Dentaltown January 2013 - (Page 100)

hygiene and prevention profile in oral health Dental Hygiene Time Management for the New Year by Trisha E. O’Hehir, RDH, MS, Editorial Director, Hygienetown Introduction No more bloody prophies in 2013! How many bloody prophies did you see last week? One is too many, but chances are, you struggle with several each day. Despite repeated toothbrushing and flossing instructions, subgingival instrumentation finds calculus and bleeding on many patients. If this is the case in your dental hygiene department, it’s time for a change that will positively impact your time management of bloody prophy appointments. A “prophylaxis” is a procedure performed on periodontally healthy patients to keep them healthy. Gingivitis and periodontitis are specific infections, like dental caries, to be diagnosed and treated differently than a prophylaxis. Removing subgingival calculus from interproximal areas where the tissue is puffy, swollen and bleeds easily is actually providing periodontal therapy. It is no longer a prophylaxis. Just because it frequently happens doesn’t make it right. A prophylaxis appointment doesn’t allow time for periodontal therapy so taking the time to treat localized periodontitis is bound to put you behind schedule. Patients don’t appreciate the “free skilled therapy” you’re providing, as evidenced by their comments suggesting you may be the “rough” hygienist. The patient’s perception and that of the insurance companies is that a prophylaxis consists of polishing the clinical crowns of the teeth. Removing subgingival calculus from infected interproximal surfaces constitutes scaling and root planing for which you are not charging. It adds time to your appointment and the patients don’t like it. Yes, they need it, but they don’t like it and it’s not technically part of a prophylaxis. Besides, it’s what stresses you out, takes more time and often puts you behind schedule. Removing supragingival calculus from the linguals of the anterior teeth is also time consuming and not the most comfortable for patients either. This also adds unnecessary time to the dental hygiene visit. Believe me; patients would love to come in just for polishing and no scraping with sharp pointed instruments. By changing two things you do at each dental hygiene visit you will avoid providing unpaid periodontal therapy and easily stay on schedule. Add two simple requests of your patients and forever change their future DH visits, making them easier and more pleasant for both of you. A prophylaxis is a procedure done on a healthy patient to keep them healthy. The exact definition: “A dental prophylaxis performed on transitional or permanent dentition, which includes scaling and polishing procedures to remove coronal plaque, calculus and stains.” No pockets. No bleeding. No subgingival calculus to remove, only coronal instrumentation, no subgingival instrumentation. Since there is no code for treating gingivitis or early periodontitis, D1110 is often used, inaccurately, for bloody prophies. Providing periodontal therapy, subgingival calculus removal from interproximal areas, during a prophylaxis visit leads to a bloody prophy. We laugh about these visits, but the truth is, a bloody prophy doesn’t help the patient or the hygienist. The patients continue to ignore their responsibility to daily clean the interproximal areas and the next visit is the same as the last. The periodontal instrumentation at each visit adds extra time and stress, often pushing the limits of the schedule. Bloody prophies need to be a thing of the past. continued on page 102 100 JANUARY 2013 » dentaltown.com http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown January 2013

Dentaltown.com Highlights
Howard Speaks: Doc, Are You a Monster?
Professional Courtesy: Have You Met TED?
Continuing Education Update
Second Opinion: Yelp Can Be Detrimental to Your Practice: Ways to Combat It
Professional Burnout
Sleep Apnea Screening and Treatment
Townie Meeting is Almost Here!
What’s on Your Tray? Composite/Restorative
Do-it-Yourself Finance, Part II: Cash Flow
Product Profile: Schick 33
Aesthetic Management Using Dermal Fillers in a Patient with Deficient Dental Volume
The Future of Dentistry is Digital: Don’t Be Left Behind
Continuing Education: Why We See Problems with Teeth Whitening: The Science of Whitening, Part III
Industry News
New Year’s Resolution: Stay on Schedule!
Perio Reports
Ad Index
Profile in Oral Health: Dental Hygiene Time Management for the New Year
Dentally Incorrect

Dentaltown January 2013