Dental Practice Solutions

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Dental Practice Solutions - Debbie Bittke

Dental Consulting | When Do We Begin Screening for Gum Disease?

By: Debbie Seidel-Bittke, RDH, BS

July 19, 2018

Dental Coach Oregon

Written by: Debbie Seidel-Bittke, RDH, BS, CEO

One of the big controversies working with dental hygienists is “When do we begin screening for gum disease?

It is a common question and each office we work with has a different answer.

What is the correct answer to this question?


In 2011, the American Academy of Periodontology published the Comprehensive Periodontal Therapy Statement, which recommends that all adults receive an annual comprehensive evaluation of their periodontal health.

The periodontal exam begins for all adults.


Who is considered an adult?

As a former dental assistant and then clinical dental hygienist, I have learned from experience, over years seeing teens and watching them grow to be mature adults, that periodontal disease begins at a very young age.

The description of adult for a dental patient begins when the patient has all twenty-eight of their adult dentition. This is the best time to begin screening for gum disease.

The conversation about gum health should begin with a patient at a very young age. You may notice that during orthodontic treatment, young patients have gingivitis. This is a great time to begin treatment for gingivitis and this conversation about the benefits of oral health.

Start educating your patients about gum health at a young age.

As dental professionals, our goal needs to be not only optimal oral health but optimal health. We are in a great position to help our patients understand that a healthy mouth can lead to a longer and healthier life. This needs to be our overarching message as a dental healthcare provider.

What does a periodontal comprehensive exam include?

The American Academy of Periodontology has a checklist that you can download. You can download this checklist here.

Your periodontal exam will begin with an overview of the patients’ total health. This will include recent surgeries, medications; herbs are included with medications because some herbs will cause more bleeding.

Here is a list of medications and herbs that may cause more bleeding then expected during a hygiene appointment or dental procedure.

What do we say when the CPE is not a good report for the patient?

It is very helpful when the clinician providing the CPE explains what is happening before they lie the patient back in the chair.

Next week I will walk you through the process on exactly what you should say before you begin the screening.

If you can explain what you are about to do for example, “I am going to use this ruler to take some measurements and these numbers mean X, Y & Z. When I am finished calling out these numbers, I will ask you “What is the highest and what is the lowest number you hear me call?”

When you explain this to your patients before you begin your screening, you will notice that patients tell you they have disease before you ask them what numbers they heard called out.


Your message

In conclusion, our goal is to help our patients live a longer and heathier life. When your patient has gingivitis, periodontitis or any type of infection in their mouth, it is a chance to sit with your patient and talk about the mouth-body connection.

We are in the business of helping people live a longer and healthier life.

When this is your message, you will have patients who schedule and pay for treatment. When this is your message you will have a dental practice of patients who return for routine care. This message shows how much you really care!

For more information about treating the patient with gingivitis and/or periodontitis download our free resource with a Hygiene Patient Flow Chart.


Debbie Seidel-Bittke, RDH, BS is a dental consultant, coach, speaker and author. She is also CEO of Dental Practice Solutions. Debbie is a world-class leader in creating profitable hygiene departments. She is well-known as a former clinical assistant professor at USC in Los Angeles and a former hygiene department program director. Dentistry Today recognizes Debbie as a Leader in Dental Consulting. She can be reached at (888) 816-1511. Send an e-mail to or go to her website:




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