Karen Davis, BSDH, RDH, says perhaps our message should be that visiting the dental hygienist may help prevent severe COVID-19 infections. Muddy flooding and sinkholes: Understanding the difference between caries and erosive tooth wear. This concept that we call the “standard of care” is not a solitary document. But her dentist’s enthusiasm was infectious. NeilR. Crystal Baxter, DDS, MDS, an expert witness who has served in 242 dental negligence cases, writes, “The fifth most common alleged negligence was failure to diagnose or treat periodontal disease in a timely fashion. 6. CHICAGO — Dentists treating patients with chronic periodontitis, a severe form of gum disease that can lead to tooth loss, are advised to use scaling and root planing (SRP), deep cleaning of the teeth, as initial treatment, according to new guidelines from the American Dental Association (ADA). The future of oral-systemic health: Dental hygienist breaks new ground treating pediatric cancer patients. He suspected this could be detrimental to his oral health and possibly related to chronic digestive problems as well as weight loss. A six-week supportive therapy was scheduled. The periodontal disease causes the connective tissue between gums and teeth to loose, and the adherence function decreases, leaving the leftovers easily trapped in the space between teeth. Kristen Nuthals, CDA, EFDA, a treatment coordinator, is a 2005 graduate from Indiana-Purdue University and Indiana University's Expanded Function Dental Course, JP Institute, LVI, and Comprehensive Care Institute. Sometimes patients expect unrealistic results from whitening treatments. The higher the blood glucose, the greater the risk for developing periodontal disease. What is the standard of care for new and existing patients with regard to periodontal screening and recording (PSR) versus full comprehensive periodontal charting? Dr. Reichwage uses a diode laser to remove diseased epithelium, and for bacterial decontamination. Our recommendation of this includes daily use of a power toothbrush such as Sonicare, floss, Hydrofloss hydromagnetic oral irrigator, and chlorine dioxide toothpaste and rinse such as CloSYS. Also, standards of care are not static, meaning they change with the advent of new technologies, new materials, and new court rulings. © 2021 Endeavor Business Media, LLC. Once, in an office where I was consulting, I conducted a chart audit of 30 adults who had been in for preventive care in the past year. In addition we performed co-diagnosis techniques with the patient by using a hand mirror, radiographs, and intraoral camera in order to have the patient involved in the clinical data process and understand the findings as we presented them. A survey of 242 dental negligence cases with a breakdown as to the sex of the defendant dentist. He can be reached at (260) 426-1086, www.fortwaynesmiles.com, or e-mail at firstname.lastname@example.org. Next, scaling and root planing were performed to fine scale and remove any residual calculus. Floss daily. Results – At this time, a marked decrease in inflammation was noted, and gingival tissue was responding well to therapy. Procedure – At the initial diagnostic appointment, a full-mouth superficial debridement was performed using microultrasonic instrumentation. Overall, tissue was reported to appear healthier and showed response from the first therapy. It also helps ease tensions between dentists and dental hygienists. "Well, I don't think I have done a periodontal chart since school.". One patient had a lesion that hurt when she ate, and another felt like she had an infection in her wisdom tooth. Our typical recommendation is a three-month cycle but it can be as short as eight weeks. David Reichwage, DDS, has practiced family dentistry in Fort Wayne, Ind., for over 30 years. Vitamin E gel was then placed on the tissue to augment healing. (A2) According to the American Academy of Periodontology, more than a third of Americans over age 30 have periodontitis. Occlusal evaluation and anterior guidance, Head and neck exam and oral cancer screening, Charting existing restorations and missing teeth, Diagnosing areas of caries, taking a full-mouth series of periapical films, bitewings, and panoramic X-ray, Considering motivational factors for the patient, as well as personality profiles, Periodontal classification: II-III (early - moderate periodontitis), Periodontal Health Index (PHI): 55 (4mm+ pockets)/102 (bleeding points), Diagnosis: periodontitis with areas of advanced periodontitis, Bleeding upon scaling: moderate around second and third molars, Bleeding upon probing: moderate around molars at 39 points, Supra calculus: very light on the lingual of the lower anterior teeth, Tissue texture: generalized pink with localized areas of red with some inflammation around third molars, Periodontal classification: II (early periodontitis). Cone-beam computed tomography in pediatrics. These include genetics, general systemic health, hormonal changes, diet, oral hygiene, occlusion, tobacco use, and stress. Luckily, periodontal disease can usually be treated and kept under control to prevent it from turning into a severe case. Co-diagnosis and treatment planning with the patient set the stage for the next step – providing conservative treatment. Consider using an electric toothbrush, which may be more effective at removing plaque and tartar. According to Frank DeLuca, DMD, JD, the standard of care in dentistry for periodontal charting is a full-mouth, six-point probing with all numbers recorded at a minimum of once per year for all adult patients. Delivery of periodontal maintenance care at … The patient was disclosed and given instructions for his co-therapy at home with a Sonicare powered toothbrush as well as proper flossing techniques with Eez-Thru flossers (Sunstar). It is within the standard of care for a general dentist to monitor and treat a periodontal condition, however, if a general dentist elects to treat a patient's periodontal condition, that dentist is held to the standard of care that a trained periodontist would give the patient. Are you inadvertently zapping your patients’ spoons? All rights reserved. Oral Care. How can periodontal health be measured without a probe? Procedure – Two weeks later, treatment began on the entire mouth and started with application of topical anesthetic along the gingival margins. Dianne Watterson, MBA, RDH, talks commission-based compensation plans: structure, how to handle PTO time, bonuses, and more. More severe forms of periodontal disease can also be treated successfully but may require more extensive treatment. The value of a dental hygiene appointment. They should always be looking for periodontitis. Of the 30 charts, only two had a current periodontal charting. Is it me or does it seem that a lot of patients out there aren’t aware that they have periodontal disease? I`d like to add a note about your article on Transcendental Meditation (TM) (March 1999 issue). Anne Nugent Guignon, MPH, RDH, CSP, says sinkholes and muddy flooding are two environmental phenomena that are perfect parallels to the damage that can occur in the oral cavity. eriodontal Health Index (PHI): 27/39 decreased from 55/102! Many of dental hygienists' greatest contributions to patient health are not reimbursed by insurance, but that doesn't lessen their importance one bit. A 15-year-old female patient presented with a desire to update her dental care. He was also started on CloSYS (Rowpar Pharmaceuticals) mouth rinse and CloSYS toothpaste with the active ingredient of chlorine dioxide, which is known for its antimicrobial properties. But I suspect that`s wishing for too much. The reason the hygienists were not conducting chartings is that they did not have the necessary time or help with recording. Actually, standards of care for dentistry vary from state to state. By David P. Reichwage, DDS; Cassie M. Jackson, RDH; Denise L. Marr, CDA, EFDA; Kristen M. Nuthals, CDA, EFDA; Amber M. Jaress, CDA, EFDA. But when the practice where she’d worked for 24 years hired a new doctor who also happened to be left-handed, she got an enviable operatory of her own. The tissue was generally pink and no longer bulbous. . https://www.adha.org/resources-docs/2016-Revised-Standards-for-Clinical-Dental-Hygiene-Practice.pdf. Formulation of a revised periodontal treatment plan, including referral to a periodontist, when indicated. These links include the inflammatory effects of periodontal disease correlating with great risks of heart attack, stroke, diabetes, lower birth weight babies, and premature births. 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