Periodontal endoscopy seems like a win-win technique. When and how does a procedure go from being “state of the art” to the “standard of care”?
This is a very good question and one that poses many levels for discussion. Answering the question fully would take several pages defining the elusive nature of standard of care. For simplicity in this format, I will condense my response and address dental endoscopy as it applies to debridement and root planing. Sulcular endoscopy is a procedure with scientific evidence supporting it. It provides clinicians with sight and magnification during subgingival root planing and debridement procedures that have traditionally been done without seeing. Clinicians mastering the use of the Perioscope enhance their patient care by improved accuracy of root deposit removal with the added clinical benefit of visual assessment of an area that has never before been seen except during surgical procedures. One definition of the standard of care can be interpreted as reasonable care provided to a patient that would be provided by similar members of a profession in similar cases and like conditions, given due regard for the state of the art. Standard of care is influenced by technology, materials, delivery methods, patients, diagnosis, location and government or individual State’s dental practice act. Dental standards of care are always changing as court rulings are made and new technologies and methods are introduced with supporting scientific evidence. A standard of care is not about popularity but has to do with appropriateness and improving the quality of life for the patient both orally and systemically. These standards are not concrete as laws are and aren’t written down but they are used to regulate the dental profession legally. Consider that there are no two levels of care. Standards are set by whomever is a specialist in that area of treatment and in that location geographically. If you, as a dental hygienist, are going to provide root planing/debridement procedures, you will be held to the standard of a dental hygienist doing the same procedure in a specialty periodontal practice located in your region. In light of the preceding statement, as sulcular endoscopy expands in prevalence, it will also rise as a standard of care. Nancy Kiehl, RDH, MSEd, Endoscopy Dental Hygienist