Periodontal documentation: Stepping beyond ‘ordinary’ diagnosis

I remember like it was yesterday, even though it was more than 25 years ago. I was attending a dental meeting in Houston with hundreds of other people, but I felt like the speaker was talking directly to me. The periodontist from New Jersey captured my attention with this statement: “If you see bleeding gums in the majority of your patients while cleaning their teeth, the problem is you.”

Certainly, I knew bleeding gums were not okay. But honestly, they had become so “ordinary” in my patients that they had lost their urgency. Then, Van Stevens, DDS, from New Jersey stepped on my toes! Fast forward to today, and I now tell my audiences that I hope they wore close-toed shoes—in case I step on their toes, intentionally.

Let’s address this elephant in the room—periodontal documentation. Already some of you know you can move on to other articles in this publication because this topic won’t apply to you. However, since thankfully I had my toes stepped on and that got my attention, I feel as though I’ve earned the right to address the subject. To have the greatest impact in your practice, dentists and dental hygienists need to read this article and discuss this topic together.

Dentists can defer to the dental hygienists for collection of the periodontal data, but in order for that to become consistent there has to be value for the time required to collect the data thoroughly, as well as explaining the significance to patients. Surprisingly, given all we know about the oral-systemic connection, thorough periodontal assessment and documentation is still an overlooked procedure. Dentists and dental hygienists settle for spot probing, periodontal charts that are outdated, bitewings that don’t show bone levels, and in some cases, no periodontal assessments at all on patients. Right now, I bet some of your toes are becoming a bit twitchy after reading that last sentence.