Helen wins an Oral-B Triumph 5000 with SmartGuide worth £179.99.

I read with great interest the letter in the summer 2011 issue of Vital regarding the ‘periodontal therapist’ (page 5).

Since qualifying in 1988 I have experienced many changes to my work as a hygienist, and have always kept myself up to date. Despite attending courses regularly, I felt that I wanted to further my understanding of periodontitis to be able to offer treatment choices to patients in a more informed manner.

Working in two private practices I was in a fortunate position to work with generally well motivated patients, but I realised that if a patient had been attending with ever deepening periodontal pockets, my regime never seemed to vary. Each appointment consisted of medical history, OHI, scale and polish, see you in three, four, or six months. Some patients did respond well to this regime, especially if they had been irregular attenders in the past, and those that didn't were referred to a local periodontist, often requiring Non-Surgical Periodontal Therapy (NSPT). It wasn't until some time later that I realised that NSPT was a course of treatment I could be offering my patients in the practice, after undergoing the necessary training.

In June 2009 I attended the Eastman Dental Institute for a four-day intensive training course: Advanced Non-Surgical Periodontal Therapy for the Hygienist. This was an immensely enlightening course, covering all aspects from risk factors through aetiology, radiographs, treatment planning and instrumentation. The course was spread over four weeks with plenty of reading material and revision of notes in between. By the end I had a far better knowledge and understanding of periodontal disease, and most importantly, how to treat my patients in practice. A few months later I undertook the necessary training, again at the Eastman, to administer ID block local anaesthesia.

I produced a document for the practice on ‘Criteria and Treatment Planning’ for a patient considered to benefit from a course of NSPT, and devised a patient information leaflet detailing the treatment and commitment of the patient involved.

Patients are referred to me for NSPT from within the practice; we also accept referrals from other GDPs who do not have a hygienist within their own practice.

My sessions vary between patients attending for routine treatment, those receiving NSPT and patients on a Supportive Periodontal Therapy (SPT) regime.

I now find that my ‘job’ has altered, I have specialist training and a higher level of knowledge to treat patients who require more intensive treatment. I can only perform this successfully because of the skills I acquired at the Eastman. Patients pay a higher fee for NSPT provided by me, though still considerably less than seeing a periodontist.

I consider that, through this training, a new category of hygienist – the ‘periodontal therapist’ – may evolve. Bearing in mind the emphasis now given to evidence-based non-surgical therapy as a valuable Phase One course of treatment, through proper training, the skills of the hygienist could be expanded to enable more patients to be treated ‘in house’.

The periodontal therapist could be the conduit between dentist and periodontist that many practices would benefit from. From the experience I have at both practices, I find that patients would often rather be treated by me, in a setting familiar to them.

I hope that a qualification in periodontal therapy will one day be recognised by the GDC, so that hygienists with the additional training will be given the status they deserve, and so that patients in general practice will benefit from the additional service being offered to them.

Correction: In her letter A new category of hygienist (Vital summer 2012 page 4), the author Helen Parkin would like to point out that she had not intended to say that she was a specialist in advanced non-surgical periodontal therapy. The letter should have read: '...I have specialised training and a higher level of knowledge to treat patients who require more intensive treatment.'. A formal correction was published in Vital 9, 5 (2012).