When I see moderate bleeding during assessment of a client, there are two things forefront in my mind.
- I want to create a sense of urgency for this patient to get optimal treatment underway.
- I want them to accept my recommendation for a BiofilmDNA™ test to screen for high risk periodontal pathogens.
How often do we assume the client will want an estimate sent to their Insurance company to see what is covered, and assume they will base their decision on coverage? This delays necessary treatment mandatory for their health.
One of the cardinal rules to apply to life in general, and especially our interaction with our clients is to “never make assumptions”.
Recently a client returned to our office after a 5-year absence. There had been many family stresses which led him to putting his own oral and overall health on the back burner. He mentioned that he was aware he needed to start looking after himself better in general which included losing some weight and looking after his oral health. I had already established some credibility and rapport with this patient in the past, and after re-acquainting and building further trust, I began my assessment:
His previous periodontal charting indicated over 30 bleeding points. (This is equivilant to a wound the size of a silver dollar) This allowed me a segue for discussion about the oral-systemic link and the benefits of BiofilmDNA™ testing to assess his risk further.
The client was taking medication for high blood pressure, and further medical history questioning indicated that his mother had diabetes, and there was heart disease in his family.
After completing one quarter of his perio charting, I noted that bleeding had increased, with two areas that were spontaneous. I stopped and said the following:
“I am concerned about the infection you have, and that the bleeding has increased. When there is bleeding, it is like there is an open door allowing harmful bacteria into your bloodstream. We need to close the door and kill the bugs causing this infection. A DNA test will help us understand if you have the high-risk bacteria that increase your risk of heart disease and diabetes. You have two options. The DNA test costs $xxx. We can either send an estimate to your Insurance company if you need to know what is covered first, or I can go ahead and do this test for you now, which will help us to understand the best course of treatment for you.”
Without hesitation he said, “If that’s all it is, go ahead because it is important.”
As we wrapped up his appointment, I suggested that the next time he sees his physician, it would be ideal to have her test for diabetes and inflammatory markers. I also offered to send a letter with our report of periodontal findings along with the DNA test, which he thought was a great idea.
The lesson here is two-fold:
- Don’t make assumptions that can delay treatment. Be direct. Share with compassion. Ask the question, and let the client respond.
- There is a need for medical/dental collaboration, and as a profession we need to start a movement in this area.
Lorraine Gambacourt, RDH has over 32 years experience as a practicing dental hygienist in a very proactive practice using the OraVital System. She has also worked with OraVital since 2010, educating and supporting dental teams in the implementation of the OraVital System. Lorraine is a strong advocate for medical/dental collaboration in the support of oral and overall wellness.
author: Lorraine Gambacourt
Lorraine Gambacourt, RDH graduated from George Brown College in 1985. In addition to currently practicing dental hygiene two days a week at a General Practice in Brantford, she has also been a Clinical Coach with OraVital® Inc. since 2010. Lorraine enjoys writing and blogging and sharing her knowledge with her colleagues. Her article, “A Healthy Mouth—A Healthier Heart” was published in Oral Hygiene in February 2018. In June 2019, Lorraine, along with her friend and past dental co-worker Val, organized an event bringing Drs. Bradley Bale and Amy Doneen to Canada for the first time to address a group of 200 dental and medical professionals of “The Critical Role of Oral Health in Heart Attack and Stroke Prevention.” Lorraine has also been a presenter for rdhu’s 'Dental Hygiene Quarterly' (now rdhq) and is one of rdhu's Soft-Tissue Diode Laser Trainers. She is passionate about implementing protocols and strategies that promote oral health, reduce oral-systemic risk, and inspire medical/dental collaboration.
