I Just Can’t Do It All – Part 1

#1 Assuming Perio is Taken Care Of

Having a sharp hygiene team is a beautiful thing. But assuming everything is being taken care of is a big mistake. Be sure you know that a complete perio exam is taking place at every hygiene visit AND the data is being recorded. This is a huge area of liability for you and it’s your hygienists responsibility to collect and analyze this information. One way to find out where you stand is to do an audit of your charts. Randomly pull 20 charts of adults seen in the last 6-12 months. How many have a complete perio exam recorded in the last year? Chances are very good that if the percentage is low, so is the amount of perio treatment.

#2 Starting Perio Treatment Too Late

My interpretation of the AAP’s Perio Classification system is that Beginning (slight) periodontal disease is 4mm pockets with bleeding and slight bone loss and 1-2mm CAL. This is a huge distinction for many dental teams. Often, these are the “difficult prophies” or the patients that have 3 month prophy intervals. I see it time and time again- teams waiting until pockets are 5-6mm deep before beginning treatment while valuable the patient loses valuable bone that could have been saved.

#3 Too Little Time for Hygiene Visits

I’ve mentioned this before and I’ll say it again. Every time I have ever coached a team to increase their hygiene time, their production has increased as a result. Now that wasn’t they only thing they did. They put in place systems to deliver a higher level of service and enroll more treatment. Critical steps that drive production are left out of the hygiene exam when time is short. When you choose to allow 60 minutes for adult recare and perio maintenance, it’s important to outline exactly what will take place during that time. If you are going from 40min hygiene visits to 60min, what are you going to add?

To Be Continued…

Wait- Here are a few action steps to help you get started NOW:

Do a chart audit-look for current perio charts
Communicate to your hygiene team that you’d like them to do a complete perio exam on every adult patient
Give your hygiene team the time they need to complete a comprehensive hygiene exam
Be proactive and get the information you need to really believe that starting perio therapy early is the right thing to do
Think back to the last time you attended a really great CE course. You came back with some great ideas and wanted to get started right away. Then you pull out your notes and realize there are 10 or more new products, services or ideas you want to put into place NOW. I know the feeling. I’ve been there myself. And I know that the next thing you feel is overwhelm. Where do you start? How am I going to fit all this into my 50 or 60 minute appointment time? Are my patients going to think I’m just trying to sell them the next best toothbrush?

Then you get that feeling that stops you in your tracks…I just can’t do it all! The good news is, you don’t have to! Here are a few tips to help you systematically incorporate all that you’ve learned, over time.

Sit down with your notes and make a list of all the new products, techniques, services you want to begin offering to your patients in the next 12 months. Then rank them with #1 being something that you must do NOW. This would be something critical like doing an oral cancer screening on every patient. Somewhere lower on your list might be completing a Caries Risk Assessment on every patient. Maybe your already doing a complete perio exam, oral cancer screening and Caries Risk is high on your list of To-Dos. This is going to vary for everyone

Then create a timeline for when it will be implemented. Maybe you start doing visual & tactile oral cancer screenings on Monday. Then you request a lunch and learn on the Velscope or ViziLite on Wednesday knowing that it will be next month before you make your decision on which testing system to use. Get that system implemented and running well and then focus on the next item. Maybe the Caries Risk and Treatment System will be 6 months out. That’s ok, just have it in your long-range plan.

Every team is going to have different priorities but there are some standards of care that must be addressed quickly. These are musts in EVERY hygiene exam:

Oral Cancer Screening
Complete Periodontal Exam with charting
Medical Review
These are important but may be on the 3-6 month To Do list:

Cosmetic evaluation with shade guide
Caries Risk Assessment Form and Treatment System
Implement a new Homecare System
We all want to do everything tomorrow but the reality is that if we don’t prioritize, we’ll get overwhelmed and not implement any of it. Now take a breath and make your list.

Next month, I’ll share how to stay on time and avoid overwhelming patients with new products/services.

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