30 Years of Periodontal Maintenance with Relapse and Cardiovascular Complications

Challenge: After decades of periodontal stability, the patient presented with a rapid advancement of pocketing and inflammation over a period of only 9 months. Background:  A 60-year-old male maintaining periodontal health for over 30 years started to relapse. Upon periodontal assessment, there were increasing pockets throughout, especially around an implant, of 9mm. The gingiva was generally medium pink with rolled margins and spongy, erythematous papilla with isolated severe inflammatio...
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MyPerioProgress® – Your Road Map

Several years ago, Dr Herb Bader wrote: “The literature supports the advantages of determining the causative organisms in the biofilm, that induces the destructive inflammatory response (Haffajee, Tanner, Teles andSocransky, 2006). In addition, there is a considerable body of evidence supporting the accuracy and sensitivity of salivary testing as being virtually identical to sulcular samples. Work by Giannoble, Wong and others (2008) have confirmed this. Data from thousands of such tests has...
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Genetic Testing with OralDNA® Labs

Genetic testing refers to the analysis of human DNA, and has become commonplace in the practice of medicine. According to the National Institute of Health, in the future “genetic testing will be an important part of health care for many individuals…we will live in a time of more effective ‘personalized medicine’. Information from genetic testing will help to detect risk for disease, guide strategies for maintaining health, offer more accurate diagnosis, and guide treatment choices for a wide...
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“New Hat” for the RDH— Oral Systemic Health Educator & Certified Lifestyle Coach

Why would the Complete Health Registered Dental Hygiene team find themselves in inter-professional collaboration with the Certified Lifestyle Coach? The answer begins with understanding that the war raging inside of us is between chronic inflammation and the body’s own host response. We’re not aware of this war because it doesn’t hurt, and we can’t see its effects since it’s going on at a cellular, even a molecular level. The mouth happens to be a major battleground in this war. Unlike a ...
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Periodontal Pathogens & Rheumatoid Arthritis

Trends in Salivary Testing wishes you a Happy Thanksgiving! Enjoy this blog re-post from 12/30/2016. 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 in...
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Gingival Hyperplasia with bone loss and Anorexia Nervosa

Challenge: A 15-year-old patient with multiple years of periodontal concerns being co-managed with a periodontist without resolution. Background:  A 15-year-old female has been presenting for care at our practice since age 4.  From an early age the patient displayed behavioral concerns and chronic poor home care.  The dental history is early eruption of #19, three month recall due to levels of supra and sub gingival calculus, and mild bone loss resulting in a referral to the periodontist ...
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When to Administer the Systemic Antibiotic…..

The use of systemic antibiotics as an adjunct to periodontal disease have been utilized for decades1. With the emergence of systemic antibiotic stewardship, a responsible approach to administering a systemic antibiotic with periodontal care is warranted. The overall “cocktail” approach-selecting a systemic antibiotic to blanket everything-could be contributing to rise in antibiotic resistance. However, a systematic approach of testing and utilizing an evidence based recommendation helps you ...
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Type II Diabetic and Periodontal Disease

Challenge: A Type II Diabetic patient, who has been a long term client, has uncontrolled periodontal disease and a history of not responding to previous periodontal treatment. Background:  This 73 year-old female with Type II Diabetes has been a patient in our periodontal maintenance program for years. She has had several courses of active periodontal therapy never achieving complete periodontal remission. In the past year, our team has been upping our game by studying under Dental Hygien...
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Dental Hygiene Excellence: A Personalized Treatment Approach

Personalized care for dental patients is more important today than ever! Oral inflammation has been established as the driver for many systemic diseases such as cardiovascular disease, stroke, diabetes, and autoimmune diseases. Periodontal disease is one of the most prevalent inflammatory diseases and does not always respond well to “cookie cutter” treatment. We now know, treatment must target the bacteria that cause the patient’s infection, and every patient is different. Dental Hygiene Exc...
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Interview with Adrian Fitts RDH & Gerald Smith DMD

Dr. McGlennen: Tell me how you use OralDNA® salivary diagnostics. Adrian Fitts RDH & Dr. Gerald Smith: When we see a patient that isn’t “normal.”  Many patients are routine with regard to their oral hygiene/plaque/calculus.  The vast majority of patients respond to usual measures, debridement, and diligent oral hygiene.  However, some patients don’t fit this.  For example, we see a relatively “clean” mouth but we are finding increasing pocketing/bleeding.  The OralDNA® tests are perfe...
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