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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A Total Health Approach at a Reasonable Price: An Interview with Dr. Isaac Comfortes DDS

Dr. Nagelberg: Tell me how you use OralDNA salivary diagnostics. Dr. Comfortes: I started utilizing salivary diagnostics in 2013. Since then my approach has concentrated on total health, which I discuss this during every patient consult. Without the use of OralDNA® salivary diagnostics, the total health conversation would be difficult. First, I ask the patient if they understand the importance of the test. Then I address the levels of bacteria and how that is expressed in their gum health...
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A Progressive Oral Wellness Center in Rural America

In our rural practice (McCreight Progressive Dentistry) in Northwest Colorado, we see periodontal disease on average in about one of every two patients, or around 46%. This is representative of the CDC statistic as posted in the May 2015 Journal of Periodontology. Whenever we read these statistics, we are puzzled. In an industrialized nation where home care tools and dental technologies are readily available, how can there be so much disease? Here are some measures (newer technologies) we ha...
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Connecting the Dots: A Role for Inflammation in Oral and Pharyngeal Cancers

September is sexual health awareness month. In recognition, enjoy a previous post by Dr McGlennen regarding oral health and sexual health. It is important to understand the role of human papillomavirus (HPV) in the development of squamous cancers of the head and neck. But it seems there is missing a fuller appreciation of other key risk factors at work with the virus, to cause bad things to happen to cells in the mouth and throat. HPV infection is very common, and with the sensitive molecular...
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Systemic Antibiotics can be Bad but Heart Attacks are Worse

I am going to ask the question, would you agree antibiotics can be bad but heart attacks are worse? As this is part 3 of my series, I hope I am hearing a unified “Yes”. In my opinion, systemic antibiotic should be used in an attempt to lessen the translocated pathogens. The high-risk patient is no longer capable of fighting, resisting, or diminishing the pathogenic loads on their own and the systemic antibiotic is an option. Yes there is a risk of antibiotic adverse reaction but a heart atta...
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Dentistry is Medicine

In the previous blog, we discussed that the use of systemic antibiotics, for high-risk patients may currently be the most effective method to treat the systemic impact of translocated periodontal pathogens. As periodontal treatment plans are formatted, utilizing a MyPerioPath test assists in determining the pathogen profile of the periodontal infection and provides  evidence- based systemic antibiotic selection. If dentistry is medicine, then utilizing a test to confirm the presence of bacte...
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Routine dental hygiene… is never routine!

The Merrian-Webster defines paradigm shift as “an important change that happens when the usual way of thinking about or doing something is replaced by a new and different way.” There is a definite paradigm shift in dentistry and a strive to parallel our dental profession to our medical counterparts. Dr John Kempton is on this front line, helping address oral systemic health with direct patient care and as a leader inspiring others to a higher quality of care. Dr John Kempton will be our gues...
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The Medical History Form and Salivary Diagnostics

A medical history form is a starting point to guide conversations and to make connections between oral health and overall health. Consider re-configuring your current medical history form to quickly be able to visualize oral systemic connections and/ or concerns. These 5 questions should be asked on your current health history form. 1) Has a parent, sibling or grandparent had a heart attack or stroke? Yes__ No__ 2) Has a parent, sibling or grandparent had diabetes? Yes__ No__ 3) Has a p...
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Communicating with Patients about Nicotine and Perio

During a recent in-office team workshop, we were discussing nicotine use and its dramatic effects on the progression of periodontal disease. To help the team fully understand the consequences of nicotine use, we talked about vasoconstriction and how smoking masks the true level of periodontal infection. The vasoconstrictive properties of smoking reduce blood flow and, in turn, oxygen to the tissue, resulting in gums that do not bleed or have reduced bleeding. Smoking patients have pockets th...
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Assessing Risk with Salivary Diagnostics

The development of commercial laboratory tests utilizing the collection of saliva is, in my opinion, an important step forward in understanding and managing inflammatory periodontal disease. There are, in fact, no tests available that will predict the onset of attachment loss. However, by gathering information on a patient’s genetic inflammatory profile as well as periodontal pathogen profile we have access to objective data when ascertaining risk, or the possible onset of periodontal disease ...
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