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In: Life at Work | April 27, 2014
The computer system we use in my office has an option titled “fine scale and polish” that we use for the 4-6 week re evaluation appointment and it is coded as D4999. We don’t charge anything for this visit so there is no issues with insurance not paying.
Question: SRP follow-up appointments | September 11, 2014
I use a purple slim line cavitron tip. It’s pretty thin at the tip so I am able to adapt it around the retainer without damaging the gingiva. I still have to go over it with a scaler and floss afterwards of course but the slim line removes most of the calculus for me.
Question: Best cavitron tip for cleaning under lower lingual retainers? | August 26, 2014
$1,200-$1,500 a day (12 hour day) and 7-8 patient minimum is expected. Exam and xrays do not count towards my production. Only cleanings, sealants, fluoride treatments, CHX bottles, and Clinpro 5000 count towards my production. I get paid hourly and every day that I work that the office as a whole makes its daily production goal (unsure of what that goal is) I get $25 bonus. I work seven 12 hour days every 2 weeks and my last check I got $175 bonus for making goal every day I worked. Not too bad.
Question: What's your daily production goal? | July 31, 2014
That is what I do with new patients if they know they have had SRP in the past, aren’t currently showing active disease (in need of SRP again) and show radiographic signs of bone loss (previous active disease). That, to me, is the definition of a periodontal maintenance patient. Just because my office didn’t do the SRP initially doesn’t mean they aren’t perio maintenance. The history and clinical evidence of past disease needs to be there and if you have that, 4910 it is!
Question: New patients and perio maintenance | July 21, 2014
I remember being taught in hygiene school that a smooth glassy root surface is the desired end result of a thorough root planing. That indicates that the cementum had been removed and with it embedded endotoxins that cause gingival inflammation and bone loss. However, I believe there has been recent studies showing that removing all the cementum is considered overtreatment and cause more harm than good. Leaving some cementum behind allows for better attachment after root planing and hopefully the development of a long juntional epithelium resulting in a decrease in pocketing. As long as you aren’t feeling big chunks of calculus or a feeling of medium grainy spicules (for lack of a better term) I would say you are doing a good job. Feeling a little roughness doesn’t necessarily mean you left calculus behind. It could just mean cementum is still present leaving a good biologic surface for reattachment.
Question: After SRP should the roots be glassy smooth? | July 21, 2014
I do take blood pressure at every appointment. I use one that goes on the patient’s wrist. You just put it on and press a button. It takes only 20 seconds. It’s easy to fit it in sometime during your appointment and so important. Alot of patients see us more than their physician so chances are we can catch hbp before any other medical professional. If its high then I use it as a good educational moment to link systemic issues to oral health. And I have never had a problem with a patient not wanting their bp taken. I just make it part of the routine and let them know they are getting complete comprehensive care.
Question: Taking Blood pressure during prophy | July 20, 2014
It makes sense to do anterior pa’s once a year like bwx. Posterior teeth are not the only teeth that get interproximal decay. And if patients aren’t flossing posterior teeth then they aren’t flossing anterior teeth either. If we only take anterior pa’s with an FMX every 3-5 years then we will miss decay when it is still small. Otherwise we only take a pa when the patient presents with pain or has very obvious decay. If insurance covers it I would take the pa’s at the same time as the bwx. If not, alternate it with bwx. My boss started recommending this when he would see decay on the distal of canines on premolar bwx and wanted us to start doing anterior pa’s every 1-2 years. Once we did we found so much anterior interproximal decay on patients!
Question: Radiograph protocol include anterior PA's? | July 10, 2014
This isn’t very fun or creative but I used my brother-in-law. He is family and knew how important it was for me that he showed up on time. I would be too nervous to depend on a total stranger for my exam. He turned out to be perfect. Not too easy or too hard and I got a 100%. And my boards were at my school’s clinic so luckily I didn’t have to pay for hotel or travel for me or him. So my advice would be look for family/friends first if possible.
Question: How to find board patients | July 10, 2014
Ultrasonic all the way. I use that first then polish with a pointed prophy cup, then floss and then scale LAST. That way I’m not wasting alot of time tediously scaling plaque off around the brackets because most of the plaque is gone by the time I even pick up a scaler.
Question: Ortho patient | June 30, 2014
We code it as a 1110 at no charge ($0)
Question: 6 Week Re-Eval Insurance Code? | June 26, 2014
hoosier-hygienist has no Best Answers.
Dental Hygiene with Kara RDH