Even though I have made some comparisons between physicians and dentists, and sparingly at that, I am not in favor of these comparisons as I have a bias toward our profession. However, even with this disclaimer, I can’t help but think if our physician colleagues had a choice between knowing what they are trying to battle and proceeding in the dark, they would certainly choose the former. This is especially true given that determining what needs to be targeted is simple and inexpensive.
This is the case with salivary identification of the bacteria causing an individual patient’s case of periodontal disease. Most dental practices are providing a one-size-fits-all approach in their treatment of periodontal disease. Not too long ago that was a valid way to proceed. Not so anymore with the availability of salivary diagnostics. Many offices prescribe systemic adjunctive antibiotics, but how can a decision be made without knowing what bugs are being targeted? Many offices use the same antibiotics in every case, typically including amoxicillin, metronidazole, and/or Augmentin. These turn out, however, to be the correct antibiotics only about 30% of the time. No wonder a high percentage of all periodontal cases are refractory according to the American Academy of Periodontology (AAP) and the Centers for Disease Control and Prevention (CDC)!
Many dental professionals are content to provide their services the same way they always have year after year, never improving the care they render for their patients. We are a weird bunch that way.
I commonly think to myself when providing any dental care: If this were my wife, mother, daughter, or my son in the chair, would I be offering treatment with a one-size-fits-all approach or would I do something more … something more accurate and predictable? We each need to answer this question for ourselves in light of every patient we encounter every time.
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