Immediate Pocket Elimination Without Flaps While Scaling and Root Planing

You're listening to The Dr. Phil Klein Dental Podcast Welcome to the show. I'm Dr. Phil Klein. Today we'll be discussing some significant issues that we face as GPs in treating periodontitis in our GP operatory. Our guest is Hillary Spencer, a full-time clinical hygienist living in Kona, Hawaii. Hillary is one of the first hygienists trained in the use of the BenTips periodontal treatment system and has become an expert in its use. Before we get started on this podcast, I would like to mention that Hillary’s update webinar titled Advanced Perio Treatment Made Easy and Profitable for the Hygienist and GP is now available as an on-demand webinar on VivaLearning.com. Simply type in the search field Spencer, S-P-E-N-C-E -R, and you'll find it. If you are a hygienist or GP, I recommend this webinar very much. Hillary, it's a pleasure to have you on Dental Talk. Hi, Dr. Phil. It's a pleasure to be here. Thanks for having me. Yeah, my pleasure. So to begin, can you explain what BenTips is and what issues in the GP practice does it actually address? Oh, yeah, sure. I think the best way I'd describe BenTips procedure is it's an easy and fast method to eliminate periodontal pockets. It permits full visual access to the calculus so we can quickly remove it and for easy maintenance. In addition, I've found it's way less invasive than traditional flap surgery. What I really like about the procedure is instead of constantly trying to battle unhealthy deep pockets during maintenance cleanings, instead, Bentips brings the patient back to complete health by eliminating all of the calculus and the pockets. So after the Bentips procedure, these shallow, healthy sites are really easy for us and the patient to keep clean and healthy. So could you explain how this device and technique differentiates itself from standard periodontal maintenance? Because you're actually removing tissue. And then we'll get into the other questions that some of the attendees asked on your webinar regarding removing tissue and what that means to the position of the gingiva. But if you can talk about the actual procedure, how it differentiates itself, what are we actually doing at the level of the pocket? So instead of like we're doing with scaling and root planing even or... maintenance where we're trying to get into a pocket without the visualization and remove the calculus instead we're actually removing the pocket with this method it kind of shaves down and cauterizes the tissue to remove the pocket that way we can actually see the root surface we can see what we're doing get everything cleaned off nice and healthy and then the pocket is gone So the attendees of your webinar had some questions regarding the new position of the gingiva after the bent tips procedure. In other words, does the procedure cause gingival recession? Is this an issue in your experience? So I did have the same concern when I was initially introduced to the bent tips procedure, but I'm really happy to say it hasn't been as much of an issue as I had originally anticipated. However, I do always discuss the probable changes that my patients will experience. both when it comes to aesthetics and home care. So I always like to start with a visual depiction of what the pockets will look like before versus after the procedure. And I found that the conversation tends to veer more toward home care changes. So my discussion is usually along the lines of letting them know after the periodontal pockets are removed. They'll probably notice that more food gets caught between the teeth, but it should be much easier to remove them before. So I do have them hold up a patient mirror and smile naturally. So I'll show them exactly where the procedure will affect them. So we do go over a lot of patient education on this. But again, so often the disease is limited to the posterior teeth that I found it has minimal or no effect on aesthetics. So it's important, though, when you're using bent tips to only focus on the area that has the pockets, because if you're moving around. throughout the entire mouth, if the case is such that the patient has only isolated perinatal disease in the posterior and the anterior areas are fine, you don't want to go near them, right? Because you obviously don't want to remove any tissue in those areas. Correct. Yeah, you wouldn't touch the areas that are with healthy tissue. Follow your periocharding and you wouldn't touch any tissue that's healthy, of course. It would do the prophy, of course, in the other areas. And then any areas that need scaling and root planing, we would reduce the pocket so we can see the calculus and remove it. And what have you experienced when using this technique regarding pain and sensitivity? Yeah, so also not much of an issue. There is more root exposure, of course. So I do educate the patients on this. But mostly the patients I've found who already have experienced sensitivity prior to the procedure tend to be the ones who are affected or who ask about it. So I do go through the same patient education that I would with anyone who might experience sensitivity. so what they can do at home as far as like sensitive toothpaste in very few cases i have placed a desensitizing agent on select areas that are sensitive on their follow-up visit but again we're talking less than a handful of patients total who have had to do that with or that have even mentioned it on their follow-up visit so it hasn't been a significant issue So you're a hygienist, right? So just curious, is this a game changer for you as a practicing hygienist? And also tell us about the legality of using this device in different states. Is it something that's controlled on a state-by-state basis, whether you can actually use the BenTips device and the particular procedure that it's designed to be used for? Yes. So definitely a game changer. I can say I don't think I could ever work in an office that doesn't. offer this procedure, definitely it's night and day from doing scaling and replaning to this procedure. And then as far as states go, yes, that's going to be based state by state on the law and if the hygienist is able to do curatage. And then there's always some dentist involvement as well. And how have you seen the results postoperatively compared to the traditional way that you... typically treated these patients before you use bend tips yeah so i found before a lot of times somewhere down the road we're having to redo scaling of root planing or you know in some cases there's little pieces that are missed because we're doing our best we're we're trying to get under the pocket and getting off everything that we feel and hope that we're getting it all but with this procedure you're seeing it all you know that you're getting it off And then the pocket's gone. So instead of the patient happy to constantly battle that pocket at home and trying to keep it clean with extra home care, the pocket is gone. And then they also have a lot easier time at home keeping the teeth clean. So on your re-care appointments, you're seeing a major difference in comparison to the traditional way you treated these patients prior to using bend tips? Yes, definitely. In your experience, Hillary , is there any reason for concern by the GP? that using BenTips in the office might have a negative impact on the GP's relationship with the periodontist. Do you think this is a valid concern? Honestly, that never crossed my mind because I think, first and foremost, I think that we're obligated to offer our patients the most up-to-date treatment that benefits them the most. So I think we can probably all agree that we don't want to sacrifice our patients' needs for the benefit of someone else. I have found in our own practice that... proper diagnosis and treatment in our office. Our hygiene department is staying very busy, but there's also still plenty of cases that we're referring to the periodontist. So surely that's going to preserve the relationship as long as you're catching the periodontitis and treating it or referring it as needed. Yeah, and as we close up this podcast, and your information has been very insightful and helpful for us to better understand band tips and the procedure associated with it, what would you say the learning curve is when starting to use this device and technique for the hygienist? Yeah, for myself and... And those that I work with, the learning curve was pretty quick. It was a little bit intimidating at first, of course, especially starting a new procedure and something you're not familiar with. But using the Bentips system is very easy to get comfortable with. So, yeah, I found that the learning curve was pretty short. And for more information for our listeners to gather on this, would they go to bentips.com or what is the web address? It would be bentipsusa. Okay, bentipsusa.com. I'm just going to say there's actually, I go to that website with every patient as I'm doing the patient education and I scroll down and there's a video that they can watch. And there's also some picture depictions, which I use to illustrate to my patient what the procedure is and how it works. Excellent. Well, thank you very much, Hillary . We really appreciate your insight. And we're talking to Hillary Spencer, a full-time clinical hygienist in... the beautiful area of the world, Hawaii. It must be nice to work there and live there. And we're very interested in this new kind of game changer device and procedure that really changes the whole landscape of treating patients that have pockets because we're actually reducing the pocket at the same time as visualizing the calculus that we're removing. And it seems that based on the use of this, tremendous clinical results, predictable results have been achieved. So we look forward to learning more about this. And again, thank you very much for joining us on Dental Talk. Yes, thank you very much.