Active Periodontal Disease with Multiple Medical Complications

Challenge: A patient with Multiple Sclerosis (MS) and active periodontal disease, most recently was diagnosed with Type II diabetes, will receive periodontal therapy. Currently, proper home care is limited to the physical difficulties of MS.

Background:  A 58-year-old female presented on 4/17/2018 with a chief complaint of xerostomia and physical difficulties challenging a proper home care regimen. Due to living with MS for several years, the patient has partial left-side paralysis resulting in no ability to use her left hand. She most recently was diagnosed with Type II diabetes and has added Metformin to her long list of medication contributing to the xerostomia. Upon comprehensive periodontal charting, the patient exhibited generalized 4-5mm pocketing with generalized hemorrhaging and edema.

Solution: Xerostomia being a chief complaint, we explained her dry mouth could be contributing to a potential growth of yeast and that a saliva test called OraRisk® Candida would be needed to rule in or rule out its presence. Additionally, a MyPerioPath® was recommended to further understand oral bacteria that may be contributing to the periodontal disease. From one specimen, the two tests were ordered on 4/17/2018. Her personalized periodontal therapy consisted of ultrasonic biofilm removal and laser treatment to remove inflammatory and granulation tissue, and ozone oil therapy. The MyPerioPath® revealed significant levels of bacteria above threshold. These bacteria were targeted with Amoxicillin and Metronidazole. The OraRisk® Candida revealed an overgrowth of C.Albicans so a prescription of Mycelx Troche was administered 5 times per day for 2 weeks. We opted for PerioProtect® as a good home care regimen as these trays are not dependent on dexterity. Trays were fabricated and were worn for 15 minutes 2 times daily. In addition, instructions to incorporate a Sonicare electric toothbrush with a paste of peroxide and baking soda, localized probiotic Probiora™ and Closys Silver mouthwash. The post therapy appointment was scheduled 6 weeks out.

Results: At the post-therapy appointment 7/23/2018, the patient reported using the PerioProtect™ trays daily along with the other home care changes of an electric toothbrush and localized probiotics. Upon periodontal assessment, complete pocket reduction to healthier levels was noted with no bleeding. A MyPerioProgress® (see photo below) was secured and later revealed all pathogens below threshold. Patient was placed on a 3-month recall. After a total of 9 months of periodontal maintenance, the patient announced she was no longer on Metformin and her A1C levels were completely normal. Periodontally, the patient has remained stable. The patient is very satisfied with the results that we as a team were able to accomplish.

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Brie Eikhoff RDH

Brie Eikhoff RDH

Brie graduated from Western Washignton University with a bachelors focused on Political Science and Sociology.Having grown up with her dad being a dentist and working in his office she felt compelled to explore the dental field.She moved to New York and completed an AAS in Dental Hygiene at SUNY Binghamton.She has been practicing dental hygiene for over 15 years.She has spent most of her career specializing in the treatment and rehablitation of periodontal disease.

Brie has attended many courses and received several certifications in the different modes of treatment of periodontal conditions to be able to provide the most effective top notch care.
Brie has attended several Bale/Doneen preceptorship courses and is listed as a provider for the preventionof Heart Attack, Stroke and Diabetes prevention program. Brie is a member of the American Academy of Oral Systemic Health. She focuses treatment around patients oral systemic health. This approach allows her to evaluate patients oral/systemic health based on lifestyle, diet, medications, systemic conditions, oral periodontal pathogens present in mouth tested via saliva sampling, inflammatory bloodwork, sleep patterns, and airway evaluation.

The modes of treatment Brie is trained and extremely experienced in allow her to provide the most optimal care to her patients. She is certified in laser assisted periodontal therapy, the use of an endoscope, supportive bone regenerating biological proteins, and individualized home maintenance care.
Brie Eikhoff RDH

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5 thoughts on “Active Periodontal Disease with Multiple Medical Complications

  1. Dr. F. Mike Farley says:

    THAT’S MY DAUGHTER!!!! Attagirl! Your dedication and desire to help others both inside and outside of our chosen field make me even more proud to have shared our profession for so many years. Please keep up the good work. I have seen many changes in my 44 years as a practicing dentist and this science is truly amazing. I look forward to your next contribution.

  2. Way to go Brie! Very nice to see your case and the utilization of many of the biofilm reducing tools! Keep up the great work.

  3. Katie Fenton says:

    Great job Brie! You are an inspiration to so many! Your dedication to dental health is extraordinary. So proud of you an all your amazing accomplishments. So happy to know one of the best. Keep doing big things!

  4. ElaineFKardong says:

    Wonderful research, Brie. Your enthusiasm is infectious!!

  5. Brandin Lamport says:

    I worked with Brie for Several years and she is amazing . She is able to far exceed results of what traditional periodontist are able to do.

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