August 2012 Award Winners - Dr.Jim Coleman & team (inc. Karla Middendorf RDH & Paula Kingsle
Seattle-based Dr. Jim Coleman and hygienists Karla Middendorf and Paula Kingsley received the Orkos Award for demonstrated excellence in a case study report involving a patient with advanced gum disease and significant fears regarding pain management. By introducing the patient to non-invasive technology, Dr. Coleman’s team helped him alleviate his fears and accept treatment. “The qualifying evidence presented by Dr. Coleman was of particular interest,” explains Dr. Tanya Dunlap of Perio Protect LLC, “because the patient would have faced surgical intervention which he was unlikely to accept, leaving his disease unchecked. It is so important for patients to get treatment and, as this case study demonstrates, helping patients overcome their fears can make a significant difference.”
Like many people across the country, the 62 year-old, non-smoking patient in this case study feared and avoided needed dental procedures until his gum disease was quite advanced. He found Dr. Coleman’s office after his previous dentist retired. On his first visit, Dr. Coleman diagnosed him with advanced periodontal disease (vertical and horizontal bone loss, 5-7mm periodontal pockets, and 37% bleeding on probing). Bacterial testing (Hain Diagnostics) revealed high levels of bacterial communities associated with gum disease (Aa and red complex bacteria).
To help alleviate his new patient’s fears, Dr. Coleman prescribed Perio Trays® to deliver medication under the gum line before root debridement therapy. The medication delivered with the special customized Perio Tray begins to address the biofilm infections causing the disease. When the patient returned after 20 days of Perio Tray and medication usage, pocket probing depths decreased by 1-3mm and bleeding decreased from 37% of probing sites to 14%. Bacterial testing indicated significant (90%) reductions in harmful red complex bacteria. Pretreatment swelling of the gum tissues had also subsided.
Despite the initial positive treatment response, the patient still feared the necessary root debridement therapy. When the patient returned a month later, Dr. Coleman prescribed an anesthetic gel delivered in the Perio Tray before the mechanical procedure. With this additional pain management step, root debridement therapy was successfully completed in one procedure. The patient was instructed to continue to use Perio Trays with medication until the next appointment.
Hygienist Karla Middendorf described his results as outstanding at the recall visit six weeks later, with only 3% bleeding on probing and no pockets measuring over 4mm. She also noted that the gum color returned to a healthy pink. According to Middendorf’s colleague hygienist Paul Kingsley who also worked with the patient, the anesthetic gel in the Perio Trays made a huge difference for this patient. “With the delivery of the numbing agent deep into the pockets,” Kingsley explains, “perio maintenance visits were much more comfortable for the patient; consequently he kept his appointments, we were able to complete the treatments, and the positive results have been maintained long-term.”
Long-term success is the ultimate goal. The Perio Tray delivery of medication is a significant advancement in patient treatment options because patients use it at home between office visits to help manage the bacteria causing the disease. The Perio Tray can be used by patients with all stages of disease, and it is designed for maximum patient comfort and convenience. Kingsley believes that when patients have access to the best tools, they have more options for proactive treatment and they are more hopeful.
Dr. Coleman initially was interested in the Perio Tray delivery of medication to help his patients with physical disabilities, like Parkinson Disease or strokes, who are now dependent upon their caregiver for their daily oral hygiene. What he and his team discovered, recounts Kingsley “was a tool that is so much more comprehensive, affordable, simple and effective for all of us and our patients.” Dr. Coleman then decided after seeing “off label” successes, why not use it for what it was design for, treating patients with periodontal disease. Middendorf, who has practiced hygiene with Dr. Coleman for 16 years, uses Perio Trays herself for preventative care: “I use it so I don’t ever develop periodontal disease. I see what many of my patients deal with – bone loss, bad breath, local and systemic infections – and I want to avoid it for myself.” Laura Brecht, a dental assistant in Dr. Coleman’s office, explains that she uses the Perio Tray delivery of medication to reduce calculus buildup and eliminate the “itchy” gums she had around a crown. Dr. Coleman also had trays made for his own personal use after seeing the benefits.
The move Dr. Coleman’s team made toward minimally invasive dental care with the non-invasive Perio Tray is indicative of his emphasis on thinking “outside the box” and embracing evidence-based science through technology. “The science behind the Perio Tray delivery of medication wowed us,” said Kingsley, “it allows us to offer targeted treatments for the biofilm cause of the disease and it has changed the way we practice.” Dr. Coleman has been in practice for 20 years in Burien, WA following a successful dental career in the US Navy.
Learn more information about the prescription Perio Tray® from Perio Protect.