Patient and dentist talking while a nurse sits in the back on the computer

How to Increase Patient Compliance in Periodontal Patients

Date: Nov 19, 2018

Author: Mirissa D. Price, Harvard DMD' 19

Patients may have the notion that "gum disease" isn't a condition to lose sleep over. "It's just gingivitis" or "Gingivitis is reversible, so nothing is really wrong," some may think. Other patients may be totally unaware they have an oral health problem.

Yet, as we all know, gingivitis is a sign of compromised oral health, which requires an improvement in oral hygiene to prevent its possible progression into periodontitis. The challenges of patient motivation are clear. So, how can we increase patient compliance and convince patients that prevention is important? How can we ensure patients leave the clinic empowered to combat gingivitis?

The Prevalence of Periodontal Disease

Periodontal disease is an important consideration in every dental practice.

  • Gingivitis: A majority of children worldwide present signs of gingivitis, according to the World Health Organization.
  • Periodontitis: In the United States, the Centers for Disease Control and Prevention reports that about 47 percent of adults have mild, moderate or severe periodontitis, while the Platform for Better Oral Health in Europe notes that over 50 percent of the European population suffers from some form of periodontitis.

Increase Patient Compliance Through Education

Education is of course critical for convincing patients to follow home care instructions for better gingival health. They may not know that gingivitis is not just bleeding gums, but rather the start of a progressive disease process. It's important to clearly explain the risks and realities of their situation, while remaining positive. For example, for a patient with gingivitis, you can explain that their gingival problems can be halted, reversed and prevented from reoccurring if they improve oral care. You can stress it is important they act now, as gingivitis can worsen to become periodontitis, which is a much more serious and irreversible condition.

For patients with periodontitis, you should explain that it's a chronic condition that requires regular follow-up and collaborative care between the dentist and patient. They should understand that periodontitis is a disease process which can progressively destroy bone and therefore lead to tooth loss. Explain that halting the disease requires specific treatment and maintenance by a dentist, as well as lasting improvement to their oral hygiene routine. Stress that you need to work as a team to beat the disease and they need to take their share of responsibility.

You can also refer them to additional resources on periodontitis. For example, according to Harvard University Medical School, periodontitis may be associated with an increased risk for cardiovascular disease, chronic respiratory conditions and pregnancy complications. Severe periodontitis can lead to increases in blood sugar levels, endangering diabetics and putting healthy people at a higher risk for diabetes, notes the British Society of Periodontology.

Drawing on analogies with other diseases may help patients see the necessity to take more responsibility. Much in the same way that a patient with diabetes checks their blood sugar at home, a patient with periodontitis must maintain a vigilant home care routine. Just as a patient with diabetes would also receive regular blood tests to check for certain markers, patients with periodontitis require regular appointments to eliminate calculus and bacteria. Framing scaling and root planing as necessary treatment and not "just a cleaning" can transform the way you and your patients discuss periodontal health.

Empower Patients

The second step toward increased patient compliance is patient empowerment. Once they're armed with the knowledge that periodontitis is a chronic medical condition, patients require the tools to consistently combat this disease. One such tool is Colgate Gum Health Physical (GHP). Patients often have key areas of their mouths that require greater attention than others to reduce plaque and calculus deposits. With an easy-to-use tool like GHP, you can provide patients with a written report of the essential areas to focus on. Sharing take-home images and instructions helps patients keep up with their own care if they forget the details you discussed during their appointments.

Many patients with gingivitis and periodontitis experience halitosis and can benefit from a discussion about products to easily reverse this symptom. Improving bad breath may be more motivating than improved gum health for some patients and may help them remember your instructions.

Review the Basics

Finally, you can discuss brushing and flossing techniques with your patients at every visit — even if they insist they already know how! By making oral hygiene education a routine procedure during appointments, you can make hygiene education a judgment-free step of every dental visit.

There is a lot patients can do to improve their oral health and reduce their risk for chronic periodontal disease. However, we as dental professionals must continue to collaborate with patients to educate and empower them at every step. Better gingival health is possible!