Why and how we should let our patients tell us they have gum disease, not the other way around.
Dearest Dental Professionals,
We are tired and frustrated with the lack of perio therapy compliance our patients give us… Traditionally this is the point of the conversation that we all get together and discuss why the patients need to figure it out and listen to us. Guess what?! They aren’t the problem in this equation! WHAT?? That’s right, you heard me, they are not the problem, we are. Dun, dun, dun…….
We are the problem because it is our job to give them the tools to decide for themselves what care they would like to have us provide. I say us because the dentist and hygienist must provide a comprehensive and unified approach to educating our patients.
“We are educating them, they aren’t listening.”
I hear you and here is how I can help:
First, a new approach to assessment is crucial. Here are the three things to remember:
- Never, ever, ever skip any part of assessment.
- This is the portion of the appointment where what each patient needs becomes crystal clear. If you skip anything in this section, have fun with your bloody prophy. Call me when you are burnt out and we can chat again.
- Here are the five things not to skip: Medical history and/or update, blood pressure reading, oral cancer screening, radiographs and full mouth periodontal chart complete with bleeding points at all six locations of every tooth.
- Keep all explanations simple enough for a 4th grader to understand.
- In doing the assessment, you are setting yourself up as the expert. A true expert knows the information so well they speak in simple terms and the patient understands exactly what is occurring.
- Show each piece of the assessment to them.
- Hey! Y’all! This is their mouth! They do not care about a pretty chart made by the textbook company. This is their skin (Ha! Pun intended!) What is in it for them? They need to look at and read: their own x-rays, blood pressure reading, perio chart etc. Here are some helpful one liners for you to try out and use as you see fit. Plagiarize or modify, certainly I have had plenty of help honing these in over the years:
- Medical history and update- “Your mouth is connected to your body. I can help you take great care of both if we know what we are working with.”
- Blood pressure reading- “Heart disease and gum disease are often related. They can help or hinder one another.”
- Oral cancer screening- “Early detection saves lives.”
- Radiographs- “This thick white line of bone should go up over and down between each tooth.”
- Periodontal charting- “1-3mm is normal and healthy gums don’t bleed.”
- Hey! Y’all! This is their mouth! They do not care about a pretty chart made by the textbook company. This is their skin (Ha! Pun intended!) What is in it for them? They need to look at and read: their own x-rays, blood pressure reading, perio chart etc. Here are some helpful one liners for you to try out and use as you see fit. Plagiarize or modify, certainly I have had plenty of help honing these in over the years:
Say that out loud with me, “One to three millimeters is normal and healthy gums don’t bleed.” Ten extra points if you say it out loud again!
When the assessment is complete, sit your patient up and review the information together. Do not, I repeat, do not tell them they have gum disease. Deliver the objective findings in terms a 4th grader can understand and then pause…. That’s right. Shhhhh. Be quiet. What is next? Drum roll please…. Nine times out of ten your patient is going to say, “What are we going to do?”
TA- DA! Yay! Yes!! What are we going to do? Good news!!! I know just what to do! We are a team and are going to treat this disease! It will require you (the patient) and I (the dental professional) to work together to complete treatment and have a new plan moving forward for home care as well as professional care.
Friends, fill in the blank after that! All that sweaty uncertainty for bad news delivery is in the past! You aren’t going to be the mean old bad news delivery person any longer. Let your patient decide for themselves, ask what is needed and then work together to provide the appropriate care!
This is a can of worms that I just stuffed into a nutshell for you. As we end our time together today, I challenge every single one of you reading this right now to try it out. Stop telling your patients they have periodontal disease and let them tell you.
*Farewell and good luck*
Love,
B
