How Do You Speak Testing? With Donna Shook RDH


Patient Bio: New patient is a 66-year-old female. Per her records, her last active periodontal therapy was over 10 years ago. Her previous dentist just retired, and she is looking for a new dental home. Her home care consists of brushing twice a day with occasional flossing. The patient started smoking at age 18 and currently smokes 1 pack per day. She has expressed an interest in quitting. Medical history includes osteoporosis.

How would you introduce therapy including MyPerioPath® to this patient?
Dental education will vary from patient to patient. Typically, I start by asking “How often do you see your hygienist or dentist to manage your disease?” Visual aids are a must; I will prepare a microscope slide of their plaque sample which is then projected onto a monitor. This microscope slide helps facilitate the bacterial testing conversation. Knowing the specific bacteria will help us develop a personalized treatment plan and provide a better understanding of any systemic connections. My “go-to” to help educate what are healthy gums versus diseased gums is the AAP periodontal disease brochure. All of my patients take this home.

The patient’s medical history will give you clues to link their dental health to their overall health. When I find one, which is practically every patient, I stress the value of finding out what specific kind of bacteria is causing the infection so we can have targeted treatment. But this also may relate to bloodwork they are potentially getting from their physician.

Smoking puts a drastic complicator into the equation. I will start with the basics and as the therapy is administered over the next few weeks, I will continue to emphasize how smoking damages the gum tissue and constricts blood flow to the gums causing reduced healing.

How would you discuss these results to your patient?
The patient always leaves with a copy of their lab results. As I explain how to interpret the results, I will use their report and express concern about the bacteria over the reference line and how it has been scientifically proven to be associated with certain diseases. Page 2 of the MyPerioPath® report shows the Systemic Effects listed right below the lab results, I love that! I highlight the fact that mechanical debridement (brushing, flossing & having a dental cleaning) will not address all of these bacteria because they are living in the gum tissue. I will use the results to support what I am recommending my patient to do. In addition to the scaling and root planing, an appropriate antibiotic and irrigation with chlorhexidine are some options I will consider. The patient will go home with the results, a Waterpik™ and chlorhexidine to irrigate with daily. When the patient understands and “owns” their disease, their value for dental health increases. As a clinician, this is my ultimate goal & greatest satisfaction; to partner with my patient and empower them to heal themselves.

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This is a hypothetical case and should be used for educational purposes only.

Donna Shook RDH
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