Interview with Adrian Fitts RDH & Gerald Smith DMD

Dr McGlennen: Tell me how you use OralDNA® salivary diagnostics. Adrian Fitts RDH & Dr. Gerald Smith: When we see a patient that isn’t “normal.”  Many patients are routine with regard to their oral hygiene/plaque/calculus.  The vast majority of patients respond to usual measures, debridement, and diligent oral hygiene.  However, some patients don’t fit this.  For example, we see a relatively “clean” mouth but we are finding increasing pocketing/bleeding.  The OralDNA® tests are perfec...
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Implants, Biofilm, & pH!

Today, dental professionals need to look at professional maintenance in a whole new light. A paradigm shift in professional maintenance and home-care recommendations for patients with tooth-borne and implant-borne restorations is occurring. I would refer to this as ‘mixed bag’ patients with natural teeth, restorations, and implants. We see these ‘Mixed bag’ patient every day. An additional resource to provide the best maintenance would be The American College of Prosthodontists guidelines fo...
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Gum Disease and Alzheimer’s Disease

In honor of National Alzheimer’s Month, enjoy this repost from 3/3/2017. A 2016 study published in PloS One1 examined the impact of periodontitis on the rate of cognitive decline in individuals with Alzheimer’s disease (AD). Sixty community dwelling patients with mild to moderate AD were cognitively assessed and blood samples were taken for detection and quantification of systemic inflammatory markers. Initial clinical assessments of periodontal health were conducted and the same assessme...
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Patient Expectations in the Dental Office

Most patients seem to have reasonable expectations of the care they receive from their dental providers. It is reasonable for our patients to expect us to provide the right amount of treatment for their dental needs- no more and no less, for a reasonable fee. For the majority of patients, the dental service most often received is of a periodontal nature, such as a prophylaxis or periodontal maintenance procedure. This generally occurs two to four times a year. Restorative treatments such as ...
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Gum Disease and Alzheimer’s Disease

A 2016 study published in PloS One1 examined the impact of periodontitis on the rate of cognitive decline in individuals with Alzheimer’s disease (AD). Sixty community dwelling patients with mild to moderate AD were cognitively assessed and blood samples were taken for detection and quantification of systemic inflammatory markers. Initial clinical assessments of periodontal health were conducted and the same assessments were repeated six months later. The study data revealed that periodontit...
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My Staff Won’t Do It

There are many justifications, rationalizations, and excuses in non-testing practices, all of which signal some level of disinterest in enhancing patient care. One of the most difficult to understand is; “My staff/hygienist just won’t do it.” If the doctor is the driving force behind testing implementation and one or more team members are resistant, a staff meeting is in order. Leadership comes from the top and it is the doctor’s responsibility to set the direction for the practice, including th...
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Stop Diagnosing the Pocketbook

Cost is a consideration for all of us, which we take into account when deciding whether or not to purchase a wide variety of goods and services. Our responsibility as clinicians is to make recommendations to help patients achieve the best health possible, without letting our preconceived ideas about the patient’s ability to afford treatment get in the way – what I refer to as diagnosing the pocketbook. One of the things we do not know and cannot predict is how much value the patient puts on thei...
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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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The Third Annual North American Saliva Symposium

I attended the third annual North American Saliva Symposium (NASS) this year which was held at New York University College of Dentistry, December 9-10. It was an event filled with globally recognized researchers in salivary diagnostics presenting updates on their respective research efforts. The following is a glance into what the future holds for salivary diagnostics as well as the exciting application of salivary tests currently available. Dental innovations of the future were captured ...
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More Insights Provided by Salivary Testing

One of the insights gained when using salivary testing is finding that good point to stop treatment. This therapeutic endpoint may be defined by the return to gingival health, reduction of pocket depth, and a stable clinical attachment level. In other words, the therapeutic endpoint tells us when we have done all we can do for the time, and let the remaining healing occur unassisted. With the easy availability of post-op bacterial testing, the therapeutic endpoint can now be expanded to include ...
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