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Feeling like a failure

I had a pt back for their 3 month perio maint following SRP. There was sub and supra everywhere and I’m just worried I messed up.

A few details on this case

This is a patient who has refused to see a periodontist as his pockets were mostly 6-7mm and above and at one point was tx planned for extractions but elected to save his teeth. At the time I felt confident in my Scaling but now I’m so stressed out about it.

I guess I just need some guidance on where to go from here and how to improve my skills.



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1 Answer

Don’t feel like a failure! You might be blaming yourself for something that isn’t even your fault. It sounds like the patient’s homecare, or lack thereof, is the issue. Your scaling ability has nothing to do with the patient’s ability to do what’s needed at home, everyday. Further, you can educate the patient until you are blue in the face, but then its up to them from there.
 
Next time, after non-surgical periodontal therapy/SRPs, make sure you take the time to explore with an 11/12 explorer. If you think there’s a pocket that just wasn’t accessed well enough, take an “after” radiograph to check that root surfaces are debris free. I don’t like to say to do this every time, but if you really need to check, it can be helpful. Make sure your instruments are sharp too. If you are using dull instruments, you may be burnishing calculus. With this said, I really do believe it’s a homecare issue.
 
If you do want to enhance your scaling skills, attend conferences and CEs put on by your local ADHA or even study clubs on instrumentation. Don’t hesitate to grab your books from hygiene school and review them too. There are also some good videos on Youtube you can check out. Don’t get down on yourself!

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