Watch this You Tube video on Gum Recession

For those cardiac patients on anticoagulant medications and who need a tooth extraction, it is important for the treating clinician to have a protocol that will help prevent major bleeding following dental extractions without suspending anticoagulant therapy.

In an issue of the Journal of Oral Implantology, a study evaluated the use of leukocyte- and platelet-rich fibrin biomaterial, which is commonly used in dentistry to improve tissue regeneration and healing. It was tested as a safe filling and hemostatic material after dental extractions in 50 heart patients undergoing oral anticoagulant therapy, according to a news release.

The heart patients in the study had mechanical valve substitutions and were placed on anticoagulant oral therapy with warfarin. It is not recommended to suspend the anticoagulant and replace with heparin prior to minor surgery, although this substitution may control the risk of postoperative bleeding

Using a platelet-rich plasma placed in postextraction tooth sockets is way of controlling bleeding without suspending the anticoagulant. While this method has shown some success, barriers to daily use exist:

The platelet concentrates take a long time to prepare and it is expensive. An alternative biomaterial that is simple and inexpensive to

prepare, platelet-rich fibrin has proven useful in daily dental practice as filling material for regeneration in order to place implants.

CDA JOURNAL FEBRUARY 2012, VOL 40, #2, pg113

note: At Reuss Dental we use Platelet Rich Plasma (PRP) taken from the patient’s arm and spun down to get the desired growth factors and concentrated platelets. We see enhanced healing, better bleeding control, and decreased post op pain.

CDA JOURNAL, VOL 39, #11, NOV 2011, p783

Reuss Dental has just started using a revolutionary approach in testing your saliva to see if you have risk factors that contribute to periodontal disease.  This new approach allows the clinician to determine which pathogens are present in your mouth and how they can affect your overall health.  During your periodontal therapy appointment we can discuss your risk factors and determine the best way to treat the pathogens that you have. Patients love this new approach because it is very simple to do. Below is some information taken from Oral DNA Labs Clinician’s Resources.

Our office is pleased to announce the availability of 3 laboratory tests relating to oral health. We think that some of our patients may benefit from these tests, but they are usually not covered by your insurance. Therefore, we will only perform them at your request. So, it’s important for you to understand the tests and their related conditions.
One of the conditions is gum disease, which can result in loss of your teeth. Bacteria and inflammation cause gum disease. More than 50% of Americans have gum disease. The other condition is oral cancer. Oral cancer can be caused by infection with a virus called HPV and by tobacco and alcohol use. HPV-related oral cancer occurs most often in people who don’t smoke or drink very much. A different kind of oral cancer occurs in smokers who drink a lot. About 36,000 Americans get oral cancer every year.
The MyPerioID® PST® test can tell if you have specific changes in your DNA. These changes might mean that you have a greater risk of getting gum disease.
The MyPerioPath® test is for patients who actually have gum disease. It finds out which bacteria are triggering the gum disease. Once we know which bacteria are in your mouth and at what amount, we can come up with a treatment plan that’s right for you. For example, this information can help us select the right antibiotic for you. We highly recommend this test if you have gum disease that has not responded to previous treatment.
The OraRisk® HPV test can tell if you have an HPV infection in your mouth. If you do, you might have a greater risk of getting HPV-related oral cancer. Like most cancers, it’s important to detect oral cancer early. If we know you have an HPV infection, we can watch you very closely for signs of oral cancer. We suggest you consider having this test if you are a non-smoker and don’t drink a lot.
All 3 of these tests are performed using a saliva sample, which is collected in our office. The sample is easy and fast to collect. Simply swish a sterile saline (salt) solution in your mouth and spit it into a container. The sample is then sent out for testing. When the results come back, we will tell you what your results are and what they mean to your oral health.

Periodontal Disease Overview

Prevalence of Periodontal Disease in the U.S.

Prevalence of gingivitis, the more common but less severe form of periodontal disease, is determined based on the presence of gingival inflammation and bleeding. According to data from the National Health and Nutrition Examination Survey (NHANES) III, about 50% of Americans have gingival bleeding.1

Prevalence data for periodontitis, the more severe form of periodontal disease, vary widely according to age of the individuals in the study population, the criteria used to define periodontitis, and the method used to examine the individuals (eg, partial-mouth vs full-mouth examination). In general, moderate periodontitis affects 30% to 50% of adult Americans, and 5% to 15% have severe periodontitis.2

Periodontal Disease Overview

The Perio-Systemic Link: Mouth, Body, Overall Health

Currently, it’s difficult to accurately predict which patients are at greatest risk of progressing to severe disease and which patients will be non-responsive to standard periodontal scaling, root planing, and debridement, complicating development of an optimal, patient-specific treatment plan.

Risk and prognosis of periodontal disease is affected by multiple factors.3,4 • Underlying pathogen(s) • Genetics: based on family and twin studies and some cytokine studies (eg, interleukin 1) • Lifestyle factors: tobacco use, stress, teeth grinding or clenching, poor nutrition • Co-morbid conditions: diabetes, cardiovascular disease, rheumatoid arthritis, osteoporosis/osteopenia,

obesity, pregnancy • Medications: long-term corticosteroids, calcium channel blockers, phenytoins, immunosuppressants,

chemotherapeutics

Periodontal disease, in turn, affects other health conditions. • Treatment of periodontal disease helps patients control their diabetes.5,6 • Periodontal disease may be a risk factor for heart disease.7-9

The underlying nature of these associations is still being investigated, but the periodontal pathogens and increased inflammation may be involved. For example, periodontal disease, diabetes, cardiovascular disease, and rheumatoid arthritis are all inflammatory conditions. Additionally, some small studies have found periodontal pathogens in atheromatous plaques.10-12 Regardless of the underlying mechanism, it’s clear that periodontal disease is linked to overall health.

Additional information can be obtained from the American Academy of Periodontology.

A new surface technology that only Biohorizon is using is the new “Laser Lok” surface on the implant. It is desined to behave more like a tooth allowing connective tissue to have a physical attachment at the surface of the implant. The advantage of this is that it helps to have a stronger soft tissue interface at the implant above the bone. This is what makes dentistry fun, all the new technology and improvements that have and are being made. Talk to you soon, Dr. Jr.

William M. Reuss IV, D.D.S.
Dr. Reuss IV graduated from the University of California, San Francisco Dental School in 1999. He received his bachelor of science degree in physiology from the University of California at Davis in 1994. Following dental school he completed a one year residency in Advanced General Dentistry at the University of Florida in St. Petersburg. This training provided tremendous opportunity in the placement and restoration of dental implants, state-of-the-art techniques in cosmetic dentistry, and full mouth rehabilitation. The residency program also benefited from the association with Dr. Peter Dawson’s Advanced Dental Center. Here, Dr. Reuss attended a series of lectures and workshops covering occlusion, TMJ, and dental reconstruction.

Dr. Reuss also completed a 10-month implant training program (2000) at the University of Miami under the instruction of Dr. Arun Garg, a leading researcher and teacher in bone grafting. Focus was upon bone grafting, sinus augmentation, and surgical and prosthetic aspects of implant dentistry.

Dr. Reuss IV completed the fourth and highest level of the Orognathic Bioesthetics International in 2006 after a three year program in full mouth rejuvenation.  Bioesthetic dentistry focuses on a health based way of evaluating the chewing system and relating it to the entire body.

Doctor is a member and currently serves on the board for the Northern California Dental Society. He was their President in 2008 and currently serves as their editor for their society’s newsletter.  He is also a member of the American Dental Association, California Dental Association, the American Association of Implant Dentistry and the International Congress of Oral Implantologists.

Dr. Reuss IV, Marie (his wife), and their three daughters keep a full schedule.   Their daughters ages are 9, 7 and 5, who are very active in school and gymnastics.  Audrie, their oldest daughter, has been the California State Champion for her age group for 2008 and 2009.  Xanthea, their middle daughter will be starting her first gymnastic season in 2010, while Daphne will be cheering for her older sisters.

Dr. Reuss has successfully completed extensive postgraduate training in comprehensive Bioesthetic rejuvenation and dental implants. In 1989 he earned status of Fellow in the Academy of General Dentistry by completing over 500 hours of continuing education and an extensive written examination. In 1991 he was inducted as an Associate Fellow in the American Academy of Implant Dentistry. In 1996 he completed the highest level of the Orognathic Bioesthetics Institute after two years of intensive study. In 2005 he achieved Diplomate status in the American Board of Implantology/Implant Dentistry (ABOI/ID) by completing an extensive written examination and oral presentation of dental implant cases spanning the past twenty years.

Dr. Reuss also maintains membership in the American Dental and California Dental Associations, and the Northern California Dental Society (having served as President for one year). He is currently a board member for the Shasta ROP Registered Dental Assisting Program. In 2001 he was instrumental in establishing a dental clinic at the Good New Rescue Mission in Redding and continues to serve as Director over a wonderful team of volunteer Doctors and staff personnel who provide free dental care at the Mission.

Doctor and his wife, Patti, were married in 1967 and were blessed with four children. The oldest, Bill IV (graduated from UCSF Dental School in 1999) and his wife, Marie, have three daughters; son Tom (graduated with Masters in Physical Therapy in 2000) and his wife, Barbara, have a daughter and two sons. Their daughter Emily (graduated from UCSF Dental Hygiene School) married Dr. Thomas Mullen (also a graduate of UCSF Dental School) and they have two sons. Their youngest son, David, graduated from California State University in Chico with a degree in Communication Design in 2003 and currently lives in Bend with his dog Snacks.

Team Reuss decided to make their inaugural commute with the National Bike to Work Week.  We met at Anderson River Park with all our bikes, gear, and support vehicles.  We overcame a few mechanical problems (helmet issues, cable poking, and rubbing packs) to successfully complete our tour to work.  We all enjoyed our ride to the office and returned to the park for lunch. Next year, we’ll have more bike commuters join us.