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When to refer to a periodontist?

Too all my fellow dental hygienists out there: when do you suggest referring out to the periodontist? I feel like I should be making more referrals but am not sure when I should.



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Generally speaking I would refer when a patient has pockets too deep for your instruments to properly clean or if a patient is not responding to treatment. Here is a great article by Dianne Glasscoe Watterson about when to refer: http://www.rdhmag.com/articles/print/volume-32/volume-12/columns/when-to-refer-to-a-periodontist.html
I hope this helps!

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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!!!!!

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