The Education / Income Perio Excuse

It is a strange dichotomy in dentistry. Just about any time I ask dentist or hygienist alike, “What percentage of the population has periodontal disease?” the answers always seem to center around a 70 to 80% range. Then I ask, “If 80% or so of the population has periodontal disease, and you are doing a good job of treating the disease, what should the ratio of total healthy mouth cleanings to perio maintenance appointments be?” It would stand to reason that if 80% of the population has periodontal disease, then 80% of what happens in hygiene should be perio treatment related. Right?

But when closer inspection of the numbers reveals something less than 80% or a lot less than 80%, the explanations start flying. “Our patients are different. We just don’t have a lot of patients with periodontal disease. Our town is more educated than most. We practice in a wealthier part of town.”

For quite some time now, I have been looking for the clinical study that proves that there is an inverse relationship between household income or education and periodontal disease. If there is one out there somewhere and you know about it, please let me know because I have not been able to find it.

On the other hand, I have yet to meet a dentist who could tell me of a trial attorney for example who is a patient who did not have periodontal disease. Maybe there is one out there somewhere, but more often than not, they have it. Why? They are educated. They get paid far more than the average person. But they have periodontal disease. They have it because periodontal disease knows no educational or income boundaries. It has more to do with a compromised immune system that it does education or income. A compromised immune system can be fueled by stress. People with a lot of education and income many times have a lot of that because of their occupations and complicated priorities.

So every time I hear the education / income perio excuse, it causes me to start looking deeper for the real cause of the lack of perio treatment in the practice. Is it a lack of diagnosis? How about failure to treatment plan? Or is it really “Approval Addiction?”

Whatever the cause of this type of supervised neglect, it is rampant. Maybe as rampant in some dental offices as periodontal disease itself.

So start taking a closer look at what is really going on in your practice. Are you really treating the disease? Or are your patients victims of supervised neglect because of the “Education / Income Perio Excuse?” The numbers rarely lie. So look at the numbers before you listen to the excuse.