Periodontal Pathogens & Rheumatoid Arthritis

Trends in Salivary Testing wishes you a Happy Thanksgiving! Enjoy this blog re-post from 12/30/2016. In December 2016 researchers from Johns Hopkins University published a study in Science Translational Medicine indicating an identified link between periodontal disease and rheumatoid arthritis (RA). It would perhaps be more accurate to indicate that rather than periodontal disease being the causative agent, the perio pathogen Aggregatibacter Actinomycetemcomitans (A.a.) was found to be in...
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Causality– It Was Only a Matter of Time

Trends in Salivary Testing Throwback: We as dental professionals have a significant role in combating the number one cause of death: cardiovascular disease. “High-risk periodontal pathogens contribute to the pathogenesis of atherosclerosis” is a powerful piece and I recommend you read it. There is scientific evidence that [periodontal disease] PD caused by the high-risk pathogens can influence the pathogenesis triad in an adverse manner. With this appreciation, it is reasonable to stat...
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A New Conversation with Your Patients

How do we introduce the idea of salivary testing to our patients? As is the approach with every dental procedure or service we recommend for our patients, the primary consideration is excellent communication. Some recommendations are routine and no explanation is necessary, including fillings and fluoride, among many others. When we introduce new procedures or services to our patients some explanation is appropriate. DNA salivary testing for bacteria is a good example. So what should we say w...
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Stop Diagnosing the Pocketbook

Cost is a consideration for all of us, which we take into account when deciding whether or not to purchase a wide variety of goods and services. Our responsibility as clinicians is to make recommendations to help patients achieve the best health possible, without letting our preconceived ideas about the patient’s ability to afford treatment get in the way – what I refer to as diagnosing the pocketbook. One of the things we do not know and cannot predict is how much value the patient puts on ...
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Gum Disease and Alzheimer’s Disease

In honor of National Alzheimer’s Month, enjoy this repost from 3/3/2017. A 2016 study published in PloS One1 examined the impact of periodontitis on the rate of cognitive decline in individuals with Alzheimer’s disease (AD). Sixty community dwelling patients with mild to moderate AD were cognitively assessed and blood samples were taken for detection and quantification of systemic inflammatory markers. Initial clinical assessments of periodontal health were conducted and the same assessme...
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We Were Always Taught

Dentists who were trained in the 70’s were always taught that the first instrument used in an operative procedure was the enamel hatchet. Caries excavation was done with spoon excavators and a belt driven low speed handpiece. We were always taught that reversible hydrocolloid was an excellent impression material, especially since you could use the same material on multiple patients. You just had to warm it back up in the water bath. We were always taught that we only needed to use a mask and...
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Where to Start

A common dilemma among many dental practices is how to transition the hygiene department from prophylaxis to comprehensive periodontal diagnosis and treatment. Among the concerns is the perception that if we are starting something new, does that imply that up until now patient needs have been inadequately addressed? The simple solution to this dilemma is referring to the constantly evolving knowledge in healthcare. Using phrases such as “Research has shown” or “We now know” , can help with t...
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WNL: What’s your definition?

During virtually every dental examination, there is a review or updating of the patient’s health history and a clinical examination. If everything is consistent with good oral and overall health the notation WNL is commonly made, which is an abbreviation for Within Normal Limits. There is however another less commonly known meaning to WNL; We Never Looked. Looking goes way beyond visual observation and includes other diagnostic tools such as radiographs, scans and laboratory testing. Let’s co...
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Perio Pathogens CAUSE Rheumatoid Arthritis– Now What?

“Rheumatoid arthritis is a chronic disease affecting over 1.3 million Americans and as much as 1% of the worldwide population.” (www.rheumatoidarthritis.org) There is a growing body of research indicating a causal association between specific periodontal pathogens and rheumatoid arthritis (RA). In a 2009 study, in Compendium of Continuing Education in Dentistry, the authors indicate that a specific perio pathogen, Porphyromonas gingivalis (P.g.), produces an enzyme capable of modifying specifi...
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Gum Disease and Pregnancy

In recognition of National Women’s Health week that begins May 14, I encourage all readers to view the 3 minute attached video. Kim Miller has recorded a highly informative video on pregnancy and periodontal disease. Among the central points in this discussion is that healthy gums do not bleed. Kim makes the point that periodontal bacteria can enter the mother’s bloodstream, cross the placental barrier and potentially have an adverse effect on the developing fetus. There is also a recommendati...
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