Dentaltown January 2016 - (Page 100)

periodontics message board What to Do With Patients Who Refuse SRP and Only Want a Cleaning How do you communicate to patients the importance of SRP? Dentaltown.com > Message Boards > Periodontics > What to Do With Patients Who Refuse SRP and Only Wnat a Cleaning Harrisjm11 Member Since: 01/10/13 AM Post: 1 of 34 Related Message Boards I Need Deep Cleaning...Really? Deep Cleaning When is SRP Indicated? SRP Indicated I've been practicing for almost four years, and at one of the offices where I work, I see a lot of older patients who used to see a now-retired DMD. I think he has been somewhat lax with periodontal diagnosis and treatment, and many of his patients come in with radiographically visible bone loss and 6mm (or so) pockets. They have been having their teeth cleaned every six months for a long time, and when I see them and we do a full charting I discuss their perio status with them, inform them that they have perio disease, discuss the consequences of no treatment, and go from there. Some patients accept SRP; some don't. I'm wondering how the rest of you handle this. I feel like on the one hand, if I inform patients of the recommended treatment and consequences of no treatment and they choose not to do SRP, then they are making that informed decision. On the other hand, we've all heard about supervised neglect, and how perio disease is underdiagnosed. Honestly, I'm afraid someone will go after me at some point because I let him or her continue to get "cleanings" done, rather than stressing the importance of further treatment. In situations like this, do you refuse to treat further? Do you dismiss the patient, and how? I write very detailed progress notes but I haven't actually dismissed someone with a certified letter or anything like that. ■ FEB 9 2015 twmdds Member Since: 02/16/04 Post: 2 of 34 There's several threads on this already. It's a constant issue. In my practice (and in yours), patients have autonomy and, once properly informed, can choose the treatment they want. So even though we have a high percentage of SRP in our hygiene practice (30 percent), we continue to have some perio patients who have chosen routine cleaning. It's more of a problem when you've just taken over a practice and trust is an issue. Most clinicians will respond to this initially by gently informing the patient of the problem and possible treatments, then letting the patient decide what he or she wants to do. I find that all new patients know what "deep cleaning" is, but don't understand the term, "scaling and root planing." Remember, once they've been informed and made a decision and you've documented that, you are not at risk. So don't go throwing any patients away. Best of luck. ■ FEB 9 2015 paulcaselle Member Since: 11/04/00 Post: 3 of 34 100 I actually have patients sign off that they have been informed of a periodontal condition and they understand the risks of non-treatment. Patients refuse treatments for all sorts of reasons, even in medicine, so we are not unique. As long as you document that they were informed of the advantages and disadvantages, benefits and risks of treatment, you have done your job. Communication is key, and having a signed document is important in case patients forget about the conversation. By the way, with the hygienist having conversations with the patient at re-care appointments, I find that very often patients will come around, in time. They read and hear stuff and they build trust over time and one day they finally say, "OK, let's do it." I have seen this happen, JANUARY 2016 // dentaltown.com http://www.Dentaltown.com http://www.dentaltown.com/MessageBoard/thread.aspx?a=11&s=2&f=137&t=254174&g=1 http://www.dentaltown.com/MessageBoard/thread.aspx?a=11&s=2&f=137&t=243511&g=1 http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown January 2016

On Dentaltown.com
HOWARD SPEAKS: What Do You Need in 2016? Another Operatory
PROFESSIONAL COURTESY: The Next Generation of Dentists
Continuing Education Update
Mom Wants to Sit in the Hallway So She Can Hear What We’re Doing to Her Child
Why You Should Never Let Patients Talk You Out of Periodontal Plastic Surgery Before Esthetic Treatment
Chasing Pain: Diagnosing and Treating Trigeminal Neuralgia in General Dentistry
Chasing Sheep: The Four Pillars of Treating the Sleep-Disordered Patient
Product Profi le: Family Dental Marketing
Implementing Orthodontics in Your General Practice
Endodontic Advancements: How Leading Technologies Help Transform Endodontic Treatment Options
The Power of Piezo: A Predictable and Painless Approach
Veneers: Utilizing Silicon Matrices to Optimize Ideal Preparation Design
Improve Your Patients’ Lives Through Pro-Bono Referrals
Progressive Smile Design: Changing the Shape of Cosmetic Dentistry
The Ultimate Handover in Your Dental Office
Meet the New Intraoral Sensor
Poll
Want to Compete with Big Business? Tap Into Your Relationships
Saving Her Smile: Immediate Implant Placement and Fixed Provisionalization with Extracted Tooth
TOWNIE MEETING 2016 Preview
Ad Index
The Heart of the Hygienist: Dental Hygiene’s Role in Public Health
What to Do With Patients Who Refuse SRP and Only Want a Cleaning
CONTINUING EDUCATION: Indirect Posterior Composite Restorations
Dentally Incorrect

Dentaltown January 2016