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Debbie Seidel-Bittke, RDH, BS is known as a top dental consultant by Dentistry Today.

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Periodontal Therapy: 5 Steps to Get Patients to Say “YES”

By: Debbie

September 24, 2013

    • Preventive CareEverywhere I go, whether it is working with a dental team in-office or speaking at a dental conference, the question always comes up: “How can we tell our patients that they have periodontal disease?” Dentists are asking “Debbie, how can we hear more patients say “YES” to our treatment plan?” How will you get your dental hygiene patients to easily say “YES” to periodontal therapy?

Last week I addressed a statement from a long time patient of a dentist who attended my conference. When doctor informed the patient that she needed to schedule for scaling and root planing, this woman was insistent that she would wait for the New Healthcare Reform to pay for her treatment. (“Obama Care” would pay for this)

Today I will cover 5 steps to bring your patients into a partnership with you so they can be positive part of this discovery process and then active treatment – Phase I Therapy.

This article will provide steps for patients to say “YES” to accepting periodontal therapy.

If you want to simplify your treatment planning process, increase case acceptance and hear your patients to say “YES” to your care, this information is a must read.

1. Communication with your patient

Does not matter if this is a new patient or a patient of record, but before you begin your periodontal screening exam, inform your patient what you will be doing. Your conversation will sound something like this:

Hygienist: (Patient is seated upright in the dental chair. Hygienist and patient are knee to knee and eye to eye) “Mr. Goodman, I am going to do a periodontal screening exam. This is where I will take this tool which is like a rule. I will slip it between your tooth and gums. The purpose is to check the health of your tooth, gums and bone. You may hear me say things like bleeding, furcation, mobility, recession and I will call out numbers. The numbers you want to hear are 1-3. If you hear my call out a 4 that means you have the start of a gum problem. Anything higher than 4 tells us that you have periodontal disease. I will explain all of this more once we are complete with this exam. Healthy gums don’t bleed so again if you hear me say bleeding then you will know this is not a sign of health gums. I want you to listen to the numbers and remember the lowest number I call out and then the highest number you hear me call out. I will ask you at the end of my exam. Here is a mirror for you to watch and you can see if there is bleeding – where this is located.”

2. Once the periodontal exam is completed you will bring you patient to the upright position (Hygienist and patient are knee to knee and eye to eye) Your conversation will sound something like this:

Hygienist: “Mr. Goodman, what is the lowest and highest number you heard me call out?”

Mr. Goodman: “I heard you call out a lot of 3’s but I also heard a few 6’s.”

Hygienist: “Did you see any bleeding or anything unusual?”

Mr. Goodman: “Yes, I heard you say bleeding a lot.”

Hygienist: “That is correct but the good news is that since we have not seen you in 2 years, you have returned at a time that we can treat your disease and there is a good possibility that with treatment now we can reverse this disease process. As you know I didn’t call out any of those other words such as mobility or furcation which are signs of more advanced disease. I believe that we can treat the disease with only 2 appointments of what we call scaling and root planing. Have you heard of this before or do you know anyone who has had this treatment?”

At this point you will begin to answer any questions your patient may have.

3. Use visual aids to explain what is happening in your patients’ mouth.

  • This is a great time to take intra-oral photos of heavy plaque, calculus, bleeding and anything else that is not normal. Have this up on your monitor to show the patient and ready for doctor to see during his/her exam.
  • Print out the periodontal exam and highlight areas of concern with a yellow highlighter. I like to draw a map of the mouth which means I will write on their printed exam, the upper lower, and left, right of their mouth.                                                – This keeps you patient engaged in their mouth and many patients will use this to make sure they spend extra time in these areas when they brush and floss at home.

4. The hygienist needs to explain about the cyclic-episodic process of periodontal disease and patients need to understand what their responsibility is for maintaining optimal oral and total health.

  • Explain to your patient homecare recommendations. Do they need to use a power toothbrush? What will you recommend for interproximal cleaning if your patient refuses to floss?
  • Explain about the 4-6 week (Re-evaluation) 1st periodontal maintenance.
  • Tell them why this is so important and why this doesn’t mean they may need to have periodontal therapy in the future.
  • Stress routine hygiene visits to prevent future permanent and irreversible loss of their teeth, gums and bone.

5. The trial close

  • Now you are ready for a trial close. This will sound something like this:

Hygienist: “Mr. Goodman, do you have any more questions?” If you patient has more questions this is a great time to address them if doctor has not been in to complete the exam. If you patient does not have any further questions you will ask:

“Are you ready to schedule for the scaling and root planing?”

By the time you have asked about scheduling treatment, you should have answered your patients’ questions. If your patient has objections, these are usually because their questions have not been answered.

If your patient has financial questions you will respond with something like this:

Hygienist: “Mary, our financial coordinator will discuss your payment options and if you have insurance, she will explain how the therapy is covered.”

Do you have patients who still have outstanding treatment for periodontal therapy? Please write your comments and questions or patient challenges to accepting treatment in the comments section below.

As healthcare providers we really need to work together as a team to conquer this disease process. There is so much research and science to support WHY we should always treat disease sooner than later. A healthier mouth means your patients will live a longer “health” status.


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Debbie Seidel-Bittke, RDH, BS is founder of Dental Practice Solutions, and has successfully designed efficient dental hygiene departments that result in high performance dental teams for over 13 years. Her focus is providing optimal patient health while consistently increasing profits for the dental practice.

Debbie is an accomplished author who also speaks internationally about her signature systems and services for the dental hygiene department. She utilizes the most recent science and research to prevent disease while increasing the teams’ enthusiasm and guiding the dental team to consistently increase profits. She is known as one of Dentistry Today’s TOP consultants. Her eagle eye observations, years of research and development as well as her customized programs are what make her known as one of the best!

Debbie has a more extensive article in Dentistry Today September 2013 Issue on Page 102: http://dentistrytoday.com/articles/hygiene-today

Debbie works with dental practices throughout the world implementing her signature dental hygiene systems as well as customized solutions for efficiency in your front and back office. She can be reached at: www.dentalpracticesolutions.comsupport@dentalpracticesolutions.com or call: 888-816-1511.