More Oral-Systemic Articles

Do root canals cause cancer?

The recent documentary on Netflix, Root Cause, is causing quite a stir. Many are questioning the safety and validity of root canals and their possible connection to the "c" word—yes, cancer. Periodontist Dr. Scott Froum and Endodontist Dr. Omar Ikram debunk accusations made in the documentary on three levels so that you can begin to have intelligent conversations with your dental patients.

5 of the most common questions dental patients ask and how to answer them

While most oral conditions can be resolved with dental therapy, there are also many systemic diseases that manifest themselves in the oral cavity, thus requiring the consult of a medical physician. Dr. Scott Froum, editorial director of Perio-Implant Advisory, addresses five of the most common questions dental patients ask about pathology in the mouth and shares answers you can use in your practices.

Canker sores: An old enemy facing new treatment

Initial onset of aphthous ulcers, also called canker sores, usually occurs in childhood or early adulthood. Canker sores affect women more than men, are self-limiting, and are disproportionately painful relative to the size of the lesion. Perio-Implant Advisory's Editorial Director Dr. Scott Froum discusses the etiology, types, diagnosis and associated systemic disorders, as well as the most effective new treatment for these ulcers that plague many.

Top causes of gingival enlargement and treatment options

Scott Froum, DDS, editorial director of Perio-Implant Advisory, describes the various causes and dental treatment options for gingival enlargement, a condition mistakenly used synonymously with gingival hypertrophy and gingival hyperplasia. He also presents a new form of surgical treatment that can assist in correcting certain types of gingival enlargement.

Personalized medicine's role in ending opioid abuse in dentistry

Synthetic opioid overdose deaths have increased 72% in the last year. Dentists and oral surgeons are among the biggest prescribers of opioids in the US, so personalized medicine profiles that analyze genetic markers and other risk factors—assessing opioid use disorder risk before treatment and thus before prescribing opiates—to provide individual treatment options for patients are welcome news for dentistry.

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.

5 pathologies most likely to affect the tongue: Importance of proper examination and diagnosis

Although the dental technology that can identify oral pathology has greatly improved in the past decade, dental professionals should still understand the importance of conducting visual exams and be able to accurately diagnose disease when present. Perio-Implant Advisory Editorial Director Scott Froum, DDS, offers dental health professionals an aid to examining the tongue, recognizing characteristics of a normal disease-free tongue, and identifying the top five pathologies most likely to affect the tongue that could represent larger systemic issues.

Medication-related osteonecrosis of the jaw: Lowering the risk of MRONJ using new drug alternatives

By now, we have all faced the clinical decision about whether to proceed with elective oral surgery for the postmenopausal female patient who has begun bisphosphonate (BP) therapy. The potential for medication-related osteonecrosis of the jaw (MRONJ) that may occur after oral surgery persists for years after BPs have been administered, due to the fact that they have been found in bone 10 years after even a single administration. Michael DiPace, DDS, offers a general review of three alternative drugs used to treat osteoporosis that have little or no known association with MRONJ.

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.

Medication-induced bleeding when your patient 'doesn't take any medication'

It is estimated that $28 billion per year is spent on herbal medications and supplements, and more than 29,000 different types of these medications exist. It is, therefore, safe to say that many patients you encounter will be taking or will have taken over-the-counter (OTC) medications. Patients often do not consider this type of vitamin and/or herbal supplementation to count when you ask, “Are you currently taking any medication?” Unfortunately, treating dentists and patients are not always familiar with all of these OTC herbal medications and supplements and their effects on hemostasis. Perio-Implant Advisory Editorial Director Scott Froum, DDS, lists his top five medications in this category in terms of popularity of patients’ use, explains their anticoagulation effects, and discusses what you can do to ensure that they don’t wreak havoc on your dental treatment plans.

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 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.

Antidepressant medications and nutraceuticals: Effects on the success of dental implants

Kevin Oberlander, RPh, says, “As a pharmacist working closely with the dental profession, I read with great interest the recent pilot study conducted by the University of Buffalo that brings to light fresh concerns over the adverse effects in dental implant patients taking antidepressants.” In this article, he discusses research concerning the value of supplementing with nutraceuticals—specifically Vitamin D and magnesium—for patients with dental implants who are taking medications that cause deficiencies affecting bone health.

Increasing dental case acceptance through the use of salivary diagnostics

A tremendous amount of literature supports the correlations between gingivitis and/or periodontitis and systemic health. Reports and research continue to find correlations between inflammation of the oral cavity and other inflammatory disease processes, especially cardiovascular disease and diabetes. Educating patients about these links and encouraging oral health awareness has always been a challenge. Dr. Michael Scialabba talks about how salivary testing along with personalized custom periodontal therapy can be a tool to help patients improve not only their oral health but also their overall health.

Sherri Lukes, RDH, MS, FAADH

Treating the geriatric dental patient

As our country experiences this dramatic increase in the older adult population, it would behoove the dental community to learn as much as possible about this complex population. The oral-systemic link has been well documented and will be even more important as we deliver comprehensive oral care to a large population of senior adults in the 21st century. Sherri Lukes, RDH, MS, FAADH, discusses what you need to know to take care of this growing segment of patients.