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Hygiene Tribue U.S. Edition

HYGIENE TRIBUNE The World’s Dental Hygiene Newspaper · U.S. Edition By Cathie Stark, RDH, Orofacial Myologist Sequence matters … The sequence of appointments is critical to achieve the goal of care for the periodontally involved patient. Proper professional care is important when addressing this dis- ease. We are challenged to treat it with compassion while promoting health by ridding the destruction to our patient’s mouth and ultimately cre- ating optimal overall health. When assessing a patient, the hygienist plays an important role by aiding the dentist in proper diagno- sis of disease. The hygienist gathers all information from the patient, including medical history, proper dental radiographs, a thorough intra- and extra-oral examination as well as periodontal charting. Proper charting includes multiple factors. A straight probe is impor- tant, as is one without burs. Proper angulation of the probe gives the clinician the best idea of the amount of bone loss in a particular location. Finally, the appropriate pressure the clinician uses on the probe, 15 grams, is necessary if bleeding on probing is used as a disease indica- tor. The Florida Probe is a “go-to” tool to assess and educate. It provides a computer voice verbalizing the read- ings of the periodontal probe. The patient’s attention is grabbed when “danger” is mentioned in pockets 4 mm and greater during an exam. It’s important to get this third party endorsement of the disease process as patients become more cognitively aware. For clinicians hesitant to bring up a person’s peri- odontal condition, this uninvolved voice from the computer takes away that hesitation as well. The Florida Probe sums up all the data professionally. The patient sees as well as hears the status of his or her condition. Keep in mind that today’s insurance world requires charting of periodontal recordings before treatment. Periodontal charting and dental radiographs help provide the utmost care in treating disease. Radiographs should be current, based on the diagnostic needs of the patient and permit proper interpretation of the status of the periodontium.1 Intra- oral camera photos before and after any procedure show the patient a before-and-after perspective. A pic- ture is truly worth a thousand words. If the oral condition is such that a diagnosis cannot be made due to calculus getting in the way, a debridement, using code (D4355), is necessary. This code is only used if calculus blocks visualization of hard and soft tissue. To complete the periodontal diag- nosis, the patient must return for a comprehensive exam (D0150) after the debridement. This exam must be comprehen- sive and involve charting existing restorations and their condition, soft-tissue condition and areas of dental decay. The periodontal condi- tion is also part of this comprehen- sive examination. Once fully assessed, the patient’s treatment is developed according to the oral condition and his or her periodontal diagnosis. If the patient does have a peri- odontal infection and non-surgical therapy is the recommended treat- ment, the treatment plan can be bro- ken down into full-mouth treatment or quadrants/sextants of periodontal therapy. Because periodontal disease is a biofilm disease, it may be isolated to certain teeth or parts of teeth. For people with less than four teeth involved in the disease, the new code for one to three teeth, D4342, may be used. Full quadrant of four or more teeth involved may be coded using D4341. Each of these appointments should take approximately one hour and should be adjusted to an appro- priate amount of time depending on the case. At the appointment time, before scaling or any other invasive treat- ment, pre-procedural rinsing with an acceptable antimicrobial mouth rinse is imperative to protect the clinician and the patient. Patient comfort is critical to a good healthy outcome. There are different types of anesthetic given by g HT page 3D February 2011 www.dental-tribune.com Vol. 4, No. 2 Crest® Oral-B® recently intro- duced the Clinical Pro-Health™ System for Gingivitis, clinically tested to virtually eliminate gin- givitis.1 With routine dental check-ups and regular use, patients with mild to moderate, persistent gin- givitis can reduce inflammation and bleeding and significantly improve their gum health. “It’s our mission to offer solu- tions to meet every patient’s oral care needs and be a resource and partner to dental health pro- fessionals,” said Ann Hochman, marketing director for Crest Oral- B. “Our patient-based approach helps us develop targeted, innova- tive solutions for varying patient- types, and include distinct, com- plete regimens in the plaque, whitening, orthodontics, pediatric and, most recently, gingivitis cat- egories.” The inspiration behind Crest Oral-B’s latest patient-based solu- tion stems from the fact that one out of two American adults contin- ues to suffer from gingivitis. In fact, 33 percent of Americans believe that having “a little bleed- inDustry news Crest Oral-B introduces patient-based solutions Clinical Pro-Health System for Gingivitis (Photo/Provided by P&G)g HT page 3D