Periodontal Disease Matters To Our Patients

Sept. 1, 2012
Periodontal disease in its most advanced stages can lead to eventual loss of teeth.


Periodontal disease in its most advanced stages can lead to eventual loss of teeth. This fact is so familiar and well understood by all dental professionals. Is it possible “oral-systemic” messages to patients have almost drowned that message out? I wouldn’t have thought so, but I was recently enlightened.

In industry, when companies want to discover how to identify customer needs, clarify marketing messages, or generate ideas to improve a product, qualitative and/or quantitative marketing research is conducted. Opposed to quantitative research, qualitative research is not statistical. It involves interviewing small groups of individuals to solicit their opinions and experiences. The research can be done through interviews, focus groups, or even electronically. Basically, I think of it as “picking the brains” of our clients to discover what matters most.

Recently, I was fortunate to get a glimpse of some qualitative research conducted in the dental industry in which patients responded about what messages mattered most regarding their periodontal health.1 Three independent marketing firms conducted the research. Their interest was in discovering which messages were most motivating to patients to make decisions about periodontal treatment.

In one focus group of qualitative research, patients interviewed had all been diagnosed with periodontal disease. Fifty percent of the patients had accepted treatment, and 50% of patients had been offered locally applied antibiotics in conjunction with nonsurgical therapy. When asked to select between educational messages that would elicit a decision to proceed with treatment, the majority of patients preferred a message related to consequences of tooth loss as opposed to messages highlighting the harmful effect of bacteria in the mouth, or the potential to improve overall health. Keep in mind only half had made a decision to proceed with treatment based upon information that had been given during the diagnosis at their dental office.

In another focus group, patients interviewed had received a diagnosis of periodontal disease and had been offered therapy, but had not proceeded with treatment. Key findings revealed that a majority of patients felt that their dentist/dental hygienist did not communicate the full disease progression and potential implications of tooth loss. Therefore, they made their decision not to seek treatment based upon the fact that they did not fully understand the seriousness of the disease.

Again, messages that focused on the consequences of tooth loss and even potential future expense were most compelling, and patients expressed a desire to have this information delivered by their dental professional at the time of diagnosis.

In market research that was quantitative (such as 300 patients interviewed as opposed to smaller groups of qualitative analysis), findings once again supported that messages of potential tooth loss were highly motivating regarding decisions to proceed with treatment. The majority of patients also expressed a willingness to pay for treatment that could help prevent tooth loss, including nonsurgical treatment as well as locally applied antibiotics, if indicated.

Based upon these analyses as well as personal experience, it is clear that not all decisions are driven by insurance benefits, as many professionals believe. Sadly, that belief has led some dentists and dental hygienists to assume that if insurance does not pay for a certain procedure; don’t bother bringing it up.

A decision to withhold information from patients based upon an assumption about payment is just as unethical as not making a necessary diagnosis for fear of “upsetting the patient.” Our patients deserve “full disclosure” about treatment and consequences of nontreatment. Personally, I have found a lot of freedom in making a decision to inform and educate patients based upon my understanding of these five words: “They need what they need.”

While the message that “untreated periodontal disease can adversely impact overall health” is something we should communicate during patient education, it appears that when it comes to making immediate decisions about periodontal treatment, patients simply want to know that, if they don’t effectively treat this condition now, they are at risk of losing their teeth. Perhaps the media focus over the last several years on smile-makeovers has served to increase patient sensitivity to tooth loss. At any rate, as a practicing dental hygienist, I want to clarify and simplify my messages to patients. “Deal with it now, or deal with it later.” This appears to communicate what patients really want to know about periodontal disease progression. RDH


1. Market research conducted by OraPharma, Inc. 2011, 2012


1. Ask your patients if they know what is the major cause of adult tooth loss.
2. Fully inform all patients of the progression of periodontal disease, inclusive of tooth loss, and utilize visuals to support patient understanding.
3. Remember that “full disclosure” includes informing patients of all options for treatment, as well as the consequences of nontreatment. Do not withhold treatment considerations based upon personal assumptions about costs and payment.

KAREN DAVIS, RDH, BSDH, is the founder of Cutting Edge Concepts, an international continuing education company, and practices dental hygiene in Dallas, Texas. She is an independent consultant to the Philips Corp. and serves on the review board for She can be reached at [email protected].

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