Supervised Neglect: Why Are We Not Doing More Full Perio Exams?

Periodontal Exam (AdobeStock_174760357).jpeg

Those of you who are not in the dental profession may not be familiar with the concept of “supervised neglect.” The holy grail of dental dictionaries, Mosby’s, defines it as a “case in which a patient is regularly examined and shows signs of a disease or other medical problems, but is not informed of its presence or progress.” This means that dental professionals have the legal and ethical responsibility to diagnose and educate patients about their oral health conditions, and do everything they can to ensure good health outcomes.

Based on this definition, I ask this question: If complete periodontal exams are not done as often as they should or could be, does this become supervised neglect? While most insurance companies cover a full perio exam once every two years and a recall check once every year – is this good enough? We’re talking about standards of care. Just like physicians reach out to their patients to schedule complete physical exams every year, why wouldn’t dentists do the same? Why would doing full perio exams be any less important than doing full physical exams – especially given the correlation between oral health and chronic physical-health conditions? Would it not be better for patients, the healthcare system and taxpayers to ensure full perio exams are done annually?

Throughout my three decades of being a practising dentist, I heard all the excuses. Full perio exams are too long. I’m under pressure to get so many other things done. I don’t have the time. I need a second person to help me with the charting, but they have their own priorities and are not available.

The importance of full perio exams is another reason I’m so proud of SmartChart™, WinTerra Dental’s new dental charting system. Because SmartChart™ is voice-activated, it significantly shortens the time it takes to do a full perio exam – 10 minutes versus about 40. Plus, it only requires one user. It should be a no-brainer to clinicians that SmartChart™ will enable them to do full perio exams every single year, resulting in the highest standard of care for their patients.