Dispel the Loss Leader Myth and Double your Hygiene Production!

Dispel the 'Loss Leader' MythDispel the 'Loss Leader' Myth and and

Double your Hygiene Production!!!Double your Hygiene Production!!!

Presented by:Presented by:

Colleen Rutledge, RDHColleen Rutledge, RDH

Perio-Therapeutics & Perio-Therapeutics & BeyondBeyond

www.PerioAndBeyond.comBeyond.com

IT wasn’t ALL about the PLAQUE afterall !!

Systemic LinkSystemic Link

Genetics DOES play role in Genetics DOES play role in periodontal breakdownperiodontal breakdown

Systemic LinkSystemic Linkresearch strongly suggests oral bacteria may contribute to:research strongly suggests oral bacteria may contribute to:

• Cardiovascular Disease• Diabetes• Pre-Term/Low Birth Wt. Babies• Atherosclerosis• Osteoporosis• Stroke• Stomach Ulcers• Pneumonia

SurgeonGeneral Report

• Oral Health in AmericaOral Health in America draws attention to draws attention to the “silent epidemic” of dental and oral the “silent epidemic” of dental and oral diseases that has affected large numbers diseases that has affected large numbers of people in our countryof people in our country

• ““Good oral health and general health are Good oral health and general health are inseparable.” inseparable.”

• May 25, 2000: SG David Satcher, MD PhDMay 25, 2000: SG David Satcher, MD PhD

Ris

k A

sses

smen

tSystemic LinkSystemic Link

Back in the 80’s we were limitedBack in the 80’s we were limited….….

Treatment Treatment

optionsoptions

ProphyProphy OROR Perio SurgeryPerio Surgery

Periodontal TherapyPeriodontal Therapy

Periodontal TherapyPeriodontal Therapy

““From what we know nowFrom what we know now…”…”

FocusFocus

ProphyProphy Non-SurgicalNon-Surgical Perio SurgeryPerio Surgery

Periodontal TherapyPeriodontal Therapy

Dental offices are operating with Dental offices are operating with

dated hygiene department protocolsdated hygiene department protocols

“Quads” “SRP” “STM” 4341 / 4342 Relying SOLELY on local anesthesia

Removing bacteria & calculus

¼ mouth at a time

Treatment completed in 2 to 4 visits

(usually 2 weeks apart)

Periodontal TherapyPeriodontal TherapyMajor DOWNFALL:

Treatment usually not completed in a timely fashion

(or at all!)

Patients numb for the procedure

Compromised clinical results with high probability of

relapse Typical ‘prophy’ services across the country are

nothing more than “supervised neglect” Many patients are left untreated due to under

diagnosis

Periodontal TherapyPeriodontal Therapy

A Contemporary ApproachA Contemporary Approach

Oral cavity is treated as an infection Focuses on decreasing the bacterial load ASAP Cases finished in same day or within a week Newer products (Oraqix) used in place of needle

Medical model vs mechanical model

Locally applied antimicrobials

ULTRASONICS! Piezoelectric technology

Brief History of Ultrasonics AKA:

Power Scaling

Accelerated

Instrumentation

1950’s used for decay 1950’s used for decay removalremoval

BIG & BULKY!

Photo courtesy of Anne Guignon RDH, MPH

Sonic and Ultrasonic Scalers gained popularity in 1960 & 70’s

Debridement of Large Debridement of Large SupraSupragingival Calculusgingival Calculus

Even though we had this technology…instruments still

ruled !

UltrasonicsUltrasonics

are asare as

effective as effective as hand scaling… hand scaling…

and may be a and may be a BETTER BETTER choice!!choice!!

Now

we

know…

"TALKING TIPS WITH COLLEEN” www.acteonsupport.com/Colleen.html

Why choose piezoelectric technology?

PerioChipPerioChip ®®

ATRIDOX®

Locally Applied Locally Applied AntimicrobialsAntimicrobials

PerioChip ®

Chlorhexadine Gluconate

2.5 mg

Locally Applied AntimicrobialsLocally Applied Antimicrobials

Adrian PharmaAdrian Pharma

single sitesingle siteFDA approvedFDA approved

Non-antibioticNon-antibioticsmall small

orange-brown chiporange-brown chip

Initial Therapy or MaintenanceInitial Therapy or Maintenance

As an adjunct to scaling and root planing for As an adjunct to scaling and root planing for

Periodontal pockets Periodontal pockets 5 mm in depth5 mm in depth

Locally Applied Locally Applied AntimicrobialsAntimicrobials

Insert curved end first, into the pocket to its maximum depth.

.

HOW to INSERT:After isolating the periodontal pocket

and drying the surrounding area:

Laschal

• Henry ScheinHenry Schein• FDA approvedFDA approved• Single site (#12 ML)Single site (#12 ML)• 1 mg minocycline (antibiotic ‘powder’)• Place tip at the base of pocket• Express handle while retracting slowly

Locally Applied AntimicrobialsLocally Applied Antimicrobials

Locally Applied AntimicrobialsLocally Applied Antimicrobials

Locally Applied Antimicrobials Locally Applied Antimicrobials Flatten the tip – most important step!

Please see complete Prescribing Information following presentation

Courtesy of I. Farmer

Courtesy of I. Farmer

FDA approvedFDA approved

        ATRIDOX® is a registered trademark of TOLMAR IncATRIDOX® is a registered trademark of TOLMAR Inc

Locally Applied AntimicrobialsLocally Applied Antimicrobials

TOLMAR Inc.

Preparation for Use

When removing caps, hold syringes with nozzles upright to avoid spilling while coupling

Twist and lock the 2 syringes. Inject the liquid contents of Syringe A (indicated by red stripe) into Syringe B (doxycycline powder)

        ATRIDOX® is a registered trademark of TOLMAR IncATRIDOX® is a registered trademark of TOLMAR Inc

Module #3 Locally Applied Module #3 Locally Applied AntimicrobialsAntimicrobials

TOLMAR Inc.

Attach the blunt cannula

Bend cannula to resemble a periodontal probe

Complete 100 mixing cycles at a pace of 1 cycle per second (or mix for 90 seconds)

Push the contents back into Syringe A

Preparation for Use

ATRIDOX® is a registered trademark of TOLMAR IncATRIDOX® is a registered trademark of TOLMAR Inc

Module #3 Locally Applied Module #3 Locally Applied AntimicrobialsAntimicrobials

ATRIDOX® ATRIDOX® Inserted Inserted subgingivally intosubgingivally into

pockets 5 mm & pockets 5 mm & greatergreater

ATRIDOX® is a registered trademark of TOLMAR IncATRIDOX® is a registered trademark of TOLMAR Inc

Locally Applied AntimicrobialsLocally Applied Antimicrobials

No brushing or interdental cleaning No brushing or interdental cleaning for for 1 week1 week in treated area in treated area

Biodegradable and bioadhesiveBiodegradable and bioadhesive

Treats Treats multiple sitesmultiple sites Reapplication - 4 monthsReapplication - 4 months

• Used in conjunction with SRP or as a “stand alone” therapy• No refrigeration or dressing required

ATRIDOX® is a registered trademark of TOLMAR IncATRIDOX® is a registered trademark of TOLMAR Inc

Locally Locally Applied AntimicrobialsApplied Antimicrobials

Locally Locally Applied AntimicrobialsApplied Antimicrobials

What makes What makes ATRIDOX® ATRIDOX® so appealing so appealing in this economy?in this economy?

Treats Treats multiplemultiple sites! sites! Excellent choice for 10, 20, or Excellent choice for 10, 20, or

even up to 30 pockets even up to 30 pockets Affordable for both Affordable for both patientpatient

and and dental practicesdental practices

Locally Applied AntimicrobialsLocally Applied Antimicrobials

SINGLE SITE LAASINGLE SITE LAA# 2 ML $40# 2 ML $40# 2 F $40# 2 F $40# 3 DL $40# 3 DL $40# 3 MB $40# 3 MB $40# 4 ML $40# 4 ML $40# 4 MB $40# 4 MB $40# 5 DB $40# 5 DB $40

$280$280

MULTIPLE SITE LAAMULTIPLE SITE LAA # 2 ML# 2 ML

# 2 F # 2 F # 3 DL# 3 DL# 3 MB# 3 MB

# 4 ML # 4 ML # 4 MB# 4 MB# 5 DB# 5 DB

$180$180

Visit the EXHIBIT Visit the EXHIBIT TABLE for TABLE for

20 % off 20 % off all all

DVD’s & CD’sDVD’s & CD’s

SPECIAL!!! FOR ATTENEDEES TONIGHT!!!

Scheduling and Production

10:00 Patient one 4910 Perio Maint $125

11:00 Patient two0180 Comp perio exam $60

4341 Perio Therapy UL $1754341 Perio Therapy LL $1754341 Perio Therapy UR $1754341 Perio Therapy LR $175

12:00 Patient three4381 Atridox $150

4341 Perio Therapy UL $1754341 Perio Therapy LL $175

1:30 Patient four4381 Atridox $150

4341 Perio Therapy UR $1754341 Perio Therapy LR $175

3:00 Patient five4341 PerioTherapy UL $1754341 PerioTherapy LL $175

Production = $2235.00 for 6 hour day…

Generates $372.50per/hour…

$447.00 per/ patient

Time Insurance Code Treatment PlanItemized

CostProduction Per

PatientPerio Classification

8:00 Patient One8:108:20 4341 UL Perio Therapy $210 Severe Perio8:30 4341 LL Perio Therapy $210 4-9 mm pockets8:40 4381 1 Atridox for both quads $180 with risk assessment factors8:50 and inflammation9:009:109:209:30

9:40 Sub Total $6009:50

10:00 Patient Two10:1010:20 4341 UL Perio Therapy $200 Moderate Perio 10:30 4341 LL Perio Therapy $200 4-7 mm pockets with10:40 4381 1 Atridox for both quads $180 risk assessment factors10:50 and inflammation11:00

11:10 Sub Total $58011:2011:30 Patient Three11:40 4341 UL Perio Therapy $190 Early Perio11:50 4341 LL Perio Therapy $190 4 mm pockets (isolated 5mm)12:00 4341 UR Perio Therapy $190 with risk assessment factors12:10 4341 LR Perio Therapy $190 and inflammation

12:204381 1 Atridox or 4

Periochip/Arestin$180

Sub Total $94012:30 Lunch

“You can not build a profitable, high quality hygiene department

without consistent 6 point periodontal charting on every adult patient”

Colleen Rutledge, RDHPerio-Therapeutics & Beyond

Scheduling and Production

Treatment Planning ExerciseTreatment Planning Exercise

Yellow Yellow highlight all pockets highlight all pockets 4 4

mmmm and aboveand above

Circle all pockets Circle all pockets 5 mm pockets5 mm pockets

and aboveand above in in REDRED

Treatment Planning ExerciseTreatment Planning Exercise

Get your perio chartGet your perio chart

Focus on 1 Focus on 1 QUADRANTQUADRANT

43414341 - 4 or more - 4 or more teethteeth have have

depths 4 mm or greaterdepths 4 mm or greater

4342 4342 - 1 to 3 - 1 to 3 teethteeth have depths have depths

4 mm or greater4 mm or greater

Treatment Planning

4 4444

4

4 4

444

44

4 444 4

44

5

5

5

55 5

Procedure Codes and Fees

• If the ratio of 4910 is disproportionate to the number of periodontal therapy procedures (4341 / 4342) then…..

• Your practice is skipping the therapy and putting patients into “maintenance”

** (gives the ‘illusion’ of a perio program)

Procedure codes and fees

4381

PerioChip

4381. P$35

Arestin

4381. AR$40

Atridox

4381.AX$180

Procedure Codes and Fees

4341$250

4341. E$240

4341. M$250

4341.S$260

Procedure codes and fees

4342$150

4342. 1$140

4342. 2$150

4342.3$160

Case StudiesBefore & After Client Profiles

Average Return on Investment:

3 - 6 months

Case Studies 1 DDS / 3 RDH Texas

* this client incorporated Oral Cancer Screening technology as well and increased

production by an ADDITIONAL $8,710

Client # 1Pre-consult 6 mo total

Post consult 6 mo total

Revenue increase6 mths

post consult

arestin 42 134 $ 2,375

atridox 0 27 $ 4,050SRP 4341 39 100 $ 10,065SRP 4342 13 63 $ 4,250

$ 24,720

*PCht 0180 69 268 $ 3,980

Case Studies 1 DDS / 1.5 RDH

Virginia Client # 2 Revenue increase

6 mths post consult

periochip 0 35 $ 1,400

arestin 0 55 $ 1,925

atridox 0 19 $ 3,420

SRP 4341 11 57 $ 13,048

SRP 4342 3 52 $ 9,702

P Mt 4910 41 64 $ 2,484

$ 31,979

Pre-consult 6 mo total

Post consult 6 mo total

Case Studies 2 DDS / 3 RDH

Pennsylvania Client # 3 Revenue increase

6 mths post consult

debr 4355 12 19 $ 1,015

periochip 0 32 $ 1,280

arestin 0 130 $ 5,200

atridox 0 52 $ 9,360

SRP 4341 12 44 $ 6,240

SRP 4342 16 147 $ 16,375

P Mt 4910 1 11 $ 1,210

Pchrt 0180 0 17 $ 1,275

$41,955

Pre-consult 6 mo total

Post consult 6 mo total

Which production scenario would you prefer??

Adult prophy

$100Supervised

neglect

Perio Therapy

$1000High quality

care

You can do this on your own….

5 things you must do to get started:

Order new probes (standardize) Full mouth charting on ALL ADULTS Email Colleen (Colleen@PerioAndBeyond.com):

RISK Assessment Teach your staff how to Treatment Plan

(use exercise form) Order Locally Applied Antimicrobials

The greatest benefits of NOT doing it yourself:

1. I will work with your ENTIRE staff hand-in-hand, step by step through the process so everyone is on the SAME PAGE

2. Your quality / variety of hygiene services are literally transformed OVERNIGHT!

3. HUGE and IMMEDIATE increase in hygiene production!

20 % off

All DVD’s

& CD’s

Don’t miss this opportunity…

Colleen Rutledge, RDH“Taking Hygiene Departments to Periodontal Therapy

Levels”

724 Fitzwatertown Road Glenside, PA 19038 Colleen@PerioAndBeyond.com

www.PerioAndBeyond.com

267-241-5833