I remember the moment like yesterday. After months of frustration, I approached my boss about the lack of calibration between myself and the four other dental hygienists on the team. I had been practicing dental hygiene for three years, and everyone loved to remind me that I was a “new hygienist” and “I would learn the real world soon enough.” That should have been a red flag for me, but I didn’t know what a red flag was back then.
I had joined this practice six months earlier after covering for someone on maternity leave, and the office manager loved me. She fought for me to receive a full-time benefits package in a modern office in the heart of the city. I felt like I had truly made it!
However, I found myself becoming very frustrated because I was probing 6 mm and 7 mm pockets that were probed as one. I felt like I was constantly playing clean up while trying not to tell a patient the previous provider in the same office missed the active periodontal disease. I find this is a common experience for new grads. Therefore, I want to equip you with the verbal skills you’ll need so you won’t compromise your licensure, and you can treat periodontal disease the same way you’d treat a healthy patient.
The prophy palace
If less than 10% of the patients in the practice are in an active periodontal program, I consider it a prophy palace. The CDC reports about one in two men and one in three women 30 years or older had some level of periodontitis.1 Nearly 60% of geriatric patients have periodontal disease.1
I find that most of us provide a high level of care without properly coding the patient. For example, a patient who has one or two areas of 5 mm or more can qualify for a limited quadrant of scaling. This means that after the scaling, the patient is eligible for a periodontal maintenance appointment, also known as a D4910. A thriving practice needs diversity in the schedule. Having a full day of prophy patients is not only boring; it can activate burnout as we become disengaged to get through the day.
How to communicate
Let’s face it: as new graduates, it can be challenging to feel confident in the way we present information to our patients, especially when they tell us we look young. Heck, even as a 36-year-old master’s degree student, I still get asked if I’m a recent grad. (Thanks to my advanced night crème for keeping my skin tight.)
Anyway, leading with confidence is key to your success. The patients may try to throw your peers under the bus for “missing” what you found. But you need to focus on the evidence of disease. Take an image of the inflamed tissue and ledge of calculus, call out the numbers of the periodontal chart, and allow the patient to experience firsthand your comprehensive approach.
When you do the final check before the doctor comes in and sees residual calculus, pick up the scaler and say, “You’ve got the perfectionist in the office.” Show excitement to provide the highest level of care possible in any environment. Use phrases like “We now know,” “Based on your specific risks,” “Your inflammation has progressed,” and “By treating now, we can prevent the progression of disease.”
Be the change in your practice
I’ve never worked in a perfect office. The goal shouldn’t be to find an office that’s perfect. The goal should be finding an office that respects each team member, values new insights, and is open to change and growth. Every single office I’ve worked in has those aspects to some extent, and when I enter with my high energy, extreme optimism, and a drive to provide the highest level of care, it sparks joy in the office. This change is often slow, but I’ve watched my peers become hungry to learn. Often, people simply need to experience what’s possible.
You have the ability to lead a patient to “yes” through powerful communication skills, motivational interviewing, and empathy. As a practicing dental hygienist, the greatest gift I give every single week is making patients feel comfortable. This transforms the conversation where they feel they can be vulnerable, and we partner to create a patient homecare treatment plan that works for them. The longer I treat patients, the less bleeding they have and the more confidence they exude! This is one of the many reasons I love clinical hygiene!
Reference
- About periodontal (gum) disease. Centers for Disease Control and Prevention. May 15, 2024. https://www.cdc.gov/oral-health/about/gum-periodontal-disease.html
