Periostat - A question for golfers 
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 Periostat - A question for golfers

Honest, there is a question at the end of this post.

After reading several posts awhile back regarding the efficacy of Periostat,
the enzyme suppressor for the treatment of {*filter*} periodontitis,  I gave a
lot of thought to Joel's claim that the best a patient could expect was a
dime's thickness of clinical re-attachment.  He got this information from
the package insert as I recall.  It was a statistical analysis of thousands
of perio pockets.

I was recently talking to a dentist friend of mine who also happens to be an
avid golfer.  He was of the opinion that Periostat was a very useful adjunct
to his traditional non-surgical treatments for perio.

When I brought up the statistical averages cited in the package insert, he
laughed and then he shared an idea that is somewhat remote, but he made a
sound point just the same.

He said, "Over the past 25-30 years, there have been some incredible
breakthroughs in the game of golf." He cited technology (graphite, metal
woods, tri-metal, changes in ball cores and covers, etc.) And he cited
training methods, including physical, emotional, and mental regimens.

He talked about how most courses are better designed and maintained than in
years past.  All this has preceded an exponential rise in the popularity of
the game.  There are more holes-in-one made today than ever before.  Players
like Tiger Woods are destroying course and tournament records that many
thought would stand for hundreds of years.  It was hard to deny that the
various things he mentioned had not had a definite positive impact on the
game.

He golfs 2-3 times each month.  He said would never go back to using either
the equipment or the techniques he had known when he first took up the sport
over twenty years earlier.  Because of all these things, he had mentioned,
he was certain that his game was better. He is now has a 6 handicap. When he
first took up the game, it was over 2 years before he broke 100.

Then he said something that suprised me.  He said one very definite
measurable fact had not changed in all those years.  The winning scores of
all PGA and USGA sanctioned events, when averaged together has not changed
one stroke in over fifty years.  He said you could use that fact to argue
that all the training, technology, and popularity has not changed the game,
and will not change your game either.  The statistical averages in golf say
that no matter what you do, statistically speaking, you will not improve
your game at all.

His point was that if you use statistical averages to determine the value of
any new therapy, you would probably decline anything new.  But when you are
looking at a specific patient, with a specific need, you need to use what
works for you and that patient.  And when some therapy fails to get the
clinical results desired, it is imperative that the clinician look for other
methods to get the desired results.

He says Periostat gets him very good results when other methods have gotten
fair to poor results.  He says he sees less bleeding, less pocket depths,
and less non-responding pockets when a patient is prescribed Periostat and
is compliant and faithful in taking the medication.  He figures he will
probably treat several hundred patients with Periostat over the next decade,
which equates to several thousand pockets.  He expects to get about a dime's
thickness of improvement if he ever averages all those pockets together.

Question:  Should this dentist stop prescribing Periostat, knowing
statistically he will only get a dime's worth of improvement over the next
decade?

OTC



Tue, 07 Oct 2003 11:57:32 GMT
 
 [ 1 post ] 

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