The Insights Provided by Salivary Testing

Posted on December 27, 2019May 20, 2021 by Richard H. Nagelberg, DDS

Without salivary testing we have no way of knowing the cause of the periodontal disease in the patients under our care. The insights provided by salivary testing include: Identification of the causative bacteria Therapeutic endpoint Risk assessment Outcomes assessment Risk of recurrence Appropriate antibiotic Incorporating the information from the salivary bacterial test into the periodontal patient’s treatment plan enables personalized care. Forget the one-size-fit...

I Don’t Need That, We’re Already Getting Good Results

Posted on November 29, 2019May 20, 2021 by Richard H. Nagelberg, DDS

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 ...

What’s Your Excuse?

Posted on August 30, 2019May 20, 2021 by Richard H. Nagelberg, DDS

It is difficult to understand the resistance by dental professionals to test for the bacteria that cause gum disease. The excuses are numerous including, “I’ve always done it this way”. A variation on this notion is “We were always taught”. Other excuses shift the decision to the patients. “My patients won’t accept it”. Equally unsupported excuses include “We’re already getting good results”, or “I don’t need that”, or “What difference will it make?” Claims of insufficient time are very comm...

Periodontal Disease, Perio Pathogens & Rocket Science

Posted on July 5, 2019May 20, 2021 by Richard H. Nagelberg, DDS

Risk factors for heart attack include; age, tobacco, high blood pressure, lipid profile, diabetes, family history of heart attack, lack of physical activity, obesity, stress, illicit drug use, history of preeclampsia, history of autoimmune condition such as lupus or rheumatoid arthritis and so on and so on. Why have all these risk factors been identified? Because it is better to prevent a heart attack than it is to have one. Risk factor identification and modification is the cornerstone of p...

Where to Start

Posted on May 24, 2019May 20, 2021 by Richard H. Nagelberg, DDS

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...

I Don’t Need That, We’re Already Getting Good Results

Posted on January 18, 2019May 19, 2021 by Richard H. Nagelberg, DDS

Periodontal Pathogens & Rheumatoid Arthritis

Posted on November 23, 2018May 20, 2021 by Richard H. Nagelberg, DDS

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...

Causality– It Was Only a Matter of Time

Posted on August 31, 2018May 19, 2021 by Richard H. Nagelberg, DDS

Trends in Salivary Testing Throwback: We as dental professionals have a significant role in combating the number one cause of death: cardiovascular disease. “High-risk periodontal pathogens contribute to the pathogenesis of atherosclerosis” is a powerful piece and I recommend you read it. There is scientific evidence that [periodontal disease] PD caused by the high-risk pathogens can influence the pathogenesis triad in an adverse manner. With this appreciation, it is reasonable to stat...

A New Conversation with Your Patients

Posted on July 6, 2018May 19, 2021 by Richard H. Nagelberg, DDS

How do we introduce the idea of salivary testing to our patients? As is the approach with every dental procedure or service we recommend for our patients, the primary consideration is excellent communication. Some recommendations are routine and no explanation is necessary, including fillings and fluoride, among many others. When we introduce new procedures or services to our patients some explanation is appropriate. DNA salivary testing for bacteria is a good example. So what should we say w...

Stop Diagnosing the Pocketbook

Posted on May 18, 2018May 19, 2021 by Richard H. Nagelberg, DDS

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 ...