Active Periodontal Disease with Multiple Medical Complications

Challenge: A patient with Multiple Sclerosis (MS) and active periodontal disease, most recently was diagnosed with Type II diabetes, will receive periodontal therapy. Currently, proper home care is limited to the physical difficulties of MS. Background:  A 58-year-old female presented on 4/17/2018 with a chief complaint of xerostomia and physical difficulties challenging a proper home care regimen. Due to living with MS for several years, the patient has partial left-side paralysis result...
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MyPerioProgress® – Curve Up Ahead

When utilizing salivary diagnostic testing, most cases we encounter will “fit the mold”. We will also encounter many unique cases where we must expand our horizons and consider other possibilities for our patients’ responses to treatment. In my career, I have found these types of cases to be the most rewarding.  In my recent blog, MyPerioProgress®-Your Road Map, we reviewed a scenario where a patient’s periodontal therapy outcome and the bacterial profiles were not aligned after treatment - ...
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Classic Periodontal Disease Reaches Remission

Challenge: Several years of periodontal neglect revealed significant disease. Background:  A 48-year-old female, new patient presented with the chief complaint of a broken mandibular molar with swelling that resolved temporarily when taking antibiotics for a sinus infection. The patient reported it has been several years since receiving dental care. The CT scan showed several teeth with periapical abscesses and furcation involvements. The periodontal assessment, including radiographs reve...
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Interview with Ashley Leiterman

Dr McGlennen: Tell me how you use OralDNA® salivary diagnostics. Ashley RDH: I use OralDNA® salivary diagnostics to assist with the diagnosis and treatment planning of periodontal disease. The MyPerioPath® and Alert 2™ testing options are typically the tests we recommend most frequently. Dr McGlennen: What are the top two things to consider when you select a patient for testing? Ashley RDH: I consider the history of their disease. I routinely recommend testing for any patient who is...
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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...
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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 ba...
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“New Hat” for the RDH— Oral Systemic Health Educator & Certified Lifestyle Coach

Why would the Complete Health Registered Dental Hygiene team find themselves in inter-professional collaboration with the Certified Lifestyle Coach? The answer begins with understanding that the war raging inside of us is between chronic inflammation and the body’s own host response. We’re not aware of this war because it doesn’t hurt, and we can’t see its effects since it’s going on at a cellular, even a molecular level. The mouth happens to be a major battleground in this war. Unlike a ...
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“Test – and Retest – for Clinical Success”

Periodontal disease affects over half of the population and expresses itself differently in different people. It is a highly personalized disease. It is initiated by bacteria, yeast, and viruses that live in a layer on the teeth we refer to as biofilm. It is this biofilm that stimulates a unique host response. INDIVIDUAL HOST RESPONSE Each individual’s host response is dictated by combining their genetics with their acquired risk factors. Acquired risk factors are things that they can ...
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Periodontal Pathogens & Rheumatoid Arthritis

Trends in Salivary Testing wishes you a Happy Thanksgiving! Enjoy this blog re-post from 12/30/2016. In December 2016 researchers from Johns Hopkins University published a study in Science Translational Medicine indicating an identified link between periodontal disease and rheumatoid arthritis (RA). It would perhaps be more accurate to indicate that rather than periodontal disease being the causative agent, the perio pathogen Aggregatibacter Actinomycetemcomitans (A.a.) was found to be in...
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When to Administer the Systemic Antibiotic…..

The use of systemic antibiotics as an adjunct to periodontal disease have been utilized for decades1. With the emergence of systemic antibiotic stewardship, a responsible approach to administering a systemic antibiotic with periodontal care is warranted. The overall “cocktail” approach-selecting a systemic antibiotic to blanket everything-could be contributing to rise in antibiotic resistance. However, a systematic approach of testing and utilizing an evidence based recommendation helps you ...
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