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Confessions of a ‘heretic’

Jan. 1, 2007
The first patient of the day enters your operatory. You exchange pleasantries then jump into the appointment.

The first patient of the day enters your operatory. You exchange pleasantries then jump into the appointment. When treatment is over, you walk the patient to the reception desk and hand him off to the business staff, who asks if he has insurance. You head back to your room to prepare for the next patient, and the cycle repeats…

Diane Thomas
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Does it have to be like this? What happens when the hygienist, dentist and office staff must gather necessary patient data, present the patient with alternative treatment plans, and create an individualized patient plan? What happens is discussed in Diane Thomas’ program titled, “Confessions of a Hygiene Heretic: Confronting Dental Hygiene Dogma.”

During Diane’s presentation, participants learn to present cases to patients in a way that supports the level of care they should have - the whole person approach to periodontal care. The goal of the program is to create a hygiene department in a general practice that truly excels in patient satisfaction, exceptional service, and increased hygiene production, while preserving the values and ethics of the hygienist - a win-win for everyone!

The program discusses how important it is to have the entire team’s support. If the entire dental team is not on board, the patient will gain no benefits. The entire office must support what the hygienist is trying to accomplish with the periodontal program. The support role of each member of the dental team, including the doctor, is discussed in Diane’s program.

During the program, Diane takes the hygienist and patient through comprehensive periodontal evaluation and data collection. Discussion centers on building trusting relationships with patients by listening. The how’s and why’s of data collection are introduced, from medical history, the role of systemic disease and risk factors, to radiographs, dental care history and restorative screenings. During the periodontal evaluation phase a total evaluation is performed that includes recording missing and mobile teeth, occlusal screenings, tooth positioning, recession and probing, furcation involvement, and periodontal case classification based on the American Academy of Periodontology’s classification system.

A periodontal diagnosis flow chart that can be used to discuss periodontal care with patients is presented during the program, and the values clarification discovery process follows. It is here that the patient is informed of his/her infection, and the hygienist and patient work together to identify various treatment options and consequences. These can include doing nothing, performing periodontal debridement with three-month maintenance, performing conservative periodontal therapy using local delivery agents, periodontal endoscopy treatment, or referral to the periodontist.

Diane then empowers the patient to choose which treatment options are best for his or her needs and lifestyle. Once this is decided, the hygienist must know how to create the appropriate treatment plan. Diane presents a worksheet that includes medical considerations, risk factors and oral findings, length of appointments, treatment to be provided at each appointment and time between appointments. Also, the total fee for service is provided for the patient, including insurance information if appropriate, so there are no surprises.

Diane discusses how the hygienist can present case fees in a way that will develop the patient/hygienist relationship and empower the patient to choose the best level of care. In her discussions with course participants, Diane uses actual cases and techniques that have worked for her. She also includes her top five tips for improving patient compliance.

After attending Diane’s program, participants should be able to:

  • Set the stage for dental hygiene case presentation
  • Gather dental, periodontal, and general health data necessary to access oral health
  • Plan dental hygiene treatment options
  • Determine and discuss fees for service
  • Empower patients to choose the level of oral care that best suits their commitment and lifestyle
  • Change old belief systems and determine the science behind treatment
  • Handouts are provided during the programs that include slides, AAP classification guidelines, treatment planning/fee determination worksheet and insurance letter templates. The lecture also includes video clips of Perioscopy, the dental endoscope. Diane is qualified as an Area Clinical Specialist for DentalView (the company that manufactures Perioscopy) to train clinicians in its use.Diane began this program because the subject has been a passion of hers since she was a surgical assistant in the mid 1970s in Scottsdale, Ariz. She received extensive training as an expanded function periodontal therapist in Arizona, and was a member of Qualitat Institute for Dental Hygiene where she learned the business aspect of conservative periodontal therapy. In 2002, Diane received the Sunstar Butler/RDH magazine Healthy Gums, Healthy Life Award of Distinction.While reviewing hers and the other winner’s patient tips for compliance, Diane realized she had a unique approach to patient care. She is the founder of the Hawaii Institute for Wellness in Dentistry and has organized continuing education courses for years, yet she never felt qualified to present them until friends and mentors pushed her. A professional storyteller and former professional dancer, Diane blends these interests into her presentation style.Diane is an active member of ADHA and has served in various capacities on the state and national level, and is a member of the American Academy of Dental Hygiene and serves on its governing council.As mentor Avrom King said, “Skills can be taught, our gifts we are born with.” Diane was born with the ability to lead and organize continuing education seminars. She began to recognize this quality the first day of summer after her first grade, when Diane told her friends she’d organize a club. “Club members will study math and spelling so we won’t forget them during the summer,” she said. Her friends ran off the porch as fast as they could.No one is running away from Diane today, who has found her niche expanding the horizons of hygienists who are eager to learn. For more information about Diane’s program, go to [email protected]. Ann-Marie C. DePalma, RDH, BS, FAADH, is currently a faculty member at Mt. Ida College’s dental hygiene program after spending more than 25 years in private practice. She is a Fellow in the American Academy of Dental Hygiene and is also pursuing a master’s degree in education in instructional design. Ann-Marie has written numerous articles and provides continuing education programs for dental hygienists and dental team members. She can be reached at [email protected].