Rethinking the Dental Examination

It’s 2018 and I am dumbfounded by the number of adult new patient appointments that begin in the hygiene chair. We all recognize this is an ‘old school’ practice, but maybe we still secretly believe it’s the right thing to do for our patient. Maybe we somehow believe it’s financially beneficial to the practice. Neither of these could be further from the truth. The dental examination of today is all about the patient of today. From a health standpoint, the patient of today is more complica...
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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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Sick & Tired of Patients Being … Sick & Tired?

Me too! Day after day, patients dismiss their oral health, writing it off as “My gums have always bled.” Inside, my head was exploding, but outside my heart was opened. I knew that I had a chance to educate my patients to a whole new level of health. One where their energy would be boosted, risk to coronary heart disease would be lowered, and the chance of them developing diabetes would be significantly reduced. I became a hygienist on a mission. I instinctively knew that if things were t...
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Everyone Has A Story

Every patient that sits in your dental chair has a story. All stories have a beginning, middle, and end, as does life. We have the wonderful opportunity to help our patients be able to live a long and productive one. Jumping to the middle of my story, my mom died at the age of 58 and my dad at age 60, both from end stage vascular diseases. They didn’t get a chance to enjoy their children into their adult years, get time with their grandchildren, or even meet their great grandchildren.  I, li...
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Managing Atherosclerotic Disease: Medical and Dental Collaboration- The New Standard of Care

Medicine and dentistry have long been aware of the connection, association, and direct links between high-risk periodontal pathogens and cardiovascular disease. Knowledge alone has a limited potential to change chronic disease outcomes unless it leads to new clinical practices. Effective and proven new protocols to identify and mitigate virulent periodontal microbes are available today. A small percentage of dentists have implemented these practices and the majority of physicians are unaware...
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Case Study: Class II Periodontitis

Background: The patient is a 54 year old female who presented with the chief complaint “My gums bleed when I brush, there are possible cavities and I don’t like the tooth crowding.” Her last dental visit was about 6 years ago. There is a family history of diabetes, cardiovascular disease, stroke and cancer. The home care consisted of manual tooth brushing 1-2 times per day with occasional antibacterial mouth rinse. During the clinical assessment, it was discovered that several amalgam restor...
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The True Cost of Clinical Lab Testing

As an in-office coach I often hear the following objection, “Clinical laboratory testing is too expensive. My patients won’t want to spend the money.” Taking into consideration the latest research, released in the online British Medical Journal November 29, 2016, which states that periodontal disease with high risk pathogens (Aa, Pg, Tf, Td, Fn) is causal for arterial sclerotic vascular disease, the patient can’t afford NOT to test for the presence of these dangerous bacteria. (1) As a pr...
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A Higher Standard of Care

For many years now, research has shown that there is a mouth body connection. In other words, what is happening in the mouth can impact what is happening with the body! In order for someone to have good health, they need to have good oral health. Unfortunately, periodontal disease is silent, as it does not hurt until it is severe. The minimal pain factor, as periodontal disease develops, may be why 80% of the United States population is suffering from periodontal disease. In the next paragra...
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Periodontist Turned Patient

  As a periodontist, I pride myself on healthy gums. I admit to only getting a prophylaxis when the schedule permitted. My home care most likely resembles what most dental professional do, brush twice daily with an electric toothbrush and flossing most days. In grad school, it was discovered I had a few 4mm periodontal pockets. However, my professors were not concerned and I was never diagnosed with periodontal disease. Now fast forward several years. At age 37, after surviving an...
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Systemic Antibiotics can be Bad but Heart Attacks are Worse

I am going to ask the question, would you agree antibiotics can be bad but heart attacks are worse? As this is part 3 of my series, I hope I am hearing a unified “Yes”. In my opinion, systemic antibiotic should be used in an attempt to lessen the translocated pathogens. The high-risk patient is no longer capable of fighting, resisting, or diminishing the pathogenic loads on their own and the systemic antibiotic is an option. Yes there is a risk of antibiotic adverse reaction but a heart atta...
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