Microbiological Testing Survey

Sept. 4, 2009
In its August 2009 issue, RDH eVillage asked dental hygienists about the frequency they administer microbiological testing.

Although dental hygienists express an interest in learning more about microbiological testing for periodontal disease, 86% said they do not administer testing in their offices, according to an RDH eVillage survey conducted in the August 28, 2009, issue.

Of the 14 percent who do administer testing on patients, 7% said they do so with under five times a week. Five percent administer tests six to 20 times a week, and 2% use the tests more than 20 times a week.

“We administer tests on all our patients, because we found that, just because their gums appear healthy, it doesn't necessarily mean that they aren't harboring some of the more harmful bacteria,” one reader noted.

Another reader, though, said, “We stopped using it because insurance reimbursement did not cover our cost on the test.”

The RDH eVillage survey obtained 112 responses.

All but 1% of the hygienists indicated they have participated in continuing education for microbiological testing, or would be interested in learning more. The survey inquired about what format of continuing education was, or would be, “highly informative.” The formats rated as highly informative were:

  • 73%, a live continuing education seminar
  • 43% online CE programs
  • 43%, lunch-and-learn programs
  • 33%, journal articles
  • 10%, Internet groups

But all of the education on microbiological testing doesn’t necessarily translate to increased admiration for dentists. The survey asked if readers believe employers would pay more for a hygienist who knows about, and implements, microbiological testing. Seventy percent said they believe dentists would not pay more.

Other noteworthy comments from readers include:

  • This only makes logical sense. The medical field has been doing microbiological testing as a standard, why should dentistry be any different?
  • We learned about microbiological testing at a CE meeting in April. The doctors that I work for don't see the need for it yet. I'm not sure that it would really help either. Except for providing a visual for the patient on the bacteria levels before and after. Also, the genetic testing is interesting, but not essential. It is hard to justify the extra expense. I would like to monitor C-reactive proteins before and after treatment. This way patient would understand the total body reaction.
  • I get a nice bonus for every test administered in our office. The doctor believes that it is our expertise that makes a patient aware and makes them healthier. It benefits the patients and the practice to do the testing therefore he pays $20 per test to the hygienist doing the test.
  • I feel that employers should pay more for a hygienist who has this knowledge and can increase practice production with this, but I doubt employers will pass this increase on to their employees. Rather, they will keep this for themselves. This has just been my experience with other practice building services.
  • We've been doing it for over two years and it's I still get amazed sometimes. How did we do it without it?
  • Microbiological testing has a long ways to go before it is useful on a daily basis. We are aware of bacterial complexes, which appear to be more virulent than individual bacteria. There is no significant literature that demonstrates that microbiological testing has a significantly positive affect on treatment results.
  • Been there, done that. We did it very routinely and then stopped. It has limitations, in that only a small segment of bacterial possibilities are tested for and only a few sites. It is easy to miss something. The results always indicated a need for the same antibiotic cocktail. Could not justify patient costs routinely. Still perform in certain situations. My knowledge and ability in this area was not cause for the dentist to pay me more.
  • This is an incredible diagnostic tool we have at our disposal and patients need to be informed that their periodontal disease is not about poor brushing and lack of flossing anymore. We can attack the disease process both clinically and systemically to increase the patients chance of success in reaching optimum oral health
  • We usually do testing on moderate and advanced perio patients (5mm +), sometimes on high-risk patients such as diabetics, and on patients that do not show response to treatment as well as expected.
  • I would hope to get each patient tested at a young age so prevention can be accomplished before caries/bacteria is an obvious problem.