How are the numbers today?

Rethinking the value, role, and protocols of today`s hygiene department has become a focus of attention for most dentists. In the past, many doctors simply felt that the hygiene department was a "loss leader." "Cleaning teeth" can seem rather insignificant in the big picture. Most dentists have a greater passion for restorative procedures.

Beverly Maguire, RDH

Rethinking the value, role, and protocols of today`s hygiene department has become a focus of attention for most dentists. In the past, many doctors simply felt that the hygiene department was a "loss leader." "Cleaning teeth" can seem rather insignificant in the big picture. Most dentists have a greater passion for restorative procedures.

We are just now beginning to raise our heads, discovering we`ve fallen behind in this area of dentistry. It does, after all, make perfect sense that healthy bone and tissue are essential in the makeup of a healthy mouth, as well as overall health.

Doctor, when was the last time you diagnosed periodontal disease in your operatories? Behind that question lies a bigger concern. Untreated periodontal disease costs dentists millions in uncollected revenues each year, to say nothing of the infection, bone loss, and eventual tooth loss suffered by unsuspecting patients.

Many doctors eventually will face the trauma of legal action taken by patients who have suddenly learned of the difference between "cleaning" and appropriate periodontal care.

Why not just assign the hygienist the task of updating the department? Granted, the hygienist`s role is paramount to its success. But compared to what the entire team can do when each member understands the importance of these services, the efforts of one professional alone will not be adequate. In fact, without the support of the entire team, the results can be marginal.

Involvement of every staff position in this transition is essential for success. The role of front desk staff comes into play when the new patient, who hasn`t been to a dentist for several years, requests a "cleaning." Awareness of the proper codes and fee structure for periodontal procedures is important, as is the ability to field any objections the patient may offer when perio treatment is scheduled.

The dental assistant provides support by assisting the hygienist during the charting process. Recording the pocket depths as they are called out is essential to formulating an accurate periodontal diagnosis and is part of the case presentation for the patient.

The hygienist then can offer preliminary feedback, explaining to the patient the findings in general terms as part of the ongoing periodontal education process. Next, the doctor reviews the information and delivers the periodontal diagnosis. Time spent discussing the office philosophy and treatment protocols with the hygienist and staff facilitates an accurate perio diagnosis and the consistent presentation of information.

The hygienist then can proceed with case presentation and the consent form. The patient either accepts or declines appropriate periodontal care. Once financial arrangements are made, the hygienist then begins the actual clinical treatment, a role for which hygienists are already very well qualified.

The circle is complete when each and every staff member is involved in the hygiene visit on some level. A weak staff link at any point can reduce the chances for patient acceptance of appropriate periodontal care.

"How does the perio chart look today?" When dentists ask that question daily in every hygiene operatory across the country, we will be well on our way to a successful and profitable transition within our dental practices. Our patients then can be assured of receiving an accurate periodontal diagnosis and appropriate options for care.

Beverly Maguire, RDH, is a practicing periodontal therapist. She is president and founder of Perio Advocates, a hygiene consulting company based in Littleton, Colo. She can be reached at (303) 730-8529 or by e-mail at perioadv@aol.com.

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