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114 thoughts on “Improving Clinical Outcomes with Enhanced Communication”
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Thank you for a wonderful webinar!
I have a patient which I have completed 4quads SRP, and then referred to the periodontist for complete evaluation. Her pockets range 5-9 mm. She went to perio and had the consultation. They recommended extraction of some teeth, followed by flaps, bone grafting, etc. The pt never returned to the periodontist for treatment, but continues to come to me every 3 months for perio maintenance visits. How do I help/assist this pt in going back to the periodontist for treatment. It feels like I am doing SRP at every visit.
Thank you! Excellent course
Where can I download the verbal examples of scheduling a patient for the preventive care, cancellations, and confirmation.It would be useful as a teaching guide for the front desk personnel.
Thank you for your question.
Yes, I believe that is the recommended protocol. The problem is that many acid challenges happen throughout the day. There is a wide range of acidity, some things far more acidic than others. Wine is considered the most acidic beverage. My colleague, risha O’Hehir, recommends brushing before eating, not afterward.
Thank you for your question.
Evidently, the patient has chosen not to accept the periodontists tx plan. So, what can you do to assist her? I have copied and pasted a response from a local periodontist for which I have great respect. You might be surprised by what he would recommend.
The most important aspect of treating any infectious disease, including periodontitis, is proper monitoring and treating the pathogenic microorganisms. Scaling and root planing is only a short-term removal of (non-pathogenic) subgingival calculus. It is the biofilm that is the problem. Although one wants to remove the calculus as a site for future biofilm growth, training her to use subgingival brushing (effective to at least 12mm) followed by an irrigator with 1/2 tsp bleach in 35 oz warm water will go much further for control. (He recommends teaching a patient how to use an interdental brush turned vertically.)
The literature has shown that using metronidazole and amoxicillin for one week three times a year will stop even advanced chronic periodontitis without any other treatment ( including scaling and root planing).
Scaling and root planing is only a component of treatment, not a stand-alone procedure. Unfortunately my specialty is slow to change. At least now no one is any longer denying that chronic periodontitis is an infectious disease.
(Infectious diseases are only monitored by cultures, microscopy, chemical pathogen profiles and serology. Not by pockets or bleeding points.)
Many thanks for your kind words. We appreciate your attendance!
My first book, titled “Manage Your Practice Well” contains much of the information I presented tonight and is available on my website at http://www.professionaldentalmgmt.com
HI Diane,
The webinar was woderful, lots of useful information.
I have been in the same office for 39 years, working full time!
How does one use new language to well established patients, won’t it seem rehearsed and not sincere?
Thanks,
Stephanie Waterman
what kind of bleach?
Thanks
Remember: patients will accept whatever you accept. When you implement new verbiage, it becomes more comfortable to you the more you use it.
Sodium hypochlorite, or Clorox.
Hi Dianne, what is the best way to explain the difference between prophy appt and periomaint appt to pt? They don’t understand why they have to pay more if the chair time is the same.
Thanks
Faye
First, I think you have to be clear in your own mind about the difference before you can help your patient understand. Perio maintenance is therapeutic – you are trying to control disease – whereas prophy is preventive. It is a well-established fact that periodontal maintenance is vitally important to the patient’s long-term success. Here’s what I would tell my patients: “Mrs. Jones, we have come a long way since we first began your periodontal treatment, but we are not out of the woods yet. We know that the microbes that cause the problems re-populate rather quickly in the beginning. We also know if we see you for your disease control visits as we should, we will have a better opportunity for long-term success. So, for the first year, I will need to see you every three months for a disease control visit. At the end of the year, we will re-evaluate everything. It is our hope that at that time we will be able to extend the time between disease control visits, but we won’t know until after the first year. People heal at different rates with varying levels of success. With both of us working together, we should expect a very good result. It takes you ramping up your homecare routine by doing the things we’ve discussed on a consistent basis and me providing the professional support you need.” If the patient protests that her insurance will only pay for 2X/year, you should congratulate her that she has a supplement to help her with her care. “However, please understand that benefits typically cover only routine things, and your disease is not routine. We know from treating many people like you that our long-term success is dependent upon how often we see you, especially the first year.”