Periodontal Therapy Without Pharmaceuticals

Challenge: A patient of record with a history of prostate cancer is exhibiting active signs of periodontal disease. Background:  A 69 year old male with a history of prostate cancer including surgical removal of the prostate. Patient also has a history of atrial fibrillation and cardiac ablation. He presents with active periodontal disease symptoms. The patient states, “I want to be proactive and per my functional medicine doctor, there could be bacteria complicating my overall health.” ...
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Flower Power: A Less Aggressive Approach

When OralDNA® testing indicates worrisome levels of periodontal pathogens, we may want to consider a dentally counter-cultural idea that can help avoid the need for aggressive antibiotics and antiseptics. Most dental professionals believe periodontal disease cannot be cured, yet a more holistic approach has been shown to overcome periodontal pathogens and may offer a way to avoid the continuous cycles of treatment to control re-infection. Our understanding of human bacteria changed as the Human ...
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Active Periodontal Disease with Multiple Medical Complications

Challenge: A patient with Multiple Sclerosis (MS) and active periodontal disease, most recently was diagnosed with Type II diabetes, will receive periodontal therapy. Currently, proper home care is limited to the physical difficulties of MS. Background:  A 58-year-old female presented on 4/17/2018 with a chief complaint of xerostomia and physical difficulties challenging a proper home care regimen. Due to living with MS for several years, the patient has partial left-side paralysis result...
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Classic Periodontal Disease Reaches Remission

Challenge: Several years of periodontal neglect revealed significant disease. Background:  A 48-year-old female, new patient presented with the chief complaint of a broken mandibular molar with swelling that resolved temporarily when taking antibiotics for a sinus infection. The patient reported it has been several years since receiving dental care. The CT scan showed several teeth with periapical abscesses and furcation involvements. The periodontal assessment, including radiographs reve...
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30 Years of Periodontal Maintenance with Relapse and Cardiovascular Complications

Challenge: After decades of periodontal stability, the patient presented with a rapid advancement of pocketing and inflammation over a period of only 9 months. Background:  A 60-year-old male maintaining periodontal health for over 30 years started to relapse. Upon periodontal assessment, there were increasing pockets throughout, especially around an implant, of 9mm. The gingiva was generally medium pink with rolled margins and spongy, erythematous papilla with isolated severe inflammatio...
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Gingival Hyperplasia with bone loss and Anorexia Nervosa

Challenge: A 15-year-old patient with multiple years of periodontal concerns being co-managed with a periodontist without resolution. Background:  A 15-year-old female has been presenting for care at our practice since age 4.  From an early age the patient displayed behavioral concerns and chronic poor home care.  The dental history is early eruption of #19, three month recall due to levels of supra and sub gingival calculus, and mild bone loss resulting in a referral to the periodontist ...
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Patient with Chronic Gingivitis & Oral Candida

Challenge: Patient presented with chronic gingivitis and oral Candida symptoms Background: A 64-year-old female sought treatment from a medical doctor for a “thrush-like” infection. The medical doctor then referred the patient to an ENT. However, this patient was already of our record and decided to start with our office. The chief complaint is a “thrush-like” infection in the mouth, throat and lips. The clinical assessment confirmed generalized white patches. Upon periodontal assessment,...
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Patient with Dental Pain, Periodontal Disease & High Blood Pressure

Challenge: To address the dental concerns to resolve patient’s dental pain. To educate the patient on the connection between dental health and overall health. Background: The patient is a 37-year-old male who presented with a dental pain emergency. The home care is poor and patient has history of only seeking dental care for emergencies. Medically, the patient has hypothyroidism, hypertension, high cholesterol and significant difficulty breathing while asleep. The blood pressure reading o...
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The Co-management of an Esophageal Cancer Survivor

  Background: The patient is a 75-year-old female with a history of esophageal cancer in 2013. The origin of the cancer was determined to be lichen planus. Surgical removal of the lesion occurred and no reconstructive surgery was needed. However, post-surgery to present date, the patient experiences severe acid reflux and sleeps with her head elevated. She has great home dental care and follows a 3-month periodontal maintenance. During the head and neck exam, no significant findings ...
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Case Study: Dental Hygienist with Type II Diabetes

Background: This patient is a 38-year-old female, who works as a dental hygienist. She was recently diagnosed with Type II Diabetes. In agreement with her medical doctor, she has committed to diet and lifestyle changes to control her diabetes before the consideration of medication. These lifestyle changes include regular exercise and eliminating sugar. When this hygienist presented in my chair, her chief complaint was “When it comes to my diabetes, I know what to do, I just need to do it! As...
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