Case Study 1 – David’s Dental Hygiene
David: It’s About More Than Dental Hygiene
David was healthy and active when he came to see us. Married, in his mid-fifties with two grown children, he watched his health and nutrition, exercised regularly and only feared not living long enough to see his grandchildren grow up.
David had no Framingham risk factors, which estimate a person’s cardiovascular risk over the next decade. He had less than a 50% risk for cardiovascular disease. His cholesterol was under control, and his blood pressure was normal. But his blood tests showed that he had an elevated LP-PLA2 enzyme—a sign of arteriosclerosis and directly associated with strokes—and the only thing known to elevate it is periodontal disease.
Using traditional observational periodontal evaluation, we found that David didn’t have bleeding gums. We observed only one pocket at 4 millimeters, and the rest were 3 or less. (Traditionally 1-3 mm pocketing throughout the mouth is considered the standard of a healthy mouth.) He seemed healthy.
We then administered OralDNA® salivary diagnostics, and the results were startling. David tested IL-1 positive, which indicated that he was at higher risk for heart disease than a smoker and that any heart inflammation would be potentially disastrous for him. David also had an elevated MyPerioPath® with P. gingivalis and T. forsythia over the threshold. This means that when certain pathogenic bacteria are reported above a Pathogen Load Threshold, it’s a sign that there might be significant tooth loss. Periodontal disease is caused by groups of specific bacteria, and bacterial levels should be considered collectively and in context with clinical signs and other risk factors.
We took immediate steps to correct David’s oral inflammation, initiating a specific periodontal protocol. We included laser pre-conditioning, anti-microbials, localized antibiotics, and followed treatment with an appropriate protocol with Perio Protect®. We did a follow-up MyPerioPath® salivary diagnostics test. His test came back with no bacteria over the threshold.
Here are the MyPerioPath steps:
The MyPerioPath® salivary diagnostic test identifies the type and concentration of specific perio-pathogenic bacteria that are known to cause periodontal disease. MyPerioPath® helps support the clinician with better risk assessment and personalized treatment options for more predictable outcomes.
The MyPerioPath® test is quickly and easily administered at the dentist’s office and takes about a minute to complete. Here’s the process:
- Patient swishes a sterile saline solution for 30 seconds
- Patient expectorates into funneled collection tube
- Funnel is removed, cap is secured to top of collection tube
- Samples are sent via pre-paid FedEx® envelope to OralDNA® Labs for DNA-PCR analysis
- E-mail notification is sent to clinician when electronic result report is available
Who should be tested?
- Patients presenting with signs and symptoms of a periodontal infection
- Patients with pockets of 4mm or greater with clinical signs of a periodontal infection
- Patients presenting chronic periodontal disease who are not responding positively to their current treatment
- Patients with Type 1 or Type 2 diabetes (and who are insulin-resistant)
- Patients with a history of cardiovascular disease
- Patients who use tobacco products
- Patients who will undergo surgical procedures or radiation treatment
- Patients who may be at increased risk for periodontal infections—establishes a “baseline”
- Patients who test positive for genetic susceptibility with the MyPerioID® PST® test
- Women of childbearing age
The MyPerioID® PST® test identifies individual genetic susceptibility to periodontal disease and enables the clinician to establish which patients are at increased risk for more severe periodontal infections due to an exaggerated immune response.
The MyPerioID® PST® test is quickly and easily administered chairside, and takes about a minute to complete. The process is similar to the MyPerioPath® test.
Approximately three months later, David’s LP-PLA2 levels were down drastically, to safe levels. David is now as healthy as his healthy lifestyle would indicate—the hidden markers that alerted us to a potentially life-threatening disease helped us treat him early. His fears of not seeing his grandchildren grow up are no longer nagging at him and, in fact, David has great confidence in dentistry as a pathway to overall health and a new zest for life—all thanks to our treatments.
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