How Do You Speak Testing? With Lisa Proffitt RDH

Hypothetical Patient Bio: Your 57-year-old male patient of 12 years presents today with the clinical signs listed below. His updated medical history includes medication for coronary artery disease. The implant on #8 was placed 2 years ago and seems stable. However, his wife states that he has had several months of bad breath.

How would you introduce therapy including MyPerioPath® to this patient?
As a dental hygienist with extensive periodontal experience, the bacterial levels for this patient, together with the medical history of cardiovascular disease, are concerning. First, I would like to discuss the pathogenic bacterial levels above the normal threshold, as well as the number of bacteria present, collectively. Additionally, I would like to educate this patient about the oral systemic link between the specific pathogenic bacteria present above the normal threshold, and the relationship with cardiovascular disease. Studies have shown that Aa, Pg, Td, and Tf are contributory for arteriolosclerosis. Finally, the high levels of bacteria present are also contributing to the active periodontal disease, and reducing the high levels of bacteria will promote stabilization of the periodontal involvement recorded. Here is a sample conversation:

Mr. Periodontal Maintenance, I am concerned. I am seeing a change, a possible imbalance. This could be a reason for the halitosis your wife is detecting. Getting you back into remission is our goal. A test from an oral rinse will give us valuable information. The overall concern is the bacteria contributing to your active periodontal disease could also be impacting your cardiovascular disease. Good news, your implant doesn’t seem to be compromised as of right now. However, I don’t believe it is safe to ignore this. Let’s test today and go from there.

Your patient says yes to testing with MyPerioPath®. You are now interpreting the results for the patient.

Mr. Periodontal Maintenance, the results are as I expected. Several bacteria are triggering the disease and these bacteria could be entering your body. We need to stimulate your body to heal with the therapy we will perform, lowering the number of total bacteria, and reducing the risk of these bacteria contributing to your cardiovascular disease. We will start with scaling and root planing, placing Arestin®, which is a localized medication, and antibiotic rinse compound – Amoxicillin 500mg/5cc 4x daily for 10 days, followed by Peridex® rinse 2x daily for 7 days. This will give you the best opportunity to reach remission. After you have healed for 6 weeks, an assessment with a second MyPerioPath® will help us determine if remission was achieved or if additional therapy is needed.

Lisa Proffitt, RDH, BS
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