Gum Disease and Alzheimer’s Disease

Posted on November 24, 2017May 19, 2021 by Richard H. Nagelberg, DDS

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...

We Were Always Taught

Posted on September 28, 2017May 19, 2021 by Richard H. Nagelberg, DDS

Dentists who were trained in the 70’s were always taught that the first instrument used in an operative procedure was the enamel hatchet. Caries excavation was done with spoon excavators and a belt driven low speed handpiece. We were always taught that reversible hydrocolloid was an excellent impression material, especially since you could use the same material on multiple patients. You just had to warm it back up in the water bath. We were always taught that we only needed to use a mask and...

Where to Start

Posted on September 15, 2017May 19, 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 t...

WNL: What’s your definition?

Posted on June 16, 2017May 19, 2021 by Richard H. Nagelberg, DDS

During virtually every dental examination, there is a review or updating of the patient’s health history and a clinical examination. If everything is consistent with good oral and overall health the notation WNL is commonly made, which is an abbreviation for Within Normal Limits. There is however another less commonly known meaning to WNL; We Never Looked. Looking goes way beyond visual observation and includes other diagnostic tools such as radiographs, scans and laboratory testing. Let’s co...

Perio Pathogens CAUSE Rheumatoid Arthritis– Now What?

Posted on June 9, 2017May 19, 2021 by Richard H. Nagelberg, DDS

“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...

Gum Disease and Pregnancy

Posted on May 12, 2017May 19, 2021 by Richard H. Nagelberg, DDS

In recognition of National Women’s Health week that begins May 14, I encourage all readers to view the 3 minute attached video. Kim Miller has recorded a highly informative video on pregnancy and periodontal disease. Among the central points in this discussion is that healthy gums do not bleed. Kim makes the point that periodontal bacteria can enter the mother’s bloodstream, cross the placental barrier and potentially have an adverse effect on the developing fetus. There is also a recommendati...

Patient Expectations in the Dental Office

Posted on April 28, 2017May 19, 2021 by Richard H. Nagelberg, DDS

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 ...

Diabetes Screening in Dental Offices: Part 2

Posted on April 21, 2017May 19, 2021 by Richard H. Nagelberg, DDS

Diabetes is completely out of control in this country. The CDC estimates that one in three adults in the U.S. will be diabetic by 2050. Today, there are 79 million pre-diabetics in the U.S.; which is three times greater than the number of presently diagnosed diabetics. This is a diabetic avalanche; we can’t see the snow roaring down the mountainside, but it is coming. The dental profession needs to be better prepared to assist, as the medical profession is clearly overwhelmed. N...

Diabetes Screening in Dental Offices: Part 1

Posted on April 14, 2017May 19, 2021 by Richard H. Nagelberg, DDS

In 2014, the New Jersey State Board of Dentistry ruled that dentists in New Jersey could screen at-risk patients for diabetes, and although such in-office screening is within the scope of licensure in the state, this testing is not to be presumed to be the standard of care. This can be interpreted to mean that the screening needs to be followed by referral to a physician for definitive diagnosis. The glycated hemoglobin (HbA1c) screening can be performed as a finger stick and analyzed in the den...

The Effects of Marijuana on Oral Health

Posted on March 17, 2017May 19, 2021 by Richard H. Nagelberg, DDS

There is a heightened level of interest on the impact of marijuana usage in the oral cavity given the number of states that have legalized the drug for medical and recreational uses. Twenty-six states and the District of Columbia currently have laws legalizing marijuana in some form. Several other states will soon join them. At the present time, the body of research on the effects of cannabis on the oral cavity and periodontitis in particular is very limited. A recent JADA article (J Am Dent ...