Why Test? Rethinking Periodontal Disease Through a Medical Lens

One of the most common questions I hear is: “How is testing going to change the therapy provided?” My answer? “It most likely isn’t.”

Wait—what?! Then why bother testing at all?

That’s a fair question, and one worth unpacking. Testing tools, such as MyPerioPath®, should not replace clinical diagnostics or significantly change a patient’s treatment plan. Rather, the use of a laboratory diagnostic test has the intent to confirm, but sometimes refute what you’re seeing clinically. Practically, and in most cases, the lab test confirms the clinical diagnosis based on the patient’s history, the physical examination, and other diagnostics procedures. But importantly the laboratory can unveil things that are not observed by clinical examinations alone. In fact, they’re incredibly valuable—not for changing therapy, but for shifting how we think about therapy.

Currently, periodontal disease is diagnosed based on clinical signs—bleeding on probing, pocket depth, bone loss, inflammation—not a lab test. But relying solely on this reactive approach has its costs. Depending on the source, between 50-75% of American adults have some form of periodontal disease. That’s not just concerning; it’s a public health crisis. Maybe it’s time to ask: Are we too late to the game? Should we be treating periodontal disease more like the chronic, systemic medical condition that it is?

In medicine, testing is foundational. Think about it—lab work drives:

    • Clinical diagnoses
    • Treatment decisions
    • Disease surveillance and monitoring

So why should dentistry be any different? By integrating diagnostic tools like MyPerioPath, we’re not just confirming a diagnosis—we’re learning more about the pathogens at play, and tailoring preventive and therapeutic strategies accordingly. This opens the door to a proactive, rather than reactive, approach to care.

Understanding the microbiological underpinnings of periodontal disease helps us take action before irreversible damage occurs. We can screen patients more effectively, educate them more thoroughly, and track treatment outcomes with greater precision. Just as important, we elevate the perception and value of what we do—not just cleaning teeth, but managing a condition with known links to cardiovascular disease, diabetes, Alzheimer’s, and other systemic diseases.

Yes, testing may occasionally introduce you to a new tool or adjunctive therapy you hadn’t considered. But its greatest impact isn’t in the instruments you use—it’s in how you think. It’s in transitioning from being a tooth technician to being the oral health care provider your patients truly need.

Periodontal disease isn’t just a dental problem; it’s a medical one. And like any other chronic disease, it deserves a medical mindset—one that prioritizes prevention, early detection, and evidence-based care. By embracing testing, we’re not replacing clinical expertise; we’re enhancing it.

So the next time someone asks, “Why test if it doesn’t change therapy?”—you can confidently say: “Because it changes everything else.”

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Diane Larson RDH, BSDH
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