In building the new practice, the key, notes Dr. Robert Fazio, is establishing a strong relationship with the patients and demonstrating that the dental team is committed to providing the best care for them, which includes providing Phase I periodontal treatment.
New Dentists want to think in terms of establishing a perio-management program to treat people with both gingivitis and periodontitis. I firmly believe that 80% of all periodontal therapy should happen in the general dentist office. That’s because I believe that the majority of periodontal problems can be treated with good oral hygiene instruction, solid recall, and scaling and root planing.
I find that oftentimes newer practitioners will refer patients with periodontal disease too soon. The key, is determining which patients are “winners”. The patients that every general dentist should treat are those with enough plaque and calculus in their mouths to account for the levels of soft tissue inflammation and bone loss. The problem patient that might need to be referred to a specialist is the one who doesn’t have a lot of plaque or calculus, and you are asking yourself why the patient is breaking down. That also applies to extraordinary disease in a young with a family history of diabetes is 2.5 times more likely to be an undiagnosed diabetic themselves. The questions that new dentists need to ask on the medical history form are: Does the patient have diabetes mellitus and also does the patient have a family history of diabetes.
If the conditions are not appropriate for local factors and patient age, those are special circumstances that probably require referral. Patients with systemic diseases, such as diabetes and those taking calcium channel blockers, also are more difficult to treat and should probably be referred. The others, general practitioners should treat in their practices.
The sidebar benefit is you are establishing rapport with the patients for those three or four visits. And the cost of that therapy is comparable to the cost of one or two crowns. So you are not asking the patient to spend an enormous amount of money.
Periodontal Guru, Dr. Robert Fazio is co-author of The Ultimate Cheat Sheets™ – The Practical Guide for Dentists, along with Leslie S.T. Fang, MD, PhD, and Tracey Menhall, BS, MS, CPA. He is currently Associate Clinical Professor of Surgery at Yale University School of Medicine. He is also co-author of Oral Medicine Secrets and author of the textbook Principles and Practice of Oral Medicine. A 1971 graduate of Harvard College and a 1975 graduate of Harvard School of Dental Medicine, he also completed Clinical Fellowships in Periodontology and Oral Medicine at Harvard.
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