Episode 467: 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.