Background: This patient is a 38-year-old female, who works as a dental hygienist. She was recently diagnosed with Type II Diabetes. In agreement with her medical doctor, she has committed to diet and lifestyle changes to control her diabetes before the consideration of medication. These lifestyle changes include regular exercise and eliminating sugar. When this hygienist presented in my chair, her chief complaint was “When it comes to my diabetes, I know what to do, I just need to do it! As...
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Dental Saliva Test
Exchanging Spit and What Else?
Recently, I had a patient who presented with generalized gingivitis. Her husband was also recently diagnosed and treated for generalized chronic periodontitis. She asked the familiar question “How did I get gingivitis? I brush and floss every day.” These questions opened the door for an interesting discussion about her risk factors. She has two children under the age of 4 and she works full time as a nurse. Both of these contribute to her disrupted and inadequate sleep patterns. She is overw...
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Salivary Diagnostics, Lasers and Beyond…
As a hygienist, one of my main duties is to provide non-surgical therapy for the treatment of periodontal disease. The goal, (during the non-surgical treatment approach), is to change the environment of the pocket, address the active infection and keep the patient in remission as long as possible. Meticulous removal of sub-gingival calculus with hand instruments and micro-ultrasonics is crucial. We must provide a biologically acceptable root surface.
In addition to detoxifying the root su...
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Case Study: Class II Periodontitis
Background: The patient is a 54 year old female who presented with the chief complaint “My gums bleed when I brush, there are possible cavities and I don’t like the tooth crowding.” Her last dental visit was about 6 years ago. There is a family history of diabetes, cardiovascular disease, stroke and cancer. The home care consisted of manual tooth brushing 1-2 times per day with occasional antibacterial mouth rinse. During the clinical assessment, it was discovered that several amalgam restor...
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An Interview with Sue Baughman
Dr. McGlennen: What are the top 2 things to consider when you select a patient for testing?
Sue RDH: I do not filter who I share this valuable information with. ALL patients have the right to know that there are tests to determine what type of bacteria is in their mouth that may be harmful to their overall health. In other words, I educate all patients on what they need and then it is up to the patient to decide. I have patients who take their total health and well-being very seri...
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What is “Differential Diagnosis”?
There is an old adage in medicine that says “When you hear hoof beats, think horses. Don’t think zebras.” This phrase can be applied to every patient and case; your eyes don’t tell the whole story. It is usually good advice to confirm the obvious, rather than spending time and resources investigating rare things. Consider the virtue of the “differential diagnosis”.
In medicine, the differential diagnosis is a process by which the consideration of diagnosing one disease is distinguished fr...
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A Higher Standard of Care
For many years now, research has shown that there is a mouth body connection. In other words, what is happening in the mouth can impact what is happening with the body! In order for someone to have good health, they need to have good oral health. Unfortunately, periodontal disease is silent, as it does not hurt until it is severe. The minimal pain factor, as periodontal disease develops, may be why 80% of the United States population is suffering from periodontal disease. In the next paragra...
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Case Study: Pregnancy and Periodontal Pathogens
Background: Patient is a 31 year old female, who presented with the chief complaint "My gums are swollen and painful." The last dental visit with exam was about 6 months ago. The radiographic examination including bitewings revealed horizontal bone loss and heavy amounts of generalized subgingival calculus. The patient's gums were erythematous with probe depths between 5-9 mm. Patient was diagnosed with generalized severe chronic periodontal disease. The additional challenge was that the patie...
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Gum Disease and Alzheimer’s Disease
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...
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Periodontist Turned Patient
As a periodontist, I pride myself on healthy gums. I admit to only getting a prophylaxis when the schedule permitted. My home care most likely resembles what most dental professional do, brush twice daily with an electric toothbrush and flossing most days. In grad school, it was discovered I had a few 4mm periodontal pockets. However, my professors were not concerned and I was never diagnosed with periodontal disease.
Now fast forward several years. At age 37, after surviving an...
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