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12.02.05 Issue #195  
New Protocol…Existing Patients

Jean Gallienne RDH BS
Hygiene Consultant McKenzie Management

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Educating and teaching new patients about the office protocol is easy. These are patients that do not know what the original protocol was, and do not have an idea of how the protocol in your office works.

After practicing dental hygiene full time for 17 plus years I have to say that it is the existing patients that are harder to work with when introducing new protocol into the office. Yes, the trust is already established, but change is a scary thing for everybody. Many people are not tolerable of change and will fight all change in their life. So, it is up to the dental professionals to help the patient through this time, and to help with educating them on why change is good. This may take a little time, but it will be time well spent.

When asked by the existing patient, “Why hasn’t this procedure been done before?”, emphasis about advances in research and the development of new procedures is a great way to educate the patient.

Here is an example presentation that can be used as the framework to build on by the staff.
 “Ms. Jones, there have been many recent advances in research, resulting in the development of new and exciting procedures in dentistry! One of the most beneficial procedures is the screening process that enables us to detect gum disease in the earliest stages. As a result, a conservative therapy can be performed before the disease and infection are allowed to progress. Although we monitor your gums at your recall appointments, many factors can affect your health. If you have been experiencing stress or your immune system is depressed, the progression of the disease may be affected. It is our commitment to screen all our patients on a regular basis since treatment in the earliest stages is the most successful.”

This verbiage is designed that you may modify the above words and find the conversation that best suits you.
The patient may bring up the question, “How could my gums be this bad…they don’t hurt?Using the comparison of high blood pressure and how serious this medical condition can be is very effective. Most patients can relate to this and are aware that high blood pressure is often painless, yet possibly life threatening.

“Ms. Jones, gum disease is often painless until the final stages. Do you know anyone that has high blood pressure? That condition is often painless and until detected by your doctor may go unnoticed, yet it is certainly a very serious condition! Just as you would be concerned about your blood pressure and getting it under control, the same applies to the health of your gums and supporting bone. If undetected, the first sign of high blood pressure is often a heart attack! I would not want the first sign of gum disease to be the loss of your teeth.”  

Another very common question a patient may have is, “I have been coming in every three months for cleanings why do I need periodontal treatment now?

Your answer may be along these lines, “We have been trying to prevent the progression of the pockets in your mouth. Now we are implementing a new method that may reduce the pockets without surgery. Not all pockets will totally improve with this new treatment that we are providing now, but there is evidence that this procedure has had great success! However, we may still need to refer you to a gum specialist if we do not get the results wanted.”

Even when patients are found to have healthy gums it is a good idea to explain the office’s commitment and protocol to treating periodontal disease. Why? This may motivate that particular patient to continue the quality of home care they are currently doing in order to prevent them from ever needing periodontal therapy. In addition to motivation, it may incline them to refer their spouse in as a new patient in order to be evaluated for gum disease.

Brief presentations that address all of the patients concerns are best. I would suggest that the clinician not be the one that presents fees, insurance information, or any payment options. The Financial Coordinator best does this and then treatment will ultimately be scheduled with the Hygienist.

When treatment planning periodontal disease, it is always a good idea to remind yourself that, regardless of insurance and insurance limitations, the patient has the right to know what the optimum care is they should receive. It is their choice how they want to continue with treatment. It is our job as a dental professional to educate the patient so they can make the most informed decision.

Next, we will look at how all of the information provided thus far may be utilized to convert a prophylaxis hygiene department into a periodontal based hygiene department. 

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