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Richard H. Nagelberg
  • 63, Male
  • Plymouth Meeting, PA
  • United States
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What is your profession?
What dental school/dental hygiene school did you attend?
Georgetown University School of Dentistry
In what state do you practice
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Richard H. Nagelberg's Blog

The need to consider what is happening under the surface

I think it is safe to say that we have all seen the following clinical scenario. Two patients, same gender and roughly the same age, both present with perio disease of about the same extent and severity. Let's say they have two sites in each quadrant with pockets of 5-6mm. We treatment plan for non-surgical therapy, including SRP with irrigation, locally applied antibiotics such as Arestin and perhaps some systemic antibiotics as well. Both patients return for re-eval, one gets excellent…


Posted on June 6, 2010 at 3:00pm — 2 Comments

Refractory Gingivitis

That's not a typo. Refractory gingivitis is not a concept, it is a clinical condition we see every day in our offices. The definition of refractory is: resistant to treatment or cure, How does repetitive gingivitis not fit this definition? Of course it does, but we don't recognize it as such. Why is the term refractory reserved only for periodontitis? By the time a patient gets to refractory periodontitis they are at the end of a losing battle, not all the time, but certainly not…


Posted on March 30, 2010 at 9:13pm — 2 Comments

More on gingivitis

So it turns out that gingivitis is not really an early form of periodontitis. I am beginning to think my nickname should be Dr. Heresy. I have done a fair amount of research recently on this topic and gingivitis is actually the gate keeper to periodontitis, not a mild or early form of it. We know this through several avenues of information. From a tissue level perspective, gingivitis is primarily a T cell mediated response and periondontitis is primarily a B cell and plasma cell mediated… Continue

Posted on February 2, 2010 at 7:30pm — 8 Comments

Clinical management of gingivitis

My previous post indicated that I approach gingivitis in my general dental practice, as a non-reversible disease entitiy. I have conluded from professional reading, dialogue with other practitioners and my clinical judgment and experience, that it is not a separate disease entity from periodontitis, just an early manifestation. Think about other conditions such as diabetes. When an individual is diagnosed with Type II diabetes, which accounts for 90-95% of all cases, they are commonly put on… Continue

Posted on December 26, 2009 at 11:00am — 6 Comments

Gingivitis is perhaps not a reversible conditon

Gingivitis not reversible? Before you roll your eyes and think this is a crazy idea, read on and let me know if you agree or not with the thought process on this. We all go through our working day with certain facts we take for granted. One of these is the reversible nature of gingivitis. Sometimes, though, it is worthwhile to think about it, especially if it has the potential to enhance the level of care we provide for our patients. I am addressing the patients in my practice with the thought… Continue

Posted on December 6, 2009 at 7:00am — 10 Comments

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At 1:58pm on November 05, 2010, Mary Jane RDH BS gave Richard H. Nagelberg a gift
Excellent course at the Tech Fair..thank you.
At 6:10am on February 19, 2010, Mary Jane RDH BS said…
Perio is is not considered an auto immune but a precursor that allows the body to be more vulnerable to conditions such as Rheumatoid. There again, the mouth and body connection..when our immune system is over loaded by chronic disease, such as periodontal, we are much more vulnerable to auto-immune ones..and if we have one, most chances we will get another.
At 4:33am on February 03, 2010, Mary Jane RDH BS gave Richard H. Nagelberg a gift
You are more than welcome
At 9:44am on December 27, 2009, Mary Jane RDH BS gave Richard H. Nagelberg a gift
That is not a touch of sarcasm for a motor mouth is it! can take it..I do so love dentistry..I mean that from my heart.
At 1:17pm on December 21, 2009, Mary Jane RDH BS said…
Sorry, that one was for Jill, Ted.
At 1:13pm on December 21, 2009, Mary Jane RDH BS said…
But Jill, since you are not a professional in the dental since and have not dealt with people as patients, please allow those that have deal with these diseases and the prevention of them.
At 3:42pm on February 26, 2009, Vicki Cheeseman said…
Welcome to the community. I'm glad you joined!


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