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Best way to suggest perio trx

just started my first dental hygiene job. I’m having a hard time on how to suggest perio treatment and referrals. What’s the best way to explain to the patient and how to stress how important it is to not leave deep pocket depths and bleeding untreated?



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2 Answers

I explain to patients that the longer bacteria goes undisturbed by not flossing/waterpik/proxybrush/etc. the stronger the bacteria becomes. While bleeding is one of the first signs of infection by this bacteria, the longer it sits there it leads to the supporting structures (bone/ligament/tissue) of the teeth to breakdown, and they don’t grow back. This can lead to tooth loss. Side note: I tend to not get too deep into how its really the immune system trying to fight the bacteria which is actually the cause of the attachment loss not the bacteria “eating” the tissue because it can be a bit too much information for some. I go on to say that the bacteria and their toxins (basically their poop) you swallow and breathe in all day, everyday. They can then enter the blood stream and effect other parts of your body. Here you can explain how many conditions have been linked to dental disease and the inflammation it causes (heart disease, diabetes, low birth weight and pre-term births, etc.) and this is why having a healthy mouth leads to a healthy body. Because of all of this, treatment to remove the bacteria/toxins/calculus/plaque is extremely important. I like to use visual aids to show the patient what tissue breakdown looks like as well. I also like to give them a mirror or take intraoral pics to show them areas of tissue loss, inflammation, calculus, etc. Showing the patient radiographic calculus on their radiographs is another great visual (I say the calculus aka tarter or hardened plaque is so thick it can be seen on X-rays). Analogies work well too. One I use is if your hands bled when you washed them, you’d be concerned right? You’d probably go to the doctor – this is the same as a perio referral.

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Breathe and let go of the fear. Keep in mind that you are there to assess your patients, explain your findings and deliver treatment options, not make decisions for them. Simply, the patient will either accept or decline treatment.
That said, if you educate your patients (using terms that they can understand i.e., “space between the tooth and the gum” not “pockets”), about the benefits of the recommended treatment and focus on the positive outcomes you anticipate, it may help with case acceptance.

Consider how you would feel if you had a disease and you were not told about it by your healthcare provider…
If your patient has periodontal disease and you detect it and treat it early it will be a win-win for the both of you.

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