Enhancing total care through communication

Sept. 1, 2005
When our patient’s time is divided between the general dentist and the periodontist, how do we as hygienists enhance total care? We all have experienced the “split-time” patient syndrome.

When our patient’s time is divided between the general dentist and the periodontist, how do we as hygienists enhance total care? We all have experienced the “split-time” patient syndrome. Our patient spends one or two periodontal maintenance appointments at our office and the others in the periodontist’s office. Coordinating treatment is imperative for the good of the patient’s dental health. A solidified team approach will ensure the best result, both periodontally and restoratively.

Although the hygienist is usually the first to evaluate the conditions of the soft and hard tissues, it is the dentist who will make the final diagnosis and referral. The hygienist registers detailed documentation regarding the patient’s periodontal condition. A treatment plan, generated by the entire dental team, determines the best course of action for each individual patient. When the patient leaves the office, he or she usually returns for restorative and preventive follow-up care. How do we ensure better treatment for these referred cases?

Periodontal offices usually generate diagnosis and treatment plan letters for their referring dental offices. It is prudent for the hygienist to read these initial letters to see what the status of the patient is and how long that patient will be in active periodontal treatment. Letters are also sent after initial preparation has been completed and the patient’s status reevaluated for possible surgery. Finally, a letter is sent after the active phase, including any surgical intervention, to alert the referring dentist that the patient will be ready for restorative needs as well as the suggested maintenance program. Again, following up on these letters will increase communication between the patient and the hygienist.

Patients will be more apt to cooperate with treatment plans and oral hygiene programs if the same information is passed on to them. Patients are less reluctant to discuss details with the hygienist than the dentist. Patients sometimes feel as if they are taking too much of the dentist’s time, asking too many questions. But they may be more open to a frank discussion with other dental team members. If you are armed with the documentation in these letters as to their periodontal health status and their cooperation level in treatment, you will be communicating vital information at their follow-up visits.

We also need to be aware of the periodontal office’s oral physiotherapy regime. Yes, we all instruct in proper brushing and flossing, while concentrating on explaining the disease process. But do we follow up in the same manner as your local periodontist? I was fortunate, as I began my dental career as an assistant in a periodontal office. I had spent hours learning the exact technique preferred by the dentist. We spent at least 30 minutes with each patient in a stand-alone appointment, focusing only on oral hygiene instruction. We also performed oral hygiene evaluation appointments throughout the course of care and especially prior to surgery. Since I was involved in teaching oral physiotherapy to the patients, I knew the tools and techniques they used.

Coordination of technique in this crucial aspect of patient care should be considered. Here are a few suggestions. Have you ever considered taking a field trip to your local periodontist’s office? It may sound a little farfetched, but there may be some adjunct devices or protocols the periodontist offers in his or her education programs that would benefit all patients under your care. Additionally, following through with the exact oral hygiene training the periodontist’s office gives to your patients during their initial phase of therapy will be paramount in the success of treatment.

If a field trip to the office is either locationally challenging or not time-efficient due to your schedule, a simple phone call to the periodontal office team may elicit similar results. The periodontal office should be ready and willing to share their strategic oral physiotherapy techniques to enhance the mutual patient’s experience. They should welcome the interest and appreciate the desire to harmonize treatment. Since patients will be spending almost half of their professional care time with the general dentist, the reinforcement of similar oral hygiene techniques will strengthen the importance of these procedures.

The main component in enhancing the patient experience of periodontal care is communication. The more information we have about the patient’s treatment plan, the better we may help the patient succeed toward the goal of periodontal health and future restorative needs. From the initial evaluation to facilitating oral physiotherapeutic programs to the maintenance of care, communication is essential to synchronize the efforts of all members of the dental treatment team. The hygienist is an essential partner in this continuum. You have the direct role to inspire your patients to succeed with your focused involvement in their periodontal treatment.

Sheri B. Doniger, DDS, has been in the private practice of family and preventive dentistry for more than 20 years. A dental hygiene graduate of Loyola University, prior to receiving her dental degree, her current passion is focusing on women’s health and well-being issues. She may be contacted at (847) 677-1101 or [email protected].