My career in dental hygiene has spanned over three decades ‒ something I find hard to believe. I have worked as a dental hygienist in various settings, including general dentistry, sedation dentistry, and prosthodontics.
While I look back fondly on my time spent learning the different skills needed for each of these dental specialties, my dental hygienist heart belongs in periodontics. I have worked exclusively with the same periodontist for about 15 years. What is it about working in a periodontics practice that keeps me still excited about dentistry?
Motivated Dental Patients
First of all, I must give credit to the patients. Patients who end up in my chair for their periodontal hygiene visits are, for the most part, motivated to keep their teeth. After having nonsurgical periodontal therapy and sometimes periodontal surgery, my patients understand the importance of their appointments.
Because I am able to focus the periodontal maintenance visits solely on the patient’s periodontal needs, as opposed to restorative and cosmetic needs as may be required in a general dentistry practice, I have the luxury of spending the hourly appointment time reviewing periodontal status, oral hygiene, and patient motivation with my patients. Patients in my office understand that their periodontal condition is a disease that must be maintained by their commitment to keeping their recommended recall interval and doing their part with effective home care. Guiding a patient to this type of self-awareness is what motivates me the most.
My hour-long appointment blocks are free from taking radiographs and waiting for a doctor’s exam at every visit. This frees up my time for an organized and thorough periodontal assessment, home care review and education, and no pressure to do a “quick prophy” with the remaining appointment time. Not having to take periodic or full-mouth radiographs or review restorative needs makes for fewer tasks to complete allowing more time for the hygiene portion of the visit.
Because I see the majority of my recall patients every three to six months, I am able to work with my patients to build a personalized, patient-centered care approach to treatment where the patient and I are partners in taking responsibility for their oral health. Being able to focus solely on the patient’s periodontal needs during the appointment time and seeing patients on a more frequent interval lends itself to learning what the patient views as needs and goals for the best outcomes for their periodontal condition. As a result, I am able to work with the patient to develop a treatment plan that works for their specific needs and wants. The result is that patients appreciate the care they receive, and I am able to closely monitor their periodontal improvement.
Motivated Periodontist
Secondly, I have found that working with a periodontist results in the shared motivation to improve patients’ periodontal disease. As a result of a comprehensive periodontal exam done by the periodontist, the patient is presented with a periodontal assessment and classification that aids in an organized treatment plan specifically tailored to the patient’s needs.
The result is that value is placed on the dental hygiene visit. The hygiene visit is not considered to be a loss leader whose value is judged by what restorative work results from the appointment. In my office, I am considered a co-therapist with the periodontist. I am not the “lady who cleans teeth!”
Demanding Appointments
As with any career, there are some downsides to working solely in periodontics. Since periodontal disease is most prevalent in the adult population, I do not have patients of different ages; no families or children.1 Because of this, it follows that my day is made up of either periodontal maintenance visits or periodontal therapy. This lack of diversity can make for a monotonous day since there is very little variety in hygiene procedures rendered per patient as opposed to a general dentistry office where a dental hygienist may see children, teens, and adults with different continuing care and periodontal needs. Variety can be helpful in reducing job-related burnout.
In addition, the lack of variation makes for the potential for more physically demanding hygiene appointments as patients present with more advanced periodontal cases that may include extensive bone loss, mobility, recession, and calculus. Patients also may be more phobic about dental procedures. Patient apprehension of the dentist (and dental hygienist) often leads to delaying treatment, resulting in more advanced stages of periodontal disease.2
Another downside to providing care to patients in the periodontal setting is that, more often than not, I do not have the luxury of restorative charting and treatment plans as well as updated radiographs from the general dentist. This lack of information may put the patient at a disadvantage for coordination of care between the general dentist and periodontist. As a result, periodontal treatment may be delayed while waiting for this information.
In order to improve communication between my office and the referring dentist, a progress letter is sent to the dentist after each appointment outlining what treatment was completed, further treatment recommendations, copies of periodontal charting, and any requests for information (such as radiographs) to be sent to our office. This letter serves as a line of information and communication between the two dental offices
As a dental hygienist working in a periodontal practice, I consider myself a liaison between the periodontist and the referring general dentist. I feel it is the periodontal hygienist’s responsibility to provide the best care not only for the patient but for the support of the general dentist’s restorative treatment. My role in helping to maintain the periodontally compromised patient’s proper tooth form and function paves the way for the long-term success of any present and future restorative needs.
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References
- Periodontal Disease. (2013, July 10). Centers for Disease Control and Prevention. https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html
- Liu, Y., Zhang, C., Wu, J. et al. Evaluation of the Relationship Among Dental Fear, Scaling and Root Planing and Periodontal Status Using Periodontitis Stages: A Retrospective Study. Journal of Dental Sciences. 2022; 17(1): 293–299. https://www.sciencedirect.com/science/article/pii/S1991790221000635
