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

“Why Care About SOPA/PIPA?”

By: Debbie Seidel-Bittke, RDH, BS

January 19, 2012

Originally posted on January 18, 2012 by Ali Brown

Have you tried visiting Wikipedia.org today? The site has shut down to join a massive 24 hour web blackout to protest two very controversial anti-piracy bills making their way through U.S. Congress: The Stop Online Piracy Act (SOPA) and the Protect IP Act (PIPA). Here’s why we, as online entrepreneurs, should care about this current debate…

SOPA and PIPA are “sister bills” created with similar, and reasonable enough, intentions—they both make an attempt to protect copyright holders (i.e., television networks, music labels, film studios, lobbying organizations, etc.) and stop online piracy. But, these bills are raising huge concerns because of what they might do to innovation and entrepreneurship.

In a nutshell, if SOPA/PIPA are passed, the U.S. government and copyright holders can sue any website associated with infringing intellectual property. For you and me, this means if someone posts a YouTube song, a lyric, or a book quote, an image to our blog, WE could be sued or shut down. Not only that, our payment processing partner might be legally required to stop doing business with us as well.

It’s obvious why companies such as Twitter, Facebook, and Google are adamantly opposed to these bills, but as online entrepreneurs ourselves, we are in the SAME BOAT. How can we prevent our community from posting anything they want on our site? What would happen to our concept of information sharing, and of course, free speech? The inspiring quotes, or educational videos that today spark lively discussions within our online community, could tomorrow take our businesses down for good.

If you ask me, Hillary Clinton captured the problem best in her response to SOPA/PIPA: “When ideas are blocked, information deleted, conversations stifled, and people constrained in their choices, the Internet is diminished for all of us,” Clinton stated. “There isn’t an economic Internet and a social Internet and a political Internet. There’s just the Internet.”

This week, SOPA was shelved (though many believe it’s not gone for good). But the Senate vote for PIPA will take place next TUESDAY, January 24, 2012.

Here’s what YOU can do today to speak up and make your voice heard.

Love and success,

P.S. Remember, this isn’t about whether you are for or against online piracy—this is about demanding a more well-thought out system that doesn’t put innovation and entrepreneurship at risk! To learn more and to join the web movement, go to Stop American Censorship.


Saying “YES!” To Dental Practice Success

By: Debbie Seidel-Bittke, RDH, BS

January 17, 2012

“Dentistry is about changing lives!” I had no idea when I chose to become a dental hygienist many years ago that I would be able to help patients live a longer and healthier life! Besides providing optimal health we also create beautiful smiles. What a rewarding career!

How does a dental office plan to create beautiful smiles, optimal patient health, be profitable and with little to no stress? The answer lies in how you begin your day. You may rush into the office at the last minute but if you take time to breathe, meet as a team for 10-15 minutes and prepare for a dream day at the office, everything else can be like the icing on the cake!

Start your day first thing at the office or the evening before you leave the office, by reviewing the patient charts. Then discuss as a team, the days patients, challenges, patients who will require pre-medication or special needs, who needs an exam, x-rays, when is emergency time available, etc. The morning team meeting is where you can create your plan for success and it is where the profitability is maximized for the practice. Talk about money: Production, collection goals and even time open on the schedule the next day or week, etc.

I talk to so many dental office managers each week who tell me that doctor doesn’t want to share the office production and collections. This is similar to having an elephant in the room! If you want to have the team on the same page, then let them know where the dental practice goals stand on a monthly basis — at least. Are you accomplishing the goals? If you answered “NO”, this is a great time to discuss as a team “why” the goals are not accomplished. Allow every person on the team to understand the “why” and “how” regarding purchasing supplies, bonuses, pay raises, etc,. etc. Allow the team members to have accountability for decreased production and also allow them to experience the bliss when there is an increase in production! Doctor, don’t hide behind the numbers.


Talking about discussions between doctor and the team, it is in all aspects of dentistry; cosmetic dentistry, and non-surgical periodontal treatment where communication is critical. With regard to cosmetic dentistry we may think the shade, size, occlusion or length of a restoration looks correct but to the patient something doesn’t feel or look good to them. Regarding our non-surgical periodontal care of patients we often neglect to reinforce the importance of regular preventive appointments. This ends up costing both the dental practice and the patient more money down the line. Questions to ask oneself are: “Did we, as a team, ask the right questions? Do we understand the emotions of this patient who is sitting in our chair today? If you answered “No” to any of these questions, there is a good chance your patient will not be satisfied with the outcome, regardless of how clinically sound the case presents. The patient may not be in the right frame of mind to hear your answers to their questions or visa versa. They may not comprehend your explanations for benefits and risk of treatment recommendations. Sit down at a team meeting and know what questions you need to be asking patients.

Treatment Planning

Treatment planning for cosmetic dentistry and all preventive treatment needs should be a group effort. This includes doctor, the entire team, the lab and even referral dentists. Your patient  expectations need to be met for the entire process of communication, case acceptance and future patient relationships to continue. It is very important that patients understand the result and benefits for completing their treatment recommendations.


Sit down as a team and discover what your patients really want. Have you used a patient survey to understand what they really want from you as their dental healthcare provider? How do you measure the success of your communication and listening skills? What percentage of treatment plans are outstanding? How do you know that patients understand the benefits of treatment and do they understand why they really need the treatment completed?

The Answer`

“YES!” is the one word you want to hear! Know what questions to ask. Then be open to listening closely to your patients. When patients believe you have listened and their questions are answered they provide you with a “Yes!” Simply put, if a patient wants it, do whatever it takes to make them satisfied. Make it happen for your patient! When you create a plan each morning, you should be able to say “YES!” To same-day emergency appointments and– –“YES!” to many same-day procedures, for example whitening tray impressions for patients who want their teeth whitener or those who need a night guard, etc.

Can you answer a resounding “YES!” to patients requests? I’m sure you get the point.

We all know the rewards of changing someone’s life with a beautiful smile. This is pure joy to the patient and YOU– the provider! Just remember that communication, planning, and execution can go a long way when you provide optimal health and excellent cosmetic dentistry. Now we’re talking success! YES!

5 Reasons People Resist Change

By: Debbie Seidel-Bittke, RDH, BS

January 10, 2012


5 Reasons People Resist ChangeOriginal Post on December 29, 2011 by Julie Rains

I thought to share this with my readers. It has very good information. Most people resist change so this is a good read for all of us!


Debbie Seidel-Bittke, RDH, BS

President: Dental Practice Solutions


I used to believe that there were two kinds of people.

  1. Those who thrive on change
  2. Those who avoid change

The former are inspired by freshness, embrace novel experiences and jump at opportunities to instigate innovations. The latter seek stability, enter new situations cautiously and place roadblocks before the slightest mention of anything different.

Now, I realize that there is a third category: people who want change but are not willing to do anything risky to achieve it.

They are intellectually curious and enjoy newness yet they hinder initiatives with their indecision and procrastination. Repeatedly (and predictably), they reject new ideas as relentlessly as they express concern that too much has stayed the same.

In short, the second and third types resist change. They avoid, dismiss and sabotage those who want to move forward in any of these areas.

  • Pursuit of a new customer segment
  • Deployment of a new technology or work process
  • Launch of a new product
  • Introduction of new techniques for sales, marketing and customer service

Understanding why they avoid newness is a key step in overcoming resistance. Addressing these concerns can help build a team that will evaluate new opportunities based on merit, not fear. Here are a few beliefs about change that inhibit creative responses and limit the willingness to let the business grow.

1. Productivity will plummet and stress will skyrocket

After years of mastering her job duties, she has an efficient routine. When employees bring problems to her attention, she gives direction by following a self-developed, mental image of a decision tree with a limited number of variables. The simplicity of her day-to-day tasks is comforting. The knowledge that she can easily complete assignments on time, on budget and on spec gives her confidence.

Changes bring complexity to her job. Decisions require new road maps. She anticipates that the mental heavy lifting will be exhausting. This extra time and effort will certainly detract from her productivity, output and peace of mind.

Fix: Establish a new performance metric when changes occur. If possible, move away from activity-based measures to assessments of creative output and profitable results. Give her enough time to assimilate new ways of doing her job and plenty of space to solve problems that require intense concentration.

2. Embracing change means admitting past mistakes.

He believes that championing new work processes or pursuing new customer segments mean public acknowledgement that previous procedures caused errors. Or perhaps marketing programs didn’t deliver the right kinds of customers.

Fix: Reassure him that the proposed changes reflect technological advances, emergence of new segments or other recent developments that have impacted the business. Emphasize the need for continual renewal, not as an indictment of the past, but as a strategy for ongoing success.

3. Failures are not occasions for learning.

She is not afraid of failure per se, and accepts that changes may not bring immediate results. What she fears is her inability to understand which factors influence success. Navigating change is like falling into an abyss rather than interpreting clues on a hidden-treasure map.

For example, she might express concerns about updating the features of a best-selling style. Her hesitation to introduce modifications has nothing to do with a perceived inconsistency between product characteristics and customer desires. Instead, her resistance masks her lack of analytical and problem-solving skills.

In the past, she has blamed failures on economic conditions, poor timing and customer misunderstanding. Unable to pinpoint (or at least guess) the reasons for certain outcomes and then make adjustments that improve results, she avoids change altogether.

Fix: Teach her how to learn from her mistakes, whether they lead to full-blown failures or lower-than-expected performance. Encourage her to articulate assumptions and predict likely outcomes of proposed changes. Then show her how to evaluate results in light of the accuracy of these assumptions.

By giving her the skills to learn from potentially risky moves, she should feel more comfortable with change and confident about her ability to correct missteps and move forward.

4. Difficult problems arise from change.

He is eager to positively impact the company but is reluctant to implement new ideas. The side effects of change may involve handling situations that he does not fully understand. He may have to deal with consequences that he cannot predict or control.

For example, he believes that staking a claim to the company’s online listing could be beneficial to marketing efforts. But the prospect of having to interact with customers who rate the business is unfamiliar and a little frightening. So he downplays the benefits. He wants to dodge possible headaches and avoid revealing his lack of competency in this area.

Fix: Identify known negatives that will likely surface as byproducts of changes. Investigate, identify and implement best practices for dealing with these situations. Acknowledge that unpredictable things may happen, ask him to alert you to these instances as soon as they occur, and assure him that you will handle problems quickly.

5. Preserving status among colleagues and employees is key.

She enjoys her title, position description and place in the organizational chart. The existing hierarchy allows her to get things done. Her colleagues and employees respect her, and she does not want to jeopardize these relationships for shaky ones with another group. She especially wants to avoid scenarios that put her in conflict with long-time associates.

Fix: Tell her the truth. Her current job and existing relationships are becoming irrelevant as the competitive landscape changes or key customers merge and go out of business. The new organization will challenge her alliances but also position her and the business more favorably in the long term. At the same time, uncover and address any areas of conflict among work groups, and coach her on methods of interacting with different personalities.

Julie Rains is a senior writer at Wise Bread, a leading personal finance community dedicated to helping people get the most out of their money. Get daily money tips by following Wise Bread on Facebook or Twitter.


By: Debbie Seidel-Bittke, RDH, BS

January 6, 2012

Dentistry is a profession that seems to be uniquely afflicted with a great
deal of stress and anxiety. This is true not only for the dental patient,
but even more so for the dental clinician. As a clinician you are
performing your duties in an extremely intimate area on clients who, in
most cases, are not totally excited about the whole situation.

This clinical situation would be enough to elevate the stress chemicals of
any normal person. Compounding it is the fact that the practitioner is
faced with additional pressures. He or she is also a small business owner.
In this capacity you must wear many hats. You are leaders, managers,
schedule coordinators, counselors and money managers. Is it any wonder
that dentists seem to rank extremely high in incidence of stress-related
maladies? These include burnout, loss of passion for their profession and
actual physical symptoms. Dentists must learn to manage their stress
before their stress manages them.

First you must recognize that not all stress is bad for you. Without any
stress you would be like a spineless jellyfish, unable to function in the
real world. The stress of owning your own business, of providing for your
family, of serving your clients to the best of your abilities can actually
be good for you. Believe it or not, I have found this to be true. This
stress can make you stronger, more resilient and more able to relate to
others. We can call this type of stress, good stress or eustress. The
stress you want to eliminate is the stress that always seems to create
anxiety and worry. Let’s call this distress or bad stress. These stressors
produce headaches, backaches, insomnia, indigestion and depression. Most
of these stressors are self-inflicted.

It is true, you cause a great deal of your own distress. I know this for a fact because I went through a period of time in my early years of practice where I suffered from constant and excruciating stomach pain . I used to lie on the floor in my back office between patients and writhe on the floor in agony. When I visited the medical doctor to determine the cause of my distress he said, “Tom, your problem is not what you are eating, but rather, what is eating you.” At that moment I broke down and realized that I had to change andlearn to manage stress before stress managed me into an early grave.

Here are 3 techniques I used that helped me manage stress and may also assist fellow dentists in that same endeavor. 1) Live life in day-tight compartments, 2) Manage your priorities and determine what are your most important and essential daily actions (your crystal balls), 3) Rule your impulses. In this article I will deal with the first technique, “live life in day-tight compartments.” In future articles I will cover the other 2 techniques.

The first technique,”live life in day-tight compartments,” I learned from Dale Carnegie and his book, “How to Stop Worrying and Start Living.” It isexemplified by the words of Thomas Carlyle, “Our main business is not to see what lies dimly at a distance, but to do what clearly lies at hand.” Unfortunately most of us do not follow this advice and stew and agonize over things that we cannot control or feel guilty over events that have already taken place.

Guilt emanates from the past. These are actions or events that are over and done with, yet you continually relive them and demonstrate regret. Worry emanates from the future. These are things or events that have not yet occurred, yet you agonize over them. Realize, you cannot live in the past. The past is dead and gone. “Let the dead bury the dead.” You cannot live in the future. The future is merely a promissory note. You have no guarantee that you will even be around tomorrow. “The load of tomorrow, added to that of yesterday, carried today makes the strongest falter.” Live for today only.” Every day is a new life to a wise man or woman. Live only
in the present, that is all you have. Close off the past and the future and live in day-tight compartments. If you can accomplish this and live only for today by living in these day-tight compartments you can eliminate most guilt and worry.
Remember that the present is just that a, “present or a gift,” that is given to us. Enjoy it. Horace, the Roman poet, wrote “happy the individual and happy they alone who can call today his or her own. They who secure within can say, tomorrow do thy worst, for I have
lived today.” Strive to shut the iron doors on the past and the future and live in day-tight compartments. This will eliminate a great deal of worry, anxiety and guilt. Start today and seize this day to obtain the most out of it. Live only in day-tight compartments.
More on this topic very soon!

Dr. Tom Tursich
The Doc of Communication

Keep Your Pedal to the Metal … Without Added Stress

By: Debbie Seidel-Bittke, RDH, BS

January 4, 2012

5 Keys to a dental office dream day

Think about all the times during your workday when you feel like you are running on a treadmill and you are behind schedule. Can you feel the stress? Does this sound too familiar? To top it off, your patients are also unhappy waiting another 10-15 minutes for their scheduled appointments. Unfortunately, a typical dental office can get off schedule on a daily basis – and it only takes one late patient or challenging case to throw off the whole day.

Think a dysfunctional schedule is just is a fact of dental office life that you must face? Think again! You can keep your pedal to the medal and get everything done yet feel more like you’re breezing by on cruise control. Just follow these five timesaving tips!

1. Huddle Together Every Morning

A daily team meeting (“Team huddle”) is key to starting the day right, and it doesn’t have to be time-consuming. A morning team huddle takes 10-15 minutes tops and is a great way to strategize who will be where, in what room, and at what time. Use this huddle to pre-plan which patients that day will need a doctor’s exam and at what time the doctor can expect to visit the hygiene room. Also check if any patients that day need screening assessments so the dental hygienist can plan for documentation support or any other needs. The team huddle is also a great time to discuss any anticipated challenges with patients, necessary pre-meds for the day’s patients, tracking daily, weekly, monthly goals, etc., etc.

Never wait until the end of an appointment to alert the doctor of a necessary exam. Offices that neglect to plan their days, and especially those who fail to plan doctor’s exams, waste huge amounts of time.

2. Don’t Stretch the Schedule – Even for a Mr. Superman

Understand the exact treatment each patient needs, and don’t try to squeeze in more than the patient is scheduled for. For example, suppose a regular prophy patient is slightly overdue for his hygiene appointment. Today, this patient has an abnormal amount of supragingival calculus, hemorrhaging and stain. Instead of having the patient return for another hygiene appointment, you try to remove all the calculus and stain today. After all,  Mr. Superman doesn’t have any other dental challenges and skipped his last six-month prophy, (Which, by the way, was scheduled ten months ago!) due to financial issues.

Creating excuses for “why” he missed his last appointment, will only add more stress to your time-crunched day. Why should you rush and stress because of Mr. Superman’s inability to understand the importance of regular preventive care? Yes, money is a concern but to treat this challenge now and provide optimal health the issue is not money but the patients’ overall health in years to come.

Tip: If you are spending more than 20 minutes scaling a patient’s teeth, you are providing more than a prophylaxis appointment.

The American Dental Association (ADA) and most countries’ dental billing codes clearly define a prophylaxis versus periodontal maintenance. Assess before you begin scaling, then communicate your findings to the patient. If you decide you need to change plans, sit the patient upright, and discuss the appropriate treatment for this appointment and what is necessary in the near future to prevent future disease.

Know the power of your language, too. If hygienists, the doctor and team use the word, “Cleaning,” instead of “Preventive Care” or even “Prophylaxis,” they decrease the value of the dental hygiene appointment – and that can make hygienists run late consistently. The next patient is left waiting for their appointment while you do your best to complete treatment on the overdue patient in your chair. AND What type of message are you giving the patient who is waiting 10-15 minutes into their scheduled appointment.

3. Let Videos Carry Part of Your Load

Creative and effective communication can be a great time saver – especially when you don’t have to do all the talking. Consider the time you take to educate your patients. You are constantly communicating about their oral health, care planning, home maintenance, and procedures they need and what they entail, etc. That process can be quite time-consuming. True, you can talk while you’re scaling, but multi-tasking will slow down your overall process, especially if you need visual aids.

A better way: When you leave the hygiene room or take a moment to document patient notes, this is a great time to play an educational video that explains information you need to discuss with the patient before she leaves. Every saved minute is precious.

If you have an iPAD in the office, check out an application called DDS GP. (http://ddsgp.com)  DDS GP has a large index of videos to communicate with your patients about everything dental from Arestin® to extractions, invisalign® , and even something as simple as an x-ray.

4. Power Up Your Scaling

Think about using this rule of thumb to save time: work smarter not harder. Ultrasonics and Piezos offer a big advantage to dental professionals and patients in this regard. When you have a patient with excessive calculus or stain, these power scalers are great timesaving tools to include in your patient treatment armamentarium. They also disrupt bacteria’s cell walls, completely destroying them, while hand scaling only smears bacteria.

Timesaving power scalers will also drastically improve your ergonomic situation. Hand scaling takes longer, causing neck and back pain, as well as and carpal tunnel syndrome. Most dental hygienists see an average of eight patients a day, and if you can save just seven minutes of scaling per patient by power scaling, you have saved yourself almost one hour of strain on your body during a day in the office. Patients will also appreciate decreasing their time in the dental office.

If patients are wary of these power tools, rest assured that ultrasonics available today offer much more comfort than they did 20 years ago. Think about a smooth ride in a Lexus versus a rough ride in a Ford F350 truck. The new ultrasonics are easier to use, too.

Important: You don’t need to completely replace valuable hand scaling techniques; instead, use the 80/20 Rule. That is, power scale 80 percent of the time, and use curettes 20 percent of the time to complete the scaling procedures.

5. Give It All a Test Drive.

At your next monthly team meeting, gather all your time-saving ideas and do some roll-playing. For example, create a script and role-play the patient-doctor exam in the hygiene room. You want to practice sitting up a patient in the chair and explain the need for additional treatment. You want to practice turning on a video (how to do this so everyone understands how it works!)  while leaving the room to document your treatment notes. Team meetings can also be a great time to role play treatment planning, communication (scripts) skills to get everyone on the same page, understanding how to overcome objections or challenges, etc. Use monthly team meetings for role playing various systems and services so everyone on your team is on the same page!

After practicing these, discuss the ups and downs you experienced during the role playing session, with the entire team. How long did these tasks take for you to complete? Did you face any unexpected challenges? Was everyone on the same page to ensure these timesaving efforts really worked? How much time did you save? Could you do better? Don’t apply these changes in the real treatment room until you’ve worked out the major kinks, but when your team is ready, take it live! Write down the answers to these questions and any others you may think of. Keep your scripts and these notes of the role playing experience for future reference and to provide new team members who come onboard. This will be a great learning tool in many ways, in years to come.


These are only a few suggestions to keep your day running smoothly and decrease the stress. You can probably think of even more. Understand, however, that saving time is not about diminishing the value of a dental appointment; it’s about using your time wisely. If you can save seven minutes scaling, for example, then you have found valuable time for patient education purposes. For practices where the hygiene department sees more than 8 patients a day, imagine the valuable time you will now have available for educating patients, providing same day services which all improve the patient experience and increase profits in the dental hygiene department.

As an efficient provider you understand that every minute a patient is in the dental chair counts. Using every second wisely will not only add value to your patient services, but your practice will profit as well.

Takeaway: If you plan collaborative, productive workdays, your patients receive optimal care, and you accomplish more in a seamless process. So, step off the treadmill, and leave the office knowing your day was “like a dream!”

For more information on benefits and usage of ultrasonic scalers see: Drisko CL, Cochran DL, Blieden T, Bouwsma OJ, Cohen RE, Damoulis P, Fine JB, Greenstein G, Hinrichs J, Somerman MJ, Iacono V, Genco RJ., Position paper: sonic and ultrasonic scalers in periodontics. Research, Science and Therapy Committee of the American Academy of Periodontology, 2000, [PubMed – indexed for MEDLINE]