Patients have a right to understand exactly what it means when they are told they have periodontal disease. “You have periodontal disease and this is what it will cost to treat it,” is not enough information. Here are three things every patient needs to know about their oral condition.

1. An explanation of the periodontal diagnosis that includes descriptors.

Find out if your periodontal disease

  • – is early, moderate or severe.
  • – is localized to just a few areas or generalized. If localized, where are these areas and what might have caused it to occur there?
  • – will result in the loss of any teeth in the next three years. If so, which ones are they?

Unless you are able to clearly understand how many teeth are at risk and how involved each one is, you will not be able to make good decisions. Some teeth have a mild condition and may simply need a few more cleaning appointments a year. Other teeth are very advanced and pursuing further complicated treatment may not make sense.

2. A discussion of treatment options.

3.An explanation about managing discomfort during the procedure.

2 Responses

  1. Asking for an anesthetic cannot be left to the patient as they are not aware of the line of treatment.The dentist (hygienist) should give them the option during consultation.

    1. Thank you Dr. Rajan for your insight and input. I actually do not think we disagree here at all. To have scaling and root planing, there must first be a diagnosis of periodontal disease. The patient must first be informed of this finding to include all reasonable treatment options. As part of this I inform patients when I believe that a dental anesthetic should be administered. Sometimes patients will not want it to be used. I then ask them this question. “If I do not give you the anesthetic and you become uncomfortable during the procedure to the point where I am not able to do a thorough job, are you willing to accept as the next procedure a periodontal surgery?” This causes them usually to reconsider. Another way to put this is to say that if I can accomplish thorough scaling and root planing because I am not limited by the patient’s pain tolerance, then it is very possible that we can reduce or even eliminate the next level of treatment.

      If I am ever the patient and I need scaling and root planing, I will indeed request local anesthesia. Once patients have been informed of the diagnosis and scaling and root planing, if in the future, they ever require it again my hope is they will be knowledgeable to discuss the local anesthesia issue.

      Although this was not the direction of the post, I do believe that repeat scaling and root planing can often be accomplished without local anesthesia. One of the differences with this and initial scaling and root planing is the level of calculus and how embedded it is in the root.

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