Inquiry: What should I do when a patient says no to periodontal treatment? Do I just have to give them a standard pattern, despite their periodontal condition?
Answer: This is an extremely common situation we face as dentists. We should not allow insurance to dictate patient care. We must remain committed to do the best for each patient. The CDC states: “One in two men and one in three women 30 years and older had some level of periodontitis.”1 The American Academy of Periodontics (AAP) says that if a patient is periodontal, they should not be observed at the same frequency as a patient who never had a periodontal disease.2
Patients in periodontal maintenance often struggle to remain at this frequency of discovery when they have never experienced anything different from their traditional standards. How is your service different? Provide laser treatment, salivary tests, underwater irrigation? This is a crucial element of our service. Why would a patient want to pay more and visit the office more often if he experiences the same service?
I believe we need to work with patients to determine why they are reluctant to treat and then work backwards to design a plan that will support them in care for their periodontal disease. I will walk how to identify why, statistics on responsibility for periodontal disease and calibration between the group.
Determine “why” with the patient
Often, a patient denies treatment because they do not fully understand the “why” behind what we recommend. I think that once patients are properly educated, it is much easier to get them to say “yes”. Education should start when they are in the chair, when we begin to show them evidence of the specific risks to oral disease.
An example of this is the review of their medicines and the discussion of the impact of Xerostomia on their periodontal. Starting the appointment in this way, they are ready for the clinician to make specific recommendations. The patient’s revelation and their appearance The plate that exists is not only a motivation technique, but also uses them to take responsibility for the weight of their biofilm.
I think this is extremely powerful with a revelation factor dating back to the bacteria to show a mature plate against a new formed plate. After the revelation process, I usually use my air to remove the bacteria and start the appointment with a detection. I start here because I have to determine the patient’s gum piece before treatment.
Today’s technology allows multiple choices, with vocal dictation to increase the involvement and involvement of patients in mapping. As the clinician invites information, such as bleeding, loss of clinical attachment and numbers greater than three, the patient is called upon to make the connection between discomfort and pocket pockets with higher depths of pocket.
All of this actively implies the patient in the process of collecting data to determine the level of the disease to be larger than that of a standard. I show the patient the plate, allow them to hear and feel the periodontal examination and explain what is happening at a systematic level. This provides all the elements needed to understand why this is necessary.
From this point, I inform them that I will work with the business team to send all the data to maximize insurance. When it comes to the economic aspect, I don’t participate. As a clinician, it is my job to collect the data to support the dentist and dental insurance to confirm the level of the disease. However, non -surgical treatment recommendations will not change on the basis of insurance coverage.
I will continue to suggest the treatment the patient needs. I can modify the recommendations for home care and supplementary agents who provide in addition to periodontal treatment, but I refuse to let insurance dictate care. I wouldn’t want an provider to provide me less than my career, because my safety did not cover. I would like to know the condition of my disease.
