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The Registered Dental Hygienist in Alternative Practice (RDHAP) is a licensed registered dental hygienist with specialized training and a license to practice in settings outside of the traditional dental office. The RDHAP is able to provide dental hygiene services directly to patients in varied settings such as nursing homes, assisted living facilities, senior living communities, schools, and private homes.

Gingivitis is the first stage of gum disease, caused by poor oral hygiene and irregular plaque removal from teeth. It is characterized by swollen, red and tender gums and it can cause bleeding when brushing. Luckily gingivitis is reversible, and through improving your oral hygiene techniques and visiting your dentist or hygienist for advice on a home dental health care program, you should be able to reverse this process.

Untreated gingivitis can lead to Periodontitis (per-e-o-don-TIE-tis). The conversion of gingivitis to periodontitis is more common in people who have a family history of gum disease, poor oral hygiene and uncontrolled diabetes. At this stage there will be damage to the gums and bone supporting the teeth. If left untreated, periodontitis becomes an advanced stage of gum disease, characterized by significant tissue and bone loss around the teeth. It is not reversible but can be controlled.

Silver diamine fluoride (SDF) is a liquid medicine used to treat and prevent dental decays and relieve dentinal hypersensitivity. It helps remineralization of the teeth for preventing and arresting dental caries. SDF can be used by licensed dental professionals.

The same services such as oral cancer screening, prophylaxis, periodontal deep cleaning, oral hygiene instruction, and cavity preventative such as fluoride & silver diamine fluoride.


Periodontal disease has been linked to an increased risk of heart disease. The inflammation and bacterial infection associated with gum disease can lead to the narrowing of arteries and the formation of blood clots, increasing the likelihood of heart attacks and strokes. Additionally, the bacteria present in the gums can enter the bloodstream and contribute to systemic inflammation, which is a known risk factor for cardiovascular problems. Therefore, maintaining good oral hygiene and seeking timely treatment for periodontal disease are essential not only for oral health but also for overall cardiovascular health.


The linked study explores the intricate relationship between periodontal disease and Alzheimer’s disease. It delves into the potential role of periodontal pathogens in exacerbating neuroinflammation and cognitive decline in Alzheimer’s patients. Through a comprehensive review of existing literature and clinical evidence, the study sheds light on the mechanisms underlying this association and emphasizes the importance of oral health care in the management of Alzheimer’s disease. Understanding and addressing the link between periodontal disease and Alzheimer’s could pave the way for novel therapeutic strategies and improved patient outcomes.

There is a reciprocal adverse relationship between diabetes and periodontal disease, with diabetes as a major risk factor for periodontal disease, and in those patients with diabetes who also have periodontal disease then there are adverse effects on glycemic control and complications such as cardiovascular disease and end stage renal disease.

Priyamvara, A., Dey, A.K., Bandyopadhyay, D. et al. Periodontal Inflammation and the Risk of Cardiovascular Disease. Curr Atheroscler Rep 22, 28 (2020).

Larvin, H., Kang, J., Aggarwal, V. R., Pavitt, S., & Wu, J. (2020). Risk of incident cardiovascular disease in people with periodontal disease: A systematic review and metaฉanalysis. Clinical and Experimental Dental Research, 7(1), 109จC122.

Kamer, A. R., Craig, R. G., Niederman, R., Fortea, J., & De Leon, M. J. (2020). Periodontal disease as a possible cause for Alzheimerกฏs disease. Periodontology 2000, 83(1), 242จC271.

Desta, N. (2021). Pathophysiological association between periodontal disease and Alzheimerกฏs disease: Importance of periodontal health in the elderly. Journal of Oral Biosciences, 63(4), 351จC359.

Genco, R. J., Graziani, F., & Hastจนrk, H. (2020). Effects of periodontal disease on glycemic control, complications, and incidence of diabetes mellitus. Periodontology 2000, 83(1), 59จC65.