A Progressive Oral Wellness Center in Rural America

In our rural practice (McCreight Progressive Dentistry) in Northwest Colorado, we see periodontal disease on average in about one of every two patients, or around 46%. This is representative of the CDC statistic as posted in the May 2015 Journal of Periodontology. Whenever we read these statistics, we are puzzled. In an industrialized nation where home care tools and dental technologies are readily available, how can there be so much disease? Here are some measures (newer technologies) we ha...
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AAP Classifications Simplified: Part 2

Last week, establishing a stage for your patient was highlighted. Click HERE to review. Once you have established the stage of your patient, the grade needs to be determined. The three grades are A, B or C. The grade indicates the speed of progression and the quality of treatment response. In order to establish the grade, there are 3 factors to consider: Direct evidence – Evidence of bone loss over the past 5 years. (You may not have access to previous records, but this highlights the v...
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AAP Classifications Simplified: Part 1

How the heck are we supposed to implement the new American Academy of Periodontology (AAP) Staging and Grading Periodontitis classifications into practice?  This new system seems so complicated, right??  Actually, it can be simplified and once that is done, the new system is extremely valuable!  As hygienists, we know that periodontal disease is multifactorial.  It is affected by systemic health, habits, occlusion, and more.  We know that it is just as much about the host response as it is abo...
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Microbiology 101

MyPerioPath® is a laboratory test widely used by health care professionals to screen for pathogens that cause both periodontal and systemic infections.  The rich report provided to clinicians includes an easy to read histogram showing the types and quantities of 11 specific periodontal pathogens detected from a simple saliva sample.  Two frequent questions about MyPerioPath®’s histogram will be discussed in this week’s blog.  First, what is the full name of each bacteria listed on each repor...
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The Insights Provided by Salivary Testing

Without salivary testing we have no way of knowing the cause of the periodontal disease in the patients under our care. The insights provided by salivary testing include: Identification of the causative bacteria Therapeutic endpoint Risk assessment Outcomes assessment Risk of recurrence Appropriate antibiotic Incorporating the information from the salivary bacterial test into the periodontal patient’s treatment plan enables personalized care. Forget the one-size-fit...
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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 ...
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Relapsed Periodontal Maintenance Patient with Breast Cancer

Challenge: A periodontal maintenance patient of record presented past due for recare. The initial exam revealed signs of active periodontal disease indicating that the patient is no longer in periodontal remission. Medically, the patient is undergoing treatment for breast cancer. Background: A 54-year-old female patient of record, with history of successful periodontal therapy, has relapsed due to missed recare and decreased oral home care. A diagnosis of breast cancer in Spring 2019 has ...
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Systemic Inflammation, Elevated hs-CRP, and Oral Bacterial Pathogens Decrease After Two Years of Natural Dental Health Treatments: A Case Study

Heart Disease Begins in the Mouth High sensitivity C-reactive protein (hs-CRP) is the most clear, quantifiable, and readily accessible marker of the oral-systemic connection. We present a case study of an otherwise healthy 62-year-old woman with elevated hs-CRP who had abundant numbers of pathogenic oral bacteria. A natural dental health treatment over two years lowered hs-CRP and lowered oral pathogens. Given the links between oral disease, inflammation, and heart disease, it is wise to ...
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The Doctor-Hygienist Hand-Off

As a formerly practicing hygienist and now a dentist, I am respectfully sensitive to the time constraints and importance of the information exchange during a periodic exam in the hygienist’s treatment room. My team and I developed, practice, and teach this exchange for thoroughness, patient benefit, and emphasis of our professionalism. When the doctor enters the hygienist’s treatment room, the hygienist is to highlight and summarize her findings in the most efficient and effective verbiag...
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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 ...
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