A new approach to periodontal care

It’s clear that the new science of (effective) preventive medicine and human longevity will focus mostly on nutrition and reducing inflammation. As periodontal disease is arguably the most common form of chronic inflammation suffered by patients, treating periodontal disease is no longer just about helping them keep their teeth but also — possibly more importantly to patients — helping them live longer!

I spent some time in a practice last week helping the principal launch, to his team, a new way for the practice to provide periodontal care. The dentists, hygienists and support team and I met to decide how to present this new approach to their patients and what language to use, and to devise treatment protocols to deliver (more effectively) healed periodontal patients.

So, at last, it’s goodbye to “a scale and polish with the hygienist” and hello to “treatment of active periodontal disease by our Active Treatment Team” or “maintain the status of healed periodontal patients with our Continuing Care Team”. (The language is so important…)

Like many practices, this one had offered a limited number of options to its patients for periodontal treatment, centred around the ubiquitous half hour scale and polish appointments for patients.

It dawned on the principal that he really had very little idea what his hygienists actually did during these appointments and he suspected that at best they cleaned the patients’ teeth and gently nagged them to floss more often.

This cross-fingered approach to periodontal care is unlikely to be very effective and it was clearly time to update their approach (in line with recent advice from the British Periodontal Society (and several other august bodies) to improve the effectiveness of their periodontal treatment and, of course, to stay out of the way of litigation or the GDC.

So, here’s what they are doing:

  • They have agreed a script for how they describe the link between gum disease and the many serious systemic diseases that can be affected or triggered by periodontal disease. This is all about informing them of the new medical science that could affect their health
  • They are going to divide their patient base into three groups. The with periodontal inflammation, those who have had this but now are healed, and those who have never had periodontal inflammation
  • They have divided their clinical team into an Active Treatment Team who will see the patients who have periodontal inflammation and a Continuing Care Team who will look after patients whose periodontal disease has healed.

The Active Treatment Team:

  • Is headed up by an Active Team Dentist
  • Provides one hour appointments at fees based on £165/hour
  • Offers fixed fees for treatment of gingivitis, mild, moderate and severe periodontitis
  • Has created treatment protocols for each of the four treatment groups including assessment, indices, patient coaching, deep cleaning/disinfection, reviews and oral hygiene collateral
  • Will handover healed patients to the Continuing Care Team

The Continuing Care Team:

  • Is headed up by a Continuing Care Dentist
  • Provides half hour appointments at £110/hour
  • Sees patients every 12 weeks, in line with recent advice that patients who have had periodontal disease should continue seeing a hygienist every 12 weeks
  • Encourages patients to join a dedicated patient plan to encourage regular visits and spread the cost

I hope the advantages to this new approach are clear. They include better patient care, more process driven treatment and auditing of results, more focused hygienists who work more closely with the dentists in the practice, and all round better outcomes. This all means practice growth because there’s more revenue from both the Active Treatment and the Continuing Care teams. What’s not to like?!

Coaching is about creating change. If you would like to change your practice contact me for a chat!

e. simon.hocken@breathebusiness.co.uk

m. 07770 430576

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