PATIENT RELUCTANCE TO ACCEPT TREATMENT RECOMMENDATIONS FOR PERIODONTAL DISEASE

It can be challenging at times to motivate patients with periodontal disease to accept treatment recommendations. Patients usually are not aware that they have periodontal disease. Since periodontal disease is often asymptomatic, patients may be reluctant to accept our treatment recommendations. As a result, periodontal disease can progress and lead to:

• The need for much more extensive treatment.
• Tooth loss.
• Other systematic health-related problems.

The following is an example of a patient who first was told that she has localized periodontal disease 10 years prior to the photographs and the radiograph is seen below. At that time, the patient did not accept the treatment recommendation by her general dentist, which was for a nonsurgical treatment consisting of scaling and root planning.

Declining the recommended scaling and root planning resulted in progressive loss of tooth support. The tooth eventually loosened to the point that chewing became painful and no periodontal treatment could salvage the tooth.

Loss of teeth is NOT due to the aging process. It is due to bacteria that remain below the gum and the patient’s immune response to the pathogens. It is very likely that if the patient had received treatment prior to the disease progressing to such an advanced state, the tooth would still be in the patient’s mouth.

CONCLUSION: Effective communication skills can motivate patients to receive the periodontal treatment they require during the early stages of the disease (gingivitis). The use of visual aids and analogies are methods that can be effective. So part of this comes down to showing patients what is going on and explaining that, like a leaky pipe, the best time to fix a problem is when you first notice it… not when the house is flooded.