Be the Guide, Not the Hero

We care deeply for our patient family and are oral-systemic experts.  Because we have invested enormous amounts of time and money in quality education, we know best what people need for strong teeth and a long health span.  Our patients appreciate this and always listen intently to what we tell them they need to do.  They happily reach into their wallets and hand us their credit card.  Right?  In my 34 years of clinical experience: Wrong!  People buy what they want, not necessarily what they...
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Nobody Has Ever Done that Before

In this era of trying to differentiate yourself from the provider down the street, a simple solution is incorporating OralDNA® salivary testing services.  Imagine a patient who has had periodontal disease and has seen several dentists and periodontists in the past.  They may have been told they have pockets, but what do pockets mean to a patient?  Perhaps a lot, but only if they have been properly educated about the consequences of a pocket deepening. Let’s look at this from another persp...
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What’s Your Excuse?

It is difficult to understand the resistance by dental professionals to test for the bacteria that cause gum disease. The excuses are numerous including, “I’ve always done it this way”. A variation on this notion is “We were always taught”. Other excuses shift the decision to the patients. “My patients won’t accept it”. Equally unsupported excuses include “We’re already getting good results”, or “I don’t need that”, or “What difference will it make?” Claims of insufficient time are very comm...
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Why I Teach Salivary Testing as a Dental Hygiene Instructor

  I am a dental hygienist and have spent most of my career in a periodontal practice. Most recently I split my time at Dr. Steven Peiser’s office and serve as a faculty member at Goodwin College in Connecticut teaching Oral Pathology to dental hygiene students. It has been so exciting to teach this course and share my knowledge and experience.  Specifically, I most enjoy teaching about the relationship of pathogenic bacteria to the oral-systemic link which is crucial to understand wh...
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Periodontal Disease, Perio Pathogens & Rocket Science

Risk factors for heart attack include; age, tobacco, high blood pressure, lipid profile, diabetes, family history of heart attack, lack of physical activity, obesity, stress, illicit drug use, history of preeclampsia, history of autoimmune condition such as lupus or rheumatoid arthritis and so on and so on. Why have all these risk factors been identified? Because it is better to prevent a heart attack than it is to have one. Risk factor identification and modification is the cornerstone of p...
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A Periodontist’s Nonsurgical Approach to Periodontal Disease: Part 2

Last week I wrote on how MyPerioPath® testing impacts patient diagnosis. Now I will address another aspect of the report, the systemic antibiotic option. There are some “purists” out there who say they don’t need antibiotics, and that they only need clinical evaluation to treat a periodontal infection. I can’t see the bacteria. I don’t know the involvement or virulence of these pathogens. While I strongly believe that antibiotics are overused in health care, when there is a true infection of...
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A Periodontist’s Nonsurgical Approach to Periodontal Disease: Part 1

I am a periodontist who has been using OralDNA® testing to determine periodontal pathogens for many years. Our practice consists of two periodontists and a restorative dentist. Most of our patients have major dental needs such as implants, bone grafts, and restorative needs, as well as a large population with chronic periodontitis. Philosophically, I believe that saving teeth is the role of a periodontist. Too many teeth are being extracted that can be saved in health for many years. There a...
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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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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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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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