New Eyes Dental Hygienists' Guided Mastermind
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This document discusses forming a guided mastermind group for dental hygienists. It would involve weekly online meetings over one month to share best practices, learn from each other, and focus on topics like periodontics, caries management, and airway health. The goal is for hygienists to improve patient care, advance their skills, and find a better work-life balance. The financial commitment would be $720 per group, which includes access to patient charts and career guidance materials.
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New Eyes Dental Hygienists' Guided Mastermind
- 1. With Shirley Gutkowski, RDH, BSDH
- 2. Shirley Gutkowski, RDH, BSDH Clinician since 1986 Author of numerous feature articles Researcher Published research International Speaker CAREERfusion Technology Coach Frustrated person
- 3. Are you happy in your career?
- 4. Or happy to get out?
- 5. Most hygienists seem to like their jobs
- 7. Hygienists don’t seem to like Asked to stay home Clocking out Money Flexibility
- 8. Hygienists don’t seem to like Counting gloves Cutting prophy paste in half Selling
- 9. Hygienists freak when they see patient like this
- 10. They like to use their brains and skills
- 11. They like/love their patients
- 12. Somehow many hygienists feel under appreciated
- 13. What would make an office manager call to ask a hygienist to come in for one hour?
- 14. How many days a month would you do that?
- 15. Are you prepared for a showdown?
- 17. How can you prove you’re worth?
- 18. What do doctors (practice owners) want anyway?
- 19. Employees Do their job Shut up
- 21. Employees Engaged with the tasks Understand there’s a business Bring ideas to make money
- 25. What does that look like to dentists
- 26. How does the dentist get that pile? Hygiene Department
- 30. patients Find work Charge as often as possible DDS gets big pile of $ RDH gets less $ and disrespect
- 31. All money comes from patient Patients are buying excellent care Not dx is not excellent care Patients get comfortable Patients resist dx in the future
- 32. Dentist Patient
- 33. All Hygienists Think They Provide Excellent Care
- 34. Even Those Who Never Perio Chart
- 35. Emotional ties to patient Perceived need to sell
- 36. Chase the oral systemic link
- 38. Learn to apply oral systemic medicine
- 39. Learn more about dietary changes to support oral health
- 40. Learn to apply oral systemic medicine Does this mean the airway is obstructed?
- 41. Learn to apply oral systemic medicine Learn how to manipulate oral biofilm
- 42. Which home products will your patients use
- 44. Pediatric exams with an eye toward the future
- 45. How does inflammation work in DH practice
- 46. The oral systemic link into practice Dirty teeth are expensive! Periodontal disease is an inflammatory disease Almost all diseases have an inflammatory component Addressing oral biofilm and salivary components is the dental hygiene department Oral biofilm is the root of almost all oral disease Patients will SAVE money when dental hygiene treatment is applied
- 47. Sleep apnea Ortho Perio case management Adopt a Nursing Home Office manual author Order responsibilities Digital radiography IO photography Marketing and PR Protocol development Cosmetic procedures Practice consulting Correspondence Patient appreciation organizer EMT Tracking production Social networking Advanced Dx Another language Tongue prophy Staff training
- 48. Cochrane Database Syst Rev. 2005 Routine scale and polish for periodontal health in adults. The research evidence is of insufficient quality to reach any conclusions regarding the beneficial and adverse effects of routine scaling and polishing for periodontal health and regarding the effects of providing this intervention at different time intervals. High quality clinical trials are required to address the basic questions posed in this review.
- 49. Cochrane Database Syst Rev. 2007 Routine scale and polish for periodontal health in adults. The research evidence is of insufficient quality to reach any conclusions regarding the beneficial and adverse effects of routine scaling and polishing for periodontal health and regarding the effects of providing this intervention at different time intervals. High quality clinical trials are required to address the basic questions posed in this review.
- 50. Cochrane Database Syst Rev. 2013 Routine scale and polish for periodontal health in adults. There is insufficient evidence to determine the effects of routine scale and polish treatments. High quality trials conducted in general dental practice settings with sufficiently long follow-up periods (five years or more) are required to address the objectives of this review.
- 51. Insurance saves money! Periodontal Treatment Saved $2,483 in medical costs
- 57. CONCLUSIONS: The occurrence of middle ear infections or respiratory tract infections during the first year of life is associated with during subsequent years.
- 59. Can a dental hygienist affect costs of ear infections? $20 to 250 $20 to 110 4 hours work
- 60. Down Line Medical costs The heart of the issue
- 61. Mean hours lost due to dental visit or oral health problem. This bar graph shows the mean number of work hours lost for those in different employment categories due to a dental visit or oral health problem. The mean number of hours lost for executives was 2.8, for professionals 4.8, for sales persons 4.3, for administrative support staff 4.3, for those in craft and precision positions 4.4, for technical staff 3.7, for service workers 10, and for machine operators 6.
- 63. VAP $10,000 to $40,000 •estimated cost per ventilator- associated pneumonia infection J Intensive Care Med. 2009 Jan-Feb;24(1):54-62.
- 64. 46% • Reduction in ventilator- associated pneumonia $2187.49 • Total cost of the oral care protocol
- 65. A decrease in cost of between $140 000 to 560,000 that year.
- 66. New Eyes Dental Hygienists Guided Mastermind
- 67. One month commitment •Weekly mastermind meetings online •Agenda to keep on track •Learn from one another – millennial style •One major topic per month
- 68. Dental Hygienists Guided Mastermind Monthly topic 1.25 hours per week online Data gathering Reporting Not production focused
- 72. Focus on perio Ways to diagnosis Diabetes
- 73. Focus on caries management Caries diagnosis, not cavities Treatments for caries infections
- 74. Focus on airway What’s a tongue tie Barrier to caries and perio treatment
- 75. Small groups • Up to 8 members per group Weekly meetings • Agenda driven • Guided sharing • Firm end time Attainable goals • Processes based
- 76. Complete email support Wiki platform for communication Team learning
- 77. One month commitment • Weekly mastermind meetings online • 1 1/4 hours • Access to patient charts • Desire to go to the next level of clinical dental hygiene
- 78. Financial Commitment $720 per Mastermind group Includes copy of Paper Persona But wait there’s more!
- 79. stuff
- 84. Mastermind your brain will overflow with new ideas.
- 85. Use each other to learn a new way Collaborate to form new paradigms
- 86. Contact me via email crosslinkpresent@aol.com
- 87. New Eyes Dental Hygienists’ Guided Mastermind
- 88. The Hygienist’s Role It’s in there
Editor's Notes
- My name is Shirley Gutkowski, after much consideration and much agonizing, I’ve decided to offer a new kind of consulting for dental hygienists in dental practice. I’ve developed a collaborative consulting model called Guided Mastermind.
- I’ve been a dental hygienist for quite some time and have written three books for dental hygienists. My research projects proved that oral health can be obtained and maintained by using xylitol. My mentoring style and arrangements have propelled many known people hygienists to their current level of exposure. I’ve helped create experts in their field and in their passion. I’m also frustrated by the status quo, and I’m always looking for a way to make things better. Which is why people have come to ask me to consult in their dental practices.
- I’d like to ask the question: Are you happy in your career
- Or are you just happy to get out?
- Most hygienists love their job
- Hygienists like
- Their goal is to make sure their patients don’t have any cavities don’t need root canals or have periodontal disease.
- They love their patients so much that they’ll often stick in an abusive dental office just to stay with their patients.
- Dental hygienists are often the only people in the office with any license or degree after the dentist. This puts them into a weird position where they are looked at as if they’re turncoats, or prima donnas.
- But the reality is that they are the highest paid members of the practice, and don’t do a lot when patients don’t come in because their worth is tied to what they do for patients. Office managers, trying to save money, ask hygienists to go home when patients cancel.
- How can a hygienist stand up for themselves? How can you tell the office manager it’s illegal in most states to clock in and out throughout the day. How do you tell the dentist that you signed on for 32 hours per week not 20 or less. Sounds like scary work if you’re trying to feed your family and keep a roof over their heads?
- There are many applicants per job posting, it’s hard to find a new job if you’re not fitting in at the current job.
- They have a big heart and often give away products or services, not thinking about how that affects the health of the practice or their job security.
- They think the dentist or practice owner sits on a pile of money that is not affected by what happens in their treatment room
- Hygienists think that they dentist just wants more money from the hygiene department so that they can sit on a bigger pile of money.
- Doctors just take these piles of money to the bank, if there’s a consultant around hygienists think their hard work is going to pay for the consultant.
- Are you stealing from your employer? Of course not! But dentists think that hygienists not providing treatments or lower cost treatments is stealing from them, the practice and their own income. No hygienist things of giving away free treatment to a few periodontal pockets is stealing from the dentist.
- Dental practice cycle, this is how a functioning healthy practice works, in its simplest form
- False dental practice cycle, there are too many ethical dentists for this to be a true picture of how the practice works.
- In reality all the money comes from patients buying excellent care. Never finding any treatment to offer is not good dentistry or good dental hygiene practice. In truth, there’s always something to find. By not making factual diagnosis patients get comfortable and become resistant when something BIG shows up. They’ll wonder how whatever it is got so big or so far along and lose faith in the practice. This is NOT a good scenario.
- Dentists are ethical, they are not out to shake money from their patients. They get paid from spending hundreds of thousands of dollars to learn their expertise and help bring patients to health.
- Patients buy excellent care, all hygienists think they provide excellent care.
- Or find problems at their earliest stages.
- Hygienists have to balance their education, their emotions, and the practice bottom line so their jobs are secure. Selling dentistry is a mind set they’re not comfortable with and resist loudly. What they need to realize is that it’s not a traditional selling, it’s finding problems early, it’s recommending expert excellent care for which the patient is paying.
- They are struggling with how to incorporate the new oral systemic science into the practice, and that’s what’s going to set them apart and prove their worth.
- There’s more to dental hygiene than removing deposits from the teeth This looks great, but this is not what we go to school to do. We learn way more than how to remove the deposits without damaging soft tissues.
- We have a long list of options that we need to know about for our patients. Hygienists can apply oral systemic medicine into their practice.
- We have a long list of options that we need to know about for our patients. Nutritional information is not just telling patients to avoid sugars and soda. Periodontal disease is a disease of the body’s imbalance.
- We have a long list of options that we need to know about for our patients. Hygienists have the unique ability to act on problems like these. And talk to patients about tongue thrust, offer thumb sucking quitting courses and more.
- We have a long list of options that we need to know about for our patients. Hygienists have ways of altering oral biofilm, using science we didn’t have 15 years ago, but has been steadily mounting.
- We have a long list of options that we need to know about for our patients. Patients are confused about oral care products, and look to hygienists as an expert in the topic.
- We have a long list of options that we need to know about for our patients. Hygienists are experts in infection control in the office and with the patients oral health.
- We have a long list of options that we need to know about for our patients. Working with children is paramount, teaching them good habits from likely the longest professional relationship that they will ever have, the one with a dental hygienist.
- We have a long list of options that we need to know about for our patients. Hygienists have a handle on the inflammatory process and can help patients reduce their inflammatory load by providing treatments and support against oral biofilms.
- Options for increasing job security are found in The Purple Guide Paper Persona.
- Looking at the research Makes a person wonder what proof we have that dental hygiene treatments are valid and that patients are healthier. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD004625. Routine scale and polish for periodontal health in adults. Beirne P1, Worthington HV, Clarkson JE. Author information Update in Cochrane Database Syst Rev. 2013;11:CD004625. Abstract BACKGROUND: Many dentists or hygienists provide scaling and polishing for patients at regular intervals, even if those patients are considered to be at low risk of developing periodontal disease. There is debate over the clinical effectiveness and cost effectiveness of 'routine scaling and polishing' and the 'optimal' frequency at which it should be provided. OBJECTIVES: The main objectives were: to determine the beneficial and harmful effects of routine scaling and polishing for periodontal health; to determine the beneficial and harmful effects of providing routine scaling and polishing at different time intervals on periodontal health; to compare the effects of routine scaling and polishing provided by a dentist or professionals complementary to dentistry (PCD) (dental therapists or dental hygienists) on periodontal health. SEARCH STRATEGY: We searched the Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Reference lists from relevant articles were scanned and the authors of eligible studies were contacted where possible to identify trials and obtain additional information. Date of most recent searches: 5th March 2007. SELECTION CRITERIA: Trials were selected if they met the following criteria: design - random allocation of participants; participants - anyone with an erupted permanent dentition who were judged to have received a 'routine scale and polish' (as defined in this review); interventions - 'routine scale and polish' (as defined in this review) and routine scale and polish provided at different time intervals; outcomes - tooth loss, plaque, calculus, gingivitis, bleeding and periodontal indices, changes in probing depth, attachment change, patient-centred outcomes and economic outcomes. DATA COLLECTION AND ANALYSIS: Information regarding methods, participants, interventions, outcome measures and results were independently extracted, in duplicate, by two review authors. Authors were contacted where possible and where deemed necessary for further details regarding study design and for data clarification. A quality assessment of all included trials was carried out. The Cochrane Collaboration's statistical guidelines were followed and both standardised mean differences and mean differences were calculated as appropriate using random-effects models. MAIN RESULTS: Nine studies were included in this review. All studies were assessed as having a high risk of bias.Two split-mouth studies provided data for the comparison between scale and polish versus no scale and polish. One study, involving patients attending a recall programme followingperiodontal treatment, found no statistically significant differences for plaque, gingivitis and attachment loss between experimental and control units at each time point during the 1 year trial. The other study, involving adolescents in a developing country with high existing levels of calculus who had not received any dental treatment for at least 5 years, reported statistically significant differences in calculus and gingivitis (bleeding) scores between treatment and control units at 6, 12 and 22 months (in favour of 'scale and polish units') following a single scale and polish provided at baseline to treatment units. For comparisons between routine scale and polish provided at different time intervals, there were some statistically significant differences in favour of scaling and polishing provided at more frequent intervals: 2 weeks versus 6 months, 2 weeks versus 12 months (for the outcomes plaque, gingivitis, pocket depth and attachment change); 3 months versus 12 months (for the outcomes plaque, calculus and gingivitis). There were no studies comparing the effects of scaling and polishing provided by dentists or professionals complementary to dentistry. AUTHORS' CONCLUSIONS: The research evidence is of insufficient quality to reach any conclusions regarding the beneficial and adverse effects of routine scaling and polishing for periodontal health and regarding the effects of providing this intervention at different time intervals. High quality clinical trials are required to address the basic questions posed in this review.
- The Cochrane review is big on compiling research to give a better picture of what is real and what isn’t. these two papers published two years apart are both looking for better quality research to prove that scaling and polishing teeth is better for patients than not. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD004625. Routine scale and polish for periodontal health in adults. Beirne P1, Worthington HV, Clarkson JE. Author information Update in Cochrane Database Syst Rev. 2013;11:CD004625. Abstract BACKGROUND: Many dentists or hygienists provide scaling and polishing for patients at regular intervals, even if those patients are considered to be at low risk of developing periodontal disease. There is debate over the clinical effectiveness and cost effectiveness of 'routine scaling and polishing' and the 'optimal' frequency at which it should be provided. OBJECTIVES: The main objectives were: to determine the beneficial and harmful effects of routine scaling and polishing for periodontal health; to determine the beneficial and harmful effects of providing routine scaling and polishing at different time intervals on periodontal health; to compare the effects of routine scaling and polishing provided by a dentist or professionals complementary to dentistry (PCD) (dental therapists or dental hygienists) on periodontal health. SEARCH STRATEGY: We searched the Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. Reference lists from relevant articles were scanned and the authors of eligible studies were contacted where possible to identify trials and obtain additional information. Date of most recent searches: 5th March 2007. SELECTION CRITERIA: Trials were selected if they met the following criteria: design - random allocation of participants; participants - anyone with an erupted permanent dentition who were judged to have received a 'routine scale and polish' (as defined in this review); interventions - 'routine scale and polish' (as defined in this review) and routine scale and polish provided at different time intervals; outcomes - tooth loss, plaque, calculus, gingivitis, bleeding and periodontal indices, changes in probing depth, attachment change, patient-centred outcomes and economic outcomes. DATA COLLECTION AND ANALYSIS: Information regarding methods, participants, interventions, outcome measures and results were independently extracted, in duplicate, by two review authors. Authors were contacted where possible and where deemed necessary for further details regarding study design and for data clarification. A quality assessment of all included trials was carried out. The Cochrane Collaboration's statistical guidelines were followed and both standardised mean differences and mean differences were calculated as appropriate using random-effects models. MAIN RESULTS: Nine studies were included in this review. All studies were assessed as having a high risk of bias.Two split-mouth studies provided data for the comparison between scale and polish versus no scale and polish. One study, involving patients attending a recall programme followingperiodontal treatment, found no statistically significant differences for plaque, gingivitis and attachment loss between experimental and control units at each time point during the 1 year trial. The other study, involving adolescents in a developing country with high existing levels of calculus who had not received any dental treatment for at least 5 years, reported statistically significant differences in calculus and gingivitis (bleeding) scores between treatment and control units at 6, 12 and 22 months (in favour of 'scale and polish units') following a single scale and polish provided at baseline to treatment units. For comparisons between routine scale and polish provided at different time intervals, there were some statistically significant differences in favour of scaling and polishing provided at more frequent intervals: 2 weeks versus 6 months, 2 weeks versus 12 months (for the outcomes plaque, gingivitis, pocket depth and attachment change); 3 months versus 12 months (for the outcomes plaque, calculus and gingivitis). There were no studies comparing the effects of scaling and polishing provided by dentists or professionals complementary to dentistry. AUTHORS' CONCLUSIONS: The research evidence is of insufficient quality to reach any conclusions regarding the beneficial and adverse effects of routine scaling and polishing for periodontal health and regarding the effects of providing this intervention at different time intervals. High quality clinical trials are required to address the basic questions posed in this review.
- The Cochrane Report is still looking for better research in 2013, so for eight years, nothing has shown up in the research to prove dental hygiene care is valid. That’s because no one is doing any research on it. If they know it, they’re not publishing their data. The studies are OLD, but maybe that’s because that’s all the proof we need. Cochrane Database Syst Rev. 2013 Nov 7;11:CD004625. doi: 10.1002/14651858.CD004625.pub4. Routine scale and polish for periodontal health in adults. Worthington HV1, Clarkson JE, Bryan G, Beirne PV. Author information Abstract BACKGROUND: Many dentists or hygienists provide scaling and polishing for patients at regular intervals, even if those patients are considered to be at low risk of developing periodontal disease. There is debate over the clinical effectiveness and cost effectiveness of 'routine scaling and polishing' and the 'optimal' frequency at which it should be provided for healthy adults.A 'routine scale and polish' treatment is defined as scaling or polishing or both of the crown and root surfaces of teeth to remove local irritational factors (plaque, calculus, debris and staining), that does not involve periodontalsurgery or any form of adjunctive periodontal therapy such as the use of chemotherapeutic agents or root planing. OBJECTIVES: The objectives were: 1) to determine the beneficial and harmful effects of routine scaling and polishing for periodontal health; 2) to determine the beneficial and harmful effects of providing routine scaling and polishing at different time intervals on periodontal health; 3) to compare the effects of routine scaling and polishing with or without oral hygiene instruction (OHI) on periodontal health; and 4) to compare the effects of routine scaling and polishing provided by a dentist or dental care professional (dental therapist or dental hygienist) on periodontal health. SEARCH METHODS: We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 15 July 2013), CENTRAL (The Cochrane Library 2013, Issue 6), MEDLINE via OVID (1946 to 15 July 2013) and EMBASE via OVID (1980 to 15 July 2013). We searched the metaRegister of Controlled Trials and the US National Institutes of Health Clinical Trials Register (clinicaltrials.gov) for ongoing and completed studies to July 2013. There were no restrictions regarding language or date of publication. SELECTION CRITERIA: Randomised controlled trials of routine scale and polish treatments (excluding split-mouth trials) with and without OHI in healthy dentate adults, without severe periodontitis. DATA COLLECTION AND ANALYSIS: Two review authors screened the results of the searches against inclusion criteria, extracted data and assessed risk of bias independently and in duplicate. We calculated mean differences (MDs) (standardised mean differences (SMDs) when different scales were reported) and 95% confidence intervals (CIs) for continuous data and, where results were meta-analysed, we used a fixed-effect model as there were fewer than four studies. Study authors were contacted where possible and where deemed necessary for missing information. MAIN RESULTS: Three studies were included in this review with 836 participants included in the analyses. All three studies are assessed as at unclear risk of bias. The numerical results are only presented here for the primary outcome gingivitis. There were no useable data presented in the studies for the outcomes of attachment change and tooth loss. No studies reported any adverse effects.- Objective 1: Scale and polish versus no scale and polish Only one trial provided data for the comparison between scale and polish versus no scale and polish. This study was conducted in general practice and compared both six-monthly and 12-monthly scale and polish treatments with no treatment. This study showed no evidence to claim or refute benefit for scale and polish treatments for the outcomes of gingivitis, calculus and plaque. The MD for six-monthly scale and polish, for the percentage of index teeth with bleeding at 24 months was -2% (95% CI -10% to 6%; P value = 0.65), with 40% of the sites in the control group with bleeding. The MD for 12-monthly scale and polish was -1% (95% CI -9% to 7%; P value = 0.82). The body of evidence was assessed as of low quality.- Objective 2: Scale and polish at different time intervals Two studies, both at unclear risk of bias, compared routine scale and polish provided at different time intervals. When comparing six with 12 months there was insufficient evidence to determine a difference for gingivitis at 24 months SMD -0.08 (95% CI -0.27 to 0.10). There were some statistically significant differences in favour of scaling and polishing provided at more frequent intervals, in particular between three and 12 months for the outcome of gingivitis at 24 months, with OHI, MD -0.14 (95% CI -0.23 to -0.05; P value = 0.003) and without OHI MD -0.21 (95% CI -0.30 to -0.12; P value < 0.001) (mean per patient measured on 0-3 scale), based on one study. There was some evidence of a reduction in calculus. This body of evidence was assessed as of low quality.- Objective 3: Scale and polish with and without OHIOne study provided data for the comparison of scale and polish treatment with and without OHI. There was a reduction in gingivitis for the 12-month scale and polish treatment when assessed at 24 months MD -0.14 (95% CI -0.22 to -0.06) in favour of including OHI. There were also significant reductions in plaque for both three and 12-month scale and polish treatments when OHI was included. The body of evidence was once again assessed as of low quality.- Objective 4: Scale and polish provided by a dentist compared with a dental care professionalNo studies were found which compared the effects of routine scaling and polishing provided by a dentist or dental care professional (dental therapist or dental hygienist) onperiodontal health. AUTHORS' CONCLUSIONS: There is insufficient evidence to determine the effects of routine scale and polish treatments. High quality trials conducted in general dental practice settings with sufficiently long follow-up periods (five years or more) are required to address the objectives of this review.
- That is until the insurance companies get in on the act. In 2011 Cigna combed through their files and found over 3000 patients who had both dental and medial insurance and had diabetes saved over $2000 in downline medical costs. That savings is over an above the cost of the dental treatment. Research from CIGNA Supports Potential Association between Treated Gum Disease and Reduced Medical Costs for People with Diabetes SUNRISE, Fla., March 29, 2011 - The results from a new CIGNA study support that there is a potential association between treated periodontal (gum) disease and reduced medical costs for patients with diabetes. The findings of the three-year claims study were presented during a recent meeting of the International Association for Dental Research (IADR) in San Diego. The study was presented by Dr. Clay Hedlund, a CIGNA dental director, Dr. Marjorie Jeffcoat, Dean Emeritus and professor, University of Pennsylvania School of Dental Medicine, Dr. Robert Genco, a SUNY Distinguished Professor, University at Buffalo Schools of Dental Medicine, and Dr Nipul Tanna, clinical assistant professor, University of Pennsylvania School of Dental Medicine. Drs. Jeffcoat and Genco are members of the CIGNA Dental Clinical Advisory Panel.* IADR is a non-profit organization dedicated to advancing research and increasing knowledge to improve oral health worldwide. CIGNA's Dr. Hedlund said the study corroborates the results of CIGNA's prior research, presented at the IADR meeting in 2009, in support of a possible association between the treatment of gum disease and lower medical costs in the treatment of diabetes. In the current study, patients who were treated for gum disease in the first year of the study and then received regular maintenance care thereafter had lower medical costs than those patients who had previously been treated for gum disease but did not receive regular maintenance care. On average, medical costs were $2,483 per year lower, or 23 percent less, for patients with diabetes who had proper gum disease treatment. “With the increase in the prevalence of diabetes, and great concern for our ever-increasing medical costs, this study suggests that periodontal therapy may help reduce the disease burden, as well as medical costs of treatment for patients with diabetes,” said Dr. Robert Genco. “The link between periodontal disease and diabetes has been firmly established and the association is a concern," said Dr. Marjorie Jeffcoat. “Periodontal disease can place individuals with diabetes at greater risk for diabetic complications, including mortality from cardiovascular disease and diabetic nephropathy. Advancing our understanding on how treatment for gum disease can affect the health of people with diabetes will help lead to the creation of evidence-based treatment standards that could benefit millions of people and help reduce medical costs at the same time.” Dr. Clay Hedlund noted, “These results suggest that treating gum disease has benefits beyond better oral health and may also help to control medical costs for some patients as well. We are pleased to be part of the dental community’s ongoing research into the links between good oral health and good overall health.” About the Research The length of the study period was three full years, 2006 to 2008. It included an examination of medical and dental claims of over 46,094 individuals aged 18-62 who were enrolled in both CIGNA medical and CIGNA dental plans. The medical cost analysis included 3,449 patients from this group who received treatment for diabetes. These patients were presumed to also have had gum disease since they had received periodontal (gum) therapy at some point. Two different groups of patients with gum disease were then compared. Individuals in the first group received initial treatment for gum disease during the first (baseline) year of the study and received regular maintenance care thereafter (1,355 patients). Individuals in the second group received treatment for periodontal disease prior to the baseline year, and did not receive regular maintenance care during the study period (2,094 patients). Lower medical costs among patients being treated for diabetes were observed in the group who received periodontal treatment in the first year and then regular maintenance care thereafter. Conversely, medical costs were higher in the group of patients who received treatment prior to the baseline year and did not receive regular maintenance care thereafter. These medical cost differences averaged $2,483 per patient in 2008. These results are part of ongoing studies at CIGNA. CIGNA is an industry leader in providing integrated medical and dental plans to address the emerging association between periodontal disease and chronic medical conditions and between periodontal disease and pregnancy. In 2006, CIGNA launched its Oral Health Integration Program, the first program of its kind to be offered by a health services company. Through this program, CIGNA dental plan customers with certain health care conditions, or those who are pregnant, are eligible to receive 100 percent reimbursement for out-of-pocket costs associated with periodontal scaling and root planing and periodontal maintenance. In addition, expectant mothers may receive extra dental cleanings as needed during pregnancy. The program was expanded earlier this year to include more people and coverage for more conditions. These integrated programs are designed to help eliminate cost as a barrier to seeking appropriate treatment for gum disease and ultimately improve health. *About the CIGNA Dental Clinical Advisory Panel – The CIGNA Dental Clinical Advisory panel helps to create innovative approaches to new technologies, medical/dental integration and evidence-based strategies. Organized by CIGNA, this independent panel consists of leaders in the dental profession, many of whom are published and have served in leadership roles within their specialty or the American Dental Association. Several panel members have current academic appointments in major schools of dentistry, including the University of PA, Tufts, SUNY, and UCLA.
- Patients compliant with their medial care, not with their dental care. This is the kind of research we need to put into practice. How will the conversations change once you have a handle on this kind of information. How can you know about it if you’re seeing patients most of the time you’re at work and then get sent home. Is this kind of research the kind of stuff you should do on your own free time? Or in the dental office between patients?
- By knowing these kinds of statistics hygiensits can have another level of conversation with their patients. One that can save them money not just cost them money.
- By having dental hygiene treatment sick patients can spend less money.
- Not just in old sick people either. Imagine the conversation you can have with the parent of a child who has ear infections. Or better yet, with pediatricians who see ear infections all the time.
- Three out of four children will have at least one ear infection by their third birthday. In fact, ear infections are the most common reason parents bring their child to a doctor.
- $25 and $250 for those without insurance, depending upon the clinic and the region of the country. Copays for office visits range between $5 and $75, depending upon the insurance company. The average insured individual in the U.S. has a $19 office visit copay. Antibiotics are typically prescribed for patients with a bacterial ear infection. These usually cost between $20 and $110 for seven days worth of treatment. One of the most common antibiotics prescribed for ear infection, Amoxicillin, costs between $20 and $70
- Dental decay and periodontal disease are both preventable chronic diseases.
- Acute care costs can also be reduced in hospitals. This study was done with nurses applying dental hygiene to people in intensive care. The impact of a simple, low-cost oral care protocol on ventilator-associated pneumonia rates in a surgical intensive care unit. Sona CS, Zack JE, Schallom ME, McSweeney M, McMullen K, Thomas J, Coopersmith CM, Boyle WA, Buchman TG, Mazuski JE, Schuerer DJ. Source Departments of Nursing, Barnes-Jewish Hospital, St Louis, Missouri, USA. css1719@bjc.org Abstract OBJECTIVE: The purpose of this study was to determine the effects of a simple low-cost oral care protocol on ventilator-associated pneumonia rates in a surgical intensive care unit. DESIGN: Preintervention and postintervention observational study. SETTING: Twenty-four bed surgical/trauma/burn intensive care units in an urban university hospital. PATIENTS: All mechanically ventilated patients that were admitted to the intensive care unit between June 1, 2004 and May 31, 2005. INTERVENTIONS: An oral care protocol to assist in prevention of bacterial growth of plaque by cleaning the patients' teeth with sodium monoflurophosphate 0.7% paste and brush, rinsing with tap water, and subsequent application of a 0.12% chlorhexidine gluconate chemical solution done twice daily at 12-hour intervals. MEASUREMENTS AND MAIN RESULTS: During the preintervention period from June 1, 2003 to May 31, 2004, there were 24 infections in 4606 ventilator days (rate = 5.2 infections per 1000 ventilator days). After the institution of the oral care protocol, there were 10 infections in 4158 ventilator days, resulting in a lower rate of 2.4 infections per 1000 ventilator days. This 46% reduction in ventilator-associated pneumonia was statistically significant (P = .04). Staff compliance with the oral care protocol during the 12-month period was also monitored biweekly and averaged 81%. The total cost of the oral care protocol was US$2187.49. There were 14 fewer cases of ventilator-associated pneumonia, which led to a decrease in cost of US$140 000 to US$560 000 based on the estimated cost per ventilator-associated pneumonia infection of US$10 000 to US$40 000. There was an overall reduction in ventilator-associated pneumonia without a change to the gram-negative or gram-positive microorganism profile. CONCLUSIONS: The implementation of a simple, low-cost oral care protocol in the surgical intensive care unit led to a significantly decreased risk of acquiring ventilator-associated pneumonia.
- This study also used nurses. What would the cost savings have been if dental hygienist would have been employed. How will your conversations with patients change with this knowledge? The impact of a simple, low-cost oral care protocol on ventilator-associated pneumonia rates in a surgical intensive care unit. Sona CS, Zack JE, Schallom ME, McSweeney M, McMullen K, Thomas J, Coopersmith CM, Boyle WA, Buchman TG, Mazuski JE, Schuerer DJ. Source Departments of Nursing, Barnes-Jewish Hospital, St Louis, Missouri, USA. css1719@bjc.org Abstract OBJECTIVE: The purpose of this study was to determine the effects of a simple low-cost oral care protocol on ventilator-associated pneumonia rates in a surgical intensive care unit. DESIGN: Preintervention and postintervention observational study. SETTING: Twenty-four bed surgical/trauma/burn intensive care units in an urban university hospital. PATIENTS: All mechanically ventilated patients that were admitted to the intensive care unit between June 1, 2004 and May 31, 2005. INTERVENTIONS: An oral care protocol to assist in prevention of bacterial growth of plaque by cleaning the patients' teeth with sodium monoflurophosphate 0.7% paste and brush, rinsing with tap water, and subsequent application of a 0.12% chlorhexidine gluconate chemical solution done twice daily at 12-hour intervals. MEASUREMENTS AND MAIN RESULTS: During the preintervention period from June 1, 2003 to May 31, 2004, there were 24 infections in 4606 ventilator days (rate = 5.2 infections per 1000 ventilator days). After the institution of the oral care protocol, there were 10 infections in 4158 ventilator days, resulting in a lower rate of 2.4 infections per 1000 ventilator days. This 46% reduction in ventilator-associated pneumonia was statistically significant (P = .04). Staff compliance with the oral care protocol during the 12-month period was also monitored biweekly and averaged 81%. The total cost of the oral care protocol was US$2187.49. There were 14 fewer cases of ventilator-associated pneumonia, which led to a decrease in cost of US$140 000 to US$560 000 based on the estimated cost per ventilator-associated pneumonia infection of US$10 000 to US$40 000. There was an overall reduction in ventilator-associated pneumonia without a change to the gram-negative or gram-positive microorganism profile. CONCLUSIONS: The implementation of a simple, low-cost oral care protocol in the surgical intensive care unit led to a significantly decreased risk of acquiring ventilator-associated pneumonia.
- Nearly half a million dollars was saved by including $2000 of oral care protocols to their patients in the ICU.
- All of this is why I decided to offer Oral Systemic Guided Mastermind sessions. To give dental hygienists a new set of eyes to see solutions to current issues and to focus on solutions to
- And work more healthfully
- The first month,
- Another month
- And another month