Stay Sharp: Technical Guidelines and Workplace Strategies

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Q: I just started out making use of the expression “nonsurgical periodontal therapy” (NSPT) when talking to my patients, and they normally question how NSPT is unique than a “cleaning.” What is the most straightforward way to describe the difference with out acquiring also complex?

A: Interestingly sufficient, when I consult with and teach, most hygienists insist that NSPT is a thing they learned in school but is not completed outdoors the finding out ecosystem, in scientific follow. So good on you for integrating nonsurgical periodontal remedy – and the phrase – into your exercise.

1st, let’s make positive everyone understands the expression. “Nonsurgical periodontal therapy” describes the many nonsurgical techniques utilized to do away with irritation in the periodontium of a individual with periodontal sickness.  The purpose is to return the periodontium to a wholesome condition that can then be taken care of by a blend of qualified care and client self-treatment.”1

To return a gingivitis affected individual to a state of well being, they would need to have to display the following parameters: <3mm pocket depths and <10% bleeding on probing. And a periodontitis patient would need to demonstrate <4mm pocket depths and <10 bleeding on probing with no 4mm pockets bleeding.2 In the case of periodontitis, this would also include the stability in attachment loss.

Nonsurgical periodontal therapy can entail anywhere from one to six additional debridement appointments and local anesthetic for quadrant or sextant scaling, plus an additional post-care appointment. Adjunctive therapy, such as chemotherapeutic agents or host modulation therapy, may also be necessary.

As for the term “cleaning,” it doesn’t exist in the dental literature. Instead, we should be using the term “periodontal maintenance therapy,” which best describes what we understand to be a cleaning appointment. Periodontal maintenance therapy is a term from the literature that “refers to the continued patient care provided by members of the dental team to help a patient maintain periodontal health following the successful completion of nonsurgical or surgical periodontal therapy.”1 The operative words are “maintenance of health.” If a patient doesn’t have a healthy state and/or you have never successfully achieved a healthy state, then a patient does not require “periodontal maintenance therapy” he or she requires “nonsurgical periodontal therapy.”

So, the easiest way to describe the difference between the need for a cleaning or NSPT to your patient, is: “A cleaning is for patients who have healthy tissues, and nonsurgical periodontal therapy is for patients who don’t have healthy tissues.” At this point, you can discuss with your patients what the parameters of health for their disease condition should be and based on their assessments where they are in comparison, plus what therapies will be needed to get them to health.

Although the term “cleaning” continues to be used by team members and patients alike, make sure the entire team understands the difference between the two terms and the best way to explain this difference to patients. Better yet, have the team delete the term “cleaning” from their vocabulary and switch to “periodontal maintenance,” and before long your patients will be referring to it the same way.

References:

  1. Foundations of Periodontics for the Dental Hygienist, Enhanced 5th Edition, jill S. Gehrig, Daniel E. Shin and Donald E. Willmann.
  2. Lang NP, Bartold PM. Periodontal health. J Periodontol. 201889(Suppl 1): S9–S16. https://doi.org/10.1002/JPER.16-0517

About the Author

A passionate educator with 30+ years of clinical and business experience, Gabriele has revolutionized the way practices optimize client outcomes, growth, and revenue through her consultancy company, GEM Dental Experts Inc. A former practice owner, published author, dental hygiene program director, quality assurance program assessor, and entrepreneur of the year, Gabriele shares her innovative views on dental hygiene through her work as a public speaker, consultant, educator, and business coach for forward-thinking dental practices.  GEM Dental workshop series is PACE approved and guaranteed to optimize your patient outcomes and practice revenue. Gabriele can be reached at [email protected] or visit www.gemdentalexperts.com.