Credibility for Being an Author ––
You Bet!
By Rodger
Kurthy, DMD (The Idea Guy - Author of The 'No Coupon' Marketable
Dentist)
Write a bi-monthly update to local physicians, chiropractors,
and optometrists. Title it something like ‘Dentistry for Doctors’,
or ‘Dental Update for Health Professionals, etc. Heck, if
you mention in your marketing piece that YOU are the author of the
Dental Update for Health Professionals, do you think this gives
you credibility? You bet! And you already know that one key to marketing
success is proof/credibility in your marketing piece.
This is Idea #6 from The ‘No-Coupon’ Marketable Dentist,
written by Rodger ‘Rod’ Kurthy, DMD. Your article could
look something like this:
John Smith, DDS
1234 Main Street
Anytown, OH 56789
(949) 588-1600
email drsmith@dental.com
/ website www.JohnSmith.com
The REAL
Story about Dental Problems/Solutions
As a health professional, you're used to answering all your patient’s
questions with confidence. But what about when they ask you questions
about dentistry? Are you prepared to answer with confidence?
Gum Disease Can Kill Your Patients--Recent Advancements in Periodontal
Treatment
Gum disease and tooth abscesses not only can cause the loss of teeth,
but we now know that gum disease and chronic tooth
abscesses contribute to the death of hundreds of thousands of people
each year! Recent studies have now proven the link between gum disease,
tooth abscesses, and multiple health problems such as cardiovascular
disease, stroke, heart attack, and even low birth weight babies.
These maladies were the focus of the studies, however it is felt
that oral infections have significant effect on many more organ
systems.
For example, the recent retrospective studies showed that a person
with gum disease or chronic tooth abscesses is 2.6 times more likely
to die from any natural cause than someone without oral infections.
These studies also found that patients with Long-term presence of
dental abscesses or gum disease have an average life span of ten
years less! It was found that only 6% of very long-living individuals
had lost all their teeth, and indeed, most had lost very few teeth.
Yet people who died younger tended to have a high rate of tooth
loss (because of gum disease or tooth abscesses) .Within similar
age groups, people with better dental and gum health also had much
less hypertension, heart disease, and strokes.
You should be most aware of this effect on your patients that require
antibiotic pre-med before visiting the dentist patients with certain
murmurs, significant mitral valve prolapse, prosthetic heart valves,
recent heart surgery, recent prosthetic joints, or a history of
bacterial endocarditis. Obviously, these patients are at higher
risk if they have untreated periodontal disease.
Understanding and TREATMENT OF GUM DISEASE has changed dramatically
in the last five years. Cutting-edge dental practitioners utilizing
several new techniques and medications are currently able to achieve
miraculous results thought impossible only a few short years ago.
Gum disease is characterized by resorption of the alveolar jawbone
that encases the roots of our teeth, and eventually much of this
alveolar bone is lost. The teeth then become loose and must be removed.
We now realize that the bacteria in dental plaque do not indirectly
cause resorption of the bone. It is the endogenous release of collagenase
in response to these bacteria that causes this resorption.When the
bone resorbs, the gums detach from the root of the tooth, resulting
in a ‘pocket’ of unattached gums around the tooth. This
pocket fills with bacterial plaque, and the patient is unable to
remove the plaque on a daily basis. Conventional treatment is surgical
and involves resection of the crest of the affected bone and resection
of unattached gums. After healing, certainly the pocket depth has
been reduced and patients can now effectively cleanse under the
gums, however even more bone has been lost, and the recession of
the gums is significant. This often causes sensitivity of the teeth,
cosmetic impairment, and open spaces between the teeth.
Today, conventional treatment is still very common, however often
it is unnecessary because of recent advances in treatment, both
surgical and non-surgical. Non-surgical therapy focuses on an attempt
to have the diseased, detached gums re-attach to the tooth roots
and become healthy. Endotoxins and exotoxins from the pathogenic
bacteria in the ‘pockets’ penetrate the root surface
several microns. Root planing is a process that strives to remove
the contaminated surface of the tooth roots. Conventional root planing
under local anesthesia is accomplished by heavy scraping with hand
instruments similar to the instruments used to clean teeth. Historically,
results of conventional root planing have been marginally effective,
and surgery is often necessary as a second phase of treatment.
The recent introduction of ultrasonic root planing has greatly enhanced
the speed, comfort, and effectiveness of root planing. Ultrasonic
planing of the root surface is much more thorough, and results in
significantly more adherence of the gums to the roots. Gum adherence
in areas of particularly deep pockets can now be enhanced utilizing
intra-pocket time-released antibiotics. There are several types
of these antibiotics, but my favorite type is called Arestin, byOraPharma,
Inc. This powder is inserted into a deeper pocket after root planing.
Once in the pocket it becomes soft and sticky, and adheres to the
root, slowly dissolving over a 7-10 day period while releasing 1
mg of minocycline HC1. Not only does this product act
as an antibiotic, but it inhibits the endogenous release of collagenase
(which is directly responsible for periodontal bone loss), the acidic
nature neutralizes any endo/exotoxins remaining in the root surface,
and studies have actually shown that it enhances fibroblast attachment
to the root surface.
A new oral medication, PerioStat, is actually a very low dosage
of doxycycline. The dosage strength is low enough to have no antibiotic
effect, yet will curb endogenous release of collagenase and also
accelerate fibroblast attachment to the tooth root surface. PerioStat
thus enhances the re-adherence of the gums to the root during healing,
and inhibits future breakdown of the tissues by inhibiting endogenous
release of collagenase. Because the dosage is less than needed to
affect bacteria, there is no concern regarding creation of doxycycline-resistant
bacteria.
We also have better tools for our patients to use at home to more
effectively remove plaque between the teeth and under the gums.
This, in turn, also increases our success of gum re-adherence after
root planing. The Braun/Oral-B 3D Excel electric toothbrush has
been shown (recent article in JADA) to be the most effective instrument
on the market to remove dental plaque. Of course, as in the past,
dental floss is our cornerstone of plaque removal between the teeth.
After mechanically loosening plaque from the gum and tooth surfaces
with the floss and brush, another recent advancement called the
Hydrofloss can flush the loosened bacteria out and help retard their
re-colonization.
Oral bacteria typically have a negative surface charge, and the
teeth/gums have a positive charge—therefore bacteria are attracted
back to the tissues. The Hydrofloss is very much like a WaterPikTM
device and will flush out the loosened bacteria. However, the Hydrofloss
is unique in that it will place a negative surface charge on the
teeth/gums, which of course will repel the negatively charged bacteria
from the tissues.
We find that utilization of these new advances allows successful
treatment of gum disease with a non-surgical approach several times
more often than with current ‘conventional’ non-surgical
therapy. However, there are still times where surgical intervention
is necessary. New advances in surgical treatment of gum disease
are equally impressive. Conventional surgery has usually involved
resection of bone and gum tissue, whereas the newest techniques
focus on regeneration of lost bone and reformation of a new fibrous
attachment of the tissues to tooth roots.
Guided Tissue Regeneration (GTR) was the first successful regenerative
technique. After thorough surgical debridement of a bone defect,
the defect is filled with demineralized freeze-dried bone allograft.
A membrane is then placed over the bone defect and under the gums.
The gums are then sutured over the membrane. The membrane physically
prevents epithelium and soft connective tissues from growing into
the bone defect, thus allowing time for the slower-growing bone
to fill in the defect. The success of these GTR procedures has been
varied. Problems have included dehiscence of the gingival flap over
the membranes allowing bacterial contamination, difficulty of adapting
the membranes to the morphology of the roots, the need for re-entry
to remove the membrane when non-resorbable membranes are used, and
increased time and cost during the initial procedure.
The newest regenerative procedure is “biomimicry”, utilizing
the new product, EmdogainTM enamel matrix protein. The dominant
protein in this matrix is an amelogenin, which is always found in
the early stages of natural tooth development. These “matrix
proteins” mediate the formation of tooth root surface, and
in turn, the formation of new bone and other periodontal attachment
elements. The Emdogain surgical technique is surprisingly simple.
A much smaller surgical field is necessary. The gums are surgically
reflected only enough to expose the bone defects. Bone defects are
thoroughly debrided, the roots are cleansed with an acidic solution,
Emdogain gel is applied to the exposed root surface and bone defect,
and sutures are placed. No existing bone is resected. Surgery is
minimized, postoperative discomfort is minimal, healing is rapid,
and the results are excellent. Not only is this technique much more
doctor and patient friendly than the use of conventional resective
surgery, or even GTR membranes, but it can be utilized in cases
where even GTR cannot. In fact, this treatment is often
successful in cases where NO other treatment would have been possible.
Below I have listed future topics I will cover in this ‘Dentistry
for Doctors’ update, however if there is a particular topic
you would like to learn about or a previous topic you'd like a reprint
of, please give me a call or drop me a note. I hope that the ‘cutting
edge’ information above has been helpful. Any comments or
suggestions would be appreciated.
Again, should you have questions regarding this information, any
questions about oral conditions, or suggestions for future topics,
always feel free to give me a call any time.
Best regards,
John Smith, D.D.S.
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