Dentaltown July 2017 - 50

message board
hendoc4ct
Member Since: 04/12/11
Post: 18 of 29

Do you want to help patients, or are you more interested in covering yourself? If you have
a new patient with 4-6mm pockets, most likely they have had this for a while. If you go slowly
and educate them, there is a better chance they will follow through. I probe, take X-rays and
sit with the patient and explain the problem. Then I do a gross debridement. Next I have them
return to do a more thorough cleaning with localized deep scaling. I charge the debridement and
PX fees. I have them come back in a month to see if there has been improvement and to make
sure they are doing their home care.
Most times, I will start to see improvement because people really do not want to lose their
teeth or have to go to the periodontist. "My mom went to a periodontist and she had a lot
of pain and spent a lot of money." Over time I have seen patients with 6mm pockets heal to
3-4mm. When I do not see significant healing in 6 to 12 months, I then refer for perio. As
long as you inform the patient, you should be covered legally. The problems develop when
you allow 5-6mm pockets to fester and have no plan. The most difficult thing is getting
people to go for perio treatment. If you document and they don't go, you have done your due
diligence. ■
5/27/2017

RockyMtnDDS
Member Since: 05/06/08
Post: 19 of 29

I can count on one hand the number of patients I've seen in 10 years that couldn't have an
exam without supragingival scaling of calculus. ■
5/27/2017

RichieDDS
Member Since: 06/06/11
Post: 20 of 29

If you've made an honest attempt to educate a perio patient on their disease condition and
they still are not onboard with treatment, let them walk and don't look back. I have no desire
to treat those patients further or deal with their BS down the road. I'm very sure these are not
patients you want; let's quit letting these types dictate treatment. ■
5/27/2017

RockyMtnDDS
Member Since: 05/06/08
Post: 21 of 29

Having your front desk filter the new patients on the phone helps a lot. We either put the
patient into HYG for a 80-90-minute new patient exam/prophy if it's been up to 1 year since
they've had preventive care, or we put them for just the comp exam, X-rays, photos in my
column (doctor schedule) first for 40 minutes, then reschedule their perio/hygiene. We've found
that treatment acceptance goes up when we start with just the exam appointment first.
Any patients who call and it's been more than 1 year since they've had any preventive care
and say, "Well I just want a cleaning!" tend to be the ones who have perio (duh), don't accept
treatment and are consistently a pain when it comes to scheduling, compliance, etc. Sometimes
they tend to go somewhere else before they come see us. These are the "insurance only" patients;
I have no problem telling them this isn't the practice for them.
However, not all practices are at a point in their evolution/growth where they can be selective about this. If you are new and need rapid growth, filtering them can limit your growth a bit.
Sometimes you have to take what you receive, initially. Get them in your door. If you filter new
patients, your growth will be slower but you'll have a more ideal practice when you evolve. We
had rapid growth in my first few years because we treated everybody; now we are scaling that
back a lot and filtering people out, and it's a good place to be.
Also, one thing I've found works very well with people is to just be honest with them regarding their disease, and don't get pushy with getting them to accept treatment. If you force them to
do something they aren't comfortable with, then you'll get backlash and negative reviews. When
they are ready, they'll do treatment. And not everyone is ready right away. ■
5/29/2017

50

JULY 2017 // dentaltown.com


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Table of Contents for the Digital Edition of Dentaltown July 2017

Dentaltown July 2017 - Intro
Dentaltown July 2017 - Cover1
Dentaltown July 2017 - Cover2
Dentaltown July 2017 - 1
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Dentaltown July 2017 - Cover3
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