How does your group practice measure up?

By Heidi Arndt

One of the biggest hygiene opportunities within the dental group practice is the opportunity to improve on the diagnosis and treatment of periodontal disease. Having a tangible way in which to measure a team’s effectiveness with treatment periodontal disease lies within one important indicator – the periodontal percentage.

The periodontal percentage is the best Key Performance Indicator to review how well a team is addressing periodontal disease. The periodontal percentage provides a look at how many of the patients are treated for periodontal disease vs. receiving a prophy.

In 2012, the CDC released a report stating that half of American Adults suffer from periodontal disease. (And remember, this number does not include “gingivitis”, as many earlier statistics did.) The rate of periodontal disease went up to 70 percent with patients over the age of 65.1

Clearly, periodontal disease is prevalent in adult patients. It does not matter where we live, how much money we have, how well educated we are … periodontal disease is affecting a large amount of the patients in every practice.
There are several ways to calculate the periodontal percentage, but here is the best calculation:

SRP Quadrant (D4341) + SRP Localized (D4342) + Periodontal Maintenance (D4910) + Prophy (1110) = A
SRP Quadrant (D4341) + SRP Localized (D4342) + Periodontal Maintenance (D4910) = B
Periodontal Percentage = B/A

The periodontal percentage looks at the definitive non-surgical periodontal therapy codes measured against the number of adult prophy’s performed in a practice.

There is one challenge with this calculation that should be addressed. While the adult prophy is a measure of 1 patient; the 4341 or 4342 code will calculate up to four times for 1 patient. Thus, the periodontal percentage is the calculation of procedures only, not of actual patients.

Making sense of the percentages
So, what does the periodontal percentage mean?

Is the team’s percentage above 60 percent?
If so, the team is delivering a very high level of non-surgical periodontal care to the patients. It is effective at assessing, educating and enrolling patients in necessary treatment.

Areas to focus on: Continue to focus on the periodontal therapy program and attend continuing education events to ensure the team is always providing the best of care.

Is the team’s percentage between 40 to 60 percent?
This is better than average. However, there are several opportunities that still exist.

Areas to focus on: Review the periodontal therapy program and focus on effective and consistent communication with the patients, and between all providers. Ensure everyone is speaking the same language to increase treatment acceptance.

Is the team’s periodontal percentage below 30 percent?
This periodontal program needs immediate attention. Most of the patients are receiving prophy’s and there is a good chance there is a high amount of untreated periodontal disease in the patient base. A low periodontal percentage is one indicator that it is time to evaluate the quality of the assessments and diagnostic care occurring in the hygiene chair. The first step to increase the periodontal program is assessing the patient and making a clear diagnosis. A strong and consistent assessment will guide you to a periodontal diagnosis for the patients.

Assessment
No matter what your periodontal percentage lands, the first place to focus on is the Periodontal Assessment. The dental hygiene team must complete a comprehensive periodontal assessment on every adult patient, with a full documentation in the patient record once yearly.

According to the Academy of Periodontology, the comprehensive periodontal assessment should include: A review of the patient’s current healthy status, history of disease, and risk characteristics. The dental hygienists must then record the probing depths, recession, mobility, furcation, bleeding and exudate.2

Using the comprehensive periodontal assessment, the dental team can develop a logical plan of treatment to eliminate the signs and symptoms of periodontal disease. The Academy of Periodontology website www.perio.org, provides numerous resources to help support a strong periodontal therapy program.

In addition, the team should attend a continuing education course focused solely on the development and implementation of a non-surgical periodontal therapy program. Your periodontal therapy program does not need to be elaborate. In fact, the best and most effective plans are created for simplicity and easily implemented into any office. Enhanced Hygiene (www.enhancedhygiene.com) offers several courses throughout the year focused on periodontal therapy programs.

Placing a focus on your periodontal therapy program will improve the level of patient care and service you provide in your group practice; and, improve your hygiene revenue.


Sources:
1. P.I. Eke, B.A. Dye, L. Wei, G.O. Thornton-Evans, and R.J. Genco. Prevalence of Periodontitis in Adults in the United States: 2009 and 2010. J Dent. Res. 2012.
2. Comprehensive Periodontal Therapy: A Statement by the Academy of Periodontology. J Periodontal, July 2011.

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