Acute periodontal (gum) infection in a patient who had not gone to the dentist for over six years. The 20 year old implant denture clasps had broken causing the denture to rub against her gums near the implants in the presence of a lot of plaque and calculus. These photos were taken after Antibiotic & Initial Periodontal Therapy were completed. The Microbiology Culture revealed the presence of 32% Enteric Gram Negative Rods (5% is normal) that were resistant to Doxycycline, Amoxicillin, Metronidazole and Clindamycin. Antibiotic susceptibility testing revealed this infection would respond to Ciprofloxacin. These two images were rotated to show the lingual view.
Oral Microbiology test results for a 41 year old female with severe gum disease who did not favorably respond to three years of antibiotic treatment with Periostat – Doxycycline – at another dental office. Enteric gram negative rods – anaerobic bacteria populated 13.8% of the microbiologic culture and were shown to be resistant to Doxycycline. This patient was successfully treated with Amoxycillin & Metronidazole antibiotics. She was also referred to an MD where a fasting glucose tolerance test showed she had early stage diabetes.
These tests will frequently show anaerobic and aerobic bacteria results featuring spirochetes, porphyromonas gingivali and actinobacillus actinomycetemcomitans. These mouth germs are highly correlated with periodontal gum disease and treatment should focus on their elimination as a goal.
Oral microbiology – Acute periodontal abscess that caused severe tooth and gum pain. 1) This patient presented with a gum fistula between tooth #’s 7 & 8. Tooth #’s 8 & 9 had acrylic teeth laminates placed about two years ago. Her general dentist had performed a gingivectomy last year to attempt to treat the occasional gum swelling in this area. 2) The radiograph of tooth #9 shows a healed apicoectomy from 12 years ago that is not related to the current problem. 3) A gutta percha point was placed in the fistula and radiographed to see where it led. It stayed at the coronal gingival gum margin probably around the margin of the dental laminate. The patient was put on tetracycline antibiotic for a week. [This is not a recommendation for everybody!] 4) Reevaluation two days later showed improvement in gum disease symptoms and gum gingival inflammation. An evaluation and treatment of the dental laminate margin will occur with the Periodontist following resolution of the acute condition.
Oral Microbiology dental bacteria cultures will become increasingly important in dentistry and medicine. The correlation between dental disease and medical illness are just now being explored. Our office refers patients with advanced periodontal gum disease for a medical evaluation.
These oral microbiology tests will frequently show anaerobic and aerobic bacteria – mouth germs – featuring spirochetes, porphyromonas gingivali and actinobacillus actinomycetemcomitans. These bacteria are highly correlated with periodontal gum disease and treatment should focus on their elimination as a goal.
Suggested reading includes: Listgarten, Offenbacher and Genco.
Acute periodontal abscess that was painful. This patient presented with this fistula between tooth #’s 7 & 8. Tooth #’s 8 & 9 had acrylic laminates placed about two years ago. Her general dentist had performed a gingivectomy last year to attempt to treat the occasional swollen gums in this same area. A gutta percha point was placed in the gum fistula boil and x-rayed to see where it led. It stayed at the coronal gingival margin probably around the margin of the tooth laminate. The patient was put on tetracycline antibiotic for a week. [This is not a recommendation for everybody!]. Reevaluation two days later show improvement in gum disease symptoms and gingival inflammation. An evaluation and treatment of the teeth laminate margin will occur following resolution of the acute condition.
A periodontal gum culture – oral dental microbiology – tests for the presence of periodontal pathogens bacteria – species of mouth germs. How to pictures. First use a cotton pellet and a college pliers to wipe away supragingival plaque. Place a medium cotton point into about six different gingival sites with the deepest periodontal pocket probings. Leave the cotton point in place for five to ten seconds and then quickly place it in the bacterial culture medium. Ship overnight to the Microbiologic Testing Lab at Temple University.
Microbiology Oral Dental Bacteria – how to pictures. Photo 1) Patient presents with an isolated mild-moderate periodontal gum pocket. Photo 2) In this case, a conservative site-specific treatment was used with doxycycline antibiotic gel – Atridox. Photo 3) The antibiotic gel is inserted into the periodontal pocket via a canula and the excess is pushed into the gum pocket with a moistened periodontal scaler without local anesthesia. Photo 4) Final placement.
These pictures show a dental microbiology culture taken from a draining gum fistula around a maxillary unilateral subperiosteal dental implant. Periodontal gum cultures should be taken before prescribing antibiotics. This infection was resistant to Penicillin, Tetracycline and Metronidazole.