Prioritising periodontal checks

  • Periodontal disease is widespread and as much a threat to patients' oral health as tooth decay. Typical symptoms can be easy to miss until it's too late to treat them effectively.
  • Dental professionals have a critical role in monitoring patients' gum health at each check-up, in diagnosing periodontal disease and advising those who are at risk.

When do claims occur?

Reasons for claims against dental professionals involving periodontal disease include:

  • Failure to diagnose and treat gum disease.
  • Poor management, where the disease is diagnosed but it is alleged the dental professional doesn't manage the condition properly or make a suitable referral.
  • Poor communication between a dentist and patient, where a patient believes they have not been fully informed about treatment, risks, benefits and possible alternatives.
  • Incomplete or inaccurate records, making it more difficult for the dentist to monitor the patient's progress.
  • Failure to record relevant details of the treatment plan and the advice given to the patient – which in turn can make it more difficult to challenge the patient's version of events.

DDU advice

Follow the guidance

Follow available national guidance to make sure your treatment is evidence-based – for example, the British Society of Periodontology's guidance on the Basic Periodontal Examination (BPE).

Keep detailed notes

Record all your examination findings in the patient's clinical notes, including their BPE scores and your assessment of their periodontal health.

Make a note of factors such as the presence of plaque, calculus and gingival bleeding that may make the patient susceptible to periodontitis and in need of closer examination at future appointments.

Communicate with the patient

Explain to the patient if they are at risk of periodontal disease and how they can protect themselves. Explain the link between diabetes and periodontitis, the need for good oral hygiene and more frequent visits to the hygienist, and the importance of stopping smoking. Make a note of the conversation.

If you decide that the patient's gum disease only requires monitoring and advice at this stage, you should still explain this to them, record your discussion and their consent to your treatment plan in the records.

Make sure you have a system in place to record the periodontal condition, such as pocketing and loss of attachment at each visit.

Obtain consent

When obtaining consent for periodontal treatment, take time to explain the risks, benefits and alternatives. Make a careful note of what you discussed and their agreement in the clinical records.

If the patient fails to respond to treatment, including a failure to carry out adequate plaque control despite repeated oral hygiene instruction, make a note of this in the records, along with the explanations given to the patient regarding the consequences.

Recognise your limits

Recognise the limits of your own clinical skills. Be prepared to offer referral to a specialist if the patient's condition does not improve despite treatment.

This page was correct at publication on 15/08/2018. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.