For decades, hygienists have probed clinical pocket depths and attachment levels, which have been recognized as the dentist's most important tools in diagnosing periodontal health and disease. We once tortured peers as we learned how to stand tall on our fulcrums in an attempt to master the walking stroke. Holding our breaths as our faculty evaluated the pocket depths to ensure our four wasn't a six, we learned the importance of early intervention in the prevention of bone loss early in our hygiene curriculum.
Once we enter the profession, the colored pencils are tossed aside, and we begin to slowly lose our determination to chart every mucogingival junction reading. The determination is replaced with pressure to remain on schedule and an exam that our professors would frown upon.
Studies conducted by Walter Loesche and Natalie Grossman have suggested that thirty percent of the adult population has Periodontal Disease.~~2 Additionally, Bradley Bale, MD, and Amy Doneen, APNP, discuss studies that have shown that periodontal disease can triple a threat of heart attack and stroke.~~3 Bale stresses the significant impact that meticulous oral health care can play in decreasing the risk of periodontal disease.~~3
As health-care providers, hygienists are vital to assisting the dentists in the diagnosis of disease in a patient. Our responsibility lies in properly educating patients and recommending treatment to benefit their current state of disease. We understand the importance of the exam, so why aren't we doing them as recommended?
The daunting task
Hygienists are often faced with the challenging task of completing a comprehensive periodontal charting on their own. Many factors can inhibit the hygienist from obtaining the recommended information such as all six surface probe depth readings of each tooth, bleeding, delayed bleeding, recession, furcation involvement, and mobility.
Many of us have struggled to keep barriers on while we turn from patient to computer in order to document data that seems impossible to obtain in a timely manner. Some dentists recognize the importance of a hygiene assistant. However, for the majority of us, we are left running behind or neglecting the ADHA recommendations for a comprehensive periodontal evaluation by only charting 5 mm and above.
When a hygienist compromises his or her evaluation of the patient’s health by not providing the ADA recommended data, a disservice is done.
I have been apart of many excellent practices. However, despite the elite care provided to patients, the office protocol of a full periodontal charting once a year never seemed to be met.
Upon becoming a team member in my current office, I expressed my concerns and began the dreaded system of trying to find an available team member to transcribe the exam. Our team of five hygienists continued to interrupt the flow of the front desk. We had to beg the assistant to assist us while she postponed her vital initial sterilization tasks. We needed a solution to the disruption!
How technology helps with charting
Our team benefited greatly from a voice recognition software called VoiceWorks. After taking advantage of their risk-free trial, our office had found the solution to preventing cross contamination, remaining on schedule, and increasing patient compliance. I was finally able to complete an exam that I was proud of. The software allows the hygienist to provide more education throughout the appointment, which leaves patients with increased autonomy that establishes a foundation for successful home care.
Providing a comprehensive periodontal exam is essential to determining the patient’s systemic and oral health. An estimated six million patients have a form of periodontal disease that require treatment.~~1 We need to dig our heels into the calculus we've been scaling and find a solution. I believe that voice recognition software is the solution to providing the standard of care our professors once taught us to provide!