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‘Delicate Balancing Act’

Award Winner: Dr. Patricia Lugo-Blanco. in Mayaguez, Puerto Rico.

Dr. Patricia Lugo-Blanco

Patients come to dental offices with certain healthcare needs, but every patient has a unique mix of desires and concerns that complicate gum disease treatment. Dentists are routinely questioned about costs, time away from work, fear or anxieties, and hopes of whiter, brighter teeth. A delicate balancing act is needed to develop a comprehensive periodontal treatment plan to satisfy each patient. Some doctors are particularly good at doing all of this. Patricia Lugo-Blanco of Mayaguez, Puerto Rico is one of them. Dr. Lugo-Blanco recently received the Orkos Award for a case study that illustrates her excellent sense of balance.

When the 71-year-old patient in this case study first came to Dr. Lugo-Blanco’s office, it was obvious that she had avoided the dentist for years. She feared dental procedures, in part because she had several teeth extracted in the past, but she knew she needed professional care. Upon examination, Dr. Lugo-Blanco diagnosed her with moderate to severe periodontitis. Her pocket probing scores ranged from 3-9mm with bone loss and she exhibited generalized heavy bleeding of the gingival tissue. Treatment of the disease was urged because the patient also had high blood pressure and is at higher risk for a cardiac event, which has a well-known association to gum disease. The patient accepted treatment. She also hoped that subsequent restorative work would repair her smile.

When it comes to the treatment of gum disease, Dr. Patricia Lugo-Blanco focuses on the bacterial infections causing the disease, so she makes sure that patients have the best tools to address the underlying bacterial cause. Treatment started on June 6. Dr. Lugo-Blanco provided oral hygiene instructions and a homecare kit that included an electric toothbrush, floss, toothpaste and rinse. Dr. Lugo-Blanco also prescribed periodontal trays (Perio Trays®) from Perio Protect, LLC to deliver hydrogen peroxide gel (Perio Gel®, QNT Anderson, LLC, Bismarck, ND) deep under the gums where the infections hide. Patients use the trays and medication at home for just minutes each day.

“Perio Protect has become a priority in our office, as important as brushing and flossing, simply because patients can’t brush and floss away periodontal disease. The bacteria are too deep below the gums to be removed with toothbrush, rinse, or floss. But with the Perio Tray®, medication is maintained below the gums to fight the infections causing gum disease or periodontal disease. And,” Dr. Lugo-Blanco emphasizes, “we really want to address the cause, not just the symptoms, to improve patient health. We start with prescription tray delivery to get the bleeding under control. Patients then continue to use their trays between office visits and also after therapy to maintain the treatment gains.” In this case the periodontal improvement was necessary before the patient would be a good candidate for the partial dentures she wanted.

After three weeks of the new homecare treatment, the patient returned to the office for the needed cleanings and laser therapy. Bleeding had already subsided significantly and continued to improve. By November the bleeding was resolved and the pocket probing scores measured within normal limits, allowing Dr. Lugo-Blanco to prescribe maxillary and mandibular removable partial dentures, which improved both the function of the patient’s bite and the appearance of her smile. Importantly for the patient, her natural teeth were significantly whiter, a nice side effect of the hydrogen peroxide gel.

“In our office,” hygienist Yesenia Ramos said, “Dr. Lugo-Blanco and our prosthodontist Dr. Rodriquez focus on patient health, but often patients want whiter teeth and fresher breath and all at an affordable price. With Perio Protect, we can provide better healthcare for patients with gum disease and cosmetic improvements at the same time. These cosmetic side effects help with compliance. Perio Protect is a great value for patients. They tell us they are more confident with their smiles.”

Dr. Patricia Lugo practices in Mayaguez, Puerto Rico and more about her practice can be found at Additional information on prescription tray delivery is available at

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