Ever been faced with this scenario? You ‘now know’ that active periodontal infection is a risk factor for heart attack, stroke, some types of cancer, and the list goes on. You ‘now know’ that waiting to recommend treatment until you see multiple 5mm pockets with bleeding and moderate bone loss is waiting too long.
So Jane sits in your chair, you do her complete perio charting with bleeding points and recession and you see that she has multiple 4-5mm bleeding pockets with slight bone loss in 3 quadrants.
You look back at your notes and notice that this isn’t getting any better, you’ve made a note of this issue the last 3 times you’ve seen her. Today, it’s time to do something different. But how do you break it to her? You’ve been seeing her for 7 years. How do you break the prophy cycle?
Well first, I can tell you what NOT to say. What you don’t want to say is this… “Jane, your gums are bleeding and you have signs of active infection. I know we’ve just cleaned your teeth before but we’ve been working with this consultant and he said that we just haven’t been doing a very good job diagnosing periodontal disease. So we’re going to get started with the treatment today. We’ll file this with your insurance and so don’t worry about it.”
I know you’re cracking up right now but seriously, this happens a lot. It leads to doubt with patients and also a lot of upsets for your financial coordinator when the insurance doesn’t pay the 100% (do they ever?).
Here’s what you WOULD say “Jane, we’ve discussed the bleeding I’m seeing with your gums more than once. You know I’ve been keeping my eye on this and I know you’ve been working hard at home but here’s the thing, you’re body is just not responding the way I had hoped with the treatment we’ve done in the past. It’s time to do something different”
“I know you take medication for your high cholesterol. We now know that an active infection in your gums and bone may put you at a greater risk for heart attack and stroke and you already have one risk factor with the high cholesterol. We have to do something different to stop this infection. So here’s what I recommend we do.”
I’m assuming you’ve already used the 3 P’s of Perio Enrollment and then you proceed with your treatment recommendation and financial options. Then of course, have the doctor confirm your diagnosis and treatment plan.
So you see it’s really not that hard. These simple key words that I’ve highlighted have worked over and over with overwhelming positive results.
Remember I told you last week not to beat yourself up? It’s not that you have been ignoring the bleeding and pocketing. But you must recognize when it’s time to do something different. Treating an active infection is easier, more successful and more cost effective when it’s done early.