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8.29.08 Issue #338 Forward This Newsletter To A Colleague

Angie Stone RDH, BS
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New Treatment Acceptance Tool For The Hygiene Department

 Mrs. Smith has been a long time patient of the practice.  Today she is scheduled in the hygiene department for her six month professional cleaning and examination.  The appointment goes as planned and includes necessary x-rays, periodontal charting, scaling and polishing and is finished up with a periodic examination by the dentist.

 Mrs. Smith has some bleeding upon probing and an occasional 5 mm pocket.  A quick review of the previous periodontal charting reveals that there were a couple of 5mm pockets at that time, but today it is noted that there is another one and the bleeding upon probing is more generalized today as well.

The practice’s hygienist knows from a conversation that Mrs. Smith has had some personal and financial difficulties as of late. The hygienist feels that now would not be a good time to discuss non-surgical periodontal therapy. The hygienist doesn’t want to be the “bearer of bad news” and doesn’t feel confident in knowing exactly what to say to the patient. She decides to make a note in the chart to reassess and discuss Mrs. Smith’s periodontal condition at the next recall visit. During the examination the doctor glances at the periodontal charting and reads x-rays. He doesn’t notice anything too different and is trusting that the hygienist is doing her job.  Mrs. Smith is asked to floss a little more often and is sent on her way to the front desk. 

In this scenario everyone involved, (the patient and the entire dental team) loses and this happens far too often in dental practices. The patient loses because their periodontal situation is not being addressed and this can lead to progression of the disease, the loss of teeth and development or worsening of systemic disease. The office looses production and opens themselves up to possible legal implications for not diagnosing and treating the periodontal disease.

The largest disconnect here is that the hygienist made a determination not to discuss the patients periodontal situation and  treatment options based on the perception of the patient’s financial concerns.  As Hygiene Consultant for McKenzie Management, recommendation of new technology and products plus direction, scripting of patient dialogues and guidance to implement these innovative changes in dental practices is an important part of the Hygiene Practice Enrichment Program.

A new product to consider Florida Probe, helps remove the “I don’t want to give this patient bad news” angst from proper diagnosis. 

 Florida Probe is a computerized periodontal probing system complete with patient education videos, periodontal chart print outs and treatment recommendations.  A typical periodontal probing when utilizing Florida Probe begins with having the patient view a 60 second video that educates the patient on the process of periodontal charting and what they can expect during the exam. The exam engages the patient because the patient hears the pocket depth called out by the computer. If the pocket is above 3mm the computer can be set up to say, “Warning, 4”, or “Danger, 5”.  When the patient has viewed the video prior to the exam, they know what they are listening for.  If the pocket bleeds, they also hear, “bleeding”.  Again, they are briefed that bleeding is not good. At the conclusion of the charting process, the patient typically will be asking the clinician what they can do to improve the health of their, “gums”.  

 At this point the hygienist has the opportunity to provide more education regarding periodontal disease by having the patient view three other 60 second videos which discuss the causes of periodontal disease, the stages of the disease and statistics about the prevalence and sequel of the disease. The patient can also be given a print out of the periodontal chart and a diagnosis handout to take home. The treatment handouts assist the clinician in describing the necessary treatment. 

Revisiting the scenario above we see that Mrs. Smith is scheduled today in the hygiene department for her typical six month professional cleaning and examination. The appointment goes as planned and includes necessary x-rays, periodontal charting using the Florida Probe, scaling and polishing and is finished up with a periodic examination by the dentist.  She is educated prior to the probing process with the educational video. She heard from the computer (a third party authority) about her periodontal diagnosis.  She views a couple more 60 second videos that reinforce what she heard from the computer and she is given her periodontal print out and detailed description of the treatment recommendations. The recommended treatment is explained by the hygienist. The doctor comes in to do the exam and is debriefed on what has transpired during the hygiene visit.

 Mrs. Smith has been informed of her current periodontal condition. She now understands what she needs to do in order to restore her oral health.  She is escorted to the front desk to schedule the necessary appointments for periodontal therapy

Need help with implementing new systems in your Hygiene Department to insure patient acceptance and compliance? Email

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