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 the...
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Periodontal Patient with Poor Diabetic Control Combined with Poor Home Care

Challenge: A periodontal patient of record is diagnosed with active periodontal disease. Therapy is needed to achieve a healthier oral state; however the patient has uncontrolled diabetes combined with poor home care that may be contributing to the patient’s oral health status. Background:  A female patient of record, age 48, presented for periodontal maintenance on 11/19/2018. Upon periodontal assessment, the patient exhibited oral inflammation with bleeding, moderate calculus deposits a...
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Periodontal Disease & Pregnancy

Challenge: The patient is expressing oral inflammation and is pregnant. The clinical signs of periodontal disease due to pathogenic bacteria look identical to the clinical signs produced by pregnancy hormones. Background:  A 21-week pregnant patient, age 34, presented for care. Upon periodontal assessment, there was generalized marginal inflammation with moderate bleeding on probing. The probe depth readings were generalized 3-4mm. The patient’s oral homecare consisted of twice daily brus...
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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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MyPerioProgress® – Curve Up Ahead

When utilizing salivary diagnostic testing, most cases we encounter will “fit the mold”. We will also encounter many unique cases where we must expand our horizons and consider other possibilities for our patients’ responses to treatment. In my career, I have found these types of cases to be the most rewarding.  In my recent blog, MyPerioProgress®-Your Road Map, we reviewed a scenario where a patient’s periodontal therapy outcome and the bacterial profiles were not aligned after treatment - ...
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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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Interview with Ashley Leiterman

Dr McGlennen: Tell me how you use OralDNA® salivary diagnostics. Ashley RDH: I use OralDNA® salivary diagnostics to assist with the diagnosis and treatment planning of periodontal disease. The MyPerioPath® and Alert 2™ testing options are typically the tests we recommend most frequently. Dr McGlennen: What are the top two things to consider when you select a patient for testing? Ashley RDH: I consider the history of their disease. I routinely recommend testing for any patient who is...
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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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MyPerioProgress® – Your Road Map

Several years ago, Dr Herb Bader wrote: “The literature supports the advantages of determining the causative organisms in the biofilm, that induces the destructive inflammatory response (Haffajee, Tanner, Teles andSocransky, 2006). In addition, there is a considerable body of evidence supporting the accuracy and sensitivity of salivary testing as being virtually identical to sulcular samples. Work by Giannoble, Wong and others (2008) have confirmed this. Data from thousands of such tests has...
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