10.3.14 Issue #656 info@mckenziemgmt.com 1-877-777-6151 Forward This Newsletter

Jean Gallienne RDH BS
McKenzie Management
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The Periodontal Process
By Jean Gallienne, RDH BS

Many of you work in offices that are under-productive with periodontal treatments. It is likely because you have always done prophylaxis as the standard of care, or you have done root planing in the past and when the patients returned they were scheduled 3 or 6 months later as a prophylaxis. This may also be true if you have always been an insurance-based practice.

It is easy to schedule new periodontal patients appropriately. The new patient will be probed, and all six-point probings will be done out loud so the patient is enabled to co-diagnose their periodontal disease. The patient should be educated about periodontal disease and their own mouth. Then the patient will be given a treatment plan and the financial coordinator will go over the cost. The treatment will either start at this appointment, or the patient will return to have the root planing and then return 3 months later for a periodontal maintenance. This is routine standard of care.

The difficulty in scheduling often comes from existing patients, such as those who have been on a 3, 4, 5, or 6 month recall and have been having necessary treatment completed, but who have never had to actually pay full price for the quality of care being provided. It is recommended that these patients have the six-point probings done out loud as well, so they can co-diagnose the need for periodontal treatment. They will need to be educated on the etiology of periodontal disease and how it pertains to what you have found in their mouth during the hygiene appointment.

How well you know the individual patient effects how you will move forward from here. What direction you decide to take may depend on the health of the patient’s mouth, his or her personality, and possibly the patient’s financial situation. If the person is a long-term patient who has never been told anything about periodontal disease, you may decide to educate him or her at this visit and schedule a return visit at a shorter interval to have their mouth evaluated again to determine the need for more aggressive treatment to help slow down the disease process.

Then there are patients who have been coming in every three months and have been educated on periodontal disease and the health of their mouth in the past. However, you are not seeing the gum tissue look any better or respond to the shorter recall appointment. As a result, you and the doctor have decided to go ahead and treatment plan the patient for their specific root planing needs, and have them return as soon as possible. The financial coordinator will go over the treatment plan when they leave and the root planing will be scheduled as soon as possible.

You may also have patients who know they have periodontal disease, but because of their personality type you have decided to educate them again on the need to do better hygiene. You plan to reevaluate them at a 1, 2, or 3 month recall to determine if they need to have root planing. These are the type of patients who may step up to the plate and start doing better with their home care, because they either do not want to have root planing again or they don’t want to have it at all. They just needed to be educated more.

These are a few examples of the types of patients you may encounter in the process of becoming a more periodontal driven hygiene department. Patients will have a lot of questions. It is important to educate yourself and staff on how to handle these questions so you don’t risk losing patients during the process. How and why you decide to convert a patient into your periodontal program is a system within the dental office itself. Once all of the protocols are in place, it is still clinically up to the provider to determine how to approach the individual patient needs.

To say that all existing patients will be educated about periodontal disease and then treatment planned for root planing at their next 3 month appointment is not recommended. The important thing is that patients are educated about the disease process, told what their needs are, and continually treated with quality of care in mind.

Interested in improving your hygiene department? Email hygiene@mckenziemgmt.com and ask us about our 1-Day Hygiene Training Program or call 877-777-6151

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