The Perio Paradox


If you’ve been reading my articles for awhile, it’s probably no surprise to you to hear about the “Perio Paradox”, a term coined by one of my mentors, Dr. Chris Bowman. Depending on what study you read, it’s estimated that 35-75% of Americans have some form of periodontal disease. And when I ask my coaching clients and Mastermind members what percentage of their patients have 4-5mm bleeding pockets, they routinely say 40-50%. Yet for many of them, perio therapy and maintenance makes up only 5-10% of their clinical hygiene services. It’s an absurd but true statement. This is the “Perio Paradox”.

So how do we close that gap? Well, first we must realize that it’s not the dentist or the hygienist’s intention not to treat perio disease. In fact, many times they are treating the disease BUT calling it a “difficult prophy”. Everyone loses in this situation. The patient loses because they are not made aware of the disease and it’s far reaching effects. The hygienist loses because he or she is working extremely hard on what should be a simple prophy. The practice loses because it’s not being compensated for the work. And the doctor loses because undiagnosed perio disease is the most common reason for dental lawsuits.

So what do you do? My readers have heard me say it a thousand times…we must be doing complete perio charting with bleeding points, recession, mobility and furcation AT LEAST once a year. How else are we going to know if the patient is healthy or has disease?

At Inspired Hygiene, we give our clients tools to use this data to educate and enroll the patient into therapy with ease. Like printing the perio chart and sharing it with the patient- knee to knee.

And we help our clients work through obstacles that might have held them back in the past from developing and implementing a truly progressive periodontal diagnosis and treatment program.

Some of the most common obstacles are:

No clear consistent system for perio diagnosis and treatment
Hygienists are not calibrated (not all on the same page)
Poor tools/instruments
No room in the schedule for perio care
Beliefs about patients’ ability to pay
Difficulty using technology
Too much scaling and not enough exam time in the hygiene appointment
Fear of presenting to long-term patients
Sound familiar? If not, congratulations! If so, you’re not alone AND there are several ways we can help. To start, we’d like to invite you to attend a Free Tele-class “Stop Losing Thousands of Dollars in Undiagnosed and Untreated Perio”. Go to for details and to register for the class. All dental team members are welcome. On the call, we’ll preview our High Performance Perio 6 Week Perio Webinar Training. Consider it an investment in the health of your practice and your patients.

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