GALAXY 1 – MISSION 1
Wake-up-call:
Rethinking Our Understanding of Periodontal Disease
Based on recent and ongoing research, we must re-orient our understanding of periodontal and peri-implant diseases. Periodontal conditions are chronic, multifactorial infections, and these chronic inflammatory diseases result from an imbalance between one’s immune system and a bacterial challenge. Stress levels, age, and other factors affect the immunological response effectiveness. Therefore, our resistance is episodic. Like many other chronic, inflammatory diseases (RA, CBD, CVD,) they follow the relapse-remission model and are not linear in progression. Unlike we previously understood, gingivitis, periodontitis, and peri-implant diseases are, therefore, characterized by periods of quiescence and activity, which is why a single patient can present with both periods of health and breakdown over time.
As clinicians, we have been traditionally trained to evaluate Periodontal disease with radiographs, periodontal measurements, and bleeding upon probing. This classic methodology determines the diagnosis of a patient’s current state of destruction that has previously occurred. This is a new understanding of periodontal disease, which means it is no longer sufficient of and by itself! As we enter an era of molecular dentistry, we have the unique opportunity to partake in a paradigm shift in our diagnostic procedures. Rather than just looking backward (looking in a rearview mirror), we can look forward and understand the present activity level of the disease. Utilizing a point-of-care, chairside, aMMP-8 biomarker, OralFitnessCheck, we can identify pre-clinical inflammation and real-time collagen breakdown, which an examination cannot detect. Again, the OralFitness score indicates the present activity of the breakdown process, not just a measurement of what has already occurred. Therefore, we propose that a clinical oral health examination requires a physical and radiographic examination and should be combined with an oral fluid, aMMP-8 OralFitness test. This would then give the clinician complete information on the patient’s oral health. A report can be generated within five minutes. Using a simple mouth rinse approach.
Note: OralFitness testing does not provide a diagnosis. Instead, it provides important additional information to motivate the patient and to assist the clinician in understanding the activity and future progress of the disease.
Preclinical?