Salivary Diagnostics, Lasers and Beyond…

As a hygienist, one of my main duties is to provide non-surgical therapy for the treatment of periodontal disease. The goal, (during the non-surgical treatment approach), is to change the environment of the pocket, address the active infection and keep the patient in remission as long as possible. Meticulous removal of sub-gingival calculus with hand instruments and micro-ultrasonics is crucial. We must provide a biologically acceptable root surface. In addition to detoxifying the root su...
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Periodontist Turned Patient

  As a periodontist, I pride myself on healthy gums. I admit to only getting a prophylaxis when the schedule permitted. My home care most likely resembles what most dental professional do, brush twice daily with an electric toothbrush and flossing most days. In grad school, it was discovered I had a few 4mm periodontal pockets. However, my professors were not concerned and I was never diagnosed with periodontal disease. Now fast forward several years. At age 37, after surviving an...
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WNL: What’s your definition?

During virtually every dental examination, there is a review or updating of the patient’s health history and a clinical examination. If everything is consistent with good oral and overall health the notation WNL is commonly made, which is an abbreviation for Within Normal Limits. There is however another less commonly known meaning to WNL; We Never Looked. Looking goes way beyond visual observation and includes other diagnostic tools such as radiographs, scans and laboratory testing. Let’s co...
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Salivary Crystal Ball – Part 3

The importance of the specific bacteria to the prognosis of an individual’s case of gum disease was known over 20 years ago. In a 1996 article in the Journal of Periodontology (Renvert et al. J Periodontol. 1996 Jun; 67(6): 562-71.) the authors concluded that the presences of Aa, Pg, and Pi alone or in combination correlated with attachment level changes. The authors further concluded that pathogenic bacteria are better predictors of disease progression than observed clinical signs. In a 200...
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The Salivary Crystal Ball – Part 2

Most general dental practices are providing the same types of services: diagnostic services, restorative procedures, prosthodontic procedures, endodontic procedures, surgical procedures and periodontal procedures. Of course there are variations in techniques and complexity of cases being undertaken, but substantially a wide swath of dental practices are providing the same services. When a patient comes for an appointment, depending on where they live and work, they are traveling past several or ...
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The Salivary Crystal Ball – Part 1

Bleeding on probing (BOP) is encountered every day in virtually every dental practice. It is so common that there may be a tendency to undervalue its importance in diagnosing gingivitis and periodontitis. BOP is like periodontitis or pregnancy in the following regards: There is no such thing as “just a little bleeding.” You have it or you don’t. There is no such thing as a little periodontitis; you have it or you don't. There is no such thing as a little pregnant; you are or you are not. You...
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