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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How do you speak Joint/Musculoskeletal Health and Periodontal Disease to your patients?

Dr McGlennen: Like periodontitis, rheumatoid arthritis (RA) is a chronic inflammatory condition.  But unlike periodontitis, where the genesis of the inflammation is the complex infections in the gingival sulcus, the cause of RA is unknown.  Recent studies, however, provide insights that, in part, oral bacteria play a role in evoking an abnormal immune response that then leads to joint disease.  In a recent meta-analysis of 21 separate studies, there was a significantly increased risk of peri...
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A Total Health Approach at a Reasonable Price: An Interview with Dr Isaac Comfortes DDS

Dr Nagelberg: Tell me how you use OralDNA salivary diagnostics. Dr Comfortes: I started utilizing salivary diagnostics in 2013. Since then my approach has concentrated on total health, which I discuss this during every patient consult. Without the use of OralDNA® salivary diagnostics, the total health conversation would be difficult. First, I ask the patient if they understand the importance of the test. Then I address the levels of bacteria and how that is expressed in their gum health. ...
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Perio Pathogens CAUSE Rheumatoid Arthritis– Now What?

“Rheumatoid arthritis is a chronic disease affecting over 1.3 million Americans and as much as 1% of the worldwide population.” (www.rheumatoidarthritis.org) There is a growing body of research indicating a causal association between specific periodontal pathogens and rheumatoid arthritis (RA). In a 2009 study, in Compendium of Continuing Education in Dentistry, the authors indicate that a specific perio pathogen, Porphyromonas gingivalis (P.g.), produces an enzyme capable of modifying specifi...
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Periodontal Pathogens and Rheumatoid Arthritis

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 involved. The link between A.a. and RA involves a process called citrullination; which is the conversion o...
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