ErgoRDH:

I’ve run into similar situations and have assured the pt how everything is sterile, etc. Be careful to not insult them and take the time to accurately and politely to answer the question, even if you feel insulted yourself. Our patients are still consumers and have every right to ask us these questions. When taking xrays, as long as you have gloves on and have a barrier on the xray button, you are good. Even in school we practiced this way. Good luck!

I work in 2 offices and one office makes us treat them, and we offer Laser treatment. If the schedule allows, the doctor will laser it before the schedule appointment. Other times, we still see them which makes me very uncomfortable, so I tell the patient we can still see them even though there is a risk of us spreading it. In my other office, the doctor allows us to make the decision, and therefore, I always dismiss and I’ve never had anyone argue it before. I wish all offices rescheduled as there is a chance it can even be transferred to us. If we are cautious preventing something like needle sticks, why aren’t we cautious when putting the patient and ourselves at risk for exposure? Good luck!

Hi aduncan! It’s never too late to refer to perio! There’s 2 different scenarios: 1- A patient’s first appointment, 2- a recall appt. Scenario 1 – it’s been many years since their last prophy, you take an FMX, you take probe readings that are at least 6ish mm in some areas. I then check for mobility. On radiographs, I first check for vertical bone loss and how deep the calculus is. If any combination of those are present, I refer to perio. Scenerio 2 – If this is the first time or even 15th time you’ve seen a patient… you’re probing depths are still 5-6 mm, you still have heavy bleeding, the gum tissue is receeded, loose, red or bulbous,heavy calculus, recurring subgingival calculus…. then I would propose perio treatment. It’s never too late…. be sure to remind the patient that we want to keep the teeth as long as possible… basically make sure to explain to the patient that the periodontist does work you cannot simply do with the tools you have in a general office. If the patient is afraid of seeing someone new, be sure to remind them that sometimes patients alternate with you and the periodontist. I hope this helps.. I have only been practicing for a year but have tried to develop a system that helps me decided SRP at a general office or PERIO…. or when you feel like your instruments are going deep enough in the pockets (like Kara said) Good luck!!!!!

I have worked in 2 offices that both do that same thing. My receptionist/OM has never worked chairside – so she doesn’t quite understand the importance of “enough time for appointments”. Quality care unfortunately drops when a patient comes in 15 minutes late…
One evening, a new patient walked in 35 minutes late to a 1 hr appointment expecting to be completed. The front desk let her come right in my chair – making me the bad news bear!! Unbelievable – needless to say she freaked out on me but came back the next day for her rescheduled appointment. She should have NEVER been allowed past the front desk….. I digress
I would talk to the receptionist first to try and get it resolved. If the problem persists – going the doctor is a must. I understand production needs need to be met – but lawsuits can result if treatment goes subpar…. agreeing to what Kara said, on time patients shouldn’t suffer for those who are late. I really feel it’s so important for the doctor, hygienists, and front desk to all be on the same page regarding late patients. Ex:
15 minutes late? Reschedule automatically as soon as they call/ show up. Maybe offer doing exam/xrays if necessary and if patient is ok with it.
I hope this gets resolved for you.

I work part-time in 2 different offices and we both get paid bi-weekly.

I have never heard of SRP tech… perhaps you mean “technique”? I typically always use Local Anesthesia to take the pain component away immediately. Then, I probe (if not yet recorded) to see how deep the instruments need to go. First, I cavitron, then hand scale, then go around quickly again to flush out the pockets. If I have extra time, I use floss as an explorer to feel for calculus both supra and subgingival. I like to use the floss as a nice finishing touch. Good luck and scale away!!!!