Wave farewell to the ‘cleaning lady’

Judy Carroll investigates periodontal therapy and the changing face of the dental hygiene profession

The role of the dental hygienist is changing rapidly, thanks to technological advances and the ever-emerging literature on confirmed oral-systemic links. The days of blind root instrumentation, and being kept in a dark box of imposed clinical limitations, are now gone.

Non-invasive periodontal regeneration, and the unparalleled level of definitive and preventive periodontal care we can now provide using a tiny periodontal endoscope, is something to behold. But, most importantly, the dental hygienist’s understanding of periodontal pathogenesis has evolved from that of ‘local oral infection’, to a more broad and accurate understanding of ‘host response’, and its important role in all chronic diseases. In essence, the hygienist’s role in the dental profession has gone from that of ‘cleaning lady’ to a more pivotal role in the dental and health care team, as ‘oral-systemic periodontal therapist’.

Big picture

PerioPeak Innovations is celebrating 10 years of providing advanced regenerative periodontal endoscopy (RPE)for clients travelling in from all over the globe. While it has been a thrilling and rewarding ride, filled with pioneering clinical discoveries, as well as saving literally thousands of hopeless teeth in the process, the big picture of our understanding of periodontal diseases has gone well beyond local factors. The diagnostic process and treatment protocol at PerioPeak has morphed into a more comprehensive ‘host response/risk assessment protocol’ – encompassing multiple oral-systemic diagnosis methodologies and therapies.

Earlier in 2011, surrounded by cardiologists, vascular surgeons, endocrinologists, MDs, and a handful of dental professionals, we attended a career-altering and intense medical continuing education course. The Bale-Doneen two-day medical preceptorship, offered by Brad Bale, MD and Amy Doneen, MSN, ANRP – founders of The Heart Attack, Stroke, and Diabetes Prevention Centre.

This was the first time (to our knowledge) that medical and dental health care professionals had converged together in one place to gain a more in-depth understanding about oral-systemic links, and how to provide more integrated care. The energy and passion in the room was palpable! We had heard about this dynamic duo through one of the speakers at the course, Dr. Tom Nabors, Chief dental officer at Oral DNA Labs, Inc. – a revolutionary salivary DNA diagnostics company in Tennessee.

While we had already incorporated salivary DNA diagnostics into our treatment protocol, we could clearly see the next indicated step for more comprehensive, holistic care – incorporating integrative strategies.  We then attended the first annual AAOSH (American Academy for Oral Systemic Health) meeting in Chicago in June, where medical and dental professionals officially came together for the first time.

It was a home run – very well organised and profoundly educational, with some of the most inspiring and pioneering clinicians in the health and dental industry. With the driving passion of the founders of AAOSH, dental and health care professionals of all specialties in all corners of the globe can finally come together for a common cause and goal – more comprehensive and effective oral-systemic treatment strategies for our patients.  What an exciting time in our profession!

All pull together

At PerioPeak, we strive to pull it all together with our periodontal patients by ordering comprehensive medical labs, providing integrative care with physicians and specialists, performing Oral DNA labs salivary diagnostics, building risk assessment profiles, educating patients about important host modulated therapy options, providing periodontal endoscopy diagnosis and treatment, using regenerative proteins and soft tissue lasers, referring to orofacial myologists, and providing antioxidant scanning and nutritional counseling. The PerioPeak protocol continues to evolve as we make important discoveries – we are passionate about teaching and training others to move in this direction. We have an open door policy and invite clinicians from around the globe to visit our clinic to learn more. With each periodontal patient there is tremendous opportunity to actually save a life, or at the very least, promote better quality of life, through multidisciplinary approach and clinical innovation.

To accomplish this we must first learn to think critically and to educate ourselves in oral systemic issues and bidirectional etiology. As a profession, we must break the ties that bind us from helping our patients in a more comprehensive and definitive way. We should passionately demand more from ourselves and the technologies we use every day by thinking out of the box constantly.  The gums can be a reflection of a systemic disease process well underway – the time is now for the emergence of the oral-systemic periodontal therapist and innovative regenerative clinician in all of us. We have moved beyond the days of seeking and providing ‘just clean teeth’ in our continued quest for long-term positive clinical outcomes and professional fulfilment.

Judy Carroll, RDH, is lecturer, clinical instructor, director and founder of PerioPeak Innovations, an ardent advocate of dental endoscope technology and minimally invasive periodontal treatment. She attracts patients from all over the world for regenerative periodontal endoscopy (RPE) – an innovative treatment approach. Her pioneering protocol for periodontal regeneration without surgery is a revolutionary stride for the dental hygiene profession.
She is a member of the ADHA and the WSDHA, and is a founding member of the American Academy for Oral Systemic Health – AAOSH.  She has earned several post graduate certificates in periodontal endoscopy, laser periodontal therapy, neuromuscular dentistry, digital dentistry, and oral-systemic education. She has worked in a variety of clinical settings, including periodontal and full mouth aesthetic rehabilitation specialty practices.

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