When a patient has been diagnosed with gum disease but refuses the recommended scaling and root planing (SRP) treatment, it can put the dental professional in a difficult position. The question arises – should a prophy be performed on this patient despite their refusal of SRP?
Gum disease is a serious condition that requires proper treatment to prevent further damage to the gums and teeth. SRP is the gold standard treatment for gum disease, as it removes plaque and tartar buildup below the gumline that can lead to inflammation and infection.
Performing a prophy on a patient with gum disease who refuses SRP may provide some temporary relief by removing plaque and tartar above the gumline. However, it will not address the underlying issue of bacteria and buildup below the gumline that is causing the disease to progress.
It is important to educate the patient on the importance of SRP in treating gum disease and preventing further damage. Without proper treatment, the disease can continue to advance and lead to more serious complications such as tooth loss.
Patients refuse treatment for a variety of reasons, but one of the main ones is finances. When people struggle to pay for housing, transportation, food, clothing, and medicine, dental care might be restricted to emergency only. We can and should offer our patients ways to finance their care through good companies such as CareCredit, and help them overcome the financial barrier to good dental care.
In cases where a patient refuses SRP, it may be necessary to have an open and honest conversation about the risks and consequences of not receiving treatment. Ultimately, the decision to perform a prophy on a patient with gum disease who refuses SRP should be made on a case-by-case basis with the best interest of the patient’s overall oral health in mind.
Keep in mind that the bacteria that causes periodontal disease forms daily within your mouth and has the potential to cause damage. Although you will be getting more cleanings for your disease, you must also become part of the team because your daily oral hygiene will determine how much bacteria is within your mouth daily. Periodontitis is an inflammatory disease of bacterial etiology resulting in loss of periodontal tissue attachment and alveolar bone. 8 The host response to the bacterial challenge leads to clinical signs such as deep pockets, bleeding on probing, gingival recession, and tooth mobility, which can ultimately cause tooth loss.
The policy in our office is if a patient has periodontal disease, past or present, the code for their preventive care is D4910. But when the patient checked out, she was most unhappy with the charge and the business assistant’s explanation. She said, “I just came in to get a cleaning and I feel like I have been ripped off! ” When the business assistant told me about the situation, I decided to send the patient a written explanation through email. I explained while there is no cure for periodontal disease, we try to control it, much like diabetes, and I was following the policies of my office.
This form looks great on office letterhead, and if stored on a convenient computer, can easily be personalized to the patient. The situation is maddening for clinicians and patients alike. Patients want to believe everything is great; they pop in twice per year for an hour, floss at their convenience, and everything will be perfect. Clinicians want to believe that all patients passionately care about their oral health and want overall systemic health.
All gums surgery and treatment at BIDC dental center are done by periodontists dental specialists, not general dentists. This letter is to introduce our patient, Jack Smith, to your practice. Mr. Smith was first seen in our office in January 1995, as a new patient. He had gross hard and soft debris on his teeth with mild periodontitis.
These are two very different diseases and gingivitis is definitely curable. So to say that periodontal disease is not curable is an erroneous statement. We both graduated 10 years ago and our doctor is a great guy.
