A periodontal path to happiness

Preventive Practice of the Year 2010 winners, Confident Dental Care, has celebrated amazing periodontal results since implementing its own dental health plan.

At the core of the practice’s approach is Confident Steps to Health, a gem of a dental hygiene plan that is evidence based and has its roots in clinical research.

Here, Ewa, joint principal at the Gloucestershire practice, takes us through it step by step…

Settling dust
The dust is settling on CQC registration and we are all coming to terms with the implications for our practices. Now is the time to move forwards, before the competition, to continue to find innovative ways to give our patients that ‘wow’ experience.

Steps to Health is a bespoke periodontal care programme that has been devised to help practice teams work together to help patients achieve the best possible periodontal health, improve practice cash flows and keep the CQC happy!

‘I don’t think I need a hygienist appointment’
How many times do we hear this? We all know the frustration of hygienists and receptionists when they are confronted with such a patient.

One of the biggest challenges of any practice is how to convince patients that prevention of periodontal disease is worth the investment.

A strong practice-based message regarding periodontal care is essential to give the patients the advantage of real and sustainable oral health. It is also important to have a simple cascade of treatment protocols in place to give a consistent approach so that all patients have access to the best opportunity to keep their teeth.

Steps to Health was first implemented by Confident Dental Care as patient-centred preventive periodontal care programme. It involves the whole team – and the patient – in a series of steps designed to achieve gum health based on BPE scores and using evidence-based treatment and appointment protocols which are standardised throughout the practice.

As this programme co-ordinates the periodontal philosophy for each individual practice, training is given to the whole team. It is a real eye opener for both dental nurses and non-clinical team members to discover and to appreciate the extensive range of treatments and advice that hygienists can provide, and to understand the real value that patients are being given.

With increased awareness and knowledge, the importance of each appointment becomes obvious, and the team is more likely to gain acceptance of the programme by patients at all stages.This gives clarity for clinical consistency in treatment planning, ensuring that any team member can immediately identify the current status of each patient and give appropriate advice.

The most important part of Steps to Health is the way in which this information is presented to the patient. Most patients find complex explanations of treatments difficult to understand, so this programme has been designed to give simple, clear visual information that is built upon as the patient becomes more aware and engaged.

Once a patient has accepted the fact that they can influence their own outcome, it is easier to introduce more complex treatments and home care.

The information is available in a PowerPoint format for showing by any team member on a computer, or as simple posters for surgery display. Patient information is given in leaflet format to reinforce the messages at home.

The information is divided into patient information and education.

The first slide is shown to the patient at examination to engage them in understanding how healthy their gums are. This makes it clear exactly why they need to see the hygienist – the treatment plan.

At the first hygienist appointment, the ideal outcome from their current position is demonstrated by the hygienist or oral health educator and is followed through with an explanation of the proposed treatment and home care. Appropriate supporting literature is available and given to the patient to take home.

Clinical protocols
These are specified for each Step and used as the agreed treatment prescription for hygienists, ensuring that all clinicians aim for the most appropriate goal with each patient. These comply with GDC requirements. They also provide clear clinical guidelines for evidence-based treatment for each BPE score.

As they are evidence based, they can be reviewed and an updated practice consensus as to best practice achieved – all lovely evidence for the CQC!

It is also possible for any team member to know exactly where a patient is on their journey through the Steps.

Standardisation of care programmes and patient outcomes improves clinical communication both ways between dentists and hygienists.

It also ensures that the periodontal status of the patient is automatically reviewed at each recall appointment during the recording of the BPE score.

Appointment protocols
This is where the financial impact of the Steps to Health programme has the greatest effect.
Appointment times can be tailored to each Step and to each treatment. These can then be costed correctly for each practice to achieve the required hourly rate for the hygienists.

The appropriate time can be allocated to give the patient the attention they deserve for correct periodontal care and maintenance.

Additionally, receptionists are empowered to clearly explain to patients how to achieve the best, personalised preventive programmes which means much fewer cancelled appointments.

Patient’s enthusiasm for Steps to Health has been phenomenal.  More than 1,000 patients know their position on their journey to preventing periodontal disease – which has increased treatment acceptance and measurably improved oral hygiene.

Clinicians can now constantly monitor progress and effectively communicate Steps using evidence-based treatment and prevention. The team gives consistent, progressive and appropriate messages.

Receptionists clearly identify appointments needed for care and ongoing maintenance, and can easily dispense appropriate oral care products, further increasing profits.

The result?
The Steps to Health Programme grows trust through understanding and communication – and leads to more acceptance of other preventive programmes and more comprehensive treatment options in general.

Practically, the practice team becomes happier and more cohesive with a better hygienist cash flow, and patients begin to refer others to the practice.

And finally, having such a robust system for periodontal care and monitoring helps everyone to sleep at peacefully by getting rid of some CQC nightmares!


Steps to Health details: 
1. The severity of each stage of periodontal disease, its activity or stability
2. Which evidence-based treatment is indicated
4. Appropriate home care programmes
5. Communication of relevant information to patients
4. What outcomes the patient can expect
5. Appropriate appointment and recall intervals.



To enter this year’s award…

The new Dental Hygiene & Therapy Award is designed to recognise the UK practice with the strongest, best established and well thought out preventive ethos, whether it be NHS, private  or mixed. As a team, you will successfully communicate the oral health message to your patients, you will work together to raise oral health standards and you will regard prevention as your number one priority above all else.

Who will be judging?
An independent panel of judges including members of the Preventive Dentistry editorial board will compile a shortlist of finalists from all entries received, at which point the position of power is passed over to you, the readers of Preventive Dentistry.
The finalists will be presented in the March 2012 issue (excerpts from their entries will be published). The readers will be asked to vote for the practice that they believe deserves the title of Dental Hygiene & Therapy Award 2011. The practice that receives the most votes will be crowned the winner.

How do I enter?
Entry ios FREE! To enter, submit your details and 500 words explaining why your practice deserves to win. You may submit as much material as you wish to support your claims such as photographs  (please send hard copies as well as electronic), patient testimonials or PR.
The more effort you make to present clear reasons why you should win, the more impressed the judges will be.

If you would like to pre-register, please email your details to [email protected]

Is there a prize?

If you are lucky enough to win, you will be celebrated as an example of excellence to dental practitioners up and down the country. You will also win £500 for your practice to  spend as you wish. Perhaps you could use it for a sophisticated team night out, or that new piece of equipment you’ve had your eye on. This Award will help you get your practice the recognition it deserves.

What is the deadline?

All entries must be received by Friday 13 January 2012. Enter now…

Thanks to our sponsor
Thank you to our official sponsor, Oral-B – without their support, this award would not be possible.

Call 01923 851751 or email [email protected] today to register.

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