“But they already scraped my teeth!” is a common refrain that we hear in periodontal offices. And that is the problem. A periodontal procedure is only as good as the diagnosis that accompanies the procedure.
I’ll give you a periodontal example first. You have periodontal pockets. Therefore, you need a procedure called root planing. Another term for “root planing” is deep cleaning. Now let’s take an example that you can relate to. “The paint on your walls is peeling. Therefore you need to repaint your walls.” Makes sense, right?
Let’s look at the paint analogy. What caused the paint to peel to begin with? If we don’t know that, how do we know that repainting the walls won’t result in the same thing happening all over again. Paint can peel for a number of reasons. There may be a roof leak that’s causing the walls to get wet. Maybe there are termites. Maybe the original paint wasn’t compatible with the new paint. New paint won’t do a thing to solve those problems.
You can look at your periodontal disease diagnosis and treatment in much the same way. Just because you have pockets, doesn’t mean that root planing alone will solve the problem. In fact, the only way in which root planing will solve the problem, is if there are hard deposits of calculus on the roots.
There’s a nasty bug that sometimes infects gums and bone. It can cause accumulation of deposits in the coronary arteries around your heart and was found to be implicated in the development of rheumatoid arthritis. The bug is named Porphyromonas gingivalis or PG. But PG doesn’t result in one bit of calculus on the roots. And therefore, “gum scraping” or root planing probably won’t have much of an effect on PG. Pockets won’t get any better. One thing that will get PG better is an antibiotic. But unless we know that PG is there, we don’t know which antibiotic to treat you with.
There is a reliable test that can be done in any dental office to test for PG. It’s called the Oral DNA test. It tests for the 11 different bacteria that cause periodontal disease, including PG. What you simply do is spit into a cup. If you have PG or similar bacteria, it will be in your saliva. The DNA of the PG is easily identified by a laboratory equipped to test for PG. In about 10 days, your dentist will know whether you have PG or any of the other 10 devastating bacteria. Such a test will also suggest the antibiotic that might be most effective for those bacteria. That antibiotic can either be delivered below the gum line or as a pill that you would take by mouth. Once you’ve taken the antibiotic, your dentist can then check your periodontal pockets once again. With the devastating bacteria now under control, your pockets may get better. And even if they get only partially better, your periodontal treatment will be that much more predictable. So will your overall health.
Lee N. Sheldon, DMD