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

“7 Keys to Reactivate and Retain Your Patients PLUS Increase Your Practice Profits”

By: Debbie Seidel-Bittke, RDH, BS

June 29, 2012

Attracting a new patient can cost five times as much as maintaining a relationship with an existing patient. Implementing this Continuing C.A.R.E. System will help you retain valuable patients and keep them returning – on a regular basis – for essential dental hygiene and preventive care appointments.

Investing in a patient retention strategy such as this Continuing C.A.R.E. System will keep your profits consistent and decrease the amount of time and money spent on advertising for new patients. Never assume that an overdue patient won’t return to your practice. Many times, patients appreciate your efforts to reconnect with them. When patients know they matter to you, their loyalty to your dental practice will grow. The Continuing C.A.R.E. System consists of four concepts rooted in effective communication: Consistent Communication, Advanced Scheduling, Reasonable Payment Options, and Efficient Planning. Combined, these steps will help motivate inactive patients and revitalize your dental practice.

Rule One: Consistent Communication

Establishing a system of connecting with your patients is essential to building and maintaining relationships.

Rule Two: Advanced Scheduling

Make every attempt to schedule the next dental hygiene appointment at the end of each dental hygiene preventive appointment.

Rule Three: Reasonable Payment Options

It is possible that many of your patients today are experiencing financial challenges and educating them about your dental practice’s flexible payment options is essential to bringing them back for regular preventive care appointments.

Rule Four: Effective Planning

Create a plan outlining daily or weekly responsibilities with the end goal of contacting inactive patients and scheduling appointments.

THE 7 KEYS TO  Reactivate and Retain Your Patients. Show You C.A.R.E. !

  1. Follow up with patients by phone as soon as possible to schedule their next visit.
  2. If there is no response to a phone call, send the first letter.
  3. Send the second letter if patients do not schedule within 6 months – if not sooner.
  4. Send the third letter with a SASE so patients can easily communicate why they are not responding the phone calls and/or letters.
  5. Please note: Many patients may desire emails or text messages instead of a phone call or in addition to phone calls. Contact patients using their preferred method of communication. With an appointment is still unscheduled always follow up with a letter.
  6. After 18 months of follow up calls, letters, emails and/or text messages without a response, this patient should now be considered inactive.
  7. New patients are the lifeline of your dental practice but keeping the old is much easier and more cost effective than brining in the new! “One is silver and the other is gold!” Effective communication and this Continuing CARE Plan will keep your schedule full!

If you liked some or all of these tips please be sure to check out our eBook with all the scripts, templates and all of the work done for you. All you have to do is follow the step by step plan created just for you!   Grab it Here:


Are You Stuck in a Rut? 4 Steps to Reactivate Your Dental Hygiene Patients!

By: Debbie Seidel-Bittke, RDH, BS

June 22, 2012

Attracting a new patient most likely costs you five times as much when you can keep an existing patient.  One of the best systems you can have in place is the continuing care system.  This will eliminate you chasing down valuable patients and it will keep them returning, on a regular basis, for their valuable dental hygiene – preventive care appointments.

Investing your time and effort in a continuing care, patient retention strategy is not just a good idea but it will keep your practice profits consistent and decrease the amount of time and money spent chasing after patients.  Never assume that an inactive patient won’t return to your practice.  Many patients appreciate the time you will take to  to reconnect with them. People want to feel important and that you care about them.  Start with your most current overdue patient list. This is a report you can very easily generate from your computer of all patients past due for continuing care in the past 18 months.  Provide reasons and the benefits of why your inactive patients need to return ASAP.

1.  Sending the Letter

Once you have sent a postcard to let the patient know they have not scheduled their hygiene appointment, within the next three months send a direct mail letter to every patient who is overdue for a hygiene appointment. In your letter provide information about the oral health/systemic health link, oral cancer, the importance of ongoing professional dental care and how much your value their overall health.  This is the perfect chance to educate patients about new techniques, technology and services available in your office, options for achieving that sought after smile and include continuing education programs your team has completed that will benefit the patient.

 2.  Financial Challenges

Many patients are experiencing financial challenges today so educate them about your various financing options for payment.

When you have a relationship with patient financing companies it will make treatment more affordable and more likely for your patients to proceed with both necessary and elective dental treatment.  Let your overdue and current patients know about your patient financing options available.  Let patients old and new know that your office will provide financing so your patients receive the type of dental care they want and need.

3.  Pre-schedule Continuing Care

Make every attempt to schedule the next hygiene appointment in the hygiene room at the end of the hygiene appointment.  My experience shows that when patients are not pre-scheduled at least 60% of your time will be spent chasing down your active patient base.  It is important for the hygienist to educate all of the patients about the value and benefits of preventive care. This is how everyone will live a longer and healthier life! Have you ever met someone who didn’t want to live a longer and healthier life? Neither have I!

There is no doubt that without optimal oral health our total health can and will most likely fail.  The philosophy of every dental practice today should include the science about oral health and the relationship it plays in our overall health.  When patients understand you care enough about their total health and not just their almighty dollar they are most likely to sit up, listen, schedule their dental appointments and refer their friends and family to your dental office.  This is what creates improved patient care and healthy profits to your dental practice!

4. Daily Patient Calls

Decide each day who can make calls to patients. When the hygienist has a cancellation, he/she plays a valuable role in contacting overdue patients.

Each day: 

  • Create a goal to call a specific number of overdue hygiene patients.
  • Create a goal to schedule a specific number of appointments.
  • Create a blocked schedule ensuring that each hygienist achieves a specific daily production goal.
  • Establish treatment plan goals and monitor your scheduled treatment each day.
  • Each month monitor your continuing care report.
  • Ask a front office auxiliary to provide a monthly continuing care success and strategy report at the team meeting.
  • Throughout the year plan to assess, strategize and create reasons for your inactive patients to return for your services again.

Many times when you make contact with an overdue patient they have no idea it has been that long since their last hygiene appointment. Surprising but so true. My how time passes so quickly!

COMING SOON! Check our website for your complimentary WHITE PAPER and receive your complimentary continuing care strategy.

Have you subscribed to our 30 Day Dental Practice Makeover? This is a great way to quickly and without a lot of cost added, increase your practice profits!

30 Day Dental Practice Makeover

6 Steps to Creating a Profitable Dental Hygiene Department

By: Debbie Seidel-Bittke, RDH, BS

June 14, 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, that 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 hours 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 periondontal 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!

Strategic Systems Today Help You Flourish Tomorrow

By: Debbie Seidel-Bittke, RDH, BS

June 4, 2012

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 an 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 front door to make up for those patients who are walking out the back door.

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 are key players to the ongoing success of your business Most patients see the hygienist more than any other auxiliary of the dental team. This is what makes the hygienist carry and important role in building and maintaining the current active patient base.

Maintaining the Active Patient Base. Always Pre-Schedule Hygiene Appointments

Always preschedule 90 percent of your hygiene department patients –Patients are more likely to understand the importance of why they need to schedule their next hygiene appointment. When the hygienist schedules the patients for their next hygiene visit there is a continuation in the practioner/hygiene communication process. You most likely see a positive patient attitude and an increase in patient compliance occur when the hygienist is engaged in scheduling the patient next hygiene appointments. Ideally this should occur when the patient is still present in the hygiene treatment room.

Communicate With Confidence: Words Do Matter

The dialogue between the auxiliary and patient is extremely important. Here is an example of how the conversation may go:

Example: “Today I found a few areas of bleeding that were considered abnormal and doctor is observing and area where you have the beginning of decay. Our schedule is very tight because patients usually schedule before they leave their dental 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 to assure that you can return on that day of the week and at that time in fact that is a very valuable and popular time for most of our patients. To make sure you have your next appointment on this day of the week and at this time, I want to schedule and reserve this time for you now. I can see you on Thursday, October 18th at am. Will this work for your schedule? ”

The dental hygienist is the oral health educator for every dental practice. It is the role of the dental hygienist 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. The 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 you this can lead to an annual loss as high as $150,000 in hygiene department profits and this does not account for the treatment normally diagnosed from the hygiene appointments.

For a hygiene department achieve success they should be scheduling 95 percent of their future dental hygiene appointments at the time of the patients current dental hygiene appointment. Always create monitors and track the scheduling ratio. 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 needs to always report in the morning huddle the open times available on the hygiene schedule each day for the next week.

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.

Team approach –Everyone on the team should understand the words which are effective for a positive patient response. Courtesy confirmation calls, emails, text messages and written communications define the hygiene appointment (continuing care) with dialogues such as this:

“Hello Mr. Goodman, its Megan calling because Maria (Insert the name of the hygienist seeing the patient) and I are looking forward to seeing you tomorrow at 3 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 you were in tested in the new whitening product we are using. We’ll see you then. By doing this, patients are moved beyond the “just-a-cleaning-and-a-check-up” mentality. It is best not to discuss any type of cancellation policy because this is only a subconscious reminder that if something else comes up they can cancel and it sets up for failure for your continuing care systems’ success. Do not ask for calls back to the office to verify an appointment. Have the expectation that patients understand the importance of their dental service and desire to come to see the doctor and/or hygienist.

Team Accountability

Chart audit and patient activation must be ongoing systems that are frequently performed in the office. This is completed through daily reviews and computer reports. While everyone on the team plays an important role, one auxiliary (the hygiene or scheduling coordinator) is responsible and accountable for keeping the daily schedule full and productive. At team meetings, the scheduling coordinator reports and discusses the scheduling effectiveness rate. Everyone needs to be aware of what is working and what is not working so that problem-solving can take place.

Creating Strategic Solutions First

Create a plan of action when there is a small crack in a system. Ask for suggestions to overcome these challenges which may occur and when you are feeling like a hemorrhaging in systems and a decline in production occurs. When challenges do occur this is a very important time for you to consider the advise of a dental expert who is knowledgeable in overcoming these challenges, especially during these stressful economic times in our world today.

When you have a water leak you most likely want to STOP it sooner than later rather than put your money down the drain for water never used. It’s the same thing with your dental business; STOP the financial leaks sooner than later! Creating a plan of action for each system you have in place will halt the progression of a small problem into a bigger one.

Annually sit down as a team to list all of your systems and re-evaluate what is and is not working. Above is only a very small example of systems you should have in place: New Patients, Continuing Care Patients, Communication and Scheduling. Creating your own list of systems is important to re-evaluate before each year begins.

Creating strategic systems for your success will STOP the water leaks in your practice before they flow out of control. Most businesses that do not have a PLAN in place have PLANNED to fail! Create your systems, write them down, re-evaluate them annually — and then be certain you flourish in the years to come! This creates a WIN-WIN for all so go ENJOY the RIDE!