Dental hygienists are divided on the 5-mm pocket, so what do we do about it?
Walk into enough dental practices and you hear the same reasoning: That 5-mm pocket has been there for years, the patient is doing fine, and the team knows them. Kelly Tanner, RDH, PhD -- DrBicuspid.com's hygiene editor -- has heard this many times. She has questions about it.
In this episode of The DrBicuspid.com Podcast, Editor-in-Chief Kevin Henry sits down with Tanner to work through what the 5-mm pocket actually represents, why the American Academy of Periodontology (AAP) staging and grading system draws a clear clinical line there, and what it means when a practice decides to watch and wait.
Tanner's argument is not that every 5-mm site demands the same response. It is that familiarity with a patient stopped being a clinical rationale some time ago. The AAP framework uses that depth as an indicator of disease -- not a suggestion or a guideline -- but a marker that something specific is happening biologically.
The question Tanner returns to is one that is often skipped: Why is that pocket there in the first place? What about the patient's immune response, stress load, systemic health, and the composition of their subgingival microbiome? And if the site has been watched for years without changing, why has it not been addressed?
The conversation takes an unexpected turn when Henry asks about gut health -- a thread from Tanner's original article that she expands on here. She is direct: The answer to a nonhealing periodontal site is not always picking up the ultrasonic scaler again. Sometimes it is stepping back and asking what the body is trying to communicate. Research is strongly backing the gut-oral microbiome connection, and Tanner argues it belongs in the periodontal conversation even when it is inconvenient to raise.
The second half of the episode addresses communication strategies when the patient refuses treatment. "You're not doing that to me," is a sentence many hygienists know well.
Tanner explains the approach she uses -- framing the body as a source of information rather than a problem to be corrected. Tanner then raises the harder questions: What is the office protocol when a patient declines treatment? What does the dentist expect? What does the hygienist do at the next appointment? Those calibration conversations, she says, need to happen inside the practice before the patient is in the chair, not after.
Tanner's continuing education courses and coaching are available at nextleveldentalhygiene.com.
5 May 2026
How your dental team should handle the everyday medically complex patient
The medically complex patient is no longer the exception in dentistry — it's the new normal. In this episode of the DrBicuspid.com podcast, Editor-in-Chief Kevin Henry sits down with DrBicuspid hygiene editor Dr. Kelly Tanner, PhD, RDH, to talk about how the entire dental team needs to be thinking differently about the patients walking through the door.
Dr. Tanner breaks down why the medical history form is far more than paperwork — it's a decision-making tool that the front desk, assistants, hygienists and doctors all need to be reading together. She explains how a patient's medication list can explain nearly everything the clinical team is seeing in the mouth, and why systemic literacy has to be a whole-team skill, not just a clinical one.
The conversation also covers how trust shapes patient disclosure, how morning huddles can help teams get ahead of complex appointments, and why communication — truly reading and connecting with patients — may be the most undertrained skill in dentistry today.
What's covered:
Why the "routine" dental patient is increasingly rare
How the medical history form should function as a team communication tool
The connection between medications and common clinical findings
How anxiety, neurodiversity and systemic conditions are changing patient care
Why onboarding new team members should include communication training
How to bridge the gap between what patients report and what the team is seeing
Dr. Tanner is the co-host of Quit Dreaming, Start Teaming, a podcast-style CE series with pharmacology educator Tom Viola. Continuing education courses are available at rarebirddentalce.com.
27 Apr 2026
A chemical shortcut to cleaner teeth and a smoother dental visit
If getting your teeth cleaned has ever felt like someone was trying to chisel dried concrete out of your mouth, you are not alone. But a product called TurboCR, made by Essential Dental Systems, is changing the math — for patients, hygienists and practice owners alike.
In this episode of the DrBicuspid.com podcast, the hosts dig into how TurboCR works and why dental hygienists are paying attention.
The science centers on chelating agents — chemical compounds that act, as one host puts it, like "microscopic chemical claws." Rather than relying on mechanical force alone, those agents target the calcium ions that give calcified plaque its structure, breaking down tartar from the inside out before the hygienist ever picks up a scaler. Hygienist Lizzie, cited in the episode, reported that applying the product via a foaming applicator or tray softened calculus by up to 50% in just one minute.
Crucially, the chemistry appears to leave enamel, dentin and titanium implants unharmed — a detail that matters most for vulnerable patient populations. Dr. Sonia Dinar, known in geriatric dental circles as the "geriatric tooth fairy," highlights TurboCR's particular value for elderly patients, those with special needs and anyone with severe dental phobia, all of whom benefit from reduced scraping and shorter time with their mouths wide open.
The efficiency gains extend to the practice side as well. Hygienist Gina Green tested the product mid-procedure on a patient she was running behind on, applying it to the untreated side of the mouth. She not only caught up — she finished with time to spare.
That kind of time recovery, multiplied across a full schedule, changes the revenue picture. It also reduces the cumulative physical toll on hygienists, whose hands and wrists absorb the strain of heavy scaling all day.
Learn more at https://edsdental.com/Turbo-CR/
Who has been a guest on DrBicuspid
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Dr Ankur Gupta
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Robyn Reis
Dr Bill Simon
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