By Dianne Watterson, MBA, RDH, GC-C
When I became a dental hygienist in 1978, I did not foresee the “love affair” that loomed in my future, a love affair in treating periodontal disease. Nothing gives me more professional gratification than taking a patient with frank disease to a state of good oral health through a series of appointments.
Of course, there are many variables to consider in treatment planning comprehensive care, such as the patient’s medical history. How might my patient with a history of chemotherapy for breast cancer respond differently than a non-chemo patient? What outcomes should I expect and how should my care be modified for my diabetic patients? A challenging variable is the patient’s motivation and willingness to “own” the disease and exercise behavior change. Many patients have lifestyle factors that influence treatment outcomes, such as smoking and recreational drug or alcohol use. What about the patient’s diet? Can a person’s diet affect treatment outcomes? And finally, what factors determine when the patient needs specialized care from a periodontist? What about the patient that refuses a periodontal referral? These are all important questions.
One of my most memorable patients was a 35-year-old patient with moderate periodontitis. His pockets ranged from 5-7 mm, his oral hygiene was mediocre, and he was a former smoker. He also indicated he consumed alcohol on weekends. I completed his definitive care. The patient was very compliant, and his oral hygiene improved significantly. But at his first supportive therapy appointment, I noticed some of his periodontal readings had actually increased. This was not supposed to happen. Three months later, I knew something was not right, as his periodontal depths had not stabilized. We referred the patient to a periodontist who asked the patient, “Tell me, how many times do you typically get up during the night to use the rest room?” The patient replied, “Three times.” The periodontist suspected diabetes, and a subsequent referral to the patient’s physician confirmed the diagnosis.
My years of experience have taught me that customization is one of the most important considerations for patient success. After all, what works for one patient may not work for a different patient. Aspects of care that require customization include the treatment plan, the patient’s at-home oral care plan, and the supportive periodontal therapy required after the definitive care is completed. Understanding how to communicate with clarity, compassion, and grace goes a long way in establishing connected relationships with patients. When patients like you and sense your caring, they are more likely to comply with your instructions and recommendations for care. When everything is finished, how do you measure success? The measure of success comes over time. There will be no continuing loss of supporting bone and attachment. This outcome will not be seen in three or even six months, but in nine to twelve months following definitive treatment, the clinician will know. To achieve this success makes the job worth all the effort!
Ms. Watterson will speak on this topic at the 2024 Florida Dental Convention on June 20-22 in Orlando. You can find more information on her courses at www.floridadentalconvention.com.
Beyond the Bite 