Honorable Hygienist

A dentist, after treating an adult female for 16 years, informed her that due to failing restorations and wear, he recommends extensive restorative dentistry including crowns, bridges, and two extractions. The treatment was completed uneventfully. By prior arrangement, the patient paid for the dental work with interior decorating services for the dentist's home. The patient presented for her recall visit to the dentist's office six months later where she was to have a prophylaxis and check-up examination. The hygienist, who was new to the office, noted severe periodontal breakdown. She questions the patient about prior periodontal attention and the patient indicated there had been none. This was confirmed by the records. The hygienist then suggested she seek the help of a periodontist. When informed of this, the dentist dismissed the hygienist.