How drug therapies helped give Lawrence optimal oral health

Regarding Dr. Michael Goldberg with great esteem, Lawrence Soloway’s Ottawa periodontist, Dr. Cameron Jones, thought it may be useful to get his opinion on Lawrence’s case. Lawrence had long suffered from periodontal deterioration (gum erosion and some bone loss). With a high bacteria count, one tooth had already been extracted. He clearly was at risk of continuing to lose even more and possibly all of his teeth because of his condition.

Lawrence’s experience was typical, in terms of undergoing multiple tests and being seen by various students. The examinations were intended to further investigate the condition of the gums and depths of the pockets, a standard procedure. However, being able to access the expertise of someone like Dr. Goldberg who could provide further input on what therapy to pursue and how to best manage the situation was unique. In conjunction with blood work, Dr. Goldberg would do a visual examination and based on aggregate assessments, the clinic would correspond with Dr. Jones’ office. Lawrence would then see a synopsis of the report. This is how Lawrence’s treatment plan is consistently refined.

Currently, Lawrence takes a prescription from Dr. Goldberg for a very low dose antibiotic in the form of Periostat®. At this dose, the antibiotic does not kill bacteria and therefore bacteria do not develop resistance. However, at this dose, the antibiotic (doxycycline) blocks the actions of tissue-destroying enzymes that are elevated in patients like Lawrence. To further address Lawrence’s problem it was also realized that additional medical help was needed and in this case Dr. Goldberg decided to also place the patient on a very low dose of an anti-inflammatory medication. At the dose used for that medication there would be little biological effect but when combined with Periostat®, this treatment approach helps to reduce inflammation and prevent the breakdown of gum tissue which in turn helps to improve tooth attachment and reduce gum pockets as well as other signs of disease such as bleeding gums. The combined effect has led to a well maintained and stabilized condition. Lawrence has seen no further erosion and is very happy with the outcome. Patients such as Lawrence will benefit greatly from this new specialized Centre.