Beverly Maguire, RDH
Recently, I spoke at the CD2000 Cosmetic Den-tistry meeting in Las Vegas. It was an awesome gathering of professional minds who came together that weekend to teach, learn, and discuss the possibilities cosmetic dentistry holds for us in this new century. Even more awesome was that hygiene "beat the odds!" What do you think the odds would have been five years ago that the hygiene department would have been part of the curriculum for a national symposium on cosmetic dentistry? I`d venture to guess that the odds would not have been good.
Dental Economics has the foresight to recognize that excellent restorative and cosmetic dentistry is only remarkable when it`s placed on a solid periodontal foundation. Thus, the role the hygiene department plays is foundational and of ongoing importance. I`d venture a guess that most professionals assume that all is well periodontally far more often than actually can be supported by complete periodontal charts, a history of appropriate treatment, ongoing maintenance procedures, or solid success with behavior modification.
Hygienists must be partners in excellence in all cosmetic practices. We cannot provide complete and excellent care to cosmetic patients if the hygiene department remains schedule-driven, doing the best possible job in the one hour allotted to patients receiving "cleanings." The historical ap-proach to hygiene services is evidenced by a "task accomplishment" mentality and is of no benefit to the fee-for-service client who invests tens of thousands of dollars in cosmetic dentistry.
Only by beginning each hygiene visit with a complete periodontal charting will we be assured of having the information needed for a periodontal assessment and diagnosis.
The diagnostic possibilities for hygiene patients include:
(1) Healthy
(2) Active periodontal disease (gingivitis; early, moderate, advanced, or refractory periodontitis)
(3) Periodontal stability
Each of these diagnoses has a corresponding treatment plan:
(1) Prophy
(2) Nonsurgical or surgical periodontal therapy
(3) Periodontal maintenance procedures
Determining the proper hy-giene diagnosis and treatment plan requires gathering accurate and complete periodontal data, followed by the implementation of critical thinking skills. Doctors and hygienists must agree philosophically and be supported by systems for diagnosis, treatment, behavior modification, and maintenance procedures.
Hygienists (or periodontal the-rapists, as I prefer to call them) are quite capable of managing and leading this important department within your practice. However, it takes a team effort to make it a reality. Don`t assume that all is well merely because your patients have hygiene visits. Excellence has never been related to just showing up, neither on our part nor theirs.
Fee-for-service dentistry is expanding into its perfect niche, cosmetic dentistry. Right next to you must be a capable and excellent partner in the form of your periodontal therapist. The hy-giene department of the 21st century is no longer merely a cleaning service. The future of fee-for-service dentistry is in the excellence of restorative and cosmetic care, supported by an effective periodontal foundation. Our patients need both departments providing the best possible options and care. Then, the odds increase substantially that we will all win - the patient, the practice, and the professional.
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 [email protected].
