A Periodontist’s Nonsurgical Approach to Periodontal Disease: Part 1

I am a periodontist who has been using OralDNA® testing to determine periodontal pathogens for many years. Our practice consists of two periodontists and a restorative dentist. Most of our patients have major dental needs such as implants, bone grafts, and restorative needs, as well as a large population with chronic periodontitis. Philosophically, I believe that saving teeth is the role of a periodontist. Too many teeth are being extracted that can be saved in health for many years. There a...
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Where to Start

A common dilemma among many dental practices is how to transition the hygiene department from prophylaxis to comprehensive periodontal diagnosis and treatment. Among the concerns is the perception that if we are starting something new, does that imply that up until now patient needs have been inadequately addressed? The simple solution to this dilemma is referring to the constantly evolving knowledge in healthcare. Using phrases such as “Research has shown” or “We now know” can help with the...
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Periodontal Patient with Poor Diabetic Control Combined with Poor Home Care

Challenge: A periodontal patient of record is diagnosed with active periodontal disease. Therapy is needed to achieve a healthier oral state; however the patient has uncontrolled diabetes combined with poor home care that may be contributing to the patient’s oral health status. Background:  A female patient of record, age 48, presented for periodontal maintenance on 11/19/2018. Upon periodontal assessment, the patient exhibited oral inflammation with bleeding, moderate calculus deposits a...
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Periodontal Disease & Pregnancy

Challenge: The patient is expressing oral inflammation and is pregnant. The clinical signs of periodontal disease due to pathogenic bacteria look identical to the clinical signs produced by pregnancy hormones. Background:  A 21-week pregnant patient, age 34, presented for care. Upon periodontal assessment, there was generalized marginal inflammation with moderate bleeding on probing. The probe depth readings were generalized 3-4mm. The patient’s oral homecare consisted of twice daily brus...
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3 Surefire Ways To Make 2019 Your BEST Year Ever

WOW! How time flies! It’s hard to believe that the first quarter of 2019 is over. Every day there are countless opportunities to enhance our patient care, create more efficiency, increase our production, and improve team morale. If you are one of those people, like me, who enjoys setting goals and celebrating when you reach them; then you will love these 3 surefire ways to make 2019 your BEST year ever! 1. Get the RIGHT People in the “RIGHT SEATS” on your bus! There have been days when...
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Do You Speak HPV? Part 3

In my previous blog, I explored three common positive responses I’ve encountered from patients when offering a test for oral HPV and how I would respond to them.  In this blog, I will address some of the objections from patients and how I would further educate the patient about oral HPV and testing options. Patient 1: I don’t think I need that test.  I’ve never been exposed. Response 1: I understand but in case you’re ever curious, remember we have this potentially life-saving service ...
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Do You Speak HPV? Part 2

Dental clinicians have been on the front lines of oral cancer prevention and early detection for many years. We have been trained to do very thorough oral cancer exams and to use various light systems to visualize tissue changes; however, according to the Oral Cancer Foundation, the death rate for oral cancers has remained higher than that of many other types of cancers which we hear about routinely.1 Many studies support that the human papilloma virus (HPV) is responsible for a large number...
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Do You Speak HPV? Part 1

Dental professionals are often uncomfortable approaching patients on topics that are unfamiliar or that feel outside the realm of “traditional” dentistry.  One such topic is Human papillomavirus (HPV).  As a hygienist of 40 plus years, I can tell you this topic never came up in my education.  Several years ago, I had to educate myself about this near epidemic viral infection. Most importantly, I had to step out of my comfort zone to find a way to share this crucial knowledge with my patients...
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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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Salivary Diagnostics: Your Molecular X-Ray

According to Merriam-Webster, one of the definitions of technology is a manner of accomplishing a task especially using technical processes, methods, or knowledge. This definition rings true for the introduction of clinical laboratory testing for the health care professions. It was noted in research by the NIH, “…it was not until 1896 that the first clinical laboratory was opened, a twelve-foot-by-twelve-foot room equipped at a cost of $50 at Johns Hopkins Hospital.”1 So for over a century, ...
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