Motivated Mindset why we do what we do with perio

diagnosis & treatment

Rachel Wall, RDH, BS President, Inspired Hygiene, Inc.

Airfloss slide

Beliefs +

Systems +

Action =

Results

Mindset is A way of thinking

And a set of beliefs That determines one’s actions

-Fabienne Fredricksonf

Struggle Inside always creates

a struggle Outside

incongruence Part of you wants a goal (conscious) Part of you doesn’t (subconscious)

The subconscious always wins

Prophy

Trap

What’s holding you back?

www.baledoneen.com/learn/red-flags/

High risk pathogens • Aa • Pg • Fn • Td • Tf

Periodontal Pathogens in Coronary Plaque • Carotid Endarterectomy • Study 1: 92% perio path in plaque, 64% 2+ • Study 2: 100% at least 1 perio path in plaque • Aa, Pg, Tf, Fn, Pi

1-Gae&-Jardim,etal.JMedMicro(2009),58,1568-15752-Figuero,etal.JPerio8/2011,DOI:10.1902/jop

• No evidence Pg starts RA process • Aa can trigger hyper immune response

Konig,etal.ScienceTranMed,12/14/16.DOI:10.1126/scitransmed.aaj1921

Hygiene Appointment

60 mins

Hygiene Exam

20 mins

Scale & Polish

20 mins

Doc Exam & Turnover

20 mins Signal Doc

Before Scaling

MOST IMPORTANT

BEFORE SCALING

BE PREPARED

ULTIMATE HYGIENE EXAM

Clinical Calibration

ANGULATION

WALKING PROBE

READING PROBE

CALIBRATE

PROBING CALIBRATION

5 mm

3 mm

8mm Attachment Loss

AAP update on perio classification

AAPBoardofTrustees,JPerio,July2015,AAPtaskforceontheupdateto1999ClassificaVonofPerioDiseases&CondiVons’

AAP update on perio classification

AAPBoardofTrustees,JPerio,July2015,AAPtaskforceontheupdateto1999ClassificaVonofPerioDiseases&CondiVons’

Disease Classification

Gingivitis Early Moderate Severe

Pocket Depth <3mm >3mm-<5mm (4mm) >5-<7mm(5-6mm)

>7+mm(7+mm)

Bleeding Yes Yes Yes Yes

Bone loss none Up to 15% or >2-<3mm

16-30% or >3mm-<5mm

>30% or >5mm

CAL <1mm 1-2mm 3-4mm >5mm

EVALUATING BONE LOSS

HORIZONTAL VS VERTICAL

XRAYS ROUTINELY UNDERESTIMATE BONE LOSS

AAP POSITION PAPER-DIAGNOSIS OF PERIDONTAL DISEASE 2003

BEG PERIO

Inspiredhygiene.com/periotool

+

INFECTION =

High risk pathogens • Aa • Pg • Fn • Td • Tf

VIcKI • PELVIC ADHESIONs • Interstitial cystitis • Sleep apnea • Hbp • Arthritis • ARTHRITIS

• ELMIRON-IC • Diovan-high bp • Mobic-pain • Elavil-depression • Optivar-itchy eyes

CONDITIONS MEDICATIONS

Prep

Including the patient

builds value

Probe

Patient hears health

vs disease

Present

Present the evidence

to the patient

Perio mode- soprocare

Dental plaque Tartar

Severe gingival inflammation

• EARLY STAGES • LOCALIZED • TREATABLE

GOOD NEWs IS YOU HAVE

• ACTIVE INFECTION • DOC CONFIRM

I’M CONCERNED

• RISK FACTORS • PROGRESSION • BONE LOSS

WE RECOMMEND

• THERAPY • ANTIBIOTICS • MAINTENANCE

•  Disinfection •  Therapy

•  Bleeding •  Infection

•  You have

•  SRP •  Deep Cleaning

•  Little Bleeding •  Little Inflammation

•  I found

Stop Start

•  NOT RESPONDING • WE NOW KNOW •  SOMETHING DIFFERENT

Jeffcoat, et al. Impact of periodontal therapy on general health: eveidence from insurance date for 5 systemic conditions. Am J Prev Med. 2014 Aug;47(2):

166-74

HIGH frequency x HIGH amplitude

96% of non-flossers used it 4 days/wk

So How Much Is This Going to Cost? •  Ms. Jones that’s a great question •  Based on what we’ve recommended for you •  The cost will be approx $900 (round up) •  Pam can answer all your questions about what

you can expect your dental benefits to contribute and how to work out the difference

•  We have a lot of options to make this work with your budget

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