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Richard H. Nagelberg
  • 60, Male
  • Plymouth Meeting, PA
  • United States
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Richard H. Nagelberg received a gift from Mary Jane RDH BS
Nov 5, 2010
Mary Jane RDH BS commented on Richard H. Nagelberg's blog post Perio disease and rheumatoid arthritis
"I had a patient who I recommended a perio work-up for years develop rheumatoid arthritis. I have always seen periodontal disease as a pre-cursor for auto-immune diseases..Thank you, Doctor, for having it make complete sense to me now."
Jul 3, 2010
Richard H. Nagelberg commented on Richard H. Nagelberg's blog post No Title
"Thanks Mary Jane. It is a fascinating case. The salivary diagnostic test results for this patient revealed high levels of bacteria. We treated her with full mouth disinfection (not SRP since all pockets were 3mm or less), irrigation with Betadine,…"
Jun 8, 2010
Mary Jane RDH BS commented on Richard H. Nagelberg's blog post No Title
"Now that is a fascinating case..just one more good reason reason never to overlook the implications of persistent gingivitis."
Jun 8, 2010
Richard H. Nagelberg commented on Richard H. Nagelberg's blog post The need to consider what is happening under the surface
"You are so right and I love your thinkng...... "know thy enemy". Very powerful. Thank you for your input."
Jun 7, 2010
Mary Jane RDH BS commented on Richard H. Nagelberg's blog post The need to consider what is happening under the surface
"I have always considered the many factors when it comes to tissue response i.e. in my periodontal patients. What is so exciting is the research that has been done to be able to know exactly what bacteria one is dealing with..know thy enemy..which…"
Jun 7, 2010
Richard H. Nagelberg posted a blog post

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 tissue…See More
Jun 7, 2010
Richard H. Nagelberg commented on Richard H. Nagelberg's blog post Refractory Gingivitis
"So right you are MJ, it is in the patient's hands, literally. Thank you for your input."
Mar 31, 2010
Mary Jane RDH BS commented on Richard H. Nagelberg's blog post Refractory Gingivitis
"Absolutely..keratinized gingiva is the first line of defense. If it is constantly in a diseased state, where can a patient's dental health go but down? With just time spent, maybe new concepts in care, total body health really emphasized by all…"
Mar 31, 2010
Richard H. Nagelberg posted a blog post

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 infrequently.…See More
Mar 30, 2010
Mary Jane RDH BS left a comment for Richard H. Nagelberg
"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…"
Feb 19, 2010
Vicki Cheeseman commented on Richard H. Nagelberg's blog post More on gingivitis
"You're making me laugh there, Mary Jane! Sounds like me before I've had my coffee... :)"
Feb 9, 2010
Mary Jane RDH BS commented on Richard H. Nagelberg's blog post More on gingivitis
"My sister is an English professor..she cringes everytime she reads what I don't edit...the word I am proud to spell and say is profession..haven't had enough coffee"
Feb 9, 2010
Mary Jane RDH BS commented on Richard H. Nagelberg's blog post More on gingivitis
"From my graduation in 1974 to now, the research, changes, etc. make me very proud to be in this professuin. I need to add my thanks to Vicki's, Dr."
Feb 8, 2010
Richard H. Nagelberg commented on Richard H. Nagelberg's blog post More on gingivitis
"Thanks for your kind words Vicki. There is presently exponential growth in terms of research findings. When we look back at this period of time, some years in the future, it will be recognized as a time in which the profession changed dramatically."
Feb 8, 2010
Vicki Cheeseman commented on Richard H. Nagelberg's blog post More on gingivitis
"Dr. Nagelberg, thank you for this post. You are doing a tremendous job of keeping us in the dental community abreast of the latest philosophy about all aspects of periodontal disease. Science continues to develop as new clinical evidence presents…"
Feb 8, 2010

Profile Information

What is your profession?
Dentist
What dental school/dental hygiene school did you attend?
Georgetown University School of Dentistry
In what state do you practice
Pennsylvania
For how many years have you been in the dental profession/industry?
27
What professional affiliations/associations do you belong to?
ADA
Do you have a Web site address?
drrichardnagelberg.com

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…

Continue

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…

Continue

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 — 11 Comments

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At 1:58pm on November 05, 2010, Mary Jane RDH BS gave Richard H. Nagelberg a gift
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
Gift
You are more than welcome
At 9:44am on December 27, 2009, Mary Jane RDH BS gave Richard H. Nagelberg a gift
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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