Dr. Jill Wade and Donna Starford RDH of Stonebriar Smile Design in Frisco, Texas received the Orkos Award for professional excellence treating a patient at high risk for periodontal disease. The patient was referred to Dr. Wade by his endocrinologist who noted continually high inflammatory markers in his blood work. The endocrinologist and Dr. Wade had both studied the Bale/Doneen Method™, a science based approach to proactively identify and manage risk factors for heart attack, stroke and type 2 diabetes prevention. One of those important risk factors is gum disease. Dr. Wade was a natural referral because she understood the risk factors as outlined in the Bale/Doneen Method™ and is also committed to achieving wellness through preventative care using OralDNA® testing and Perio Tray delivery. Because of other health concerns, the patient wanted proactive treatment options to address disease causes, not just the symptoms.
The first DNA test was performed in June 2012 and results showed 5 bacterial species with a known association to periodontal disease to be above the test threshold, indicating a rationale for adjunctive periodontal therapy. Systemic antibiotics are frequently recommended in these cases, but the patient and his physician had reservations because past experience with antibiotics had left the patient with painful digestive side effects. Their concerns are not uncommon. Many patients, doctors, and even the Center for Disease Control and Prevention have concerns about prevalent oral antibiotic usage. In this case study, the patient and Dr. Wade agreed to start adjunctive treatment with prescription Perio Tray® delivery of Perio Gel® containing 1.7% hydrogen peroxide.
In addition to Perio Tray® delivery, the patient also requested professional hygiene care and frequent bacterial testing, which Dr. Wade included in the treatment plan. At the outset of treatment, hygienist Donna Starford completed professional debridement therapy to physically remove the bacterial populations. The patient was then instructed to use a chlorhexidine rinse twice a day for two weeks along with a Sonicare toothbrush and air floss. After this initial phase, the patient returned for a professional hygiene cleaning and daily Perio Tray® delivery began on August 30, 2012. The patient returned on September 20 for another professional hygiene cleaning and a second periopathogen DNA test, which resulted in a reduction of bacterial loads and fewer species above the test threshold. On October 4, the patient returned for a third recall visit including hygiene prophylaxis and a third DNA test which revealed only one bacterial species above the threshold. When the fourth, fifth, and sixth tests were completed respectively on October 17, December 3, and January 3, 2013, no bacteria were above the test threshold.
These results in decreased bacterial loads are consistent with research findings. According to Dr. Duane Keller, the inventor of the Perio Tray®, usage of this 1.7% hydrogen peroxide gel has been shown to breakdown the cell walls of oral bacteria when the hydrogen peroxide gel is held in place 10 minutes. Hydrogen peroxide delivered into the pockets by the Perio Tray® also adds oxygen under the gums. “This is important,” he says, “because many of the dangerous bacteria in the mouth are anaerobic and oxygen prevents their proliferation. The trick of course is getting the oxygenating medication under the gums for a long enough time for it to work, and this is the benefit of the Perio Tray®.”
The goal of all perio treatment is to stop the progression of the disease. In this preventative case, the goal to decrease the potential systemic inflammatory burden caused by oral bacteria was also realized. “This pro-active approach,” Dr. Wade argues, “confirms the importance of dental care to general wellness.” When the referring physician completed additional blood tests, the markers looked better than ever. “The exact words spoken over the phone,” she recalls, “were ‘Whatever you are doing – keep it up.’” She intends to do just that and to continue to collaborate with physicians for optimal patient care.
Learn more information about about the prescription Perio Tray® from Perio Protect.