Don’t Do THIS During Your Perio Exam!

Don’t Do THIS During Your Perio Exam!

(It’s a huge mistake that most dentists and hygienists make)

There is a huge mistake that most dentists and hygienists make during the perio exam, one that prevents patients from moving forward with treating their periodontal disease.

Please put yourselves in the patient’s shoes (or mouth) for a minute. What does a perio exam feel like and sound like? In most offices, they are asked to open wide, feel a few sharp pokes, and hear a bunch of numbers that sound like some weird anti-Fibonacci sequence

“Three, two, three… three, three four (OUCH!), four, three, five…” and on and on and on. Then, a few minutes later they are being told they need some periodontal treatment, but really don’t understand why.

The great Dr. Bob Barkley used to talk about “co-discovery” and “co-diagnosis,” and the perio exam is a great opportunity to do just that.

What if before every perio exam you did this:

1. Tell the patient what you are about to do, using easy to understand terminology.

“Now we are going to check your gums for inflammation and infection.” (Nobody wants inflammation and infection!)

2. Tell the patient why you are doing this.

“A large percentage of adults have some level of inflammation and infection in their gums, and it’s really great if it can be caught early. Did you know that more adults lose teeth due to gum issues like these than due to anything else? We’re also learning that gum inflammation is linked to heart disease, diabetes, and other chronic health issues, so this is really important.” (At this point the patient is hoping their gums are healthy!)

3. Tell them exactly what you are going to do (in patient friendly terms!!)

“The way we check for this is to use an instrument that is like a little ruler. It measures how tightly your gums are attached to your teeth.” (I see no problem with substituting 100% scientific accuracy for having a patient understand what’s going on.)

4. Tell the patient what to listen for.

“You are going to hear a bunch of numbers. Twos and threes are typically considered to be healthy areas. Fours and above are areas of concern. And if you hear the letter B, that means we detected a little bleeding in that area, a sure sign of inflammation.” BOOM! You better believe the patient is paying attention now!

Now when the exam is over, the patient will KNOW there is an issue, and will listen carefully when you discuss the treatment options. I always like to throw in something like “fortunately it doesn’t look like you are at the stage where you’ll need gum surgery, and that’s what we’re trying to avoid.”

This is a great example of co-diagnosis and co-discovery. Do it!! And think about ways that you can incorporate this into other things in your practice.


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