to Dental Practice Solutions

Welcome to dentistry’s largest dental hygiene practice management resource center! We are the leading dental hygiene consultant/coaching business.

We will increase your TOTAL dental practice profitability without working more hours or days each year.

- Debbie Seidel-Bittke, RDH, BS, Speaker, Author. Dental Hygiene Coach & Consultant

Dental Practice Solutions - Debbie Bittke

The Looking Glass of Success Driven Practices

By: Debbie Seidel-Bittke, RDH, BS

March 29, 2010

Success-largeWe have experienced some challenging economic times lately. Since January 1, 2010 we seem to be seeing some recovery. As this recovery occurs how will you claim or reclaim your vitality? What are you plans? We are well into the year 2010 and where are you headed?

If you knew that there were 4 specific tools to take you to your goal would you use these tools? How will you feel when you see a turn around of possibly $2,000.00 each day from this day forward? If you work 50 days each year this will be $100,000.00 additional revenue this year. If this were to continue you will be adding millions to your revenue over the next 5 years.

Do you think this question is too outrageous to even ask: “How do I do it?” Maybe you think this is all very interesting but are answering:”We are on track and don’t need to make any changes or do anything differently.”

I am amazed at what I see dentists put themselves through year after year. Everyday I see and experience dental offices that are left deep down under the weight of unnecessary stress and anxiety, telling themselves all the while that “this is just the way dentistry is.” Not true! This is the way you have chosen to spend your career. I want to invite you to take the next 12 months and spend a few dollars to make some necessary changes to improve just 4 systems. These are systems that are certain to change your dental practice and your life. I want to invite you to follow a new path. Let us take a look through the looking glass and move you towards the path of success. This is where a pot of gold awaits you and the entire team. May be hard to believe but it is the truth.

The numbers in the above paragraph are correct. This is what Dental Practice Solutions can do for all practices. We don’t have a cookie cutter solution but many solutions to guide each dental practice towards success.

With our 4 step process we are currently taking practices to over 100k in additional revenues this year – 2010. People coming on board now are still able to capture this lost revenue and make this success a reality in 2010; even one quarter of the way into 2010.

We are currently showing our clients 4 areas within the dental hygiene department which will increase patient value and practice revenues. It is not the amount of revenue alone that will begin to account for the huge improvement, but also in the quality of life and decreasing stress. The path of increased success will provide time to enjoy life and save for retirement, build a team that respects and works well together to be the best they can be.

With adding all of this you can be rest assured that your patients will be educated about dentistry and how important this is for their total health. They will say “Yes” to treatment plans you present. Your patients will appreciate what you do for them and they will be your best source of referrals spreading the good word about your dental team.

For most dentists the numbers and results are very important to see so we invite you to click on our link for the free practice assessment. When you take time to complete the assessment we can discuss with you and show you a clear view from where you stand now. We can show you the potential and uncaptured revenues in your practice. We are here to be your guide and your resource.

Many dental practices spend thousands of dollars in marketing their practice. We are here to find the upcaptured revenue with the patients you already have in your practice. We guide you and show you exactly how to add value and health to your current patients.

The choice is yours. You can continue on your current path with your head in the sand and. no changes you can choose to hold up a looking glass to view what is there, to build not only health but wealth with the patients currently in your practice. This suggestion and recommendation is regardless of a failing or profitable economy.

We invite you to take a look and increase your practice revenues. We want to guide you down the path that shows you the enjoyment and payoffs when utilizing our proven strategies. These are not strategies used 30 years ago but what we know works for a thriving practice in 20101! We will take you down the path called “success”!

Please call or email to walk that path of success today.

Much Success to you!

The Dental CEO and VIP’s

By: Debbie Seidel-Bittke, RDH, BS

March 22, 2010

When asking dental team members about their role in the office most will respond that they are a clinician. This is a perfect answer. The entire office needs to be happy about this response and most importantly the patients. Most dental professionals have had hours of training and the dental hygienist spends many long hard hours not only studying but practicing in the mouths of volunteer patients. After years of practice the dental hygiene student will pass national and state exams to be licensed as a professional.

As healthcare professionals we are dedicated to our profession. The business owner and dentist is considered the CEO and team members in the dental business are the VIP’s of each department where they actively participate as a team member in the dental office. This is a time in history where these roles and how they are defined become very important. Now we have dentists who are cutting out their dental hygiene department all together. Some dental businesses are cutting their auxiliary salaries in half. Now is the time for dental auxiliaries to become very serious about the health of their career in the dental office. Each team member needs to be analyzing their production and what they bring to the dental practice

Every team member needs to be on board with the knowledge of business skills. Now is the time for the entire team to look at the numbers they produce in their dental department. Each team member needs to understand the business skills for running a dental practice = a business. The reasons for doing this are not only about employee compensation and job security but most importantly to be an active participant in the business of dentistry.

The majority of team members in a dental office are usually not personally invested as a business owner but when it becomes apparent that the team may need to take a cut in wages, benefits or reduce their hours, team members will pay attention to either directly make a change in what occurs or the business will make the unwanted change for them.

The dentist and business owner is the CEO of the business and the team members are the VIP’s. They are the Very Important Members of a dental business.

Each day, the previous day’s production needs to be discussed at the morning team meeting. This is also a great time to discuss the dental business goals for the year and where the business stands year to date.

During the morning team meeting (Morning team huddle) the VIP of Finance needs to give a report on the financial health of the dental business. Each team member should keep a log of patients they see; if they cancel, no show and all procedures performed. Along side of patient information team members should also keep a log of the number of hours they are paid each day. Track how many hours each day you work with non-patient time. Keep a record of the fees for each patient seen and the amount of production produced from the operatory you work in. These are minutes or hours which the CEO- your dental employer pays you for and has no income to support your salary.

Once you have created your log you can now begin to determine production per hour, add up your total production for that day and divide it by the hours you were paid, not just the hours you saw patients. If you’re paid for an eight hour day but only saw ten patients, you will take the total daily amount, let’s say it is $10,000, and divide it by ten. This means that the office produced $1,250.00 per hour. You can take this same formula and apply it to only the amount of production produced by the patients you saw in your operatory. Divide this amount by your paid salary. If you bring in $1,250.00 and are paid $300.00 then the percentage of salary to your production will be 42%. If the employee benefits should be approximately 1/3 of the production this would be over and above the amount the employee should be making.

This entire process can be eye opening. It can tell you if the office is losing money during the day while you worked. It can also be a guide to increasing your salary when the time comes. It gives team members a reason to ask for a raise and it can also give the CEO a reason to decline a raise. The CEO, business manager or practice owner will now with reason explain the dental business can’t afford to give an increase in benefits and the proof is written in ink.

It has been well written that the hygiene department needs to produce three times what they are paid. What are you getting paid per hour? When you do the math from the information given above you have reason to rejoice and find a solution to increase the profits. The math can produce a winning solution.

Small Town Dentist: Follow Up

By: Debbie Seidel-Bittke, RDH, BS

March 15, 2010

One of our clients lives in a small town along the coast of Oregon. Small town life style but big time dental practice. It has been a thrill to watch this practice thrive!

The dental team has now been with the practice for 3 years and the patients continue to grow in numbers each month. How can it be that a community of fewer than 20,000 people can generate close to 2,000 active patients? And the revenues – they continue to grow along with the patient numbers. The 2,000 patients mentioned are a true active count because we have counted utilizing the formula we learned from New Patients, Inc.

The philosophy of guiding a dental office is to work smart and not so hard. As a full-service consulting business focused on driving the profits in the hygiene room we know what it means to thrive in the business of dentistry. We are there working on the practice – – with the team and no one person works solely in the practice.

What may be different about this practice is that we guided them to take away the “drill and fill“and choose not to just extract teeth. The focus here and the paradigm shift in the dental profession is now about prevention. We have also shown our clients that they need to specialize in things no one else specializes in.

Every dental practice needs to have a special proven practice methodology and not just a cookie cutter approach to how they treat their patients. We are here to guide our clients and find out what works best for them and what makes them most profitable.

The assessments with our Oregon Coastal Client allowed us to pick special ingredients for the perfect recipe to increase the revenue. This allows for success to occur quickly and see their practice thrive!

If you understand that the hygiene department is the foundation of each and every dental practice you can step forward with the 4 step process we recommend at Dental Practice Solutions. The 4 steps are the same but how they are utilized specifically in each practice is what varies and allows each dental practice to live their own special successes.

Many dentists we talk to ask us “How are you going to make hygiene profitable?” When you are able to put preventive assessments into place and stimulate the communication process to get a “Yes” from patients you will see your hygiene department contribute to at least 40% of the total practice production.

No matter where you practice in the nation you will find that when you treat 100 of your current patients with non-surgical periodontal treatment this year and they receive treatment utilizing the locally applied antimicrobials in the areas which are 5mm’s or greater your revenue will increase by approximately $120,000.00. You may feel it is difficult to wrap your head around this but we have never stepped foot into a dental office and not found 100 patients in the active patient base who didn’t need non-surgical periodontal treatment. How can a hygiene department average this much? The answer to this that when we communicate prevention properly and patients are able to understand your important information; they will sit up, listen and take action. Action means that they will say “yes” to treatment.

The recipe we put together for this Oregon Coastal Dental Office is one example of how this can work for your practice when you learn the simple steps and how they specifically work with your team and your patients to make a “win-win”.

When the team and doctor are open to learning communication skills with their patients and how to communicate to each patients communication style; patients understand their needs and the value added.

People will buy what they want not just want they need. When patients began to understand about the importance of their oral health and how this plays a role in living a longer and healthier life they will do what is necessary to live a healthier life. Patients who are at moderate to extremely high risk for caries now need to be seen every 12 weeks for oral hygiene instructions, review of oral homecare, biofilm or salivary assessments and a fluoride varnish treatment. This can be done by the dental assistant and takes no more than 30 minutes. When you provide this valuable service it can be completed in a consultation room and the CDT7 codes support this preventive treatment. When you understand that non-surgical periodontal treatment can increase your revenues by $120,000 you will now add this preventive treatment worth $15,000.00 to the annual revenues.

Great results still continue to come from this new CAMBRA* model for treatment of moderate to high and excessively high risk for decay. The benefit to risk value? A lot less money spent in the dental office on restorative treatment and missed work. Now it is $30.00 for the quick visit to prevent caries which includes a fluoride varnish treatment, etc. The periodontal patient comes in every 12 weeks and some who have isolated areas of more aggressive periodontal disease come in sooner.

The success of your dental practice and increased revenues will come with just a few of these ingredients added for a recipe of success.

Your daily practice needs to remain stress-free for the dentist the team. If you have the correct team (one important ingredient) then all you need to do is empower and train them. Appreciation for them is always graciously accepted as well. These are two of the ingredients for a recipe of success. Talking about providing preventive treatments can not only provide you with a smart treatment and business model but your patients will receive improved overall health and added value. Preventing disease is an important role and something to feel proud of. You will love what you do at the end of the day.

Next week we will write to you about a secret to increase your revenue another $60,000.00. Stay tune!

The team at Dental Practice Solutions
* Caries Management by Risk Assessment

Dancing with Your Stars! AKA: Clients, Patients, and Friends

By: Debbie Seidel-Bittke, RDH, BS

March 8, 2010

As dental professionals we sometimes feel like we are changing our dance steps too quickly and without preparation. These past 2 months we have been talking about adding to your hygiene profitability. We told you about 10 assessments you need to implement on a daily basis with each of your recare clients. We are not asking for you to add all 10 assessments but to take it a step at a time. We want you to choose one or two assessments which you may not be providing your recare patients and begin this month with just one or two from the list. If we learn all the steps at the same time we may begin to feel frustrated and quit very easily. When you teach your patients a new home care technique you may tell them to “Be patient.” “This is a process of time.” We are going to tell you the same thing. Be patient with yourself. Be patient with each member of your team. This is a process of time. Pick two assessments from our list below or maybe one. Make it a point to begin implementing one or two of these tomorrow.

You may ask “How can I do this when I only have one hour with each patient?” We hope you are spending the first 10 minutes each morning with you team to plan your day. (The team huddle) If you need to complete a full mouth perio assessment today then please ask another member of the team to come and assist with this. With help and assistance it takes 10 mins max and not 20 minutes. If you need to implement the new CAMBRA protocols have the front desk give the patient a risk assessment form when the patient checks in at the front desk. When we work as a team we can dance to the tune and stay in harmony. When we fail to plan we can end with a migraine. How do you plan your day? Dancing with the stars or ending with a migraine? This what a difference the team huddle can make!

Our hope is that each patient is already receiving the majority of the assessments on the list below. CAMBA (Caries management by risk assessment) is very new. We have many of the assessment forms on our website under the membership area.(www.dentalpracticesolutions.com) Smile analysis is another assessment which can be completed at the front desk upon check in. Choose one or two today. Next week we will share about the non-surgical periodontal treatment and how you may be missing six figures to your revenue in 2010.

At first, it may feel awkward to add one or two of these missing steps. (assessments) It will begin to feel easier and more comfortable as you practice the new “dance steps”. Before you know it, you’re an expert at completing all the steps on the list. Your patients will feel wowed, your profits and value will increase right alongside as this dance takes place. Take the time to learn how you can put these assessments together one by one- step by step. You will feel ready to dance and enjoy your day with the team and patients who value your services.

Below is a list of 10 to do’s with your recare patients.

10 (Assessments) Profit Centers in the Dental Hygiene Department

  1. Perform oral health care assessments that include the review of patients’ health history, oral cancer exam, biofilm assessment, salivary pH test.
  2. Expose and interpret dental radiographs (x-rays); co-diagnose
  3. Non- Surgical Periodontal Treatment, FM periodontal screening exam, scaling and root planing, antimicrobial agents, laser therapy, etc
  4. CAMBRA (Caries Management by Risk Assessment)
  5. Apply cavity-preventive agents such as fluorides varnish and sealants to the teeth
  6. Administer local anesthetic and / or nitrous oxide analgesia
  7. Home care products
  8. Discuss whitening treatment and take impressions when applicable
  9. Administer smoking cessation programs
  10. Smile Analysis

A Profit Center within Your Dental Business: 10 Facts

By: Debbie Seidel-Bittke, RDH, BS

March 1, 2010

When you see the words “the business of dental hygiene” what do you imagine? Perhaps you see a treadmill where high volume and financial reward are the main focus of the dental hygiene department? Or do you see a hygiene department where quality patient care and profitability are congruent, operating with systems and protocols that would not allow one to compromise the other?

A Paradigm Shift

During the past ten+ years the goal of helping our patients has now progressed from treating infection and disease into good overall health. One thing that hasn’t changed is the cost of doing the business of dental hygiene. It is important that the team understand the cost of running a business and a hygiene department. It is when the team understands these financial aspects of the business that the members of the dental team will be committed to excellence. It is important to have team meetings that educate every team member of the cost associated with the daily operations of running the business of dentistry and dental hygiene.

The Facts

The fact is, the hygiene department is the second largest profit center in the dental practice and provides support for the practice as a whole. Within the hygiene department are several other areas of profitability for the dental practice.

Most of your patients spend one hour–two to four times a year with the dental hygienist(s) and because of this ongoing relationship patients are more likely to remain in your practice, accept treatment recommendations and refer patients to the dental office. This makes your hygiene department a business within a business and it makes the executive in this department held accountable for his/her success. When the dental hygienist is held accountable for the department success and when he/she understands the vision and principles of the dental practice, success will follow. You will find the team working in harmony when they understand the vision for the practice share the same code of patient ethics and take ownership for the way patients are treated.

When every team member takes ownership of their role the patients are sure to experience a caring attitude, an ultimate dental experience, the highest level of care and the profits are sure to follow. This provides a win-win situation.

One of the most important aspects of the dental hygiene treatment that is often overlooked is the list of assessments. Dental hygienists feel as if they are on a treadmill but when the team plans the day effectively these assessments can really make the day run smoothly, allow patients to feel they received the highest level of care and now allows for a more comprehensive treatment plan to occur. The treatment plan now moves to a higher level of care.

New Treatment Heights

There is a list of 10 assessments and patient procedures that stimulate profitability in the dental hygiene department. These ten are all important aspects of the patients’ oral and total health. Not all offices participate in this list of 10 and

If you take a look at the list below and notice a missing piece choose to just implement 1 or 2 within the next month. Make an appointment this month to discuss with your team how to implement these ten successfully into the hygiene patient appointment time. Be patient with these changes and take time to discuss how to effectively implement these with full participation from the entire team.

The most overlooked assessments are the annual full-mouth periodontal screening exam. Still in the 21st century many hygienists who see a patient every six months, neglect to pick up a periodontal probe prior to picking up a curette. Most dental offices have approximately 15% of their adult patients with untreated periodontal disease. If each of these patients continues down this path we know that the research states this disease process will continue and the patient will at some point experience tooth mobility and possible tooth loss.

What will this cost the dental business? Take into account that most non-surgical periodontal treatment plans are approximately $1,000.00 for four quadrants of just scaling and root planing not taking into account the use of antimicrobials or laser therapy. Now take into account the frequency of the periodontal

maintenance appointments that follow about every 90 days. Once a periodontal patient, always a periodontal patient. It is the same as a patient with diabetes or high blood pressure. These patients are seen frequently and always at risk for future disease after the disease have been halted. We are not talking about money lost but improved health!

Another new area of treatment that is overlooked at this time is the pediatric patient – first visit. CAMBRA is a new evidence-based protocol for assessing caries. It is now the standard of care for the pediatric patient to have their first visit when the first primary tooth erupts. This appointment can be done in a consult room with the child seated on the mothers lap. This is an appointment to assess the tooth structure, biofilm and any suspicious areas of the child’s oral cavity. If you are concerned about receiving payment the CDT codes have you covered.

How many patients qualify for this preventive measure? How will this benefit your patients and your bottom line?

When the hygienist and team all understand the need to prevent and intervene at an early stage vs. wait and watch; not only does the patient gain an improved level of health but the dental hygiene production will increase. Establish periodontal and the various preventive protocols today. Now is the time to cease treating the periodontal patient with a prophy appointment and begin to utilize the

preventive measures according to the new CAMBRA guidelines.

Another area in dentistry that has changed in the past decade or more is selling home care products. Many decades ago we wrote a prescription or sent our patients to a pharmacy with names of products written on a piece of paper. Our knowledge and research over the past few decades states that 70% of these patients returned to our dental office and never took time to get the prescription filled. Patients seldom took that piece of paper with them to purchase the specific product recommended. When patients have the toothbrush they are to use and shown in the dental office how to use that new power toothbrush they are more likely to use the brush effectively.

This is the one area of your dental practice that has a net profit of about a 70%. You can spend hours preparing a crown or bridge and you have lab fees to pay at the end. The ROI (return on investment) for home care products sold in the dental office is about 70%. We want patients to buy their home care products from the experts, the people who know which toothpaste, toothbrush, mouth rinse, etc. is appropriate for the individual patient to use at home. The sales person at the local drug store and even the pharmacist is not the person to educate a patient about xylitol and its benefits let alone what type of silica is appropriate to use on the expensive restorations the dental patient just paid for.

By engaging and empowering the entire team your dental business is certain to excel. You will create a cohesive team and a dental practice based on excellence and the extraordinary. Realizing the potential of the dental hygiene team and creating a thriving profit center inside this valuable department of your business is essential to building the dental practice you have always dreamed of. This assures you long-term relationships along side your success.

Your team and the dental hygiene department are all very important assets to the health, profitability and success of the dental practice.

The 10 FACTS for Profitability:

  1. Perform oral health care assessments that include the review of patients’ health history, dental charting, oral cancer screening, periodontal assessments, biofilm assessment, saliva pH test, smile analysis, xerostomia, etc.
  2. Expose and interpret dental radiographs (x-rays); co-diagnose
  3. Non-surgical periodontal procedures, antimicrobial agents, laser therapy, etc.
  5. Apply cavity-preventive agents such as fluorides varnish and sealants to the teeth;
  6. Administer local anesthetic and / or nitrous oxide analgesia;
  7. Educate patients on proper oral hygiene techniques to maintain healthy teeth and gums and recommend home care products
  8. Discuss whitening treatment and take impressions when applicable
  9. Administer smoking cessation programs; and
  10. Counsel patients on the importance of good nutrition for maintaining

Debra Seidel-Bittke, RDH, BS is founder of Dental Practice Solutions an evolutionary full-service dental consulting and speaking business. Ms Seidel-Bittke is considered a leader in the field of dental hygiene. Dental Practice Solutions is an evolutionary business focused on increasing the profitability of your dental practice through 4 areas of the dental hygiene department. Research and technological advances have created more opportunities to deliver a higher level of non-surgical periodontal care. An important component of any successful dental business is the function and profitability of the dental hygiene department. Dental Practice Solutions offers a complimentary hygiene department analysis and also provides free bi-monthly webinars to increase profitability.

Ms. Seidel-Bittke can be reached at debrabittke@comcast.net or 503-970-1122. www.dentalpracticesolutions.com