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Dentistry plays a significant role in reducing the impact of chronic disease in patients who have made loyal commitments to our practices and have trusted us to guide them in making healthcare decisions. Every component of the dental practice will be rewarded when transforming from a traditional dental hygiene program to an oral medicine platform. There will be team member satisfaction and fulfillment, patient appreciation, and personal professional growth experiences. And yes, when patients experience the concern we show for their overall health, extending above and beyond saving individual teeth, case acceptance should go up in every category. Traditional dental hygiene has focused on disease remediation by providing local therapy: mechanical debridement. In this inadequate model, tissue architecture has dictated diagnosis and some descriptor of treatment success. Periodontal disease is not a local disease defined by pockets and recession. It is now known that periodontitis is a systemic disease diagnosed by pathogen presence and concentrations. In reality, we now know that one infected pocket means an entire infected mouth. The pathogens responsible for local oral tissue breakdown can be found in distant translocated microbiomes initiating the same tissue damage to cardiovascular tissue or other critical organs. Current landmark research has moved high-risk oral pathogens past the ‘level A’ risk factor designation to causal for atherosclerotic vascular disease. Dentistry has been aware that mechanical debridement does not alter the distant microbiomes of these high-risk pathogens, and in fact, perhaps traditional scaling and root planing as the sole therapy for periodontitis is now a substandard care modality. It is not essential that all members of the dental team completely understand some of the complex science that supports a recommended treatment platform for periodontal disease. It is important for all team members to know that evidence exists and that they can become experts by simply being authentic in their chairside conversations. In short, this training workbook allows dental teams to treat high-risk pathogens in high-risk patients to avoid and/or minimize the effects of chronic inflammatory diseases exacerbated or initiated by oral bacteria. The 12 Steps will guide your dental team to completely understand and then implement a comprehensive oral systemic platform in the dental hygiene department of your practice. Many of the principles discovered will be transferred to any invasive dental procedure being accomplished in the practice to protect high-risk patients from the negative impact of high-risk pathogens. This profession has been blessed by the work and persistent commitment of several oral systemic pioneers; it is their voices that echo throughout the pages of this manual.
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