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RDHs must put patients and not insurance first to prove their value.
RDHs must put patients and not insurance first to prove their value.
RDHs must put patients and not insurance first to prove their value.
RDHs must put patients and not insurance first to prove their value.
RDHs must put patients and not insurance first to prove their value.

Creating value in the dental hygiene profession: A patient-centered approach

Nov. 28, 2023
Assessing, diagnosing, educating, and coding—hygienists are juggling a lot. Here's a look at how focusing on fundamental principles maximizes the value of our services.

The dental hygiene profession plays a pivotal role in safeguarding oral health and preventing dental diseases. To maximize the value of our services, we need to focus on fundamental principles and implement effective strategies for assessments, diagnosis, and treatment. By placing emphasis on accurate evaluation of caries risk and periodontal assessments, dental hygienists can ensure precise diagnoses and treatment plans supported by relevant procedure codes.

As primary oral care providers, we have the responsibility not only for delivering clinical services but also for empowering patients with evidence-based information. This enables them to make informed decisions about their oral health. Here I’ll explore the value of dental hygienists' services, highlighting their role in providing evidence-based information to patients from reputable sources such as the American Academy of Periodontology (AAP) and the American Dental Association (ADA).

I’ll also emphasize the importance of accurate coding for procedures aligned with a patient's diagnosis, and advocate for a patient-centered approach rather than allowing insurance to dictate the services we provide. By doing so, dental hygienists significantly contribute to the overall oral health and well-being of their patients.

The importance of accurate assessments and diagnosis

At the heart of providing effective dental hygiene services lies the foundation of accurate assessments. Caries risk assessment involves evaluating various factors such as oral hygiene habits, diet, and fluoride exposure. By conducting thorough assessments, dental hygienists can develop personalized preventive strategies for each patient's needs. Periodontal assessments also help identify the presence and severity of gum diseases, which leads to appropriate diagnosis and treatment.

To underscore the significance of assessments, statistical data from reputable sources such as the AAP and the ADA can be employed. These organizations provide valuable insights into the prevalence and treatments of dental diseases, thus supporting evidence-based practices and ensuring patients receive the most effective care.

The role of the AAP's new classification

The AAP’s new classification system offers a valuable framework for dental hygienists to treat patients more effectively. This system categorizes periodontal diseases based on staging and grading, considering factors such as severity, extent, and complexity. By using this classification, dental hygienists can determine appropriate treatment for each patient.

The AAP's classification system provides a standardized approach to diagnosing and treating periodontal diseases, facilitating clear communication between dental professionals, and enhancing the quality of care. By incorporating this classification into practice, dental hygienists can provide evidence-based treatments that are supported by the latest research and clinical guidelines.

To reinforce the value of the AAP's new classification, we can refer to data and information available on the AAP website. This data supports the importance of accurate diagnosis and highlights the impact of periodontal diseases on oral health and systemic well-being.

The power of evidence-based information

One key strength lies in our ability to effectively communicate evidence-based information to patients. The AAP is a reputable source for guidelines and recommendations related to perio health. We can leverage this valuable information to educate patients about the importance of maintaining healthy gums and preventing gum diseases.

By sharing evidence-based practices, we empower patients to adopt proper oral hygiene routines, make dietary changes, and follow preventive measures. Armed with this knowledge, patients are more likely to comply with treatment plans, which leads to improved oral health outcomes and a reduced risk of dental issues.

Accurate coding for optimal diagnosis and treatment

Proper coding is a critical aspect of our services, ensuring that the diagnosis aligns with the appropriate treatment and procedure codes. We use standardized codes such as 1110, 4346, 4341, 4342, and 4910 to indicate the specific diagnosis and the corresponding treatment required.

  • Code 1110: This code says that the diagnosis indicates healthy gum therapy. It’s used for patients who require routine dental cleaning and maintenance of their already healthy gums.
  • Code 4346: Dental hygienists use this code when a patient has been diagnosed with gingivitis, indicating inflammation of the gums. This diagnosis requires specific treatment to address and control the condition and no bone loss should be present.
  • Codes 4341 and 4342: These codes are used for patients diagnosed with periodontitis. The choice between 4341 and 4342 depends on the teeth per quad needing scaling and root planing (SRP).
  • Code 4910: This code represents perio maintenance, which is an ongoing service provided to patients diagnosed with periodontitis. Periodontal maintenance is essential for preserving the health of the dentition and preventing disease progression.

By using accurate coding procedures, dental hygienists help dentists and insurance companies understand the nature of the treatment and its necessity. This contributes to efficient billing processes and ensures that patients receive the appropriate level of care.

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Moving away from insurance dependency

One obstacle to providing optimal care is the influence of insurance coverage on treatment decisions. To create value in the dental hygiene profession, don’t let insurance dictate the services provided. Instead, the focus should be on what’s best for the patient's oral health and overall well-being.

To avoid insurance dependence, collect comprehensive patient data. By gathering accurate information about patients' oral health history, habits, and lifestyle factors, dental hygienists can make informed decisions based on an individual’s needs rather than being limited by insurance restrictions. This patient-centered approach ensures that the treatment plan aligns with the patient's specific requirements. Placing patient needs at the forefront allows dental hygienists to provide optimal care without compromising quality.

Our profession requires a patient-centered approach that emphasizes accurate assessments, proper diagnosis, evidence-based treatments, and ensures we use correct codes based on diagnosis. By imparting evidence-based knowledge from reputable sources such as the AAP and ADA, dental hygienists empower patients to take charge of their oral health. We can ensure appropriate diagnoses and treatment plans.

Relying on patient data and reputable sources provides the necessary evidence to support the services our patients need. By prioritizing patient care over insurance considerations and using the AAP's new classification system, dental hygienists can enhance the value of our profession and contribute to improved oral health outcomes. Through these efforts, we become vital partners in promoting oral health, empowering patients, and ensuring long-lasting smiles for our patients. Together, we can create value for our profession and the services we provide.

Rafael Rondon, BS, RDH, has been in the dental field for more than 30 years. He worked in a hospital setting and private practice, and for the past 20 years with dental group practices. He’s helped develop a dental hygiene standard of care for the organization, which includes periodontal therapy, communication, efficient hygiene schedules, improving patient care, and team development. He’s also founder of Mr. RDH, a platform for male hygienists to network and discuss factors that affect men as dental hygienists.

Editor's note: This article appeared in the November-December 2023 print edition of RDH magazine. Dental hygienists in North America are eligible for a complimentary print subscription. Sign up here.