Aly Virani Discusses Periodontal Maintenance

Cosmetic and Perio Treatment
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Aly Virani puts forward a "win-win-win" periodontal scenario

Maintenance of periodontal health is dependent on patient compliance with their home routine and attendance to the practice. The burden of properly caring for these patients and providing them with the necessary monitoring, motivation, education and appropriate intervention has traditionally fallen on the shoulders of the dentist.

This was often by choice as we all suffer from the need to control our surroundings after all! However, there are many benefits to engaging other team members and sharing the responsibility across several individuals.

Clinician, patient and business benefits

For instance, all the clinicians involved tend to enjoy their work more. Dentists have more time to focus on complex treatments and procedures, while dental hygienists and therapists benefit from a more varied workflow and an improved community atmosphere within their practices. This can help to improve time management for all clinicians, reduce stress levels and improve overall job satisfaction.

This collaborative approach provides a second set of eyes looking at each patient’s needs, sometimes from different perspectives. It also allows for patients to develop a relationship with another healthcare provider.

The most powerful tool in our armoury for stabilising and maintaining periodontal health is our ability to engage with patients and help them understand and take control of their own health. Simply put, there is a greater chance of doing this effectively if professionals work as a team.

Consequently, the patient experiences improved treatment outcomes and a more comprehensive and holistic approach to their care. For the business, resources and finances can be optimised through careful and effective skill mix utilisation.


How can the team approach be implemented successfully? Regular communication is essential to ensure that everyone is on the same page. Dentists have to be willing to listen and discuss cases with colleagues and team members have to be willing to suggest diagnoses, treatment approaches and changes in workflow that could enhance the way that patients are cared for. For this to happen, open communication channels must be available, without the worry that one may be belittled or ignored when a suggestion is made.

The next step is for this communication to take place in front of patients. It’s important that they understand their care is not being delegated to someone else for whatever reason. Instead, they should be helped to appreciate that they are receiving care from a group of professionals, with each individual bringing something different to the table and using their combined skills to ensure that the patient receives the very best care. Only once this change in perspective is communicated to and embraced by patients can the team truly be hygiene-led.

It is just as important for professionals in the team to have complete trust in each other. This can only be achieved once everyone understands what each of their colleagues can do and how their skills can benefit patients. Allowing each member of the team to then work within their full scope of practice goes a long way in developing the dynamic that allows for a hygiene-led approach.

As the team gains in experience and confidence, the process tends to evolve organically. This does mean that relevant training is important, whether this is completed as a whole team or whether individuals take it upon themselves to invest in areas where they feel that they lack knowledge or confidence.

Making the change

Change starts by everyone coming together to share and discuss new ideas. Our profession will only develop further if we make an effort as a team to learn and deliberate in the same physical space. This is becoming rarer in the age of the internet, so it’s important to make the time and create opportunities for the team to come together in a productive way.

ADI Study Clubs provide an ideal chance to do just this. Held across the country throughout the year, these sessions are open to all members of the team and provide valuable CPD.

I will be running an ADI Study Club looking further into how the team can share responsibilities for their periodontal and implant patients in East Grinstead on 2 October 2019 and would encourage both dentists and hygienists to attend. There will be relevant information for all and I hope to share some insights to help you improve your collaborative approach to patient care.

Implementing a hygiene-led team strategy is beneficial in every way. The hard part is taking the leap to change the way that most of us have traditionally worked. When it’s done right, however, it becomes a win-win-win scenario for dentists, team members and patients.

The views expressed in this article are those of the author, and not necessarily those of the ADI.


Aly Virani is a graduate of Cardiff University and works as a Clinical Research Fellow and a Clinical Lecturer at Bristol Dental Hospital, University of Bristol. His research interests include developing research methodologies, periodontal conditions, bone augmentation and peri-implant lesions, the scientific evaluation of oral health care products, toothwear, dentine hypersensitivity and tooth whitening.

He is currently involved in clinical research studies with publications in peer-reviewed journals. Aly is involved with undergraduate teaching and training of Periodontology at the University of Bristol and also lectures in the national forum.

Aly also works in private practice at Rhiwbina Dental Surgery in Cardiff. He maintains a general list with a particular interest in periodontal disease and implants.

For information on upcoming ADI Study Clubs, or to book, visit