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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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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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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I Don’t Need That, We’re Already Getting Good Results

The enemy of optimal patient care is complacency. Why would anyone settle for good results when optimal results are so easily achieved? Put yourself in your patient’s place in the exam chair: would you then want only good enough? Patients trust their dental professionals to provide the voice in decision regarding their care. If given the choice between practicing blindly, with no information about the specific bacterial cause of their individual case of periodontal disease, and having the ba...
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Genetic Testing with OralDNA® Labs

Genetic testing refers to the analysis of human DNA, and has become commonplace in the practice of medicine. According to the National Institute of Health, in the future “genetic testing will be an important part of health care for many individuals…we will live in a time of more effective ‘personalized medicine’. Information from genetic testing will help to detect risk for disease, guide strategies for maintaining health, offer more accurate diagnosis, and guide treatment choices for a wide...
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OraRisk® Caries: Identifying Bacteria for Risk Assessment

Dental caries is defined as the progressive destruction of a tooth and is considered a major health issue in both adolescents and adults, in which reportedly 90% of the population is affected1.  Cavities are formed when acid erodes the hard tissues of the teeth (enamel, dentin and cementum). Acid is produced in the mouth when certain bacteria, such as Streptococcus mutans, ferment sugars into acid.  For decades, S. mutans was believed to be the main bacteria involved in caries initiation ...
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