Episode 721: Perfecting Perio Protocol

 As offices are considering the remainder of 2023, Tiff and Brit are hearing a lot about perio protocol. In this episode, they touch on four important aspects when it comes to perfecting and initiating that protocol: the importance of perio protocol; who uses it; who makes it; and key standards to include.

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Transcript:

0:00:05.8 Kiera Dent: Hey everyone, welcome to the Dental A Team podcast. I'm your host Kiera Dent. And I have this crazy idea that maybe I could combine a doctor and a team member's perspective, because let's face it, dentistry can be a challenging profession with those two perspectives. I've been a dental assistant, treatment coordinator, scheduler, filler, office manager, regional manager, practice owner, and I have a team of traveling consultants where we have traveled to over 165 different offices, coaching teams. Yep, we don't just understand you, we are you. Our mission is to positively impact the world of dental, and I believe that this podcast is the greatest way I can help elevate teams, grow VIP experiences, reduce stress, and create A teams. Welcome to the Dental A Team podcast.

0:00:52.4 Kiera Dent: Hello Dental A Team listeners, this is Kiera, and you guys, you are in for the best treat of your life, Consultant Takeover. That's right. Get ready, they are dropping some dynamite. Our consulting team is incredible, guys, and we are so blessed and so fortunate to have them sharing tips and tricks with you today. And as always, thanks for listening. I'll catch you next time on the Dental A Team podcast.

0:01:14.3 Tiff: I am so excited to be here with one of my all-time favorite consultants, admin members and hygienist. I think... [laughter] Britt, I love podcasting with you. I say it every time, I feel like we burst out so much in a very short amount of time, so I'm excited to do that with you today. We've got a couple of things to chat about. Welcome. Thank you for being here with me.

0:01:38.8 Britt: Thanks for having me. I always love getting to podcasts with you too. We say it all the time, like I feel like this is the time we actually get to hang out with each other. Sounds pretty awesome.

0:01:48.3 Tiff: I know, I know. I podcasted with Denae, and she was in Arizona for a few weeks, but I was gone most of the time, she was there, and so I was like, I didn't get to see her. I was like, add it to Britt's forte, we live 20 minutes apart and don't see each other, so that's fine.

0:02:04.6 Britt: I mean it's like...

0:02:05.1 Tiff: It's my schedule.

0:02:05.8 Britt: We obviously like each other for a virtual company, I tell you, we connect real well. Maybe not in person all the time, but virtually we do a real good job.

0:02:14.0 Tiff: We do, we do. My favorite thing is that I get to tell all of my clients and my friends and my family and everybody that we have every morning at 9:00 AM Pacific a morning huddle. And it's so cool. I know we're not talking about morning huddles today, but I think it's really cool because we preach morning huddles to businesses all the time, and I think it's awesome to be able to see that business is business and what works in a dental practice, we can duplicate and translate that to multiple business structures, we do it for our own, and my practices get to see that it works for us, so you can implement and work it into your business as well. So it's just really cool and that is how we stay so connected, I think, as a virtual company. I think that's one of the best things that we've implemented. Obviously, our weekly meetings, things like that, we do a lot of the same things you guys that we tell you to do, but it really, really helps keep us connected. So I love it. Every morning I get to see your face and then when we podcast I get to see your face as well. So I love it. Thank you. Thank you.

0:03:12.8 Britt: I know. I think, all for the sake of like keeping us on the same page, right? Like communication point, we're all on the same page and we're moving forward so it helps, and that's like guys systems and things that we do. Like we do practice what we preach.

0:03:28.7 Tiff: We do, we do. Which I love. I love being able to go into my practices and be like, I know this works because I do it all the time. So it's super cool. So another thing that I've been talking to a lot of practices about, especially right now because I think this time of year we're really prepping for hygiene, right? Because we've got September coming up not too far from now and everybody knows what September looks like, but I think this is a really good time to make sure that we have all of those protocols and procedures in place. And summertime, to me, summertime is a great space of life for most practices, not my pedo practices.

[laughter]

0:04:04.7 Tiff: They're a little psychotic right now. And my oral surgery practices, yeah. My specialty practices are going a little buck wild, crazy right now, but my GP practices, they tend to see a little bit of a slowdown or some more vacation times, kind of things like that. Doctors are going on vacation, admin teams are looking for things to do, hygienists are looking for things to do. So I think this is a really great time to really take a look at systems protocols and figure out what do we need the rest of this year to look like, what are those protocols, I've been working really heavily with a lot of my practices right now are perio protocols and really kind of figuring out what are my expectations of my hygiene team and my hygiene department so that they know how to calibrate what they're doing and they know what it looks like to win. Like, you know how to do your job, doctor's not here to tell you how to do your job, but I'm here to tell you how can you be successful and feel like you're winning in your position within that practice.

0:05:00.1 Tiff: And I think, to me that's what the perio protocols really boil down to. And maybe I'm wrong, Britt, you're the hygienist here, like I don't think it's like everyone who has this number has to be this category. I think it's very patient dependent and I trust my hygiene team and my hygienist to make those decisions, but we need guiding tools so that not everybody's like, one hygienist says something, another hygienist is like totally off base with that thing. How do you feel the perio protocols really do services in practices?

0:05:35.5 Britt: Yeah. And I think it's those standards, like this is our preparation time of getting these protocols in place, our preparation time, so that when you are going buck wild, it doesn't feel so wild. [laughter]

0:05:45.8 Tiff: Yeah.

0:05:46.1 Britt: And we know what to do. We're all on the same page and it's really nice and clear. One of the biggest helps I think perio protocols give us for a hygiene department is it allows us to like all move forward with confidence and be on the same page, and also make sure that our standard of care is consistent for every single patient. For me as a hygienist, having periodontal protocol in place helps me so that... It holds me accountable, so I kind of don't start to waiver too. I'm like, "Well, I don't wanna have that conversation today." Like, "Yeah, this one can slide." It holds me accountable to what actually needs to happen and especially when you work on a hygiene team. Most of my hygiene career clinical I was working with hygienist up to like six was the most we had in one office.

0:06:35.7 Tiff: Wow.

0:06:36.2 Britt: And I'll tell you, when we've got that many hygienist, if I'm seeing a patient someone else's seeing, and I like, "Oh, what were they doing last time [0:06:47.7] ____ do this last time? And now, I get to deal with it." Perio Protocol is huge because then it's the same standard for across all hygienists. We're not kind of passing the buck to someone else to deal with it later. And we're ensuring our patients have the same standard of care. And like for doctors too, I think it allows doctors when we've got that Periodontal Protocol in place to truly trust your hygienist to where they could make the right recommendation. You make that official diagnosis of things, and you're confident in what's being done. And it's much more efficient on time, so doctor doesn't feel like they've got to go through and like... Yes, they can look at it, but if I'm making a recommendation, they know I know the standard, they know I'm gonna recommend according to the standard, they can come and confirm. And our job is a lot more efficient.

0:07:27.8 Tiff: I love that. I'm writing a couple of notes because I have some ideas. You know me. Oh my God. I can't remember. So a couple of things that you said that I'm pulling out is, one, I wanted to highlight the doctor piece because you said the doctor can trust their hygiene team, which is huge. The foundation of a team is that trust level. So I think that's huge. And then I think I can flip that. My hygienist might laugh at me for this. I'm gonna flip that and say, when my doctors know our Perio Protocol and they're getting new patients and they're Perio probing because we know that they do that every time and they love to probe, they can help the hygiene department by following a protocol as well.

0:08:24.6 Tiff: Because I think one of the biggest fights... I'm gonna call it, one of the biggest upsets we've ever had it's when a hygienist gets a prophy, new patient. This new patient was seen on doctors schedule. They get a prophy in their schedule, and they're like, "Are you kidding me?" The calculus is like flying out of the mouth at this point. They're like, "What are you thinking? There's no way this is a prophy. This is clearly an SRP." And so there's this like... Doctor is like, "I don't know. Do it." And you're like, "Well, guess what? We can't do a cleaning today even though that's what you came in for." So I think it will help the trust factor from hygiene too. If a doctor knows what the Perio Protocol is that they can then sufficiently diagnose the way their hygienist would. So I think that's a great calibration tool, and I thought it out while you were saying that.

0:08:57.4 Tiff: So another thing I thought of, you said you had six hygienists, that's a lot. That's so many and so cool that you're able to do that and work in a practice like that. I love that you mentioned you'll see somebody else's patient and think, "Oh my gosh. What happened?" I love that, and I used to do that to my patients who didn't require a specific hygienist.

0:09:03.3 Tiff: When I was scheduling patients, I would try to mix them up, especially when we had a new hygienist on board because that's your calibration tool. That's how we know how the other hygienists are doing because we don't know. We have literally no idea what's coming and going, unless the doctor is going in behind you like you're at school and checking your prophies. And nobody has time for that nor do we have desire. I don't even as a non-hygienist wants to have that done. So I would say row-sham-bowing your patients as much as you can, giving them consistency and as... The consistency is within the appointment. The consistency is with the rest of the team, making sure that they're feeling that. They don't feel jostled, but seeing how the other hygienist are doing and then calibrating back to the Perio Protocol. So those were two things that I thought of and I was like, "Oh my gosh. You are so smart, Britt."

0:10:13.6 Tiff: So one question I have for you is... And especially 'cause you had this giant practice with so many hygienist, and I know you've implemented... I know hygiene is top of mind for you, always so within your practices you consulted, you've implemented Perio Protocols a ton. So who do you think... What's your opinion who should be making these Perio Protocols for the team and how should they be doing it?

0:10:37.8 Britt: I really like to see doctors and hygiene come together and build this protocol together. It's some really important pieces to make sure that you have in your protocol are gonna be, like your philosophy to treating periodontal disease. So if our philosophy is, "Great, we're always gonna try to treat them here first and then refer them somewhere else if needed," or like, "We're always gonna be proactive. We wanna take care of Perio as soon as possible." Whatever your philosophy is, it's very much gonna be doctor-driven, hygiene-driven. Build that together so you've got an overall idea of what you're wanting. And then build out your standards. If there are pocket depths, recession, give the specific guidelines of, "If you see these things, then it will be this treatment," and all the pieces of that treatment that are included.

0:11:28.4 Britt: So if that appointment, they're coming in for SRP, what qualifies them for an SRP, what amount of time, what are we doing during that appointment? And so that you're all on the same page. And then a really important piece of this protocol that's always a fun one to have the discussion and build is, what if patients refuse periodontal therapy or scaling root planning? So what are we gonna do as an office in that situation? How do we wanna handle those patients? And also, what's our point where we're gonna refer? We are not gonna see them here. We just need to refer them directly to somewhere else. Those are really important things, and they're kind of like the tough conversation you don't wanna have. But guess what? You're gonna end up with those patients. And it's a lot less fun in the moment to try to figure out how to deal with it. If we know ahead of time, your life is much easier.

0:12:17.6 Tiff: Totally, I love that. That was beautiful, beautiful. So I think those were completely actionable steps, and if you guys missed any of those pieces of what that perio protocol should be, rewind this, it's very simple, rewind this, slow it down, write it down, because she literally just give you the how-to on building that protocol. So, action items that I've got for you guys, we talked a lot about this perio protocol you understand the importance, you understand who can use it, and now who can make it, so I would say doctors and hygiene make an appointment, build an appointment into your schedule, I'm sorry meeting, build a meeting into your schedule where you guys can build out this protocol together, it is incredibly important. Doctors, I implore upon you to have your hygiene department a part of this. It will go much better, it will be used, it will be so smooth. So, doctors and hygiene, get a meeting together, build out this protocol, Britt just gave you all of the pieces of it. Some big pieces that I took away are philosophy, that's huge, and you guys should all agree on the philosophy.

0:13:20.1 Tiff: And then your standards, she wrote down those standards for you, again, rewind this, be specific, when are you gonna refer all of those pieces. Another protocol to build into it, and I would say this is even an actual protocol that you can build into your perio protocol, but the whole practice needs to be aware, because oftentimes front office will get the phone call to cancel SRP or will be calling to follow up an unscheduled treatment. We have to have these conversations as well. So what if your patient refuses your periodontal therapy, what does that protocol look like? So build out your periodontal protocol with your hygiene and doctor teams, and then what to do if a patient refuses, and then train your team on it. All of the clinicians should know how to utilize your perio protocol, all of your front office and maybe even dental assistants, especially hygiene and clinical doctors, should know how to do the refusal as well. So those are action items, I think this was huge, that was so tactical Britt, I love it, I love your details you know that, it was incredibly tactical. So you guys... Britt, thank you, first of all, thank you so much. I knew this was your jam, so I appreciate you.

0:14:24.7 Britt: One tip, because I know how we hygienist could be that we love our details and we definitely have opinions on about...

0:14:30.6 Tiff: So true.

0:14:31.0 Britt: Perio protocols, is before you go into that meeting to build this out, honestly, I'd have everybody go write out what you think that is. So what's your philosophy... Like come with an idea to the meeting instead of starting from scratch, what's your philosophy, what shouldn't... How should we treat certain scenarios, pockets-devs, recession, bleeding, inflammation, like what should we do for that treatment and what do we think our protocol should be when it comes to those people who are refusing periodontal therapy? And I think if you guys come into that meeting at that starting off point, you'll make a lot more progress.

0:15:03.4 Tiff: For sure that all I love that. Good job. Good job. Alright guys, you have the tools, we have the tips, you have the tools, go implement this, go get started and let us know how it goes. We love to hear from you, you can reach us at [email protected]. So if you've got questions, if you've got comments, if you got things that have worked for you, or let us know how this protocol goes for you, please let us know. And also, never forget to drop a five star review, we wanna hear from you. And I tell you guys all the time, there are people who read through those reviews and they get tips and they get tricks from you based on what you say, and then they also get a little glimpse into what this podcast was all about. So leave us a review, send us an email if you need to, and we cannot wait to catch up with next time.

[music]

0:15:48.4 Kiera Dent: And that wraps it up for another episode of The Dental A Team podcast. Thank you so much for listening and we'll talk to you next time.