assessment: Adult chronic periodontal disease

Additional Comments: There is a suspicion of sleep disordered breathing along with an anterior tongue tie.

The Solution:

  • Date of MyPerioPath® test: 7/22/2020
  • Periodontal therapy: 4 quadrants of scaling and root planing(SRP) under Oraqix® with ultrasonics, hand instruments and irrigation with diluted betadine.
  • Systemic Antibiotic used: Amoxicillin 500 mg tid for 10 days and Metronidazole 500 mg bid for 10 days was administered immediately following scaling and root planing.
  • Home Care: Patient was instructed to use OraCare medicated mouth rinse 2 times/day and oral probiotics, in addition to gumline brushing and Waterpik™ use daily.
  • Date of MyPerioProgress® (post-therapy) Test: 10/5/2020

The Result:

The patient responded to the periodontal therapy favorably, resulting in zero bleeding on probing. We will continue to monitor some isolated periodontal pockets on #14DB and #15MB and test again when needed. The post MyPerioPath® had a 70% reduction in periodontal pathogen (burden) load which is a significant shift. Patient was very happy with the look and feel of his teeth. In subsequent visits, we will address our suspicion of sleep disordered breathing.

About the Author:

Brenda Dunlop is a registered dental hygienist in Austin, TX. She attended the University of Texas Health Science Center where she graduated with a Bachelor of Science in Dental Hygiene in 2004. Brenda has been working at Arbor Oaks Dental with Dr. C. Ian Brawner, DMD since he took over the practice in 2016. The focus at Arbor Oaks Dental is complete and comprehensive care for each patient. Brenda has also trained through the IAOM for Myofunctional Therapy and will be working at IMyo: Orofacial Myology of Central Texas https://imyotherapy.com/