Sunday, March 13, 2016


For those of you who don't know, I'm a mom to 3 kids and a part-time hygienist. I love my job/career, but I love being a mom more and being home with my kids as much as possible. THAT being said, I filled in for the other hygienist I work with and worked more days then usual last week. Can we say PERIO MADNESS PURSUED!! 

Half of my patients this past week had ACTIVE periodontal disease. Guess how many accepted my proposed treatment of a deep dental cleaning (scaling root planning)? ZERO. NADA. ZIP. NO ONE! I was feeling seriously rejected...despite my thorough education for the patient and telling them why I felt a deep cleaning was necessary, they just wouldn't accept! Most of them didn't even seem concerned! So is this normal? Unfortunately...yes, this is very normal.

How do you deal with this rejection? As a hygienist  you KNOW the only way to get these patients back to health is by doing a deep scaling! However, begging & pleading do no good. All you can do is inform your patient of the risks involved with no treatment and let them know you're concerned about their oral health. I then write a thorough note in their chart about what was discussed & proposed and that the patient ultimately refused and signed the refusal form.

I always do a "regular" cleaning on the patients that refuse the deep cleaning and I never try to sneak anything past them by doing a "mini" SC/RP on one or two teeth and then billing out for it. Honesty is the best policy for ME. I want my patients to trust me and know that I have their best interest at heart. I try to gain this trust a little at a time and by revisiting their "diagnosis" at each subsequent visit. I'll remind them "HEY remember 6 months ago when we talked about perio?? Well you still have it! It didn't just heal up on its I informed you that it wouldn't". ;-)

That being said I'm reminded of a story from this past week...I had a patient come in that I hadn't seen in over a year. The last time she had come in I had informed her of her active perio and had recommended SC/RP. She refused and I went about the normal cleaning but informed her that this wouldn't correct itself.

Fast forward a year later, when I see her again I ask how she is! And she informed me she went to a different dental office for her last cleaning and that they told her she actually didn't have perio! I said "Oh yeah?? Well since it's been a year I was planning on doing a full mouth probe on you today and I would love to see how everything is going!"

I then proceed in doing the FMP and guess what? SHE STILL HAS PERIO! And it had gotten worse. She had generalized 5-6mm pockets (last year they were 4-5mm) and generalized BOP (bleeding on probing). Her mouth and gums were a mess! :-( I then had the joy of informing her that my diagnosis from a year ago still stood and that she did indeed still have active perio. I felt like I had been put into an awkward situation though and needed to handle it gently and not accusatory whatsoever.

After the FMP, I sat her up and went over my findings with her and how they compared to her last appointment with me. She seemed very confused and upset (not at me...just in general) and stated that at her last appointment with the new office she hadn't felt they had done a thorough job...but was hoping they had been correct. She had come back to our office because the other place was pushy about procedures she had felt were unnecessary, but perio wasn't one of them! THAT being said...she still refused treatment for the deep cleaning! AHH!

Moral of this post? #rejection hurts...even in the dental chair.