The Co-management of an Esophageal Cancer Survivor

Background: The patient is a 75-year-old female with a history of esophageal cancer in 2013. The origin of the cancer was determined to be lichen planus. Surgical removal of the lesion occurred, and no reconstructive surgery was needed. However, post-surgery to present date, the patient experiences severe acid reflux and sleeps with her head elevated. She has great home dental care and follows a 3-month periodontal maintenance. During the head and neck exam, no significant findings were disc...
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Chronic Anterior Inflammation Finally Resolved

Challenge: The patient's main concern was to reduce chronic inflammation around tooth #8 and #9. The patient previously had received treatment at a general dentist and a periodontist without significant improvement. Background: A new female patient, age 28, was last seen by another dentist on 12/5/2018. Her home care consists of brushing twice daily with Tom's of Maine® toothpaste and a Sonicare™ power toothbrush, and Crest® Pro-Health™ rinse with occasional flossing. Her family history i...
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Case Study: Class II Periodontitis

  Background: The patient is a 54-year-old female who presented with the chief complaint “My gums bleed when I brush, there are possible cavities and I don’t like the tooth crowding.” Her last dental visit was about 6 years ago. There is a family history of diabetes, cardiovascular disease, stroke and cancer. The home care consisted of manual tooth brushing 1-2 times per day with occasional antibacterial mouth rinse. During the clinical assessment, it was discovered that several amal...
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Class II Generalized Periodontitis and Rheumatoid Arthritis Requesting Implant Placement

Challenge: To establish periodontal remission by addressing the clinical manifestations of periodontal disease and altering the oral flora in order to lower the incidence of periodontal disease relapse. Bacterial management will eliminate a source of total body inflammation and increase success of implant placement. Background: The patient is a 66 year-old-male with rheumatoid arthritis, taking Lisinopril and is a potential candidate for implant to restore #19. Patient’s daily home care r...
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Traditional Periodontal Disease Case Study

Challenge: Patient with extremely limited history of dental care presents seeking dental wellness. Although patient is anxious, she is highly motivated to create a healthier dental foundation. Background:  A 33-year-old woman with history of acid reflux, seasonal allergies and anemia is seeking to better her dental care. The patient has limited recollection of any dental care in her life, even childhood. The patient’s home care consists of manual tooth brushing 1-2 times per day with the ...
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Dental Clearance Without the Guesswork

Have you ever been uncertain when providing dental clearance for crucial treatments, such as heart surgery or joint replacement? In my practice, we look at the clinical signs and symptoms for oral disease, but we additionally observe the patient’s oral health at the molecular level. Let me share a case with you that illustrates the importance of salivary testing and its profound impact on the credibility of clearing a patient for surgery. A long-standing patient presented to my office on...
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