Home Clinical Why can’t Patients See the difference between a Prophy and Periodontal maintenance?

Why can’t Patients See the difference between a Prophy and Periodontal maintenance?

by Wendy Briggs

If you want less resistance and more patient acceptance when presenting periodontal services, than this might be the most important article you read all year. In this article, I will walk you through my 3-step process for presenting periodontal services in a way that has patients thanking you as opposed to running out the door thinking all you are doing is scamming them!

The reason that patients don’t understand the difference between a prophy and periodontal maintenance is because we have never focused our attention on what we need to do to help them differentiate the 2 services. Patients don’t understand dentistry. They think that all they need to do is come in for a simple cleaning and maybe have a cavity filled once or twice in their life – above that, they think that everything else is just a money-making scam to pay for the dentist’s new car or summer lake house.

❝It all starts with a deeper understanding and better education of what is happening with periodontal disease.

How Can We Help Them See The Difference?

At one time, there was a huge push for lengthy time spent on patient education in dentistry and when that didn’t work everyone pulled back. Education works, but educating patients about technical and clinical terms won’t work. We have to educate them in terms that they can and will understand.

It all starts with a deeper understanding and better education of what is happening with periodontal disease (as it relates to them) and explaining that there is now a need for a constant reduction of the bacterial load that exists in the mouth. They have to SEE that something has changed in their mouth. If they don’t see a difference, then they won’t see a need to change from their bi-annual cleanings.

Most patients have no clue that periodontal disease is an ongoing battle. It is our job to help them see this as a change in their health status just like diabetes requires changes in their diet and healthcare regimen, periodontal disease requires changes in their dental healthcare regimen. Not only in our office but also with home care products.

In order to do this, I use a 3-step approach in presenting periodontal disease

Step #1 >>>

I like to start by saying “To help you treat this infection, we need to do 3 things….” This introduces the idea that there is an infection (and they can relate ‘infection’ just like they would with their medical health.)

“We need to do a deeper more aggressive cleaning than you have ever had before, we call this periodontal therapy or scaling and root planing.” This explains that the treatment needs to be different then their normal cleaning. I purposely use the word cleaning, because that is the word that the patient is used to. I then introduce the clinical name that they will hear this being called, so that they are aware that what we will be doing is different. Plus this is what will show up on their insurance EOB, so it reduces questions later on. I continue with …

“I hate to use the words deep or aggressive because people tend to think that it will be painful, but we have state-of-the-art equipment and advanced training so that we can provide this for you as comfortably as possible.” Again, I am differentiating this cleaning as more than their normal cleaning, but then assuring them that just because it is more it will not cause any more discomfort. That is step 1.

Step #2 >>>

“I am going to need to see you back more often. Once you have periodontal infection, it is important that we remove the bacterial load more frequently than you may be used to.” I have set the expectation that they will need to come in more than they were used to and provided an explanation as to WHY they need to come in more than usual. I continue with an analogy to help them see that they have been diagnosed with an infection that doesn’t just go way.

“Periodontal disease is not like a broken bone where you treat it once and it’s fixed, it’s a chronic disease like diabetes and arthritis and has flare-ups from time to time, so we will work together to keep this under control. This is why I need to see you more often.” We can’t just mandate, we need to provide the reason why – the “what’s-in-it-for-me as a patient” – how will this benefit me. This is the education that creates the importance in their minds. Once our patients see their periodontal disease at the urgent level we do, they are much more compliant with home care and accepting of the treatment plan.

Step #3 >>>

“We need to get you better tools to help you keep the bacteria under control from day to day.”

[Then I share all the tools such as prescription strength mouthwash, power brushes, any and all necessary aids] all of these are resources that I share as I put together the ideal plan for each patient.

If you have successfully expressed step #1 and #2 to your patient, step #3 will come very naturally and many will be asking you what they can do to fight this disease before you even make it to step #3.

Once they come in for their first periodontal visit, you will still want to be educating – just because you did a great job on their initial visit which resulted in the acceptance of treatment, if we don’t continue to educate the patient on what we are doing DIFFERENTLY in perio maintenance visits vs. a prophy visit. They will quickly resort back to “why am I paying more when I could just have a regular cleaning.”

To do this, you want to differentiate every step that we do that is different in layman’s terms – In states where it is legal, I like to use the soft tissue laser. But everyone can talk to the patient – why are we using the power scalers? What is the science behind this process and why is it important that we use those consistently when doing a perio maintenance? This is what patients need to know.

The most important thing we can do, as hygiene providers is to educate – share with the patients what you are doing, why you are doing it, why this is important, and build value for the services we do all the way throughout the appointment.

That is how patients are going to understand the need for periodontal maintenance services and why they are very different than the prophy service.

I created a periodontal brochure that I use with all my patients and our clients are using with their patients. At each visit I am able to document where we are at in fighting their infection, continue to educate them on the disease, and recommend home care products and aids.

You can download a copy of the brochure that I use at www.WendysPerioBrochure.com.

Wendy Briggs is the co-founder of The Team Training Institute. She is a registered Dental Hygienist with more than 25 years of experience. For the last 15 years she has taken her unique skills in doubling hygiene production directly to the practices. She has consulted with more than 3,718 dental practices in 12 countries. Hygiene is her passion… and exploding productivity, case acceptance, and profits are her areas of expertise.


If you have a specific question or hygiene-related topic you would like Wendy to address, please contact her at be.theprofitabledentist.com/hygiene-help.

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