Periodontal Maintenance. We all know it exists, but many offices tend to hide it in a closet and act like it isn’t there. Being a consultant over the last 20 years has taken me into many different dental practices across the United States. I continually see a lack of consistency in regards to a solid Periodontal Maintenance program.
Offices tell me they do not bill it out because the patient refuses treatment or will not pay for it. But just imagine that happening anywhere else. If a doctor diagnoses a patient with high blood pressure, do you think that patient would ever tell the doctor, “No, I am not paying for that diagnosis or that medicine! Change my records to show that I don’t have symptoms and my blood pressure is perfect.” Would that doctor do it? NO, they would not! So why would a dental office do the same for a periodontally diseased patient?
Many offices have the patient sign a refusal form, and then keep treating them as a non-diseased patient. But doing that will not release you from liability. There is not a refusal for what is deemed to be malpractice and is commonly referred to as “Supervised Neglect”. In fact, one of the top five dental malpractice lawsuits is failure to diagnose and treat periodontal disease.
What You Should Do
Start with educating your patients. Make sure your Hygiene Department is clear and concise in addressing every patient’s need. Spend time with the patient. Educate them on the health consequences if it is left untreated. Explain and show bone loss, etc. through x-rays, photos, and educational materials. When doing your chart audits, check if the patient has recently gone through Scaling and Root Planning, has 4mm pockets or greater, bleeding on probing, or bone loss. If so, they are a Periodontal Maintenance patient.
Research tells us that about half of the adult population has some form of periodontal disease. Periodontal patients who do not receive proper disease treatment and maintenance lose two to three times more teeth. They also need active therapy twice as often. Go ahead—turn the “P” word from something dreaded into something treated.
“If you don’t stand for something, you will fall for anything”. – ALEXANDER HAMILTON
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