Do you value Perio Maintenance?


Today, I’m in Dallas with my friends at Productive Dentist Academy. I’m so excited to learn and reconnect with some old friends and meet new ones. Take a look at the call I’m doing for our Mastermind members today. I’ll give you specific benchmarks for hygiene profitability, perio awareness, specific services and recare. Don’t miss it.

Have you ever heard your hygiene team question the real difference between a prophy and perio maintenance?  Guess what? If you and your team question the value of perio maintenance, so will your patients. This week’s feature article will share some light on this subject and give you some valuable resources to finally create a mindset that supports the high value of perio maintenance.

Do you value Perio Maintenance?

Perio maintenance is one of those procedures that always brings up questions and differing opinions. Much of that is due to the conflict between the CDT definition of perio maintenance, that patients with periodontal disease should stay on periodontal maintenance for life, and the insurance industry’s lack of support for this service. There are a few challenges to overcome to get better results when enrolling patients into a perio maintenance program.

First, ask yourself a few questions.

  • Are you alternating perio maintenance and prophies for patients that have periodontal disease?
  • Do you have a hard time getting patients to “buy in” to perio maintenance every 3 months?
  • Does your hygiene team see very few periodontal maintenance patients each week or each month?
  • Do you ever feel that there is little or no difference between the services you provide during a prophy and those you provide at perio maintenance?

I bet you answered “yes” to at least one of these questions and you are not alone. There are thousands of hygienists and dentists that share your frustration. Here are a few strategies to help you increase the value of perio maintenance and keep your patients healthy. Isn’t that our #1 job after all?


#1-You must believe in what you do. I could write a book on this alone. It especially applies to periodontal therapy and maintenance. If you don’t believe in your heart that the treatment you are recommending is the best treatment for that patient, they won’t believe it either. Alternating perio maintenance with prophy creates confusion and degrades the value of your skills to help prevent perio disease flair ups. Although every patient may not need to remain on perio maintenance forever, it’s for sure that patients with moderate to severe disease will benefit from 90 day maintenance for LIFE.

#2-Know the science. If you’re not sure what you believe about perio, that’s ok. It just means you need more information. Learn more about the mouth-body connection. Three months is not an arbitrary number made up by some periodontist. It is based on classic studies and the AAP’s statement on the benefits of frequent maintenance intervals. Learn some of the new information about bacteria and biofilm.  Two great resources for the latest in perio science are Dr. Richard Nagelberg and Trisha O’Hehir and they’re both guest speakers in our upcoming Profitable Perio Online Workshop. Click here to check it out. This program is the perfect place to update your perio knowledge.

#3-Educate early. When you first recommend perio therapy to a patient, include the fact that the long-term success of your treatment depends on maintenance and what they can do at home. Don’t let perio maintenance or the additional cost be a surprise to your patients. Remind them as you proceed through therapy and even schedule their 1st perio maintenance before therapy is complete.

#4-Make it different. Always, always, always do a complete periodontal assessment and charting including bleeding, mobility, furcation and recession at every perio maintenance visit. You must believe that your perio maintenance therapy is different from a prophy and that your frequent clinical services are critical to preventing future perio breakdown and worth MORE than the fee you charge. If it’s not different, make it different.

#5-Add extra services. Maybe you simply add irrigation with an anti-microbial rinse at the end of the perio maintenance appointment. Maybe you add fluoride to coat those root surfaces or create a special fee for Arestin placement at perio maintenance. The definition of perio maintenance includes the isolated treatment of recurrent perio infection. Set guidelines so you know when it’s time to recommend active therapy again.

#6-Make sure your patients get what they pay for. When you know they’re getting more than they paid for, you will feel great about the service you provide and you will have no trouble enrolling patients into a lifelong maintenance plan. This includes giving patients support with the right tools for homecare too.

Stay Inspired,


Where Do You Stand?


If you’ve been reading my articles for awhile, you’ve heard me mention that you must know your Perio Percentage.  Every consultant has a slightly different way of calculating this percentage but they all come down to comparing perio procedures to prophies.

So where do you stand? In my opinion, this is the single most important indicator of the growth potential of your hygiene department.  It’s easy to find out with a simple tool.

I’m happy to share our Perio Calculator Tool with you.  Click here to download the tool. With a 12 month production report this tool will help you determine your perio percentage in just a few minutes with no cumbersome calculations.

Once you’ve determined your perio percentage, it’s time to take a look at what that number means.

If your percentage is below 15%-then your perio program needs immediate attention. Most of your patients are receiving prophies and there is a good chance that there is a lot of untreated periodontal disease among your patient base. A low perio percentage is one indicator that it is time to evaluate the quality of diagnostic care occurring in hygiene. The 1st step to increasing perio treatment is making the diagnosis. This is of course a team effort between the hygienist and the doctor. The hygiene team collects all the data and educates the patient and the doctor confirms the findings and the diagnosis.

If your percentage is between 20 and 30%-you are doing better than most practices. Perio maintenance also keeps perio percentage at a healthy level so be sure that all patients that are enrolled in active therapy are aware of and committed to ongoing maintenance. If you are at this level, take a look at the perio program and see where you could shore up a few systems to increase enrollment and take it to the next level.

If your perio percentage is over 30-40%-you are delivering a very high level of quality care and should be very proud of this accomplishment. Continue to review your protocol at least twice a year to be sure you are on the cutting edge with techniques and adjunctive services.

If you’d like to explore how to increase your perio percentage and hygiene productivity along the way, check out or email to schedule a time for us to talk.

Stay Inspired,


The Buck Stops With You!


Obstacle #3: There Is No Accountability

Out of all the obstacles, this one might just be the most ‘in our face’ on a day to day basis.  When there’s no accountability, things fall through the cracks. These can be little things like running out of cotton rolls or they can be big things, like a patient showing up for their crown delivery appointment and the crown’s nowhere to be found.

We’ve all been there, right? It’s embarrassing, frustrating and it can makes us look bad in the eyes of our patients.

Being accountable is knowing who is in charge of a certain job or task and then that person carrying it through to completion. When you agree to be accountable, the buck stops with YOU.  Now, you don’t have to complete every part of the task personally but you are responsible for making sure it is complete and accurate. To create more accountability in your practice, here a few things to implement:

1 – Create an action list during every team meeting.  Assign each task to a team member and agree to a date on which it will be done. This is the What, Who, By When. I recommend using a piece of 3M Post-It flip chart paper and put it on the wall of your meeting space. This way,  you can check things off when they’re done and go back to items that haven’t been completed to find out why.

2 – Utilize trackers!! Tracking your progress is imperative. In fact, many consultants have seen that tracking alone increases productivity by 10% or more, without implementing any other changes. When you’ve implemented something new, whether it’s a new marketing strategy or perio program, using a tracker will allow you to see what’s working and where you need to make adjustments. If your hygiene team is presenting the perio treatment but it’s not showing up on the tracker as completed, then you know you need to look at how you’re admin team is presenting financial arrangements or if the schedule is allowing those patients to be cared for quickly.

3 – Assign ongoing tasks. Being very clear about expectations is one secret to success as a leader. Create clear, consistent accountability by assigning one person to be in charge of OSHA, another in charge of the supply budget and inventory and another in charge of patient confirmation, for instance. Try to choose folks that are good at that skill. The person in charge of the supply closet should be an ‘organizer’ at heart.

In a couple weeks, I’ll share a bit about training. I bet you know what I’m going to say…

Stay Inspired,


P.S. If you missed Obstacles #1 & #2 just email me at and I’ll be happy to share those with you!

Plan for Success in 2011


Join us for the January Hygiene Profits Mastermind Call on Thursday, January 20 at 1pm.

Plan for Success

Everyone wants to start the year strong and improve on last year’s results. But do you know what you should be striving for? While every practice is unique, there are benchmarks for hygiene productivity and service. Knowing and understanding these benchmarks allow you to set goals that are attainable and yet a stretch from what you’ve done in the past. On this call, I’ll share:

  • Specific benchmarks for hygiene profitability including what numbers to consider when calculating this for your hygiene department
  • How to set goals that excite your team rather than weigh them down
  • Benchmarks for open time and specific services and how to find out where you stand
  • Some specific strategies to help get from where you are today to where you want to be in the areas of perio awareness, scheduling and open time and restorative co-diagnosis

Not a member of The Hygiene Profits Mastermind but want to join us for the call?

Sign up for a 2-month free trial membership. You’ll not only get to attend the tele-class, but you’ll also receive 2 months of CD and transcripts of our events plus private coaching opportunities and much more (you’ll only pay $9.95 for shipping).

Stay Inspired,