Beverly Maguire, RDH
Earlier this month, I spoke at the CD 2001 Conference in Las Vegas that is sponsored by Dental Economics. The audience of dentists and hygienists came together as professional partners. They sought to move our profession forward from both a cosmetic and standard-of-care perspective. Hygienists often play a key role in facilitating patients' choices for both health and beauty.
Hygienists are responsible for the foundation of patients' health and stability from a periodontal perspective. They want to move beyond the "calculus removal" focus of appointments to that of diagnosis-driven hygiene care, where the patient is consistently probed, charted, evaluated, and diagnosed. Hygiene services are then based upon a clinical diagnosis and not the schedule on the wall!
As simplistic as that may sound, it is not being successfully implemented. I evaluate assessment forms from hundreds of dental practices throughout the United States each year. The average percentage of prophys dispensed by those attending my seminars is 92 percent! Are 92 percent of adult patients healthy? Not according to the AAP!
Hygiene care relates to maintaining health, treating early and moderate periodontal disease, and maintaining periodontal stability. These basic services should be predictable and reproducible from one practice to another. However, hygienists report difficulty when changing positions within their region or across the country. Many practices have differing standards of hygiene care. Some practices are "cleaning teeth," while others are diagnosing and treating periodontal disease. Where does this leave our unsuspecting patients?
In upcoming issues, I will address the eight areas necessary to transform your hygiene department. They are as follows:
- Establish a philosophy of perio hygiene for general practices.
- Establish staff commitment to change and the teamwork necessary to ensure success.
- Incorporate probing and charting into each patient visit.
- Organize treatment plans for gingivitis, early to moderate periodontitis, and referral guidelines.
- Implement guidelines for diagnosis, case presentation, and financial arrangements.
- Administer up-to-date treatment modalities.
- Teach effective home care and behavior modification.
- Establish an ongoing maintenance program.
Most doctors and hygienists attend numerous seminars on perio and have adequate knowledge regarding the current standard of hygiene care. But without each one of the transitional steps being implemented, we will continue to find that our hygiene statistics do not measure up to the standards we truly desire to provide for our patients and our practices. Successfully transitioning your hygiene department is not an optional project!
Dentists deserve to be enjoying productive hygiene departments. You should be sleeping well at night knowing that your patients are being diagnosed and treated to the current standard of care. Having the proper protocols in place preclude the need to worry about the legal issues behind failing to diagnose periodontal disease, a common concern today.
In conjunction with diagnosis-driven hygiene protocols, the new adjunctive periodontal products - such as Periostat, Atridox, and Perio Chip - provide an additional level of care that we can make available to our patients.
Only you as the dentist, business owner, and leader of the practice can facilitate the transition. Remember, a successful transition means healthier patients, higher productivity for the practice, and professional rewards for your staff. Next month, we'll begin with establishing the philosophy behind diagnosis-driven hygiene.
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 firstname.lastname@example.org.