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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


By: Debbie Seidel-Bittke, RDH, BS

April 30, 2012

For many years the dental hygiene department has been known as a loss leader. We live in a new era of dentistry. If you have specific systems in place you will add value to your patient services, increase case acceptance and increase your dental business profits.  Here is a 6 step process to streamline this process and increase your profits.

For many years the dental hygiene department has been thought of as a loss leader. Furthermore, many dental professionals believe they must see more patients each day and complete more procedures during a patient appointment to become more profitable. Perhaps, if you are a dental hygienist, when you hear the phrase, “Increase profits,” you cringe and think of working longer hours.

The good news: This doesn’t have to be the case for you! But why are some hygiene departments more profitable than others? We’ll tell you why and share the secrets to success in 6 steps. Times have changed, and the business of dental hygiene can mean profits for the entire dental team. When the correct systems are in place, a day in the dental office will feel less like a migraine and more like a mission accomplished

1. Understand the Importance of the Hygienist’s Role

Hygienists play a huge role in the growth of a dental practice today. In fact, the hygiene department should be the second-largest profit center in the dental practice. Think of the dental hygienist as an ambassador for the dental practice. Indeed, the hygienist is in a very unique position, spending a large majority of one-on-one time with patients in the chair. The hygienist is first in line to present the risks and benefits of preventive and aesthetic dental treatments. The dental hygienist can, thus, set the stage to help patients accept treatment plans, large and small.

Furthermore, when a hygienist sees the same patients multiple times a year, he or she has a chance to develop personal relationships with these patients — and this means building more trust. This added trust will, then, make patients more likely to listen to the hygienist’s treatment plan suggestions and more likely to ask the hygienist for help in their decision-making process.

Examples of where a hygienist can — and should — get involved with suggestions and decision-making include:
• Choosing the best restorative options
• Deciding upon various cosmetic/aesthetic procedures
• Understanding preventive products, such as power toothbrushes and knowing which one is best for them
• Choosing which mouth rinse to buy and what toothpaste is best suited for their oral condition.

2. Foster Daily Teamwork

All successful businesses begin with a collaborative team. Even the vocabulary the world’s most successful businesses use will describe their employees and show the companies’ high regard for teamwork. Wal-Mart employees are known as associates. When you’re a guest at the Ritz Carlton, employees and guests are known as, “ladies and gentlemen, serving ladies and gentlemen.”

And there’s no reason your dental office can’t emanate (and profit from) these very same values. For starters, everyone should be on the same page. Each member of the dental team needs to be enthusiastic and well-versed in discussing the benefits of preventive and aesthetic dentistry. Also, the doctor and the auxiliaries must share a practice vision and philosophy for patient care. That’s where dental professionals can make a difference. Expert dental coaches can analyze your dental office’s highest potential and create a custom, step-by-step plan that capitalizes on your practice vision and brings you more success than you thought possible.

Meanwhile, start with a morning team huddle to get your team on the same page, and if you don’t already, plan monthly team meetings to provide a time for collaboration and exploration of new ideas and systematic processes. This is where the right hand learns what the left hand needs to do, so to speak. Then, your team will have the ability to be in complete harmony… which leads to higher profitability. Taking time during team meetings to set the backdrop for a seamless day at the office creates added value to the patient services — and the team doesn’t feel dead at the end of the day.

Let’s not forget the value of dental team-to-patient teamwork. When the dental team takes time to review its patient communication skills and the team understands how to communicate the science behind the art of dentistry, patients see the opportunity (and importance of) optimal health. This is when it becomes a winning situation for the patient and the dental practice. See a trend here? If you can build a relationship where the patient looks to the hygienist as a trusted advisor, patients are more willing to agree to an optimal plan of care — which means better health for them. And remember: happy patients refer other patients to your office. It’s a win-win situation.

3. Move Beyond the Prophy

A critical item to discuss in your team meetings is changing your practice’s treatment approach paradigm. Many dental practices in this new era of preventive dentistry face challenges moving from the Prophy to treating the patient’s total health. Many dental hygienists today still feel pressure to complete the cleaning when; in fact, the most important service they can provide is education and a treatment plan to reverse the disease process.

Diagnosing and treating based on what insurance will cover or based on what the patient wants, instead of what the patient’s needs, helps neither your patient nor your practice.

So here’s another example that demonstrates the value of your dental hygiene department: When the hygienists regularly move beyond the Prophy, they add value to the patient’s services. Most patients see their dental hygienist more often than their physicians. And when you begin offering a variety of services, such as blood pressure screenings, oral cancer exams, fluoride treatments, xylitol products, periodontal exams, smile analyses, etc., you increase the value of your services — and your patients start to see amazing potential to improving their overall health just by visiting the dentist. Plus, many of these services incur a small fee, adding to the profits of the dental hygiene department.

Afraid you’ll scare your patients away if you go beyond the Prophy and present a treatment plan that’s in their best interest? You won’t, if you show patients you’re on their side. You can’t go wrong with stating the facts. Always present the scientific evidence to support your findings. Then, show patients their options, along with the risks and benefits of completing and not completing treatment. It is when you discuss the science and your expert knowledge of oral health that you add value to your services. The increase in profitability will come alongside when patients sit up, listen, and then take action to treat their disease.

4. Tap Into The Recare System Gold Mine

Remember that myth we busted at the beginning of this blog, which you don’t need to pack in extra patients each day to build profit? If you’re still wondering how this works, the answer is in your practice’s recare system — with your hygiene department at the helm.

Imagine the hygiene department as an energy cell and the recare systems the mitochondria of the dental practice. When a well-developed system is in place, your practice will experience increased profits.

The key is in pre-scheduling. That is, before the patient leaves the hygiene room, the hygienist or hygiene assistant schedules the patient’s next appointment. The hygiene department has the best auxiliary to schedule the next appointment because they intimately understand the patient’s needs and desires for the next appointment and the necessary procedure to schedule. This is your ticket to success: You must have close to 95% of your hygiene patients leave with their next appointments already scheduled. And you should know the barriers and patient objections which may occur ahead of time so you can plan accordingly in your team meetings.

For example, many times patients will not know what they are doing in two weeks, and especially they may not know their schedule in 4 or 6 months. So, the hygienist and the hygiene team need a plan of action to communicate with patients who may object to scheduling a next hygiene appointment.
Short on ideas? Try this: Take time during a team meeting to role play, and create a plan of action for various types of objections patients have toward scheduling a next appointment. Also, keep in mind that so many people these days carry smart phones and PDAs with their calendars, so a patient with a device like this can easily check his or her schedule and add to it instantly.

One dental practice our team of experts worked with originally had 75% of their hygiene patients leave the hygiene appointment without scheduling a next appointment. With help and guidance, the team has taken on a new attitude. Here is an example of a patient dialogue after the team changed the way it communicated and viewed the appointment schedule.

Kris (Hygiene Assistant): “Beth, I understand that you travel a lot, and I want to make certain that you return in three months for your regular maintenance appointment. Today, I found a few areas that are bleeding, and I am concerned that if you call us to schedule you next hygiene appointment, we won’t be able to accommodate your schedule. I want to suggest that you make your next hygiene appointment today so we can attempt to accommodate your busy travel schedule. If you find you can’t make this appointment, then you are welcome to call us a month before the appointment to reschedule. I know you prefer to come later in the day, and we have so many patients who want this time of day, that it is best for you to schedule this appointment today and only change if you find there is a conflict.”

Beth (Patient): “Mary, I understand what you are saying. I am a procrastinator, and I can see how waiting to make my next appointment can most likely create more problems in my mouth. I really do not like hearing my gums are bleeding, and I believe that I can rearrange any travel plans or change my work schedule so I don’t have to change this appointment. From what I heard today about my mouth, I really want to take better care of my teeth and gums. I never knew how important the gums are to my overall health.

Kris: “Beth, I am so happy that you understand how important your oral health is to your overall health. We can see you on Tuesday November 12th at 3:30pm. Will this time work for you?”
Beth: “I’m looking at my calendar, and I don’t see any conflict with this date or time so let’s schedule it!”

Notice how this type of communication between the patient and hygiene auxiliary allowed the patient to be in control. Beth felt involved in the process of scheduling her next appointment. Beth took responsibility for her health, and she was an active participant in the conversation.

This dental team also has changed to a blocked or tiered schedule which can better accommodate new patient appointments, alongside the preventive care appointments, periodontal maintenance appointments, and scaling and root planing appointments, etc. Not all patients are seen at the same interval of time, but the office can accommodate patients in a timely manner with this type of scheduling system.

5. Improve Cancellation Rates

Scheduling the recare appointment is only half the battle, though. The recare appointment is the most canceled and failed appointment on the dental schedule. And one cancellation per day in the hygiene department will lead to what is called a loss leader. This means a loss in the hygiene and doctor productivity. Many offices experience a cancellation and patient appointment failure rate of 25%. But this need not occur when you use the strategies we suggest. In fact, a realistic goal to set when following these suggestions is 95% or better in scheduling effectiveness.

Most important strategy: Have written guidelines for patients that explain what will occur when they cancel an appointment at the last minute or fail to be present for their scheduled appointment. Some practices post these in a visible place in the office, in addition to having new patients sign that they’ve read and understand the cancellation policies.

Just make sure you write your expectations using positive words. Check out our example below of guidelines written in a positive manner:

“We will always respect your time, and our team will make every effort to schedule appointments that accommodate the needs of all of our patients. In return, we ask that our patients make every effort to keep their reserved dental appointments. When a patient appointment is broken or an appointment is missed, it creates scheduling challenges for other patients as well as for our dental office.

Our dental office will charge a fee for cancellations and appointment failures without 72 hour’s notice. We understand that emergencies and personal situations do arise, so after a series of two failed or broken appointments outside of the 72 hour guideline, a charge will apply to your account before a next appointment is scheduled.”

Bottom line, when effective communication occurs between the patient and the dental team, a change in the patient’s attitude occurs, which translates into improved patient compliance. Consequently, the dental practice will see a reduction in cancellation and appointment failures.

6. Measure Your Success

Seeing the fruits of your labor is extremely important to continued success. Knowing exactly how much your numbers have improved each month can guide you to know where more potential remains. Not to mention, seeing your improvements is a huge morale booster — now you know that all your hard work is worth it!

Not sure how to track your progress? It is recommended that each month, the hygiene team or office administrator run and review (with doctor) a “Production Analysis Report”. This report will analyze all dental hygiene procedures each month to determine what percentage of production the appropriate hygiene department codes represent. And what better time to review this data, which tracks the hygiene department’s effectiveness, than during your monthly team meeting?

It’s exciting, actually. You’ll see that when you implement many of the assessments and procedures just described, you will experience at least a 30% increase in your hygiene department within the next six to nine months.

Services that may account for this increase in hygiene profits are fluoride treatments, (Utilizing the Evidence-based science from CAMBRA) sealants, antimicrobials, xylitol products, oral rinses, toothpastes, 5% sodium fluoride for at home use, and power toothbrushes.

Change Your Patient’s Paradigm, Too

A final word: The twenty-first century is a new era for dentistry, and particularly dental hygiene. Cleaning teeth is no longer the standard of care. In fact, we suggest removing this word from your dental practice terminology when talking with patients. Today’s dental teams must talk to their patients about prevention — and the dental hygiene appointment is actually a preventive care appointment.

If the patient has any level of disease, the time to treat is now! Take the classic example of a patient in the early stages of periodontal disease. Phase I of non-surgical periodontal treatment ends with the periodontal maintenance, which is a 4-6 week post-operative appointment to evaluate the disease state. The last appointment of Phase I non-surgical treatment is the first of regular periodontal maintenance appointments. The patient who does not have a healthy evaluation must return for more treatment in the Phase I level of treatment. In fact, this is the time where you may need to refer the patient to a periodontist.

If a patient is healthy at the final evaluation (The first periodontal maintenance appointment) then he or she will return consistently for the rest of his/her life every 3-4 months for periodontal maintenance. Periodically, a patient may have episodes where the disease state returns and the hygienist will need to schedule the patient to return for scaling and root planing and even antimicrobial therapy.
All that said, you must communicate with all periodontal patients that periodontal disease is episodic and the idea that “once a periodontal patient, always a periodontal patient.” If the patient has a hard time taking the information seriously, explain that his/her situation is the same as when a patient is diagnosed with high blood pressure or diabetes.(And various other disease conditions.) The physician will always monitor the disease state even when everything seems to be “status-quo”.

Most successful dental businesses have implemented these systems. No longer will you hear that the Dental Hygiene Department is a “loss leader.” Expectations of the dental professional may be high, but remember you don’t have to take this path of success alone. Begin with these few guidelines to get on the path to where you want to be. And remember, we have many experts available to guide you along the road to success so don’t ever feel like you have to walk the path to success alone. Dream big and happy planning as you embrace this new era of dentistry!


What is a Mastermind Group?

By: Debbie Seidel-Bittke, RDH, BS

April 24, 2012

I have found that being a part of a mastermind group allowed me to leap forward with my business. I was able to discover new ways to achieve the same goals but with a guide to draw out my strengths which were inside of me but “I was “too close to see it”. Now, I am where I really want to be and I got there in half the time!

Generally speaking, a mastermind group is a group of like-minded professionals who work together to achieve a particular goal in their own life personally and professionally.

What does a mastermind group look like?

  • A group of 5-10 professionals
  • These people will be like-minded
  • The members of this mastermind group will agree to offer support, encourage one another, bounce ideas off of one another and even promote and support projects for each other when appropriate.

How will members of the mastermind group meet and communicate?
The mastermind groups I’m a part of do most of their communicating via SKYPE and email and my business specifically has a web portal for the group to share ideas and post privately to one another. The web portal allow for specific information to be shared with the group. We meet live – in person–twice– two days at a time.

Are there rules?

Members will receive a general explanation of what the group is hoping to achieve and what’s expected of the members. Personally, I like informal without a lot of rules because it leaves a lot more room for genuine relationship.

What do we do in a mastermind group?
All mastermind groups work differently, but in the ones I’m a part of, we include the following to our program:

  • Brainstorm ideas.
  • Share victories and defeats.
  • Ask for help promoting your services, products, ideas, etc.
  • Want to discover new profit centers in your practice? We will discuss this!
  • Our mastermind group will meet at a location in a calm but scenic environment which is not only relaxing but conducive to growth. Our group will have a light breakfast, light snacks and drinks at the break, a catered lunch, a cocktail hour after one of the two days when we meet live in person.
  • We will shoot the breeze and share life.
  • Each month members receive a 1:1 personal call with me to discover their current needs to move forward, receive support with any challenges or discuss whatever is on their mind
  • We will  meet via SKYPE or a conference call each month and we have guests to present topics which all of the group members find informative and      valuable for them personally and in line with their goals professionally.  These are well known experts in their field such as : New Patients, Marketing, Products for Prevention of Disease and Profits to Your Practice, Communication for “YES” to Case Acceptance, Insurance Billing, and so much more…

For me, mastermind groups have made a huge difference in my success in so many ways and I want to “Pay this forward!”
What about you? Are you currently in a mastermind group? How is this working for you? Any suggestions about mastermind groups?


Passion, Purpose, and Profits!

By: Debbie Seidel-Bittke, RDH, BS

April 20, 2012

“From Your Purpose with Your Passion to the People you Serve.”

So, do any of these three words above feel magical? When you feel passionate about your purpose, I believe you will see your profits soar and suddenly everything is well… ummmm magical! Life is GRRREAT!

And easy.Here’s the scoop:

1. Understand EXACTLY who you are at the deepest level, and what your unique message is. This will help you stand out from the other dentists in your neighborhood. This is how you will be the most profitable. This is when you will find it easy to corner that specific market that is especially yours. You will stop trying to follow models that self-proclaimed gurus use and finally realize the greatest gift you have is unique to you… and THAT is what brings you the income you really want.

2. Provide patient serves that are rich in benefits and provide solutions for your patients. These solutions are your natural talent. You will simply turn your passion into a profit center. Then you exponentially increase the lifetime value of your patients by leveraging your knowledge and skills. (Your God given talent) When you solve problems for people, they are more than happy to pay for those services which create answers to what they really want. (Mental note: You can’t get to step 2 until you have thoroughly completed step one.)

3. Find Your Niche and get in front of people who want what you enjoy providing. Share your unique message about what you represent. This is where strategy is King. (or Queen, depending upon…) You must find and then associate with your unique set of patient(s). These people are YOUR market. They are like you in some way, and you are like them in many ways. Research what the people you want to serve need and then give it to them. Get involved. Be their expert. Be their solution.

4. Create Profit Centers. Yes, I said “Profit CenterS”. Plural. There are more than one or two areas in your business that – if you have systems in place, you will create Profits — Profits and MORE PROFITS! You must have a strategy, a timeline, specific services and a strategic structure for your dental practice. This is the large package where –Your business– will grow and fluorish for many years to come. Sounds easy enough, doesn’t it? Here is where very often, I see people fall short. Many dentists don’t clearly see where the fastest path to profitability lies. This is that time when they throw spaghetti at the wall (metaphoric pasta) and hope for their cash cow to roll in. They are now overworked and they have under planned their strategy. They become a slave to their business. It’s not pretty. Why are you in business for yourself? Do you own a dental practice because you love freedom? Freedom does not include slavery. Get. A. Plan.

Your business success is a glorious mix of passion, purpose, and PROFITS. All three ingredients must be present in order for the recipe to turn out like a beautiful soufflé. If your masterpiece is collapsing you simply must adjust the recipes and spruce up your ingredients. Then whoola…. magic.

If you want to accelerate your results join me as a part of our Dental Practice Owners Mastermind Group

Debbie Seidel-Bittke, RDH, BS, is an international speaker, author and one of Dentistry Today’s 2012 Leaders in Dental Consulting. She is president of Dental Practice Solutions, a dental practice management business specializing in patient-centered solutions, uncovering hidden office potential and maximizing profits. DPS touches dental practices worldwide with its top-notch consulting and has most recently debuted a one-of-a-kind, online comprehensive coaching program for dental teams. This step-by-step program is designed to give dental practices an “extreme makeover,” jumpstarting improvements in finances, teamwork, productivity, and more. Ms. Seidel-Bittke, seamlessly combines her sharp knowledge of the latest dental hygiene science, financial savvy and her knack for solving the toughest dilemmas of the dental team to put even the most struggling dental practices on the fast track to success. To learn how you can unlock your practice’s potential, email Ms. Seidel-Bittke at info@dentalpracticesolutions.com, call toll-free, 888-816-1511 888-816-1511 or visit her website at http://www.dentalpracticesolutions.com/.



It’s all about Total Health!

By: Debbie Seidel-Bittke, RDH, BS

April 11, 2012

We know today that oral health and systemic health are interrelated and the importance of a dental hygiene appointment is now more than “just a cleaning.” The various assessments completed during a dental hygiene appointment can be lifesaving.

Take a look at the “to do” list during a dental hygiene appointment. If you had to prioritize this list what would you put at the top of your list? Once you select your #1 service, break down your dental hygiene appointment into sections: the beginning of the appointment (exam and assessments), the middle of the appointment (scale & polish), and the end of the appointment (the doctor exam and scheduling the next hygiene apt.). What service in the dental hygiene process of care do you dedicate the most time to? Is it the beginning, middle, or end? Are you dedicating the most amount of time to the service you identified earlier as the most important? Do you find that you are spending more than 20 minutes during the mid-point (Scaling and polishing) of the dental hygiene appointment? If you say “Yes”, then you are most likely providing something that is “More than a Prophylaxis.” If your mid-point is greater than 20 minutes in length you need to re-think what the diagnosis or periodontal type of this patient truly is.

Patient assessments, especially the review of the health history, blood pressure, periodontal screening exam, and the oral cancer exam are the most important services you will provide during a dental hygiene appointment.

As a dental hygiene coach/consultant, I typically find that a large majority of dental hygienists say they “don’t have time to do these screenings”. I have also discovered that many hygienists don’t understand the importance of the oral cancer screening because they have never actually found a suspicious lesion. To that I say “Are you going to WAIT until the 1st time a patient has a melanoma or suspicious area to begin examining for oral cancer?” Many hygienists focus on scaling and polishing the teeth. After all, most of the patients expect to leave the dental hygiene appointment with clean teeth!

Many clinicians will classify the appointment a “success” when they are able to scale and polish perfectly, every tooth in the arch, while eliminating extremely important screenings in order to do this.

Do you provide blood pressure screenings at least once a year as a courtesy to your patients at every visit? This is a great value add service to your patients and will go a long way creating a “win” for everyone!

Regarding the oral cancer exam, the death rates associated with oral cancer are not attributed to issues with diagnosis. The death rates are directly related to late diagnosis. Epidemiologists state that until we have standardized, comprehensive programs to screen for oral cancer, patients will continue to get diagnosed far too late in the disease progression; the late stage discovery where the disease is already metastasized is extremely common. Between 1988 and 2004, the incidence of-positive oropharyngeal cancers increased 225%.(1)

When you have less than 60 minutes for a prophylaxis or supportive periodontal maintenance appointment it becomes almost impossible to complete the very important screening exams which can be a life-saving tool!

Remember the motto for the twenty-first century “The Dental Hygiene Appointment is about Providing Total Health!”


1. J. Clin. Oncol. Chaturvedi, A. et al 2008; Incidence Trends for Human Papillomavirus Related and Unrelated Oral Squamous Cell Carcinomas in the United States. 26:612-9.


Boost Your Hygiene Department’s Scheduling Prowess

By: Debbie Seidel-Bittke, RDH, BS

April 5, 2012

Every dental hygiene department has potential to be the second-highest profit center of the dental practice. Is yours in this category? Why do some hygiene departments have more success than others? Do these hygiene departments see more patients? Do they perform more dental hygiene services? Do the auxiliaries work longer hours?

The secret is in maintaining a constant flow of patients, both new and old.

New patients are the lifeline to every successful dental practice. Without new patients, production will decline and the practice will not exist. Every dental practice has a normal attrition of patients. This is a fact of business. People move, pass away, or leave because you are not on their insurance plan, and this can mean a potential annual loss of 10%. Just as your heart beats at least 60 beats per minute, you must have a continual flow of new patients walking in the door to make up for those patients who are walking out.

If new patients are the lifeline, then patient retention (continuing care) is the heartbeat of the dental practice. Your active patient base consists of patients who value your care, accept your recommendations, and pay for treatment. These are the people who trust you and your team. They refer their families, friends, and colleagues to you. These are the key players in the ongoing success of your business.

That said, to keep your lifeline and heartbeat going, you must have a scheduling system that maximizes the number of filled – and fulfilled – appointments. Think you have no control over patients refusing to schedule and patient cancellations? Think again. These next few suggestions show how you can tip the outcome to your favor, and quite successfully, at that.

Get the Hygienists Involved in Scheduling

Most patients see the hygienist more than any other auxiliary of the dental team. Thus, the hygienist carries a critical role in building and maintaining the current active patient base.

You will usually see a positive patient attitude and an increase in patient compliance occur when the hygienist is involved in scheduling the patient’s next hygiene appointment. Ideally this should occur when the patient is still present in the hygiene treatment room.

The dental hygienist is a valuable oral health educator for every dental practice. The role of the dental hygienist is to educate patients about the relationship between oral health and systemic health. Patient involvement and active participation create ownership and accountability and will ultimately reduce the cancellation and failure rates of the continuing care patients. Patients are more likely to understand the importance of why they need to schedule their next hygiene appointment when they are still in active conversation with the hygienist. There is a continuation in the patient-practitioner communication process.

Watch Your Words

Everyone on the team should understand effective words for a positive patient response. Courtesy confirmation calls, emails, text messages, and written communications define the hygiene appointment. Shoot for wording such as this:

Hello Mr. Goodman, it’s Megan calling from (insert dental practice name). We are looking forward to seeing you tomorrow at three o’clock for your preventive care appointment. I see on the schedule that Maria will be doing your annual periodontal screening exam, and Dr. Goodtooth mentioned to me that she is watching a few areas that may have possible decay in the near future. We look forward to seeing you then.

Note how the wording suggests far more than “just-a-cleaning-or-a-check-up,” adding value to your services. Also note the positive expectation of seeing the patient. Megan does not discuss the cancellation policy because it would only be a subconscious reminder that the patient can cancel if something else comes up. She also does not ask for a call back to the office to verify an appointment. She keeps it simple. Above all, set the expectation that patients understand the importance of their dental service and desire to come to see the doctor, hygienist and team members. The dialogue between the auxiliary and patient in the office is also extremely important. Here is an example of how a conversation about scheduling a next appointment may go:

“Today I found a few areas of bleeding that are considered abnormal, and the doctor is observing an area where you have the beginning of decay. Our schedule is booked tightly because patients usually schedule future appointments before they leave their hygiene appointment. I know that you like to come in first thing in the morning on Thursdays, so I recommend that we reserve your next appointment now since that’s a popular time. I can see you on Thursday, October 18th at 8am. Will this work for your schedule?”

Note the opening educational dialogue. The patient suddenly is tuned in to the importance of coming back for another appointment. Also, the wording suggests consideration for the patient’s preferred schedule, while at the same time, gently insisting on a commitment now.Tip: When patients see the doctor but are overdue for a dental hygiene appointment, if you have an opening, ask them to stay for a dental hygiene appointment when doctor is finished with treatment that day. The hygienist does the same if the doctor has an opening and the patient has incomplete treatment.

Use wording such as, “we can save you time from missing work another day,” or “we can save you time returning to the office,” etc. In summary, create statements that are certain to benefit the patient.

Build a Well-Oiled Scheduling Machine

Ideally, a brief morning meeting (a “team huddle”) enables the entire team to communicate, delegate, and maximize the day – especially the current days’ schedule. One of the most important topics reviewed at huddles with my consulting clients is having the clinical assistants audit patient records and identify who seeing the doctor that day and also overdue for hygiene care.

To achieve and assure a full and productive schedule (for all providers), the hygienist should review patient records for incomplete dental treatment, update x-rays, exams, perio exam, medical history, etc. With this current information, the hygienist can prepare to discuss issues with the patient, demonstrate/educate (with an intraoral camera), answer questions, and provide the facts, risks and benefits, when the doctor enters the treatment room. The hygienist can also discuss scheduling future appointments much better, knowing where the patient is in his/her treatment cycle.

With these facts under the team’s belt, scheduling will be much more efficient. For a hygiene department to achieve success, it should attempt to schedule 95 percent of its future dental hygiene appointments at the time of the patient’s current dental hygiene appointment.

The dental practice needs to create monitors and track the scheduling ratio. For example, count the total number of patients seen in the hygiene department each month and divide this number by the number of appointments available for the month. The hygiene or scheduling coordinator should then report the current scheduling rate to the team at monthly team meetings. The scheduling coordinator should always report in the morning huddle any open times on the hygiene schedule each day for the next week. When you have more open holes in the schedule over the next 2 weeks a strategic plan must be in place to halt the decline of the practice profitability. What is your plan when times get tough?!Chart audits and patient activation must be ongoing systems whether done via daily reviews or computer reports. While everyone on the team plays an important role, one auxiliary (the hygiene or scheduling coordinator) should be responsible and accountable for keeping the daily schedule full with paying patients to be productive. At team meetings, the scheduling coordinator should report and discuss the scheduling effectiveness rate.

Everyone needs to be aware of what is working and what is not working so that the team can create a plan of action when there is a crack in the system. Ask your team mates for suggestions to overcome challenges when you are feeling a hemorrhage in your dental hygiene schedule. You may want to consider the advice of a dental expert (consultant)who is knowledgeable in overcoming these challenges, especially during these stressful economic times.

Manage Cancellations Wisely

Preventive care and supportive periodontal maintenance appointments have the highest cancellations and failed appointment rates of any service in the dental practice. If you have one hygienist working four days a week and each day you have one cancellation, this can lead to an annual loss of at least $80,000 in hygiene department profits. (this calculation is based one hygienist with an average dental hygiene appointment cost at $150.00 USD. The hygienist sees patients 200 days a year and each patient will spend an additional $250.00 USD average annually for products and/or treatment.) The numbers used for this calculation are low but can give you an idea of the loss potential when just one patient each day no shows or cancels last minute- and- this is only taking into account one hygiene schedule!

Many dental practices charge a fee for failed appointments, and the effect of doing this has been positive in raising patient awareness of the importance of the time set aside for their appointments. Be sure, however, to put your cancellation fee in writing.


By working together, the doctor, hygienist, and entire team, communicate and share a practice philosophy for the patients, the hygiene department, and the practice. Working with the dentist as a partner in oral and systemic health care, everyone on the team is committed to the vision of the practice, proudly recommends optimal dental treatment, and refers family and friends to the dental practice.
Facilitate change by regularly scheduling meetings with your hygiene team and as a whole team to support and reinforce initiatives and explore new ideas and opportunities for growth and development, especially in scheduling. Open communication pathways will lead to mutual respect and will be reflected in increased profits, a harmonious dental team, and most importantly, healthier patients. It’s a win for all!