This was followed by microultrasonics with Acclean chlorhexidine gluconate 0.12% (Henry Schein) to flush out and irrigate diseased tissue. Her new setup makes it more comfortable for her to practice, makes it easier to educate patients, and is HIPAA friendly. We conducted a diagnostic and comprehensive oral evaluation. Gagging in the dental chair is embarrassing and awkward for everyone. How teledentistry can help protect and retain staff and patients. We conducted a comprehensive clinical and diagnostic evaluation. Therefore, dentists and dental hygienists must stay up-to-date with accepted standards in their professions. Is it dental and medical schools, state boards, continuing education seminars, the legal profession and bar association, or individual practitioners and their own level of knowledge, skill, and judgment? Cell phones are here to stay. By David P. Reichwage, DDS; Cassie M. Jackson, RDH; Denise L. Marr, CDA, EFDA; Kristen M. Nuthals, CDA, EFDA; Amber M. Jaress, CDA, EFDA. Read all about it here! David Reichwage, DDS, has practiced family dentistry in Fort Wayne, Ind., for over 30 years. However, it does not stipulate how often periodontal charting should be performed.4. Karen Davis, BSDH, RDH, explains the basics of the spoon theory and how it’s relevant to your practice. 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. She stated she had noticed bleeding from her mouth when she brushed her teeth. Follow-up after periodontal therapy is crucial. Microultrasonic tips give better access to deep, narrow pockets as well as furcations. Treatment plan – We reviewed the radiographs, and there was no evidence of bone loss. Is it me or does it seem that a lot of patients out there aren’t aware that they have periodontal disease? DIANNE GLASSCOE WATTERSON, MBA, RDH, is a consultant, speaker, and author. PSR has utility only as a screening tool and was never meant to take the place of a comprehensive periodontal charting and recording. For optimal dental appointment outcomes, it’s important to go the extra mile for patients living with a chronic illness. I formerly worked with a periodontist who used this protocol. Denise Marr, CDA, EFDA, a treatment coordinator, is a 1999 graduate from Indiana-Purdue University and Indiana University's Expanded Function Dental Course, JP Institute, LVI, PAC, and Comprehensive Care Institute. At a recent dinner meeting of professional colleagues and hygienists, I overheard a con… Our evaluation includes the following: Our periodontal evaluation form also becomes an educational tool for each patient. The reason he recommends recording all numbers is that if a jury of nondental individuals examines a periodontal chart that has only a few scattered numbers, it appears (to them) as an incomplete chart. Despite improvements in dental care, millions of Americans suffer tooth loss -- mostly due to tooth decay, periodontal disease, or injury. Amber Jaress, CDA, EFDA, a treatment coordinator and expanded function dental assistant, has been schooled at LVI, PAC, JP Institute, and Comprehensive Care Institute. The ultimate goal of periodontal therapy is to stop disease progression and to stabilize and improve tooth attachment. Periodontal Reevaluation Following Initial Therapy. Floss daily. Her role has expanded to treat a variety of oral pathologies. These include genetics, general systemic health, hormonal changes, diet, oral hygiene, occlusion, tobacco use, and stress. My mantra to dental hygienists is to always have their periodontal radar engaged. It was noted that his medical history was negative and presented no contributory data. Luckily, periodontal disease can usually be treated and kept under control to prevent it from turning into a severe case. The patient was congratulated for her work and progress with her home care. We use a systematic approach to patient care, and the model we have created is based on our standard of care. It’s made a very positive difference in the practice. These upgraded visits known as periodontal maintenance (PM) are actually a continuation of your treatment. The laser was set at 1.4 continuous wave and was used to remove diseased epithelium in the periodontal pockets with a brush stroke motion. 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. My answer to you is that I agree with your former employer, the periodontist. Patients at risk for periodontal disease are often allowed to Òslip between the cracksÓ during a routine visit because they may be in the early stages of the disease. His primary concern was that he had noted changes in his gum tissue, especially bleeding when he brushed his teeth. Scaling was next performed to fine scale and remove any residual biofilm. "Well, I don't think I have done a periodontal chart since school.". As a clinical consultant, Nancy Miller, RDH, saw plenty of enviable operatories. She helps good practices become better through practical analysis and teleconsulting. We have found that when the standard of care is practiced, applied by the book, and follows accepted protocol, it produces a win/win/win scenario for patient/team/practice! Brush your teeth twice a day or, better yet, after every meal or snack. Amanda Hill, BSDH, RDH, explains why. Jack L Martin, MD . Modern oral rinses: A revolution in dentistry, Bridging communication and comprehensive care with teledentistry, The untold secrets of managing dentinal hypersensitivity (part 2), Finding long-term whitening solutions with hydrogen peroxide. Published 2016. According to the American Academy of Periodontology, “Research has shown that periodontal disease is associated with several other diseases. We performed co-diagnosis with this patient using a hand mirror and intraoral camera in order to have the patient involved in the clinical data process and also understand the findings as we presented them. States all over the country are weighing the benefits and risks of legalizing and/or decriminalizing marijuana. Remember, in the eyes of the law, if it’s not recorded in the chart, it never happened. Probing depthsBleeding pointsSupperationMucogingival relationships/defectsRecessionAttachment level/attachment loss. If your periodontal disease has caused a loss of bone or gum tissue, your dentist may recommend bone or tissue grafts in addition to surgical pocket reduction. It is my fervent hope that the 468 readers who responded to an RDH survey about occupational health are the only ones experiencing job-related pain. An appropriate periodontal maintenance program, specific to individual circumstances, has been recom- mended to the patient for long-term control of the disease, as well as for the maintenance of dental implants, if present. the injury was proximately caused by the clinician’s substandard care. 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. A six-week supportive therapy was scheduled. Yes. Cone-beam computed tomography in pediatrics. Lastly, Periostat (Collagenex Pharmaceuticals) is used in three, six, nine, or 12-month intervals depending on the patient's progress. A survey of 242 dental negligence cases with a breakdown as to the sex of the defendant dentist. Results – At this time, a marked decrease in inflammation was noted, and gingival tissue was responding well to therapy. a duty of care is owed by the clinician to the patient; the clinician violated the accepted standard of care; the plaintiff (patient) suffered a compensable injury; and. Linda Meeuwenberg was a 17-year-old high school student when she took a job at a general dental practice in her hometown of Fruitport, Mich. She was hired to type, file, answer the phone, and pay the bills. It is not necessary to do probings on a patient who only comes in for emergency treatment, but if that patient becomes a ‘regular’ patient, probings must be done and recorded routinely.”5. Periodontal disease is directly related to the supportive tissue around the root of the tooth, including gum disease and tissue-damaging conditions. Jamie explains how she and her practice accommodated this patient and what she learned in the process to make future appointments go more smoothly. Two weeks later, the same procedure was done on the upper and lower left side. Decriminalization and legalization of marijuana in the United States. What is the standard of care for new and existing patients with regard to periodontal screening and recording (PSR) versus full comprehensive periodontal charting? 3. In the majority of these cases, x-rays were not taken routinely, and periodontal probings were rarely or never recorded . Whitening: Helping patients prioritize and set realistic expectations. J. Some marginal redness was noted around the third molars. Cassie Jackson, RDH, is a 2004 graduate from Indiana University-Purdue University, JP Institute, LVI, and Comprehensive Care Institute, and holds a certificate from the Periodontal Laser Academy. The following clinical findings were noted at the six-week appointment (see Figure 6): In our opinion, the standard of care that determines protocol for any and all procedures in dentistry should apply equally from peer review committee to megapractices to dentistry in the small offices. Nardone Limited website. J Crystal Baxter, DMD, MDS, website. Even if all dentists in the community do not use a periodontal probe on examinations, a dentist’s nonuse of the periodontal probe probably would be considered below the standard of care. The patient was a 45-year-old male who reported it had been at least 20 years since his last dental visit. This dental hygienist admittedly had mixed emotions when she first heard the pediatric practice where she works was purchasing a CBCT unit. We explain to our patients that this is the most efficient way to determine their progress and periodontal health at a glance. Co-diagnosis and treatment planning with the patient set the stage for the next step – providing conservative treatment. Some states have written standards; some do not. He can be reached at (260) 426-1086, www.fortwaynesmiles.com, or e-mail at fortwaynesmiles@yahoo.com. Simply put, prevention is the best periodontal disease treatment. Using a periodontal probe routinely during examinations is a painless, quick, easy, inexpensive method to check for periodontal disease. Actually, the standard of care refers more to a set of expectations, specifically that the dentist or dental hygienist will use a degree of care and skill that is expected of a reasonably competent clinician acting in the same or similar circumstances.1,2. Consider using an electric toothbrush, which may be more effective at removing plaque and tartar before. Or snack for replacing missing teeth has utility only as a standard care... 'S Hospital in 2019 to lower infection rates in the original interview and.... 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