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October 2008 | Modern Hygienist Patients | Perio Trends
Perio’s path Advances in technology have made treatment and diagnosis about way more than just scaling and root planing. Heart disease. Stroke. Diabetes. Low birth-weight babies. In recent years they’ve all been linked in some way to periodontal disease, changing the way hygienists think about their patients’ mouths. The oral/systemic link first became a hot topic in the late 1990s, and since then hygienists have become more involved in the overall health of their patients. “It’s exciting because now we see hygienists working more with medical professionals. There’s more cross collaboration and cross referrals,” says Kirsten Jarvi, RDH, BS. “The mouth is the gateway to the body, and sometimes we’ll be the first ones to see something is going on and make the appropriate referral.” Hygienists have more ways to find and treat periodontal disease than ever. Risk assessment, customized treatment and localized antibiotics are some of the advancements making it easier to spot and treat perio early.
The localized option LAAs (locally applied antimicrobials) like Arestin (myarestin.com) from OraPharma represent an innovative approach to reducing bacteria. Arestin uses a microsphere technology that slowly releases minocycline —a second derivative tetracycline— in the pocket for up to 21 days. When used as an adjunct to scaling and root planing, LAAs can help reduce pocket depths and bleeding for optimal healing and regeneration, says Ms. Jarvi, Arestin’s Customer Relations Specialist for the Western region. Biofilm is complex, Ms. Jarvi says, and can replicate within days of scaling and root planing. That’s where LAAs come in.
These days, periodontal diagnosis involves much more than the traditional clinical signs you’re trained to spot. The concept of personalized medicine has changed the way hygienists find and treat perio, with companies like OralDNA Labs Inc. (oraldna.com) targeting pathogenic bacteria and genetics susceptibility as two critical components of diagnosis and risk assessment. “Modern oral microbiology has taught us that each biofilm is different,” says Dr. Tom Nabors, OralDNA’s Co-Founder, Chairman and Chief Dental Officer. “And so rather than looking at biofilm as being a constant entity for every patient, we need to understand the biofilm and how it differs in every patient. And we can’t do that visually, and we can’t do that with x-rays.” OralDNA’s tests use DNA-PCR (Polymerase Chain Reaction) to provide personalized patient information. MyPerioPath defines pathogenic bacteria in quantity and quality, while MyPerioID PST involves susceptibility. DNA-PCR can look at a human cell and determine a person’s genetic susceptibility for hyper response to pathogenic bacteria. But this doesn’t mean you should do away with pocket probing and other traditional perio-finding methods, Dr. Nabors says. Typical clinical signs and symptoms can help create a visual baseline of where patients are today.
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