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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Author: Richard H. Nagelberg, DDS
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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The Insights Provided by Salivary Testing
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 perio patient’s treatment plan enables personalized care. Forget the one-size-fits-all of t...
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What Happens Once Samples Leave Your Office?
The video entitled; "A Day in the Life of Dina the OralDNA Sample" explains how a salivary sample is analyzed at OralDNA Labs, ultimately resulting in a report indicating the specific pathogens involved in the patient’s case of gum disease. It is a highly informative animation of the various steps involved in identifying the bacteria in the salivary sample. The processes involved in sample analysis are presented with great clarity and conciseness in an entertaining manner. I highly recommend vie...
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Bacterial ID, Easy as 1-2-3
Testing for the specific bacteria causing the periodontal disease for the patient in your chair is as easy as 1-2-3. The following is a detailed description of the sample collection: There is some sterile salt water; have your patient gargle and swish for 30 seconds. Have your patient spit into a vial, cap it, and stick the bar code label on the vial. You are now done administering the salivary test. No separate visit is necessary. It can be sent from the office later that day by anyone in t...
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Pregnancy and Periodontal Disease: It’s All About Prevention
There is a large body of research examining the potential association between periodontal disease and adverse pregnancy outcomes. Even a casual examination of the research reveals inconsistent conclusions regarding the effect of gum disease on preterm birth and other adverse pregnancy outcomes including preeclampsia. There is a similar level of inconsistency in the interventional studies. Some showed a reduction in preterm births following periodontal therapy and others did not. One study, b...
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I Don’t Need That, We’re Already Getting Good Results
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 ...
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We Were Always Taught
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...
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What’s Your Excuse?
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 common e...
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