By Rachel Wall, RDH, BS
If you've been reading my articles for a while, it should be no surprise to hear about the "Perio Paradox," a term coined by one of my mentors, Dr. Chris Bowman. Depending on what study you read, it's estimated that 35% to 75% of Americans have some form of periodontal disease. When I ask my coaching clients and Mastermind members what percentage of their patients has 4-5 mm bleeding pockets, they routinely say 40% to 50%. Yet for many of them, perio therapy and maintenance make up only 5% to 10% of their clinical hygiene services. It's an absurd but true statement. This is the "Perio Paradox."
So how do we close that gap? First we must realize that it's not the dentist or hygienist's intention not to treat perio disease. In fact, many times they are treating the disease but calling it a "difficult prophy." Everyone loses in this situation. Patients lose because they are not made aware of the disease and its far-reaching effects. The hygienist loses because he or she is working extremely hard on what should be a simple prophy. The practice loses because it's not being compensated for the work. The doctor loses because undiagnosed perio disease is the most common reason for dental lawsuits.
So what do you do? My readers have heard me say it a thousand times ... we must do completeperio charting with bleeding points, recession, mobility, and furcation at least once a year. How else will we know if the patient is healthy or has disease?
At Inspired Hygiene, we give our clients tools to use this data in order to educate and enroll them into therapy with ease. We help our clients work through obstacles that might have held them back in the past from developing and implementing a truly progressive periodontal diagnosis and treatment program.
Some of the common obstacles are:
- No clear and consistent system for perio diagnosis and treatment
- Hygienists are not calibrated (not all on the same page)
- Poor tools/instruments
- No room in the schedule for perio care
- Beliefs about patients' ability to pay
- Difficulty using technology
- Too much scaling and not enough exam time in the hygiene appointment
- Fear of presenting to long-term patients