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3.28.08 Issue #316 Forward This Newsletter To A Colleague


Angie Stone RDH, BS
Consultant
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Not Just Tooth Loss Anymore

The patient’s need for periodontal therapy has been identified. The patient has been informed that, without the recommended periodontal therapy, he/she may lose his/her teeth. The patient‘s reply to this information is, “Well, I feel pretty lucky I haven’t lost my teeth yet. My Mom lost her teeth when she was 50. She does just fine with her dentures. I will lose my teeth eventually too.”

What can the hygienist say that will convince the patient he/she needs to keep his/her teeth? It is apparent the tooth loss scenario is not going to work with this patient. He/she has already conceded to a life without teeth at some point. The patient is right: people do live without teeth and people with teeth do not perceive the edentulous person’s life to be any different than theirs.

The issue here is that periodontal disease is not only about losing teeth. The conversation with this (and every) patient should have been directed down a different path to arrive at the periodontal therapy destination.

The news is not new to dental professionals that correlations exist between mouth health and heart health, lung health, adult onset diabetes, etc. The mainstream population is not fully aware of the overall health implications of periodontal disease. The job of the dental team, particularly the hygienist, is to educate patients about these connections. Patients are not aware that elevated C-reactive protein (CRP) levels are a better indicator for heart attack and stroke than cholesterol levels and that, untreated, uncontrolled periodontal disease leads an increase in CRP. With periodontal therapy, CRP levels can be reduced, causing an improvement in overall health. If the aforementioned conversation had incorporated a discussion that included words such as heart attack, stroke, cardiopulmonary obstructive disease and/or diabetes, the patient would have more than likely been compelled to listen. Patients are more apt to move forward with recommended periodontal therapy when there is more at stake than “losing a few teeth.”  

When periodontal therapy recommendations are accepted, the patient wins by way of improved health. The dental practice is also a winner because periodontal therapy brings in more revenue. Not only are periodontal fees higher than prophy fees but periodontal patients require more than the typical two visits a year. Production increases with the need for more appointments and higher associated fees. Though production is important, treating more periodontal disease raises the feeling of achievement for the hygienist.  

When a clinician sees a patient who is in an unhealthy state and, through education and clinical services, helps the patient obtain a state of health, the hygienist begins to see that his/her services are definitely valuable. The more the hygienist is able to assist in this process, the more he/she gets comfortable with and confident in his/her skills. The attitude of being a “prophy mill” vanishes.

Routine prophies become mundane to a hygienist, much like placing occlusal restorations would be for a dentist if done day after day. Performing prophies all day becomes automatic so conversations can easily turn to subjects other than dentistry. This is when the doctor begins to notice a lot of idle chit chat about family life, weekend events, etc.

An interceptive periodontal therapy program requires a constant thought process. Each patient needs to be evaluated on several different levels. Health histories become more important when the shift has been made from strictly mouth health to whole body health. Blood pressure screenings are of utmost importance. A patient’s general state of health can be an aid when deciding on an oral care protocol. Gathering the information allows the clinician to assess the oral cavity more effectively and allows her/him to make evidenced- based decisions for periodontal care. With this type of assessment and subsequent treatment, there is hardly an opportunity to become complacent with hygiene services.

McKenzie Managements Hygiene Practice Enrichment program can assist the hygiene department with the implementation and management of an effective periodontal therapy program.  

Interested in knowing more about how to improve your hygiene department?
E mail hygiene@mckenziemgmt.com.

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