Dr. McGlennen: Tell me how you were introduced to OralDNA® salivary diagnostics.
Ziv Simon DMD MSc: I am a periodontist and implant specialist in Beverly Hills where I have practiced for the past 20 years (our practice has been in this location for 42 years!). When I started, we were already doing bacterial testing using paper points inserted into the pockets. These were then sent to a lab for aerobic and anaerobic cultures. Although that system worked, the testing process was inconsistent, and the results could be as well. We would occasionally get a result of zero pathogens in patients with advanced disease. Over 10 years ago we started using OralDNA® Labs and that has been our go-to system for detecting periodontal pathogens in our periodontal practice.
Dr. McGlennen: You and your practice have been using OralDNA® services since July 2010. Do you recall any Ah-Ha moments?
Ziv Simon DMD MSc: That first Ah-Ha moment came when I was introduced to DNA testing and getting educated about the process. There was no longer the need to sample certain deep pockets. The consistency and simplicity of collection made choosing the OralDNA® system a no-brainer. The second Ah-Ha moment came when I assessed patients with implant disease and implant failure. In close to 100% of all cases, significant numbers of periodontal pathogens have been detected. Without getting into the pathogenesis of peri-implantitis, we are now including the testing when implant disease is diagnosed.
Dr. McGlennen: What are the top two things to consider when you select a patient for testing?
Ziv Simon DMD MSc: Very clear answer is active periodontal disease, patients with active signs and symptoms. Testing is also beneficial for cases where we don’t see a good response following periodontal care. I need to add a third here – Peri-implant disease. Like I mentioned before, periodontal pathogens are the same pathogens involved with peri-implantitis. I would even take it this far: When you are considering implants, make sure the oral environment is healthy – clinically and microbiologically.
Dr. McGlennen: What are the biggest benefits to using salivary diagnostics?
Ziv Simon DMD MSc: Clearly the simplicity of the testing and identifying the pathogenic culprits. It’s great for patient education as well as being able to include this in a report to our many referring dentists. It is also a growth center where considerable income is generated while providing important diagnostic data.
Dr. McGlennen: What is your favorite part of the MyPerioPath® results? Why?
Ziv Simon DMD MSc: The favorite part is the visual presentation of the results plus the data provided below the graphs where patients and doctors can gain additional information about the detected pathogens.
Dr. McGlennen: How do your patients respond to this technology? What is their #1 question?
Ziv Simon DMD MSc: Most patients are aware of DNA testing. We educate them that MyPerioPath® is not measuring “their” DNA but the DNA of the pathogens in their mouth. Most patients are very supportive of getting the test done and are eager to hear about the results. For doctors out there considering using bacterial DNA testing, make sure to build value for the test when you communicate. Do so before quoting the fee for the test. In this order, you will have better case acceptance.
Dr. McGlennen: What is your biggest challenge? How do you overcome that obstacle?
Ziv Simon DMD MSc: The biggest relative challenge is that patients across the board dislike taking antibiotics. There is more awareness about the negative side effects on gut bacteria and the environment globally. So, the best approach is as always – communication. We must communicate some of the negative side effects and use antibiotics with caution. Talk to your patients about previous bad experience after taking antibiotics and of course allergic reactions. There has to be a clinical inflammatory problem and often also radiographic pathology to justify antibiotic use. Communicate well so you will deal with an educated patient. I often recommend probiotics in cases we are concerned with GI side effects.
Dr. McGlennen: If a new OralDNA® provider were to ask you for advice, what would be your best tip?
Ziv Simon DMD MSc: First, educate yourself about the diagnosis and management for periodontal disease. In my education company, Surgicalmaster® (www.Surgicalmaster.com), one of our most popular courses is simply called “The Perio Program.” In the program you learn how to examine a periodontal patient, reach a diagnosis, create a periodontal treatment plan, and then provide periodontal treatment (both surgical and non-surgical). I also teach how and when to use the OralDNA® test, when you need to re-test and how to interpret the results. You are not treating the test results. You are treating a complex human being. So, my strong advice is to be confident about perio diagnosis and management and learn how to use OralDNA® lab tests efficiently.
Dr. McGlennen: Where do you see salivary diagnostics in 3-5 years? 10 years? What would be the impact on your practice/patients?
Ziv Simon DMD MSc: Although my doctorate thesis was in the realm of microbiology and I deal with pathogens every day, I don’t consider myself an expert in testing or knowing the trends in the field. However, I’m quite clear that testing will be more specific, we’ll know more about the connections and interactions of the oral microbiota. Testing in the future will have a much greater predictive value and hopefully better treatments based on the results. I think that noninvasive testing with a higher frequency and almost real-time data, can help us in disease management. For example, I foresee that doctors will have a constant flow of information from the patient’s body into an analysis system. In the field of dentistry, that would include the status of the microbiology of the oral environment. This might allow us to customize the frequency of cleanings which could be based on the bacterial count and the quality of the pathogens. I also foresee a proactive approach where patients get tested daily in a simple way. For example, the sink will collect the samples after brushing teeth. The sample will be analyzed in a simple way and will send the result to the doctor in a hands-off system. I’m not a futurist but love to imagine the future. Many of the things that I’m involved in, such as technologies and the use of AI, are preparing me for the future.
He is a Diplomate of the American Board of Periodontology and Implant surgery and a Fellow of the Royal College of Dentists of Canada in the discipline of periodontology.
Dr. Simon has conducted scientific and clinical research on bone engineering, dental implants and soft tissue surgery and has published articles in peer-reviewed journals.
He is the founder of the Surgicamaster, an online education platform for dentists teaching excellence in surgery through its programs on implants, periodontics, soft tissue grafting, suturing and more. Surgicalmaster is one of the fastest growing surgical online education platforms in the world with a community with over 100,000 dentists worldwide, millions of views in social media and thousands of doctors in surgical training and mentorship programs.
- Interview with Ziv Simon DMD MSc - March 3, 2023