Bleeding on probing (BOP) is encountered every day in virtually every dental practice. It is so common that there may be a tendency to undervalue its importance in diagnosing gingivitis and periodontitis. BOP is like periodontitis or pregnancy in the following regards: There is no such thing as “just a little bleeding.” You have it or you don’t. There is no such thing as a little periodontitis; you have it or you don't. There is no such thing as a little pregnant; you are or you are not. You...
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Periodontal Disease
Ready to Stop Being a Prophy Machine?
Is your hygiene department ready to stop the daily routine of prophy after prophy? Are you ready to have a happier dentist and hygiene team, healthier patients, and overall transform your office into a stellar perio-focused practice?
Instead of limiting yourself to 30-minute patient appointments for a prophy, affording hygienists one hour per appointment, or longer if SRP is scheduled, allows you to offer comprehensive perio services, like salivary testing, non-surgical perio therapy, and...
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My Staff Won’t Do It
There are many justifications, rationalizations, and excuses in non-testing practices, all of which signal some level of disinterest in enhancing patient care. One of the most difficult to understand is; “My staff/hygienist just won’t do it.” If the doctor is the driving force behind testing implementation and one or more team members are resistant, a staff meeting is in order. Leadership comes from the top and it is the doctor’s responsibility to set the direction for the practice, including th...
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Stop Diagnosing the Pocketbook
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 thei...
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Causality: It Was Only a Matter of Time
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 state PD, due to high-risk pathogens, is a co...
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Periodontal Pathogens and Rheumatoid Arthritis
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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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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