Type II Diabetic and Periodontal Disease

Challenge: A Type II Diabetic patient, who has been a long term client, has uncontrolled periodontal disease and a history of not responding to previous periodontal treatment. Background:  This 73 year-old female with Type II Diabetes has been a patient in our periodontal maintenance program for years. She has had several courses of active periodontal therapy never achieving complete periodontal remission. In the past year, our team has been upping our game by studying under Dental Hygien...
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An Uncontrolled Diabetic Patient – Referred by Physician

Background: The patient is a 41-year-old female who has not been seen by a dental professional since 2008 (10 years). The patient stated her chief concern as “My doctor said my uncontrolled diabetes could be caused by my mouth.” Other medical concerns are high blood pressure and acid reflux. The home care routine consisted of manual tooth brushing only. Following the periodontal assessment, the patient was diagnosed with active, localized, chronic periodontitis due to the present sub-gingiva...
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Testing and Coding Improving Patient’s Health

  Periodontal disease starts with a biofilm-based infection that creates a wound that in turn, induces the inflammatory cascade responsible for the disease. This wound should be taken seriously! A variety of tests are available to determine risk, genetics, and the specific pathogens involved with periodontal disease. OralDNA® Labs salivary diagnostic testing helps improve oral health outcomes and enables patients to make more informed choices regarding their professional treatment...
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Case Study: Dental Hygienist with Type II Diabetes

Background: This patient is a 38-year-old female, who works as a dental hygienist. She was recently diagnosed with Type II Diabetes. In agreement with her medical doctor, she has committed to diet and lifestyle changes to control her diabetes before the consideration of medication. These lifestyle changes include regular exercise and eliminating sugar. When this hygienist presented in my chair, her chief complaint was “When it comes to my diabetes, I know what to do, I just need to do it! As...
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The Medical History Form and Salivary Diagnostics

A medical history form is a starting point to guide conversations and to make connections between oral health and overall health. Consider re-configuring your current medical history form to quickly be able to visualize oral systemic connections and/ or concerns. These 5 questions should be asked on your current health history form. 1) Has a parent, sibling or grandparent had a heart attack or stroke? Yes__ No__ 2) Has a parent, sibling or grandparent had diabetes? Yes__ No__ 3) Has a p...
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Diabetes Screening in Dental Offices: Part 2

Diabetes is completely out of control in this country. The CDC estimates that one in three adults in the U.S. will be diabetic by 2050. Today, there are 79 million pre-diabetics in the U.S.; which is three times greater than the number of presently diagnosed diabetics. This is a diabetic avalanche; we can’t see the snow roaring down the mountainside, but it is coming.   The dental profession needs to be better prepared to assist, as the medical profession is clearly overwhelmed. N...
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Diabetes Screening in Dental Offices: Part 1

In 2014, the New Jersey State Board of Dentistry ruled that dentists in New Jersey could screen at-risk patients for diabetes, and although such in-office screening is within the scope of licensure in the state, this testing is not to be presumed to be the standard of care. This can be interpreted to mean that the screening needs to be followed by referral to a physician for definitive diagnosis. The glycated hemoglobin (HbA1c) screening can be performed as a finger stick and analyzed in the den...
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