1999 - in the final stretch to the new millennium:

Happy New Year! So much has been made of the Y2K bug that the approach of the year 2000 has many of us quite concerned. The forthcoming new millennium can also be viewed as a time for re-tooling and re-vitalizing our practices to make them 2000 compatible. In periodontics, there has already been a whirlwind of new paradigms in understanding about Periodontitis, and several innovations in therapy. Consider the following menu of materials at my disposal for treatment:

Starters - PerioChip wafers and Atridox gel are antibacterials that now join Actisite fiber as agents to aid management of site specific pockets. For patients with recurring or residual pocket depth, these resorbable products add a measure of convenience above that of the tetracycline fibers which required follow up visits for removal. Prima Piatti - Periostat systemic low dose doxycycline adds punch to the results anticipated from Initial Therapy scalings and root planings. Clinical trials demonstrated that enzymatic breakdown of collagen is reduced with this medication resulting in enhanced pocket depth reduction. The Entree (we have a few today) - first let me suggest Alloderm gingival graft material. This is carefully chosen tissue which has been "acellularly marinated" to render it suitable for gingival augmentation AND root coverage. This offering will warm the hearts of those patients who consider manipulations on the "roof of the mouth" not particularly palatable. Next, let me suggest Bio-Oss bone regenerative material, and BioGuide resorbable membrane. Only the choicest bovines (none of whom are really mad about their selection) are used for production of these materials. Genetically they are close to the real thing (us), which is good, but free of concern about infection transmission, which is great! Lastly, consider Bioglass, a synthetic for bone grafting. Although it is very user friendly and bio-compatible, it yields clinical attachment rather than regeneration in intra-osseous defects. For the vegetarians out there, however, this is still a viable option. For Dessert - there are too many choices to list here. It is best if you log on to www.perio.org and click on Healthy Gums, Healthy Body. There you can also learn about the relationship between periodontal disease and systemic factors. If you're not used to surfing the net, check out the Globe's recent Health & Science article, "Floss or Die." Call me for a reprint if you missed it.

Closing Thought:

Dale Carnegie was an enormously successful man. As we try to achieve more patient compliance and treatment plan acceptance, we should ponder his quote, "...there is only one way to get anybody to do anything.....and that is by making the other person want to do it." That's the key! ........a concept to keep in mind for the start of 1999. Best of luck.