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Wednesday, July 30, 2008
Be Aggressive!
I think that the majority of people in the world tend to be conservative. No we are not talking about political views, but in everyday life. We are afraid to put it out there or tell the truth when it comes to tough situations. I think dentistry is no different. I know that I tend to shy away from things and go with the easy way for most things.
I think that this does our patients only harm and no good. Think about things from the periodontal perspective. If you have a deep pocket, over 6 mm, and you know from your daily study of the dental literature that you can't get that area clean, but you don't want to hurt the patient or charge them more, you gloss over the area.
Now think about what you've done. You've left a nidus for infection, because the bacteria and the 400 layers of biofilm that exist in that area are still present. But now you've sealed up the top half of the pocket. Now it takes a few days to fester but you've created a periodontal abscess.
Now the patient will be in pain, need antibiotics, and have to see the periodontist, hopefully me. This could have been avoided if you noticed the area, gave a bit of local and scaled out the area with an antibiotic placed, we prefer Arestin.
In this case, being a bit more aggressive would have been the right thing to do and the healthy thing. First do no harm! This is easier for experienced hygienists than newbees, but they'll learn.
I think that this does our patients only harm and no good. Think about things from the periodontal perspective. If you have a deep pocket, over 6 mm, and you know from your daily study of the dental literature that you can't get that area clean, but you don't want to hurt the patient or charge them more, you gloss over the area.
Now think about what you've done. You've left a nidus for infection, because the bacteria and the 400 layers of biofilm that exist in that area are still present. But now you've sealed up the top half of the pocket. Now it takes a few days to fester but you've created a periodontal abscess.
Now the patient will be in pain, need antibiotics, and have to see the periodontist, hopefully me. This could have been avoided if you noticed the area, gave a bit of local and scaled out the area with an antibiotic placed, we prefer Arestin.
In this case, being a bit more aggressive would have been the right thing to do and the healthy thing. First do no harm! This is easier for experienced hygienists than newbees, but they'll learn.
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