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dental implants, oral hygiene, tooth decay

Implant-induced decay or just poor oral hygiene?

When discussing pros and cons of dental implants, many dentists claim that implants are impervious to tooth decay as a treatment benefit. But they often don't discuss the possibility of adjacent teeth getting decay from poor oral hygiene. Dr. Jonathan Ford stresses that each case has different contributing factors and thus warrants different treatment options.

dentistry, dental profession, floss, dental implants

5 routine things we do in the dental profession that do not make sense

B. Michelle Strange, RDH, MSDH, talks about five areas that have become routine in the dental profession—including telling people to floss and placing dental implants in patients who cannot manage to clean their natural teeth—that, when analyzed, are pretty ludicrous. She says, “If the recommendations that we give patients time and time again are not producing needed results, why continue to give them? Helping patients find the best way to achieve their oral health—on an individual basis—will help redefine the future of dentistry.”

Dental hygiene nightmares no more: At-home maintenance for success with dental implants

It is no secret that the benefits of plaque reduction around teeth and dental implants can improve oral and overall systemic health. Michelle Strange, RDH, MSDH, says it’s imperative to spend time with patients to find the best dental hygiene tool(s) for their specific appliance and capabilities. She explains how interdental brushes can be used as an alternative to floss and an effective interproximal cleaner, as well as suggests tips to add to the hygiene armamentarium to customize the at-home maintenance routines for your patients.

halitosis, bad breath

Halitosis: Etiology, diagnosis, and treatment

Halitosis, also commonly known as “bad breath,” is a concern of many patients seeking help from health-care professionals. Scott Froum, DDS, editorial director of Perio-Implant Advisory, discusses the etiology, diagnosis, and treatment of halitosis. Due to its multifactorial complexity, patients should be treated individually, rather than categorized. Diagnosis and treatment needs to be a multidisciplinary approach involving the primary health-care clinician, dentist, an ENT specialist, nutritionist, gastroenterologist, and clinical psychologist.

A novel approach for the treatment of desquamative gingivitis

Periodontal conditions vary in their level of pain and severity, but desquamative gingivitis (DG) is one of those delicate gingival conditions that can be extremely painful for sufferers and may limit their ability to eat and perform basic oral hygiene care. Robin D. Henderson, DMD, MS, explains a technique he uses in his practice that involves Perio Trays custom-fabricated tray delivery system to deliver multiple medications precisely to the affected tissues. The process helps effectively manage both the periodontal and autoimmune symptoms of DG, while empowering patients to have a part in co-managing their disease.

periodontal disease, periodontitis, type 2 diabetes, inflammation

Periodontitis and its association with type 2 diabetes

Type 2 diabetes and periodontal disease are separate inflammatory diseases that augment each other. A complication such as type 2 diabetes makes people more likely to have problems with oral health and has been shown to promote periodontal disease. In turn, periodontal disease appears to exacerbate type 2 diabetes. Duane C. Keller, DMD, FAGD, explains how cellular inflammation from immune cells appears to be the common biological denominator linking type 2 diabetes and periodontal complications such as periodontitis.

flossing, oral hygiene, dental hygiene, interproximal cleaners

Lies, damned lies, and statistics: The truth behind the importance of flossing

Last week the Associated Press released an investigative report citing “weak evidence” behind the importance of flossing. This week Scott Froum, DDS, editorial director of Perio-Implant Advisory, gives the history behind this investigative report, examines what the term “weak evidence” means in the larger scheme of things, and offers dental professionals talking points when patients ask about the importance of flossing.

street drugs, narcotics, periodontal disease, dental caries, Scott Froum, DDS, Joseph Palamar, PhD, MPH

The new street drugs some of your patients may be using that you have never heard of

Perio-Implant Advisory’s Editorial Director Scott Froum, DDS, teams up with Joseph Palamar, PhD, MPH, to highlight how some of the more well-known street drugs are being adulterated by new synthetics that are less expensive to make yet cause even greater damage to the person taking them. They discuss a few of the more potentially deadly street drugs that your patients may be taking with or without their knowledge—a synthetic opiate that produces a heroin-like high but is thought to be 10,000 times more powerful than morphine, a new psychedelic with stimulant properties much more dangerous than LSD, and the very potent $5 insanity. You’ll learn to spot the signs and symptoms of drug abuse on the oral cavity.

Antibiotic resistance and periodontitis by Duane C. Keller, DMD, FAGD - antibiotic resistance, periodontitis, periodontal disease, wound care

Antibiotic resistance and periodontitis

Bacteria dividing every 20 minutes can form more than 5,000 billion, billion bacteria in 24 hours, and this number of divisions fosters the possibility of mutations, some of which can enable the bacteria to produce enzymes that inactivate antibiotics while other mutations protect the bacteria from the antibiotic—for example, modifying the entry point on the bacteria. The New York Times recently reported on infectious bacteria resistant to all antibiotics, and the CDC has long raised awareness that antibiotic resistance is a danger, calling it the “public health’s ticking time bomb.” Duane C. Keller, DMD, FAGD, details how antibiotic resistance acts in the sulcus, making treatment of periodontitis extremely difficult, and talks about what you can do to overcome the challenges.

oral-systemic, periodontal disease, salivary diagnostic testing, salivary diagnostics

Oral-systemic links and tests we never thought about

Oral-systemic interconnections—typically understood to mean the impact of periodontal disease and periodontal pathogens on a variety of systemic diseases and conditions—have been studied intensely for generations. The consensus is that they are now accepted in both the dental and medical professions, although the strength of the various relationships is still being investigated. An equally impactful oral-systemic link that has quietly proceeded largely unnoticed by many dental professionals is the use of saliva to detect the presence of an incredible number of diseases and conditions by evaluation of biomarkers of disease. Richard H. Nagelberg, DDS, discusses the advancements in salivary diagnostic testing and explains how the effects of this technology on health care and the dental profession in particular will be profound.

Perio Protect Perio Trays, periodontal disease, dental implants, salivary diagnostics

Improving traditional nonsurgical methods for peri-implant disease: A new adjunctive therapy

Peri-implant disease is an increasingly common challenge with multiple nonsurgical and surgical treatment options. The pathogens that cause periodontal disease can be hard to manage between office visits due to the recolonization of bacteria after surgical or hygiene procedures. One adjunct to treatment that can help with nonsurgical periodontal and dental implant procedures as well as improve home care is tray delivery of hydrogen peroxide gel. Jeffrey N. Goldstein, DMD, presents a case example of how prescription trays were used to reduce diseased tissue around dental implants and teeth to avoid more invasive surgery.

halitosis, periodontal disease, periodontal pathogens

Predictable halitosis treatment: Using microbial testing and antibiotic rinse therapy

Treatment of patients with breath concerns is a difficult process, because no formal training currently exists in dental or dental hygiene schools. The perception of halitosis is that it is related to poor oral hygiene or due to a medical concern. However, oral bacteria—mainly periodontal pathogens—are the most common cause of halitosis. Jim Hyland, DDS, presents a case study showing a novel way of treating halitosis predictably through objective measurements and microbial testing to identify the location of the infection followed by antibiotic rinse therapy.  

A patient’s perspective on the importance of tooth-sparing periodontal treatment by Martin Heilweil, PhD

A patient's perspective on the importance of tooth-sparing periodontal treatment

Martin Heilweil, PhD, faced severe bone loss and periodontal treatment consisting of extraction, bone grafts, sinus lifts, implants, and crowns. He didn’t like the idea of losing his teeth. He didn’t like his dentist. It was time to do something about this. It was time to shop for a new dentist. After some research, he decided he wanted to give the “saving the teeth” option a try. Here is his story.

dental scalers Dreamstime.com periodontal treatment

Call to the dental profession: Saving the art of scaling and root planing in periodontal treatment

Dr. Victor M. Sternberg sets forth the value of scaling and root planing for the maintenance of periodontal patients. As such, he references studies that speak of its value for periodontal treatment and explains how he believes the procedures of scaling and root planing have become abandoned in the institutions of graduate schools, dental schools, dental hygiene schools, dental practices, the dental industry, and patients themselves. As he says, “At one time, the giants of periodontology walked the halls of American dental schools.” He offers four frank suggestions to remedy these problems as he sees them.

A guideline for clinical practice: The search for a successful adjunctive periodontal therapy by R. Bruce Cochrane, DDS

A guideline for clinical practice: The search for a successful adjunctive periodontal therapy

In July 2015, the Journal of the American Dental Association published an “Evidence-based clinical practice guideline on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts.” Dr. R. Bruce Cochrane says, “The problem for all practitioners is that the guidelines offer only a limited evaluation of adjunctive care.” In this article, he explains the protocol he uses that helps him achieve his goal of solid teeth, little to no bleeding, minimal pocket depth, and happier and healthier patients.

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