Prophylaxis

A prophylaxis, or prophy, is the preventive cleaning most patients picture when they think of a hygiene visit. On its own it is a low-fee procedure, and that is why it matters to the business side of the practice.

Ryan's diagnosis of an unprofitable hygiene department is specific: recall visits that include x-rays and a doctor's exam are not the problem, and neither are scaling and root planing appointments. The appointments that drag a department down are routine prophy and perio maintenance visits with no x-rays and no exam, hour-long slots producing little.

He also argues the profession under-treats gingivitis by lumping it in as a "prophy." A "bloody prophy" is not the right care for a patient with active inflammation, and treating gingivitis with its own protocol and codes is better for the patient and more appropriately paid.