2.23.07 - Issue # 259 Forward This Newsletter To A Colleague

Carol Tekavec
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What is the Difference?
“Cleaning”, Root Planing, Perio Maintenance?

Do your patients understand why they have been scheduled for a root planing procedure?  Do they complain about coming in for “cleanings” several times a year?  Do they understand what a “cleaning” actually is and how it differs from periodontal maintenance?  Most patients don’t!  Patients rely on dentists and staff to help them understand their treatment, but it can be difficult to choose the right words.  What follows are excerpts from my patient education brochure, “What is the Difference Between a “Regular” Cleaning, A Root Planing, and Periodontal Maintenance”, available from McKenzie Management.  The statements in the brochure can help staff focus on common issues before talking to patients; while giving the brochure as a “take-home” handout supports staff explanations later. What is needed is something that actually answers the kinds of questions patients really ask; not a brochure that is “institutionalized” and therefore, frequently tossed away without a thorough reading. Here are some typical questions and answers taken from the brochure:

What is a “regular cleaning”?
A “regular cleaning” is known as a prophylaxis in dental terms.  The American Dental Association describes a prophylaxis as “removal of plaque, calculus and stains from the tooth structures”.  It is recommended for persons who do not have any bone loss, periodontal disease, or infections around their teeth.  There should also be no bleeding, mobility of teeth, receded areas where the gums have pulled away from the teeth, or gaps where spaces around the roots of the teeth are exposed.  In other words, the mouth should be healthy with no gum or bone problems.

How often do I need to have my teeth cleaned?
The old system of everyone having their teeth “cleaned” twice a year has fallen out of favor.  Most dentist and hygienists are now setting up a patient’s cleaning schedule based on individual needs.  This may be as often as four times a year.

What is periodontal disease?
Periodontal disease is very common, but does not always have distinct symptoms.  It is an inflammation and infection of the supporting structures of the teeth, which includes the gums, bone, ligaments, and root surfaces-- that can eventually result in the loss of teeth. You may notice that your gums bleed easily, you have a bad taste in your mouth, your gums appear red or swollen, your teeth appear longer or seem to have shifted…or you may not notice anything at all.

What is a root planing procedure?
Patients with periodontal disease may require root planing to remove diseased deposits from the roots of the teeth.  Other treatment, including surgery, may be required.  Root planing removes bacteria and its toxins, tartar, and diseased deposits from the surfaces of tooth roots.  Scaling (using dental instruments or an ultrasonic “machine” scaler to scrape away deposits) is required for the full length of the root surface, down to where the root, gum, and bone meet.

What is periodontal maintenance?
After the disease process is under control, a “regular cleaning” is not appropriate anymore.  Instead you will require special ongoing gum and bone care procedures, also known as periodontal maintenance, to keep your mouth healthy.  Periodontal maintenance is different in scope from a “regular cleaning”, even though a hygienist may perform both services.  Periodontal maintenance can include a medical and dental history update, radiographic review, dentist exam, gum and bone exam and periodontal probing, a review of home care, and scaling and root planing, polishing and irrigation of the gums as needed.  The dentist’s exams and X-rays are not included and are billed separately.  Typically an interval of three months between appointments may be needed.

Will my insurance pay for these procedures?
Most plans will pay for root planing for patients with a defined amount of bone loss on a “once every two years” basis.  The majority of plans also will pay for two “regular cleanings” a year or two periodontal maintenance procedures per year.  Insurance can help you pay for treatment that you need, however, it was never designed to pay for everything.  Most plans pay a minimum, regardless of what you may need as an individual.  It is a mistake to let benefits be your sole consideration when you are making dental decisions.

Being prepared to answer patient questions and having easy-to-understand patient education materials available can make dealing with periodontal issues a little easier.  Patients look to their dentists and staff to help them with their concerns. The “What is the Difference” brochure can help.

To order this brochure visit the McKenzie web-site….here.

Carol Tekavec CDA RDH is the author of the Dental Insurance Coding Handbook, designer of an inexpensive dental chart, an informed consent booklet, and several patient education brochures. While still functioning as a clinical hygienist, she is a featured speaker at most national dental meetings.  Contact her at 800-548-2164 or visit www.steppingstonestosuccess.com.


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