How patients can manipulate dentist and dental hygienists to do what they want but may not be what they need.
With the perception of dentistry changing over the years and patients feeling like they can go in and dictate their care, I am here to tell you: The dental office is not Burger King, and you can’t always have it your way.
With the ever expansive, WORLD-WIDE WEB and the ability for patients to turn to google MD, your latest influencer, and a slew of other media EXPERTS you are bound to find someone to give you the narrative you want, for the ailment you have. Of course, you are always given options, different routes of treatment, and of course you always have the right of refusal, but so does the practice. I am a licensed practitioner of the state, which means I have guidelines of my own I must follow to maintain my license. By providing you with what you want and not what you NEED would be putting me in a position of supervised neglect. The state dental board knows that I have been educated in this field, unlike the average patient. Too often, dental hygienists are bullied by our patient into treatment that is unethical, and frankly a disservice to your overall health. Here are the different types of cleaning you may hear or have heard of at your appointment and what they mean: Adult Prophy- This is your routine “normal” cleaning. This patient will have no bone loss, and no pocketing measurements over 4mm present. There is no tarter build up below the gums, the overall gum health is good with light pink issue, and overall bleeding. Periodontal Disease (AKA bone loss) has many stages but once you have it your only
options are Debridement, SRP (deep cleaning) or periodontal surgery (performed by a periodontist) followed by periodontal maintenance cleanings most often for life. People often get upset with this so let me explain, once you have healed and your bone loss has stopped, your bone never grows back. You now are at a higher risk of infection, of decay on the exposed roots and to going back to losing more bone. Due to this we must put those patients on a shorter recall and different protocol to maintain their current periodontal status. Pending on the severity of bone loss and where it is located…sometimes patients can go back to a “routine cleaning” if the bone loss was minimal and only in a localized area, but this decision will be up to your provider and your own medical health. SRP (deep cleanings) is usually the first line of defense, and most times provides very effective results. SRP can be done with different types of anesthetics and are non-surgical procedures. They removed the debris and hardened “cement” like tarter from below the gum line. Without removing this debris and only providing routine cleanings when this exists is like having a hole in your leg and taking an alcohol swab around the hole but never addressing the hole. While you may be removing the plaque on top you are never addressing the actual issue that will continue to spread infection. The bacteria will travel throughout your body via bloodstream and can affect other areas of your body as well laying plaque in areas around your heart and arteries. There is another option during SRP that your provider may think is helpful but it isa case by case basis. These additional items can include Arestin, Laser therapy and other periodontal applications. As your clinician, I understand the cost associated with these things, but I promise the longer you wait the problem only gets more expensive. I hope this give you a clearer picture and that all of us really do want what’s best for you and sometimes that doesn’t always align with what you want but is most definitely what you need. I won’t compromise on your care, and neither should you.