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‘Patient Anxiety Leads to Pain and Discomfort’

Award Winners: Dr. Wendy McCreight and Jamie Rotunno, RDH.

McCreight Progressive Dentistry.

Dr. Wendy McCreight and Jamie Rotunno, RDH

When fearful patients who have avoided the dentist for years come to the dental office reporting pain, the dental team often has to soothe patient anxieties before treatment can even begin. Dr. Wendy McCreight and Jamie Rotunno, RDH in Steamboat Colorado are the most recent recipients of the Orkos Award in case study for their careful attention to a patient’s anxieties and oral health. Making treatment as comfortable as possible enabled the patient not only to accept and complete the treatment but also to commit to regular preventative care.

Patients who are anxious about dental care often ignore early signs and symptoms of gum disease, like bleeding gums and bad breath, because the gums don’t hurt yet. When the disease advances to the point of discomfort, it is harder to ignore. The patient in this case study came to McCreight Progressive Dentistry complaining that it hurt to brush his teeth and to eat. He assumed he had a cavity, but Dr. McCreight diagnosed periodontal disease.

Hygienist Jamie Rotunno addressed his concerns by carefully explaining his periodontal charting and ideal treatment steps, the first of which included bacterial testing and prescription tray delivery of medication to fight the infections. Reducing infection and inflammation before the dental cleanings, she explained, should make the entire treatment more comfortable. He agreed.

The patient exhibited generalized periodontal disease, with moderate to heavy bleeding, calcified bacteria below the gums, and spaces between his teeth and gums measuring up to 7mm (normal is 1-3mm). Bone surrounding his teeth had begun to break down and bacterial testing indicated high levels of pathogens. Treatment started with the prescription Perio Tray® to reduce the bacterial loads and inflammation. After two-weeks of tray usage, four deep cleanings in the office were completed. The prescription tray homecare continued two times a day for 15 minutes between hygiene visits.

Six weeks after the cleanings were completed, the patient returned to the office. Rotunno documented significant improvement throughout the mouth. Bleeding decreased from 90 sites to 6 sites. Deep pockets (between teeth and gums) dropped from 84 sites to 8. The remaining measurements were within normal limits. Healthy stippled tissue was observed and pathogen testing indicated a reduction in bacterial loads in every category tested. Three months later at a maintenance visit, the healthy results had been maintained.

“At McCreight Progressive Dentistry, we take gum disease seriously,” says Rotunno. “The bacteria causing infection can contribute to inflammation and compromise patient health. We take a lot of time to get the cleanings done well and we focus on homecare. We recommend Perio Trays for use at home because this deep delivery of medication below the gums fights infection and inflammation, makes the cleanings easier, and maintains healthy results longer. Results are better when patients use the trays.”

“But this case is about more than good results,” explains Rotunno. “It’s great to do an excellent job removing calculus and biofilm, but it’s the patient experience that really counts in the end, how we make them feel when they have left the office. Without the Perio Trays, the patient would have had a much more involved hygiene procedures and not have had as good of an experience. When you can address patient anxieties, everything is easier, including ongoing maintenance care for gum disease.”

The patient told Rotunno that what has kept him motivated to maintain his health at home after the initial treatment is how much better his mouth feels. “I don’t know what I would have done without my Perio Protect trays,” he said to Rotunno. “As a business owner, I appreciate the convenience of the trays.”

Because Perio Trays deliver medication deep below the gums where toothbrush, rinse, and floss can’t reach, “It’s an easy way for patients to keep the gums healthy,” says McCreight. “Patients also like the fresh breath and white teeth that are the best side-effects of any dental treatment. It’s like getting three treatments in one.”

The work at McCreight Progressive Dentistry demonstrates not only excellence in patient care but also a genuine concern for patient comfort and experience that will encourage patients to continue their own care at home. This combination of in-office and at-home attention sets the office apart and yields superior results for patients, as this case shows.

The Orkos Award was created to identify excellence in case study for the treatment of periodontal disease. “This case is exciting,” says Managing Director Tanya Dunlap, “because it can be hard to convince fearful, anxious patients to acknowledge that they have gum disease and to accept treatment for it. The Perio Protect method of treating gum disease with adjunctive Perio Tray therapy was created exactly for this kind of patient and we congratulate the team at McCreight Progressive Dentistry. It is our pleasure to recognize the excellent of the dental team.”

For more information about McCreight Progressive Dentistry visit For detailed information about the prescription Perio Tray therapy, visit Perio Protect.

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