Periodontal Risk Prediction

Using PreViser for effective treatment planning and patient motivation

Periodontal disease is the primary cause of tooth loss in adults.  It also has causal associations with rheumatoid arthritis, diabetes and cardiovascular disease amongst others, and therefore the efficacy of your treatment and communication in the dental practice has far reaching implications for the overall health of your patients. Importantly, perio disease is preventable / controllable if a risk based approach is taken to identify the disease early (Axelsson1991), and factors that put patients at risk, genetics aside, are modifiable.

Are you taking a risk based approach and are your patients aware and informed of the positive effect that your care and their participation can have on both their oral and general health?

Prevention has to be the key message today in dentistry, as it is unquestionably better for health, and cheaper for all stakeholders, than cure.  Cosmetic dentistry has its place, but only with the fundamental understanding from the patient that success is dependent on a healthy periodontium.

The Steele report identified periodontal risk assessment as one of the building blocks of the Oral Health Assessment, and you are unlikely to find a perio course today that does not advocate the determination of risk as the foundation stone of successful treatment planning.  Patients vary in their susceptibility and it would be wrong to treat them purely on the basis of identified disease.  Indeed the American Association of Periodontology has stated that risk assessment should form the basis of every oral examination. 

But how do you assess risk?  Periodontal risk assessment is complex.  It is an amalgamation of different risk factors that manifest different and variable weights and which are not simply additive.   You will not be surprised to learn that studies have shown that dentists, whether periodontal specialists or GDPs, vary widely in their subjective perception of risk when examining the same patient set (Persson 2003)

The PreViser Solution

Building on a wealth of research, dentists at PreViser have developed an internet based tool which offers a unique solution to the dual challenges of risk assessment and patient motivation.  From the perspective of the operator, whether dentist or hygienist, PreViser is incredibly simple to use, taking just 3-4 minutes.  Data is entered from a routine examination whilst your patient is in the chair and in seconds, the PreViser algorithm quantifies patients’ risk and disease levels into objective and reproducible scores (risk 1-5 and disease 1-100) which are presented on a personalized colour coded report.   Treatment guidance, determined in accordance with European best practice, is also optionally available.

The scores enable your patients to understand their current state of health and their future disease progression (if no action is taken) in a way that traditional classifications of perio disease, and the presence of disease in a patient despite an absence of pain, have historically been difficult to communicate.   Both scores are sensitive to minor changes so on subsequent visits, a graph within the report shows the changes in the scores over time, demonstrating the value of your treatment and the efficacy of the patient’s home care. 

Benefits

  • The ability to systematically categorise patients according to risk, thus helping to determine more objectively the nature of treatment plans and recall intervals.
  • Personalised feedback raises motivation and own risk factor management of patients leading to improved compliance and uptake of hygiene appointments
  • PreViser proves that the treatment being implemented is providing benefit for your patients by reducing risk and disease
    scores
  • In this medico legal world where 1/3 of the highest value claims are for perio, by ‘PreVisering’ your patients, you can be
    confident that you have identified the patients disease and risk and the patient is fully informed of their status

Denplan Excel Pilot

PreViser was initially introduced to the UK through a pilot with Denplan Excel.  You can read about the reactions of the pilot dentists and their patients in Denplan’s 2010 March Newsletter here. 

Try it out

Our software is downloadable from the internet free of charge at www.previser.co.uk and can be used on an unlimited number of patients without cost for a one month period.   Please try it for yourself to understand what a difference it makes to your practice and to your patient’s perception of, and motivation towards, their oral health. 

 

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