Dentaltown January 2017 - 41

Standard of care and insurance never belong in the same sentence or thought. Insurance
is about one thing and one thing only: money. Pure and simple. The patient still needs PMs
regardless. Frequency is determined by current periodontal status. This is something though the
ADA needs to address. The ability for insurance companies to put a limit on PMs needs to be
removed, as with anything else that is 100 percent against health. All the insurance company
is doing is trying to save money. They need to go the other direction and just raise premiums if
they want more profits. ■

380Dental
Member Since: 07/22/11
Post: 17 of 21

10/29/2016

I work with patients who want to avoid dental treatments. My career has been helping
patients reverse cavities and periodontal problems-and then they go back to their own dentists/
periodontal offices for follow-up. I have numerous clients who have received their money back
after pre-paying for treatment. Others have extended the length of time between treatments,
tested clear on oral DNA testing and they have no more pocketing or bleeding. Next, they find
improved A1c and CRP markers (improvement in body inflammation.)
Resolution depends on protecting healthy biofilm (balancing the mouth ecology) as much
as removing unhealthy pathogens. This consideration of "what is in a healthy mouth?" is rarely
addressed. Most treatments involve SRP and then antibiotics and antiseptics that kill all the
bacteria in the mouth-good and bad. Imagine doing this to your garden-what comes back?
Weeds. Over and over.
When you promote a healthy ecology at the same time as you tactically remove pathogens
you will get resolution over time-usually about 6 months. Of course, the whole family has to
be involved since this is a contagious situation between spouses etc.
I also explain why a patient needs to clean their toothbrush every day until the infection has
gone. A simple step that can make a world of difference. ■

zellie
Member Since: 07/22/08
Post: 18 of 21

10/29/2016

This is something new this year with insurance companies dictating the need for retreating
with SRP. We have had it happen as well and our insurance person received notice that this was
coming. Maddening for sure. We have sent narratives when patients have been denied their perio
maintenance benefit. Patients understand how wrong it is for their company to dictate their
treatment needs when they have full trust and confidence in our care.
We are all aware of not committing fraudulence with insurance companies. Seems fraudulent in a sense to me, the other way around, by calling someone a "healthy" adult prophy when
they are not by all AAP classifications with recession, furcations, mobility, systemic factors...
but stable. Our patients have made a commitment to the process and have worked too hard to
be stable! We have worked hard coming alongside of them as well! We have to report what is
actually done at each appointment. This is a fight. National level? Patient level? Patient company
HR level? DDS office level? ■

jodyhardwick
Member Since: 01/31/07
Post: 19 of 21

10/29/2016

I appreciate your serious inquiry into a debatable issue between some third-party payers and
sound clinical science.
Periodontitis is a chronic inflammatory disease that is not contagious (yes, to transmissibility),
not an infection, and thus parallels other conditions of this nature as diabetes, CVD, etc.
This group of conditions cannot be "cured" or "fi xed" and are therefore managed by the clinician and the patient. The descriptor for prophylaxis does not contain verbiage for managing
periodontitis.

sperio
Member Since: 07/17/05
Post: 20 of 21

dentaltown.com \\ JANUARY 2017

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