All too often patients with periodontal disease are seen for scaling and root planing, and then placed on "forever" periodontal maintenance. Hygienists save lives! Yet, the majority of dental offices simply do not give them the time required to eliminate periodontal disease due to time constraints in the schedule. But the biggest problem is when the patient comes back for their initial treatment exam, they typically have additional need for more scaling and root planing. This never gets treatment planned, and the patient is asked to pay an additional amount of money for additional treatment. This is viewed by the average consumer, your dental patient, as paying for something twice. That's always a fun conversation with the patient, often passed on to the front desk. We need to be treatment planning the periodontally involved patient for the worse case scenario, and collecting up front for it. You can always refund them if treatment turns out better than expected.