Dr. McGlennen: Tell me how you use OralDNA® salivary diagnostics.
Dr. Samaha: OralDNA® testing has been a standard and integral part of our intake of all patients with periodontal disease since early 2007. Our practice is well known for our protocol of diagnosing and treating periodontal disease and increasing total health profiles. Although I am a general dentist, over 95% of our new patients have some form of periodontal disease, from gingivitis to advanced, aggressive levels and we do not wait for the disease to manifest to an advanced degree in order to test. One thing we know for sure is that periodontal disease is a subclinical disease. It is present even when symptoms are not visible. We begin by performing a quick microscopic slide of the patient’s biofilm and once we see activity on the slide, we share what that means to the patient and they agree to the bacterial DNA test, MyPerioPath®, in order to specifically identify which bacteria are causing their disease. The objective testing makes it very personalized care. Patients like that. They understand the value in such an approach.
Dr. McGlennen: What are the top two things to consider when you select a patient for testing?
Dr. Samaha: If they have bacterial activity on their phase contrast microscopic slide and if they bleed upon probing or scaling.
Dr. McGlennen: What are the biggest benefits to using salivary diagnostics?
Dr. Samaha: Objective testing of the quantity and quality of the bacterial profile.
Dr. McGlennen: What is your favorite part of the MyPerioPath® results? Why?
Dr. Samaha: Learning the types of bacteria infecting the patient. Knowing what we are dealing with and coordinating the information with the scientific research that shows the array of systemic diseases associated with the individual bacteria. For example, being able to say “The science tells us that P. gingivalis increases cardiovascular disease… F nulceatum is implicated in serious health issues to include pregnancy complications, cardiovascular disease and…” I have created chairside flip charts to help patients understand. They are VERY powerful. This kind of conversation, along with the show-and-tell of the test results, makes it real to the patient.
Dr. McGlennen: How do your patients respond to this technology? What is their #1 question?
Dr. Samaha: We are careful to explain to them we are analyzing their oral pathogen/bacterial DNA. They get it. No questions. They always understand. It is just like objective testing for other medical conditions and diseases.
Dr. McGlennen: If a new OralDNA® provider were to ask you for advice, what would be your best tip?
Dr. Samaha: Become comfortable with presenting want the patient needs, not what you think they can afford. We have developed an easy to follow protocol that makes sense to every member of our team. We have a small practice, but our acceptance of the testing is near 100%. We take our time educating our patients and helping them understand a new way of thinking and treating. They value that. We are known for the progressive way in which we help our patients achieve total health.
Also, help educate other medical/dental professionals. This testing makes sense. And importantly, it makes sense to medical practitioners of all kinds.
Dr. McGlennen: Where do you see salivary diagnostics in 3-5 years? 10 years? What would be the impact on your practice/patients?
Dr. Samaha: As I have already been using salivary diagnostics for over 10 years, I have a wish list. One, as the oral/systemic connections become more predominate, display more of a connection of specific periodontal pathogens to specific systemic diseases, such as F. nulceatum and cardiovascular issues as well as adverse pregnancy outcomes, etc…. on the actual report results. Include continuation of the concept of personalized medicine/dentistry by learning more of the patient’s biofilm profile.
Two, I would like to see testing for the good bacteria. Replenishing the good bacteria in addition to better controlling the bad is so important. We have our patient’s use probiotics (ie, Probiora™ Pro) to help assure that the good bacteria flourishes. Then we can look at the samples objectively, with testing for good bacteria, as opposed to just diagnosing from clinical observation. This will assure long-term health and stability.
On a side note, I would also like to see a healthy, targeted nutritional supplementation approach to therapy which can help increase a good bacterial profile and decrease a negative profile. Both improved nutrition and oral probiotics can ensure positive results once the pathogens are moved out. Nutritional stability for soft tissue integrity, in particular, is necessary to help build a healthy “terrain” in the gingival sulcus as well, so that the pathogens cannot penetrate the sulcular epithelium and migrate systemically. This is a key understanding that we don’t see taught in dental circles. It is an area of expertise I developed in the early 1980s, and one I have become known for in my teaching seminars.