Salivary Crystal Ball – Part 3

Posted on February 17, 2017May 19, 2021 by Richard H. Nagelberg, DDS

The importance of the specific bacteria to the prognosis of an individual’s case of gum disease was known over 20 years ago. In a 1996 article in the Journal of Periodontology (Renvert et al. J Periodontol. 1996 Jun; 67(6): 562-71.) the authors concluded that the presences of Aa, Pg, and Pi alone or in combination correlated with attachment level changes. The authors further concluded that pathogenic bacteria are better predictors of disease progression than observed clinical signs. In a 200...

The Salivary Crystal Ball – Part 2

Posted on February 10, 2017May 19, 2021 by Richard H. Nagelberg, DDS

Most general dental practices are providing the same types of services: diagnostic services, restorative procedures, prosthodontic procedures, endodontic procedures, surgical procedures and periodontal procedures. Of course there are variations in techniques and complexity of cases being undertaken, but substantially a wide swath of dental practices are providing the same services. When a patient comes for an appointment, depending on where they live and work, they are traveling past several or ...

The Salivary Crystal Ball – Part 1

Posted on February 3, 2017May 12, 2021 by Richard H. Nagelberg, DDS

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...

Ready to Stop Being a Prophy Machine?

Posted on January 27, 2017May 12, 2021 by Richard H. Nagelberg, DDS

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...

My Staff Won’t Do It

Posted on January 20, 2017May 12, 2021 by Richard H. Nagelberg, DDS

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...

Stop Diagnosing the Pocketbook

Posted on January 13, 2017May 12, 2021 by Richard H. Nagelberg, DDS

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...

More Insights Provided by Salivary Testing

Posted on December 16, 2016May 12, 2021 by Richard H. Nagelberg, DDS

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 ...

The Insights Provided by Salivary Testing

Posted on December 9, 2016May 12, 2021 by Richard H. Nagelberg, DDS

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...

What Happens Once Samples Leave Your Office?

Posted on December 2, 2016May 12, 2021 by Richard H. Nagelberg, DDS

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...

Bacterial ID, Easy as 1-2-3

Posted on November 25, 2016May 12, 2021 by Richard H. Nagelberg, DDS

Testing for the specific bacteria causing the periodontal disease for the patient in your chair is as easy as 1-2-3. The following is a detailed description of the sample collection: There is some sterile salt water; have your patient gargle and swish for 30 seconds. Have your patient spit into a vial, cap it, and stick the bar code label on the vial. You are now done administering the salivary test. No separate visit is necessary. It can be sent from the office later that day by anyone in t...