09.11.09 Issue #392 Forward This Newsletter To A Colleague

Carol Tekavec
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Talking to Patients About Periodontal Disease

Most dentists and hygienists want their patients to accept their recommendations for appropriate periodontal treatment. However, it is often hard to get this done. Despite the fact that periodontal disease is one of the most common ailments affecting people in today’s world, many patients don’t know they have it! Recent estimates show that 61% of adults over age 25, and 86% of adults over age 45 have at least one periodontal disease site in their mouths. But they may not be experiencing symptoms that they recognize as being part of a disease process, or they may not be having any symptoms at all.

How can we persuade our patients to do the right thing and address their perio concerns?  In a word: education. Without understanding what is going on in their mouths, most patients will typically not be moved to do anything about it. It’s up to you to provide a compelling explanation. Good health and good looks are topics that are generally effective in engaging patients. But how do you know where to begin? 

One way is to use a patient centered brochure. This does not mean a generic “smiling faces” type of publication, but one that addresses the real concerns of real people. An advantage of a brochure is also the fact that they are generally inexpensive. Just be sure that any educational materials you select address patient’s real questions.  

For example:

Q: What is periodontal disease?
A: It can be described as an inflammation and/ or infection of the gums and bone which support the teeth. It typically begins with an accumulation of plaque on the teeth and roots. If left undisturbed, this soft plaque can combine with minerals in a person’s saliva to form calculus or tartar, which is hard and somewhat like cement.  Once calculus forms, it provides additional surfaces for bacteria to grow on. The bacteria and their toxic by-products can seep into the gums and bone, eventually destroying the bony support and foundation for the teeth.

Q: How can I tell if I have periodontal disease?
A: Warning signs of periodontal disease include:

  • Bleeding gums
  • Red, swollen, or tender gums
  • Gums that have pulled away from the teeth (the teeth look “longer”)
  • Bad breath or a bad taste in the mouth
  • Teeth that appear to be shifting or seem loose
  • Changes in the way the teeth fit together (your “bite” seems different)

Q: Can periodontal disease cause tooth loss?
A: Yes!

Q: Can’t I just use strong, over-the-counter mouthwashes to cure periodontal disease?
A: Despite what you may have seen in television commercials, a mouthwash alone cannot control gingivitis (inflammation of the gums) or periodontal disease. Certain prescription mouthwashes may help, but they cannot be your only weapon.

Q: If I lose my teeth due to periodontal disease, can’t I just get dentures or implants? Is treating periodontal disease worth it?
A: Implants are a proven treatment option for missing teeth. Dentures have long been used to help patients continue to eat and preserve their appearance, (although most denture wearers express that they would much rather have their own teeth). Even so, these solutions can be time consuming and expensive. Most dentists and patients agree that a person’s natural teeth are best. Preventing or treating periodontal disease is definitely worth it. A person’s smile, attractiveness, ability to chew and enjoy food, and general sense of well being are dependent on good dental health!

Q:  What is the treatment for periodontal disease?
A:  Your dentist and hygienist will set up a plan just for you, however, treatment usually begins with scaling and root planing. Using special dental instruments, calculus is removed from the teeth and roots of the teeth. Embedded bacteria and their toxins within the root surfaces are also cleaned away. With these removed, the immune system can begin healing the gums and bone and tamping down inflammation.  If scaling and root planing do not get a handle on the disease process, surgical treatment may be needed. After your disease is under control, a standard “cleaning” at your check-up appointments will not be adequate. Instead, you will need to receive periodontal maintenance therapy in order to keep your mouth healthy.

Patients are interested in good health and good looks. The key to helping patients accept periodontal treatment is to promote an understanding of the disease process, how it may be treated, and how investing in their periodontal health makes sense.

More answers to patient questions are found in my brochure, Periodontal Disease. What You Need to Know, available from McKenzie Management.

Carol Tekavec CDA RDH is the president of Stepping Stones to Success, and a practicing clinical hygienist.  She is a consultant to the ADA Council on Dental Practice and was the insurance columnist for Dental Economics for 11 years.  She is also the author of the Dental Insurance Coding Handbook and the creator of the “First Encounter™” Chart.  

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