Periodontal disease diagnosis and treatment will never be the same at our office. The DIAGNOdent Perio Tip is a paradigm-changing product. We no longer need to wait for periodontal disease to progress to the point where subgingival accretions are large enough to be seen on x-rays, or the disease has progressed to the point where pathologic changes have occurred in the soft tissue and bone. We can treat our patient when calculus has just started to form subgingivally because we can now easily and reliably detect it. Co-diagnosis of the problem is a snap with the audible tone the system generates.
The original function of the DIAGNOdent is caries detection. The unit works by sending laser light of 655nm into tooth structure. Healthy tooth structure exhibits very little fluorescence at this wavelength. Carious tooth structure does however fluoresce strongly, and as the system’s electronics detects the amount of fluorescence, it emits a proportional tone along with a numeric readout (Fig. 1).
A reading of 30 would indicate caries that has penetrated into the dentin. This allows for more reliable detection of beginning occlusal caries than is possible with an explorer alone. For me, this application alone was reason enough to invest in the technology. I have owned a DIAGNOdent Classic model since it was first introduced. I found it to have one of the best ROI’s (return on investment) of any product I have ever purchased for my practice. In my lectures on high technology, it heads the list of “must own “products for every dental office.
The 655nm laser light coincidently also excites fluorescence in calculus! Thus, KaVo introduced a new tip for the system, the Perio Tip, to take advantage of calculus detection (Fig. 2).
For very little additional investment, merely the cost of this new tip, the utility of my laser detector has more than doubled! We are using the system so much now that I acquired the new pen model to supplement my Classic unit (Fig. 3). If you have ever looked at a DIAGNOdent but were undecided about purchasing one, don’t wait. Get one now! You and your hygienist will use it on every patient, those that comes through your recare program as well as new patients.
I consider myself a progressive “high tech” dentist. I have always considered my in office’s perio program to be first rate. A recent practice analysis done for me by my local dental supplier opened my eyes. The number of patients in periodontal therapy is far under my estimate of the percentage of my patients who need care. The DIAGNOdent periodontal tip has become the engine that will bring our perio program up to speed. As my patients cycle through the perio department, many more are now entering active periodontal care. I’ve asked Angela Pavicic-Demko, RDH (Angie), one of my hygienists, to share her experience with the Perio Tip on both the DIAGNOdent Classic and DIAGNOdent pen units.
Implementing calculus detection with the Perio Tip into the dental hygiene therapy appointment has been an exciting new procedure. It is easy to use and integrate into a thorough exam. I use it during new exams, scaling and root planing appointments, periodontal maintenance appointments, and routine therapy visits to help deliver higher quality dental care.
Even the most thorough clinicians can miss areas of calculus in periodontal pockets when using the traditional means of detecting that calculus. X-rays do not detect calculus on the buccal or lingual surfaces. Probing can miss small bits of calculus that infect the tissue. The DIAGNOdent Perio Tip helps me detect areas that need treatment or additional debridment during treatment.
Here are the advantages of using this system:
- Not as many post-op RP&S radiographs needed
- The unit will register readings even if slight residual calculus is present; these detectable areas can be smaller than would show on any radiograph
- The probe can detect concretions in pockets up to 9mm deep
- It is ideal for checking difficult areas such as furcations and deep line angles
- Readings will also register for root caries and debris around crown margins
- It is an easy and quick procedure to do a scale check (This is how Dr. Davidson introduced this piece of equipment--he surprised me with it at the end of a procedure. I checked the teeth and found areas that needed more treatment. I was convinced!)
- It’s a small investment that enables the dental hygienist to be more thorough and generate more revenue.
- The dentist is confident that his dental hygienist is providing the highest quality of care.
- It has a high rate of patient acceptance; patients ask for treatment when they hear the alarm!
After explaining to the patient what the laser probe is and how it works (Fig. 4), I quickly calibrate the unit, and they are ready to participate in co-diagnosis with me. The system alerts us both when readings register. If they hear the tone, they know they need treatment! There have been appointments that have amazed me. My RP&S technique has improved based on the feedback I receive from the DIAGNOdent.
The last thing I do when I complete scaling on a tooth, is insert the probe into the pocket, parallel to the long axis of the tooth (Fig. 5). If there is a reading (using the scale below), I re-scale until the reading decreases or is gone.
- 40 Concrements in the periodontal pocket
- 5-40 Very small concrements
- <5 Clean pocket
I believe this technology is instrumental in treating periodontal disease. Dental hygienists collect diagnostic data, medical histories, chart hard and soft tissue, take radiographs, and encourage patients to accept needed periodontal treatment. For the patients, it is necessary to understand that all of this information means that they have an active infection. Patients need to understand that we can stop the infection from progressing if we treat the disease in the office, along with them doing their part with daily plaque control. Educating the patient on periodontal disease, explaining how bacteria within the biofilm stimulate immune response and tissue destruction, and its links to systemic health, is what helps patients to have confidence in and accept our treatment recommendations. The DIAGNOdent Perio Tip makes it easier for me to do this!
Using the DIAGNOdent probe at the end of the appointment will assure the patient that they are leaving the dental practice not only with thoroughly debrided pockets, but squeaky clean teeth!
As Angie pointed out, implementing calculus detection into daily practice was easy! We unpacked the tip and started using it right away. With more and more evidence linking periodontal health to systemic diseases we owe it to our patients to be thorough in our care and diagnosis.
The following quotes are from the American Academy of Periodontology web site:
- Researchers have found that people with gum disease are almost twice as likely to suffer from coronary artery disease.
- Two new studies emphasize the potential link between periodontal diseases and adverse pregnancy outcomes.
- Diabetic patients are more likely to develop periodontal disease, which in turn can increase blood sugar and diabetic complications.
The DIAGNOdent was a great product when all it could do was detect decay. Now that it can detect subgingival calculus it becomes invaluable. The utility of It will help me grow my practice through expansion of my periodontal program while at the same time delivering a higher standard of care, enhancing the overall health and well-being of my patients. the system has more than doubled. It’s a home run for me and my patients—who could ask for more?
DIAGNOden Perio Probe
The DIAGNOdent Perio Tip will help me grow my practice through expansion of my periodontal program while at the same time delivering a higher standard of care, enhancing the overall health and well-being of my patients.
Patients have no more excuses for addressing their periodontal health.
The Bottom Line
For very little additional investment, merely the cost of this new tip, the utility of my laser detector has more than doubled!