Gum Disease and Pregnancy

In recognition of National Women’s Health week that begins May 14, I encourage all readers to view the 3 minute attached video. Kim Miller has recorded a highly informative video on pregnancy and periodontal disease. Among the central points in this discussion is that healthy gums do not bleed. Kim makes the point that periodontal bacteria can enter the mother’s bloodstream, cross the placental barrier and potentially have an adverse effect on the developing fetus. There is also a recommendati...
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5 Medical Facts that Every Dentist Simply Must Know

5 Medical Facts that Every Dentist Simply MUST Know. . . There is a well-substantiated link between oral health and certain systemic diseases.1 Diseases can lower the body’s resistance to infection, making it more susceptible to developing or exacerbating periodontal disease. Pregnant women with periodontal disease tend to have earlier term babies and babies of lower birth weight.2 Rheumatoid arthritis, Sjogren’s Syndrome and even Alzheimer’s can affect oral health.3 Recent ...
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Patient Expectations in the Dental Office

Most patients seem to have reasonable expectations of the care they receive from their dental providers. It is reasonable for our patients to expect us to provide the right amount of treatment for their dental needs- no more and no less, for a reasonable fee. For the majority of patients, the dental service most often received is of a periodontal nature, such as a prophylaxis or periodontal maintenance procedure. This generally occurs two to four times a year. Restorative treatments such as ...
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Diabetes Screening in Dental Offices: Part 2

Diabetes is completely out of control in this country. The CDC estimates that one in three adults in the U.S. will be diabetic by 2050. Today, there are 79 million pre-diabetics in the U.S.; which is three times greater than the number of presently diagnosed diabetics. This is a diabetic avalanche; we can’t see the snow roaring down the mountainside, but it is coming.   The dental profession needs to be better prepared to assist, as the medical profession is clearly overwhelmed. N...
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Diabetes Screening in Dental Offices: Part 1

In 2014, the New Jersey State Board of Dentistry ruled that dentists in New Jersey could screen at-risk patients for diabetes, and although such in-office screening is within the scope of licensure in the state, this testing is not to be presumed to be the standard of care. This can be interpreted to mean that the screening needs to be followed by referral to a physician for definitive diagnosis. The glycated hemoglobin (HbA1c) screening can be performed as a finger stick and analyzed in the den...
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Missing the Boat When it Comes to Perio Therapy

During a recent national speaking engagement, a hygienist told me that they used to do clinical laboratory testing. “We stopped doing it because when we tested months later, the bacteria had come back and the patient had an active infection again. We decided ‘it’ wasn’t working so we stopped,” she explained. I thought to myself, wow, this is very interesting and a perfect example of ‘throwing the baby out with the bath water’! It wasn’t the clinical laboratory testing that wasn’t working, it ...
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The True Cost of Clinical Lab Testing

As an in-office coach I often hear the following objection, “Clinical laboratory testing is too expensive. My patients won’t want to spend the money.” Taking into consideration the latest research, released in the online British Medical Journal November 29, 2016, which states that periodontal disease with high risk pathogens (Aa, Pg, Tf, Td, Fn) is causal for arterial sclerotic vascular disease, the patient can’t afford NOT to test for the presence of these dangerous bacteria. (1)   As a prof...
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The Effects of Marijuana on Oral Health

There is a heightened level of interest on the impact of marijuana usage in the oral cavity given the number of states that have legalized the drug for medical and recreational uses. Twenty-six states and the District of Columbia currently have laws legalizing marijuana in some form. Several other states will soon join them. At the present time, the body of research on the effects of cannabis on the oral cavity and periodontitis in particular is very limited. A recent JADA article (J Am Dent ...
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Dental Clearance Without the Guesswork

Have you ever been uncertain when providing dental clearance for crucial treatments, such as heart surgery or joint replacement? In my practice, we look at the clinical signs and symptoms for oral disease, but we additionally observe the patient’s oral health at the molecular level. Let me share a case with you that illustrates the importance of salivary testing and its profound impact on the credibility of clearing a patient for surgery. A long-standing patient presented to my office on...
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Gum Disease and Alzheimer’s Disease

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 assessments were repeated six months later. The study data revealed that periodontit...
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