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 were disc...
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A Common-Sense Approach to Diagnosis and Treatment Planning: Weekly Case Reviews with Dr. Lee Sheldon

Most webinars explore new, innovative, fabulous procedures. What about the day-to-day procedures such as the new patient, the periodontal case, or the restorative case? What about the basics? • How to communicate to the patient? • How to prioritize to make dentistry within reach of the average person? • How to gain greater case acceptance? • How to remove the insurance obstacle? Dr. Sheldon brings his whole team approach to patient management and communication to his new webinar series....
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Chronic Anterior Inflammation Finally Resolved

Challenge: The patient's main concern was to reduce chronic inflammation around tooth #8 and #9. The patient previously had received treatment at a general dentist and a periodontist without significant improvement. Background: A new female patient, age 28, was last seen by another dentist on 12/5/2018. Her home care consists of brushing twice daily with Tom's of Maine® toothpaste and a Sonicare™ power toothbrush, and Crest® Pro-Health™ rinse with occasional flossing. Her family history i...
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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 amal...
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Case Study: Periodontal Disease and Cardiovascular Disease

Challenge: A new patient who has neglected dental care for 20 years with a chief complaint of broken teeth and bleeding gums appoints to address his dental concerns. Background:  A 70-year-old male patient with broken teeth and bleeding gums appoints to our office. His last dental visit was estimated to be 20 years ago. Surprisingly the patient was not experiencing dental pain. The periodontal assessment revealed generalized 4-6 mm pockets with localized 7-9 mm pockets, inflamed and bulbo...
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Class II Generalized Periodontitis and Rheumatoid Arthritis Requesting Implant Placement

Challenge: To establish periodontal remission by addressing the clinical manifestations of periodontal disease and altering the oral flora in order to lower the incidence of periodontal disease relapse. Bacterial management will eliminate a source of total body inflammation and increase success of implant placement. Background: The patient is a 66 year-old-male with rheumatoid arthritis, taking Lisinopril and is a potential candidate for implant to restore #19. Patient’s daily home care r...
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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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