Designed for dentists who want to revitalize an under producing hygiene department, this course focuses on unearthing the 'hidden' non-surgical therapy cases that are sitting in your charts! Learn a practical protocol that can be easily implemented for a successful periodontal therapy program. Practical applications for locally-applied antimicrobials including Periochip, Arestin and Atridox will be discussed, as well risk assessment and treatment planning exercises. Don't miss this career-changing course! As Linda Miles says: "If your hygiene department is holding you back, make this the year you decide to fix it and reap the rewards for your patients, your team and you. A higher level of quality care and a better net income awaits."

1. Dispel the 'Loss Leader' Myth
and
Double your Hygiene Production!!!
Presented by:
Colleen Rutledge, RDH
Perio-Therapeutics &
Beyond
www.PerioAnd Beyond.com

2. Systemic Link
Genetics DOES play role in
periodontal breakdown
IT wasn’t ALL about
the PLAQUE
afterall !!

3. Systemic Link
research strongly suggests oral bacteria may contribute to:
• Cardiovascular Disease
• Diabetes
• Pre-Term/Low Birth Wt. Babies
• Atherosclerosis
• Osteoporosis
• Stroke
• Stomach Ulcers
• Pneumonia

4. Surgeon Gener al Repor t
• Oral Health in America draws attention to the
“silent epidemic” of dental and oral diseases that
has affected large numbers of people in our
country
• “Good oral health and general health are
inseparable.”
• May 25, 2000: SG David Satcher, MD PhD

5. Risk Assessment
Systemic Link

6. Periodontal Therapy
Back in the 80’s we were limited….
Treatment
options
Prophy OR Perio Surgery

7. Periodontal Therapy
“From what we know now…”
Focus
Prophy Non-Surgical Perio Surgery

8. Periodontal Therapy
Dental offices are operating with
dated 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)

9. Periodontal Therapy
Major 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

10. Periodontal Therapy
A 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

11. Brief History of
Ultrasonics AKA:
Power Scaling
Accelerated
Instrumentation

12. 1950’s used for decay
removal
BIG &
BULKY
!
Photo courtesy of Anne Guignon RDH, MPH

13. Sonic and
Ultr asonic Scaler s
gained popularity
in 1960 & 70’s

14. Debridement of Lar ge
Supr a gingival Calculus

15. Even though we had this
technology…instruments still
r uled !

16. Now
we
know…
Ultrasonics
are as
effective as
hand scaling…
and may be a
BETTER
choice!!

17. "TALKING TIPS WITH COLLEEN”
www.acteonsupport.com/Colleen.html
Why choose
piezoelectric
technology?

18. Locally Applied
Antimicrobials
PerioChip ®
ATRIDOX®

19. Locally Applied Antimicrobials
PerioChip ®
Chlorhexadine
Gluconate
2.5 mg

20. Adrian Pharma
single site
FDA approved
Non-antibiotic
small
orange-brown chip
Initial Therapy or Maintenance
As an adjunct to scaling and root planing for
Periodontal pockets ≥ 5 mm in depth

21. Locally Applied
Antimicrobials
HOW to INSERT:
After isolating the periodontal pocket
and drying the surrounding area:
Insert curved .
end first, into the
pocket to its
maximum depth. Laschal

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

23. Locally Applied Antimicrobials

24. Locally Applied Antimicrobials
Flatten the tip – most important step!
Please see complete Prescribing Information following presentation

25. Courtesy of I. Farmer

26. Courtesy of I. Farmer

27. Locally Applied Antimicrobials
FDA approved
ATRIDOX® is a registered trademark of TOLMAR Inc

28. Module #3 Locally Applied
TOLMAR Inc. Antimicrobials
Preparation for Use
When removing caps, hold Twist and lock the 2 syringes.
syringes with nozzles Inject the liquid contents of
upright to avoid spilling Syringe A (indicated by red stripe) into
while coupling Syringe B (doxycycline powder)
ATRIDOX® is a registered trademark of TOLMAR Inc

29. Module #3 Locally Applied
TOLMAR Inc. Antimicrobials
Preparation for Use
Complete 100 mixing cycles at a pace of Attach the blunt cannula
1 cycle per second (or mix for 90
Bend cannula to resemble a
seconds)
periodontal probe
Push the contents back into Syringe A
ATRIDOX® is a registered trademark of TOLMAR Inc

30. Locally Applied Antimicrobials
ATRIDOX® Inserted
subgingivally into
pockets 5 mm &
greater
ATRIDOX® is a registered trademark of TOLMAR Inc

31. Locally
Applied Antimicrobials
Used in conjunction with SRP or
•
as a “stand alone” therapy
• No refrigeration or dressing
required
 No brushing or interdental cleaning
for 1 week in treated area
 Biodegradable and bioadhesive
 Treats multiple sites
 Reapplication - 4 months
ATRIDOX® is a registered trademark of TOLMAR Inc

32. Locally
Applied Antimicrobials
What makes ATRIDOX® so appealing
in this economy?
 Treats multiple sites!
 Excellent choice for 10, 20, or
even up to 30 pockets
 Affordable for both patient
and dental practices

33. Locally Applied Antimicrobials
SINGLE SITE LAA MULTIPLE SITE LAA
# 2 ML $40 # 2 ML
#2F $40 # 2F
# 3 DL $40 # 3 DL
# 3 MB $40 # 3 MB
# 4 ML $40 # 4 ML
# 4 MB $40 # 4 MB
# 5 DB $40 # 5 DB
$280 $180

34. SPECIAL!!!
FOR ATTENEDEES TONIGHT!!!
Visit the EXHIBIT
TABLE for
20 % off
all
DVD’s & CD’s

35. Scheduling and Production

36. 10:00 Patient one
Production = 4910 Perio Maint $125
$2235.00 for 6 11:00 Patient two
0180 Comp perio exam $60
hour day… 4341 Perio Therapy UL $175
4341 Perio Therapy LL $175
4341 Perio Therapy UR $175
4341 Perio Therapy LR $175
Generates 12:00 Patient three
4381 Atridox $150
$372.50 4341 Perio Therapy UL $175
4341 Perio Therapy LL $175
per/hour… 1:30 Patient four
4381 Atridox $150
4341 Perio Therapy UR $175
$447.00 per/ 4341 Perio Therapy LR $175
3:00 Patient five
patient 4341 PerioTherapy UL $175
4341 PerioTherapy LL $175

37. Itemized Production Per
Time Insurance Code Treatment Plan Perio Classification
Cost Patient
8:00 Patient One
8:10
8:20 4341 UL Perio Therapy $210 Severe Perio
8:30 4341 LL Perio Therapy $210 4-9 mm pockets
8:40 4381 1 Atridox for both quads $180 with risk assessment factors
8:50 and inflammation
9:00
9:10
9:20
9:30
9:40 Sub Total $600
9:50
10:00 Patient Two
10:10
10:20 4341 UL Perio Therapy $200 Moderate Perio
10:30 4341 LL Perio Therapy $200 4-7 mm pockets with
10:40 4381 1 Atridox for both quads $180 risk assessment factors
10:50 and inflammation
11:00
11:10 Sub Total $580
11:20
11:30 Patient Three
11:40 4341 UL Perio Therapy $190 Early Perio
11:50 4341 LL Perio Therapy $190 4 mm pockets (isolated 5mm)
12:00 4341 UR Perio Therapy $190 with risk assessment factors
12:10 4341 LR Perio Therapy $190 and inflammation
4381 1 Atridox or 4 $180
12:20 Periochip/Arestin
Sub Total $940
12:30 Lunch

38. Scheduling and Production
“You can not build a profitable,
high quality hygiene department
without consistent 6 point periodontal
charting on every adult patient”
Colleen Rutledge, RDH
Perio-Therapeutics & Beyond

39. Treatment Planning Exercise
 Yellow highlight all pockets 4
mm and above
 Circle all pockets 5 mm pockets
and above in RED

40. Treatment Planning Exercise
 Get your perio chart
 Focus on 1 QUADRANT
 4341 - 4 or more teeth have
depths 4 mm or greater
 4342 - 1 to 3 teeth have depths
4 mm or greater

41. Treatment Planning
4 4
5 4 5 5 5
44 44 4 4
44 5 4 4
4 4 4 4
4
5 4 4

42. 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)

43. Procedure codes and fees
4381
PerioChip Arestin Atridox
4381. P 4381. AR 4381.AX
$35 $40 $180

44. Procedure Codes and Fees
4341
$250
4341. E 4341. M 4341.S
$240 $250 $260

45. Procedure codes and fees
4342
$150
4342. 1 4342. 2 4342.3
$140 $150 $160

46. Case Studies
Before & After Client Profiles
Average Return on Investment:
3 - 6 months

47. Case Studies
1 DDS / 3 RDH
Texas Revenue increase
Pre-consult Post consult
Client # 1 6 mo total 6 mo total
6 mths
post consult
arestin 42 134 $ 2,375
atridox 0 27 $ 4,050
SRP 4341 39 100 $ 10,065
SRP 4342 13 63 $ 4,250
*PCht 0180 69 268 $ 3,980
$ 24,720
* this client incorporated Oral Cancer Screening technology as well and increased
production by an ADDITIONAL $8,710

48. Case Studies
1 DDS / 1.5 RDH
Virginia
Client # 2 Pre-consult Post consult Revenue increase
6 mo total 6 mo total
6 mths post consult
arestin 0 55 $ 1,925
atridox 0 19 $ 3,420
SRP 4341 11 57 $ 13,048
SRP 4342 3 52 $ 9,702
periochip 0 35 $ 1,400
P Mt 4910 41 64 $ 2,484
$ 31,979

49. Case Studies
2 DDS / 3 RDH
Pennsylvania
Pre-consult Post consult Revenue increase
Client # 3 6 mo total 6 mo total
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

50. W hich pr oduction scenario
would you pr efer??
Adult prophy Perio Therapy
$100 $1000
Supervised High quality
neglect care

51. 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

52. 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!

53. Don’t miss this opportunity…
20 % off
All
DVD’s
&
CD’s

54. Colleen Rutledge, RDH
“Taking Hygiene Departments to Periodontal Therapy Levels”
www.PerioAndBeyond.com
267-241-5833
724 Fitzwatertown Road Glenside, PA 19038
Colleen@PerioAndBeyond.com