How do you speak Cardiovascular Disease and Periodontal Disease to your patients?

Dr McGlennen: There is consensus within the medical and dental community that periodontal bacteria contribute to the initiation, progression and prognosis of cardiovascular disease. From key studies, including prospective, retrospective and even meta-analysis studies, persons with untreated periodontal infections have up to a 20% increase in their risk of coronary vascular disease.1 The multiple of risk for stroke (1.74-2.85 fold) and peripheral vascular disease (1.41-2.27 fold) is equal or ...
More

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...
More

Rethinking the Dental Examination

It’s 2018 and I am dumbfounded by the number of adult new patient appointments that begin in the hygiene chair. We all recognize this is an ‘old school’ practice, but maybe we still secretly believe it’s the right thing to do for our patient. Maybe we somehow believe it’s financially beneficial to the practice. Neither of these could be further from the truth. The dental examination of today is all about the patient of today. From a health standpoint, the patient of today is more complica...
More

Causality– It Was Only a Matter of Time

Trends in Salivary Testing Throwback: We as dental professionals have a significant role in combating the number one cause of death: cardiovascular disease. “High-risk periodontal pathogens contribute to the pathogenesis of atherosclerosis” is a powerful piece and I recommend you read it. There is scientific evidence that [periodontal disease] PD caused by the high-risk pathogens can influence the pathogenesis triad in an adverse manner. With this appreciation, it is reasonable to stat...
More

Sick & Tired of Patients Being … Sick & Tired?

Me too! Day after day, patients dismiss their oral health, writing it off as “My gums have always bled.” Inside, my head was exploding, but outside my heart was opened. I knew that I had a chance to educate my patients to a whole new level of health. One where their energy would be boosted, risk to coronary heart disease would be lowered, and the chance of them developing diabetes would be significantly reduced. I became a hygienist on a mission. I instinctively knew that if things were t...
More

Life & Death and a Saliva Test

Sometimes I get so frustrated with the profession of dentistry. Here is my case in point: Five oral originating pathogens have been identified as causative in the development of atherosclerosis by the BaleDoneen™ peer reviewed study published in the British Medical Journal. Wait a minute, so they concluded that these oral bacteria are causative of atherosclerosis? Seriously? Yes!! And in the last one hundred years, atherosclerosis has killed more Americans than any other disease. Atheroscler...
More

Patient with Dental Pain, Periodontal Disease & High Blood Pressure

Challenge: To address the dental concerns to resolve patient’s dental pain. To educate the patient on the connection between dental health and overall health. Background: The patient is a 37-year-old male who presented with a dental pain emergency. The home care is poor and patient has history of only seeking dental care for emergencies. Medically, the patient has hypothyroidism, hypertension, high cholesterol and significant difficulty breathing while asleep. The blood pressure reading o...
More

Managing Atherosclerotic Disease: Medical and Dental Collaboration- The New Standard of Care

Medicine and dentistry have long been aware of the connection, association, and direct links between high-risk periodontal pathogens and cardiovascular disease. Knowledge alone has a limited potential to change chronic disease outcomes unless it leads to new clinical practices. Effective and proven new protocols to identify and mitigate virulent periodontal microbes are available today. A small percentage of dentists have implemented these practices and the majority of physicians are unaware...
More

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...
More

Systemic Antibiotics can be Bad but Heart Attacks are Worse

I am going to ask the question, would you agree antibiotics can be bad but heart attacks are worse? As this is part 3 of my series, I hope I am hearing a unified “Yes”. In my opinion, systemic antibiotic should be used in an attempt to lessen the translocated pathogens. The high-risk patient is no longer capable of fighting, resisting, or diminishing the pathogenic loads on their own and the systemic antibiotic is an option. Yes there is a risk of antibiotic adverse reaction but a heart atta...
More