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Advanced Salivary Diagnostics

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Advanced Salivary Diagnostics

myperiopath2-789x1024This is the OralDNALabs test for pathogens causing infection in your mouth.
It detects both quantity of pathogens (disease causing microbes) and the specific pathogens causing your disease.

When I look at the quantity of pathogens present, I’m evaluating your bacterial load.

Is your bacterial load too heavy for your body to handle? Are you going to need help? Is it low enough to handle just by improving home care?

The next thing I need to know is, “Who are the ‘Bad Guys’ ?” Are they highly toxic, and tissue invasive, even resistant to the most aggressive treatment, or are they of low toxicity, and easier to kill?

The same specimen can also test for your genetic response to inflammation….your natural ability to handle infections. 35% of the population has a genetic mutation that hinders their ability to handle infection and inflammation. Those of you who are positive for this gene mutation are much more vulnerable to diseases and serious infections, like aggressive gum disease, arthritis, diabetes, cardiovascular disease – any inflammatory disease (dental AND non-dental related).

This test is for full body health and wellness. It lets us know in advance how to better guard and fight a more challenging battle than most people, in staying healthy.

Regardless of your gender, your age, your current systemic or oral health, knowing you PST type is important. Even if you’re 6 years old and have good general health with zero gum disease and no cavities, knowing your PST type is important. This is a test for all human beings.

Knowing your PST type allows you, your dentist and every health care provider you have, to adjust your health requirements to minimize exposures and consequences of inflammatory diseases for your lifetime. This test is taken only once in your life. And it could mean the difference between living in well or living sick.

Your PST type is very important to me, as your dental medicine provider, because it changes how I diagnose and treat your oral and systemic health …..for the rest of your life.

When I have the PerioPath test AND the PST test:

  1. I know which pathogens are in the mix. How many of them are present. Is that load too much for your system to handle. Are any of your pathogens resistant to normal treatment methods. Are they aggressive and tissue invasive? Or, are they just milder groups of pathogens. All of this determines how I need to treat your case.
  2. Especially of great value is the PST. If your one of the 35%, who test positive for the genetic mutation, we’ll need to approach your oral and systemic health in a very different way.

 

These tests are very simple, easy and comfortable. All you have to do is swish for 30 sec and spit the saline solution into a tube. The lab processes your specimen. Clones the bacterial DNA and amplifies it using PCR technology, (Polymerase Chain Reactions). A report is returned to my office.

And I’ll review it with you.

Let’s take a look at the first test, your PerioPath test for gum infection….

At the top of the page are 3 boxes: High Risk Pathogens , Moderate Risk Pathogens and Low Risk Pathogens.

Each box has numbers on the left side. These numbers tell us how many disease causing bacteria are present.The quantity of pathogens. Like a thermometer taking your temperature, when you’re sick.

On the lower section of the main box are color coded cubes, with letters inside each cube. The letters are abbreviations for the genus and species of each pathogen known to cause gum infections. Its the “first and last name” of each microbe we want to kill,
if we find them in your mouth!

In this example report (Doe, John A.) has 5 pathogens above “Threshold” and 3 pathogens below threshold but above “Detection Limit”.

Let’s pretend you are the patient, and you’re sitting with me in my consultation room.
We’re not in a dental chair. You’ve already had your gums checked by the hygienist a week ago at your cleaning appointment.

My hygienist told you that your gums were swollen and “puffy” looking and you had some 4 mm gum pockets.

All you remember, is you had some early stage gum infection in a few areas and, if you want to stop it now, before it gets worse, Dr Tinney needs to know which bacteria are causing the problems. And, he needs to know about your DNA and the bacterial DNA.

Because you’re concerned about your health , and because you need to keep your costs down, you chose to go ahead and take the recommended DNA tests.
Doctor Tinney (Dr): “Hey, John ! Thanks for coming in . Scoot up a bit closer to the desk here, I’m gonna show you what your DNA test looks like.”
John (J): for the sake of brevity, I’m not going to enter your responses. There is a FAQ section in this area that should answer the most common questions.

As an active patient, of course, you will have as much time as you need
(at no cost, because I never charge for consultation time….never)
Dr: “John, first let’s look inside the ‘High Risk Pathogens’ box, here. Looks like Aa and Pg are above the black lines.
Those black lines are your body’s lode thresholds . The concentration of Aa and Pg is too much for your immune system to win the battle.

Over here in the other boxes, Fn, Pi and Cs are also above your load threshold.

You also have other pathogens that are just above your “Detection Limit” (the earliest concentration that can be detected in your mouth) In 30 years of practice, I’ve never been able know how serious your gum disease is… until this genetic medicine became available!”
“Well, let me detail each of the culprits we’ve found:”
Aa (Aggregatibacter actinomycetemcomitans)

1) Aa is the most virulent (the most damaging) pathogen in the mouth. Normal treatment can not kill it.Even if we deep clean and and scrape off all of your root surface cementum (thats very aggressive scraping), this pathogen will not go away!

  • it can attach to the roots (root scraping should get rid of that), but it also swims around in saliva and, and it’s tissue invasive. It attaches to any kind of soft tissue….. like mucous membranes (the lining of your mouth), your gums- especially in your gum pockets, as well as the inner lining of arteries in your body.

So, aggerssive scraping of your roots now and every 3 months will never get rid of it.
The DNA from Aa tells me most of what I need to do…more on that later.

  • Aa (even at small, low, detection levels) is extremely virulent.
  • It excretes a biofilm. A toxic, “slime” that covers it like a blanket. Your immune system can’t penetrate the biofilm. Root scraping can’t eliminate it. Not only does it allow Aa to continue populating, it gives all the other pathogens protection, under the blanket!
  • Aa is also found in coronary (heart) arteries and peripheral arteries. It’s in the plaques that block the flow of your blood through arteries,

2) Pg (Porphyromonas gingivalis)

Pg also swims around in saliva, attaches to the roots and it’s also tissue invasive and resistant to normal treatment. Not as much as Aa but more so than other pathogens.

  • It’s also found in arterial plaques of coronary and peripheral arteries.

FN (Fusobacterium nucleatum/periodonticum)

3) Fnis a moderate risk pathogen, but in the presence of Aa or Pg, it becomes a toxic, high risk pathogen.

  • Fortunately, it has adherence properties. It sticks like glue to root surfaces and to other pathogens.
  • It’s not tissue invasive (not in the same way as other tissue invasive pathogens). It’s still found floating in saliva and in the bloodstream.

Pi (Prevotella intermedia)

4) Pieven though its classified as a moderate risk pathogen, its virulence (its ability to destroy tissues or the function of tissues)…. Is toxic and tissue invasive

  • It floats around in saliva and gum pockets; Attaches and burrows deep into soft tissues and mucous membranes

Cs (Capnocytophaga species: gingivalis, ochracea, sputigena)

5) Csis a low risk pathogen frequently found in gingivitis (early stage infections). It floats around in saliva. Floating around in saliva means its transmittable (it goes wherever saliva goes….mouth-to-mouth)

Cr (Campylobacter rectus)

6) Cr is usually found among other groups of pathogens. Its a moderate risk pathogen. It gives you a moderate risk of tissue damage in low concentrations. This level of load is normally controlled by your immune system if you’re healthy and NOT PST positive.

Pm (Peptostreptococcus micros)

7) Pmis a moderate risk pathogen in higher concentrations. At this load level your mouth is at low risk. This pathogen is normally detected at higher loads in actively infected gum pockets. In other words, It is NOT usually found in early stage infections like yours, with such a low detection load…it could increase without treatment, at this time.

Ec (Eicenella corrodens)

8) Echas moderate risk capability at higher load levels, right now it has “low risk” for infection. Ahealthy body with normal PST should be able to handle this load, in the absence of the other ones you have.

**All of these pathogens are “social”. They love to colonize together. As their “social communities” enlarge, toxicity and difficulty of treatment increases.

So, I need to see the whole picture to customize our attack, before we begin treatment..

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“The goals I would set for treating your case would need to :

  1. Disrupt the biofilm! Remember? We need to remove that protective “slime” layer covering the pathogens. And we need to remove or reduce the entire community of pathogens. Kill as many as possible
  2. Both root surfaces and gum pockets need to be treated.
  3. You have Aa, Pg and Pi. Lasers penetrate 360 microns into the gum tissue where these pathogens have embedded themselves. Our cleaning instruments won’t reach all of these areas. And remember? Aa and Pg are “immune” to those instruments. We need an edge to ensure their kill rates.
  4. First of all, that means fortifying your natural immunity to the pathogens. We have a special neutraceutical (a natural supplement…not a medication) proven in double blind medical studies to improve gum health by 40%
  5. Your DNA test tells us that we also need antibiotics taken at the start of treatment. What you need specifically, is:
    • Amoxicillin 500mg , 3 capsules a day for 8 days and,
    • Metronidazole 500mg, 2 capsules a day for 8 days
    • Like I said, at the start of treatment .
    • The DNA test also recommends that we retest in 6-8 weeks later, after treatment.
  6. Your also going to need a medicated mouth rinse, chlorhexidine. Its a Rx drug. Some medical insurances cover it. We’ll be using it during each the hygienist sees you for the therapy and you’ll need to continue using it at home daily. Once a day is fine.
  7. Your hygienist needs to spend 3 very critical, important sessions with you: One before we start your therapy; One during; And one at the end of therapy.

We need to assess the efficiency of your daily home care. Make any adjustments that’ll target biofilms better.

When your daily home care works like “laser guided missiles”, it’ll disrupt the biofilm and reduce the bacterial loads so they don’t repopulate.

I know you’re diligent…brushing your teeth and such, but I don’t believe you’re reaching the biofilms enough to disrupt them. Otherwise DNA test would be better.

Oh, there’s a special toothpaste we may want you get and (if you use mouthwash) a special mouthwash.These items are not RX’s. You can get them at Walgreens or Rite Aid . They kill anaerobes….the ones your DNA test identified.

That’s what I need to do in order to optimize your bacterial kill rate.

It’s possible that your pathogens have caused inflammation in your body. If you want me to assess that, we need to check your blood. That’s a finger stick test for 2 markers (indicators). One finger stick is good for both tests.

I need this before you start treatment.

It is a good idea to have me check this because most medical doctors won’t be using these tests for your gum infections. And if your tests are too high , there may be a need to refer you to a Medical Professional.

John, Your bleeding points at your last cleaning appointment didn’t look too bad. You had a few 4mm gum pockets. What bothered us, however, was the inflammation and swelling….the “puffy” areas.

It just didn’t look right. That’s why I wanted the DNA tests.

Your DNA test was PST positive. And that may explain why your mouth was inflammed.

This next report is your PST.

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“John, Just under the results area in your report, are some letters and numbers. There’s also 4 boxes with letters in them.
You have 2 genes here, IL-1A and IL-1B.

If the letter “T” is found anywhere in both genes, you’re positive for the test.
Gene IL-1A has to have at least one “T.”
Gene IL-1B also has to have at least one “T.”
Whenever BOTH genes have at least one “T,” that’s a positive test
…..and that’s not good. This will be a serious lifetime risk for you.

But don’t worry….we are able to help you, a great deal!

Your test is positive for this genetic variation. On average 35% of caucasian populations are positive. That number varies for other ethnic groups.

Regardless of ethnicity, you have a genetic mutation that puts you at 3-7 times higher risk of contracting severe gum infections.

Because of this, you need more aggressive gum care and more preventive follow up surveillance. I use the term surveillance in a military sense of the word, because this disorder requires vigilance because it can also affect your systemic health.

All humans have these 2 genes, John. They act like a light switch. When the switch is off, the lights are out. When the switch is on, all lights activate.

When your gums and the rest of your body are healthy and balanced, your gene switch is off. Your immune response is on hold, guarding your mouth and your body against the threat of pathogens and inflammation
….ready to defend.

When your genes detect pathogens,toxins,infection or inflammation, your gene switch activates. It sounds the call for defensive action. Your immune system activates and it comes to the rescue like a police SWAT team.

Normally that’s good. Its the way our bodies fight off infection and inflammation.

The problem with a positive PST test, is that your genes fail to turn it off. Instead, they continue pumping in the troops until a whole lot of collateral damage occurs. Too much of a good thing becomes detrimental.

That’s why its important to stay on top of your oral and systemic health. There is a mouth to body disease connection …..its actually a 2-way street, going both ways.

When your gums contract infection, your genes work “double overtime.” Pathogens and toxins penetrate into the bloodstream unimpeded and your immune system kicks into overdrive, without stopping.

The goal is to stay healthy in mouth and body so the switch stays off.

Do you smoke, John? Studies have verified that your genetic disorder is even more severe if you’re a smoker, a diabetic, if your brushing and flossing technique is infrequent or inefficient and if you continue to have uncontrolled gum disease.

In spite of your genetic disorder (and all of this depressing information), we can reduce the inflammatory load in your mouth which will also help to unload the inflammation in your body.

All you need to do is first understand, and then decide you want to do whatever it takes to stay healthy.

We’re able to help you.

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“Patient 8, your HPV genetic test has come back positive. That means you have cancer in your mouth.”

“Oh Lord, I pray I never have to say this to any human being….ever.”
In this test, the ORARISK-HPV test, the lesion was 8mm x 88mm. That’s about 3 1/2 in. long and a little wider than a pencil.

How could you miss something even half that size?

This lesion was found in the far back wall of the pharynx. That’s behind the base of your tongue, behind the uvula, that thing that dangles down when you say, “Ahhhhh” for the doctor when he looks at your throat.

Its all the way back. These lesions are commonly red, the same color as your throat. Some people have such a large tongue in the back, that you can’t even see into their throat.

It might have taken a long time for any pain or difficulty in swallowing to develop. Typically no symptoms are evident in early stages. Lesions can mimic normal tissues.

By the time most oral cancers are discovered, 66% of them are already at stage 3 or 4…too far advanced for recovery.

Oral (mouth) and oropharyngeal carcinomas are the 6th most common cancers in the world.

Heart disease is still the number one cause of death in America. It kills one person every 35 seconds.

Oral cancer kills one person every 60 seconds.
The 5 year survival rate is 54% and hasn’t improved for decades.

The rate of death from oral cancer is higher than cervical cancer, Hodgkins lymphoma, laryngeal cancer, cancer of the testes, thyroid cancer and cancers of the skin.

Survivors of oral cancer are at 20 times greater risk for recurrence within 5-10 years after their first occurrence.

According to the Centers for Disease Control over 20M Americans are infected with HPV. We’re seeing 5.5M new cases every year.

In the 1970’s HPV related cancers of the tonsils were 23.3%. By 2002 that number increased to 68%.

HPV is becoming the number one STD in America. Its estimated that 85% of sexually active women will contract HPV in their lifetime.

There over 130 strains of HPV.

The majority of HPV related cancers of the mouth , tonsils nasopharynx and throat are associated with the genital HPV types (16 and 18) being transmitted by oral sex.

There is no cure for HPV. Vigilant surveillance can intervene and prevent serious cancer lesions and painful, disfiguring treatments of advanced stage disease.

With early detection and treatment, 80-90% of complications from oral HPV related cancers can be prevented….with vigilant, ongoing surveillance.

An obvious sign of HPV infection is the presence of warts or sores in the mouth.

These lesions come and go, in and out of dormancy and reactivation. During this time of transitions, cancerous changes are taking place within the oral tissues.

As I said earlier, most lesions are not detected until they’re already advanced ….66% of the time.

1)Should you have symptoms here’s what you need to look for: Non-healing sores in the mouth; Any firm lumps or areas of red or white changes in the cheeks or gums.
These signs could be non-HPV related cancers or pre-
cancerous lesions.

2) Early detection is absolutely imperative! The most accurate and earliest method of diagnosing HPV related cancer is a genetic test for the virus, ORARISK-HPV.

*This test will not diagnose oral cancers from non-HPV types.

3) Here are the risk factors for contracting HPV virus (benign) and oral cancer related HPV-16,18 :
*Alcohol and tobacco, multiple sex partners or “serial monogamous” sexual partners, mouth to vaginal oral sex.

According to the New England Journal Of Medicine, “Men and women who reported having six or more oral-sex partners during their lifetime” had 9 times greater risk of contracting cancer of the tonsils or base of the tongue.
This same study determined that those who already had HPV were 32 times more likely to develop this kind of cancer than those who had no HPV

Solution!

*If you fit into this profile of risk factors, it is strongly recommended that you take the ORARISK-HPV test annually.
*Your dentist can perform your annual cancer examinations, indefinitely.

*Should you have a positive DNA test for HPV Immediate referral to appropriate medical professionals and ongoing, follow up with both medical and dental providers is necessary….for the rest of your life.

*The key is early diagnosis with appropriate treatment as needed.

Taking the ORSRISK-HPV test is simple, comfortable and affordable.

All you do is swish vigorously with sterile saline solution and gargle for about 30 sec and spit it into a tube. Our staff takes care of everything else.

For detecting HPV-16,18 related oral cancers, there is no other test as accurate and as capable of early detection.

With early detection (even before lesions erupt) and with early intervention, survivability is 80-90%.