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

Minimize Short-Notice Cancellations and No-Shows: Important Facts You Need to Know

By: Debbie Seidel-Bittke, RDH, BS

May 28, 2013

Shows open holes in schedule











What can you say about your schedule today? We are about half way through another year so if you have something you are not satisfied with let’s do something about this challenge. I promise you are not alone!

In a recent survey we took, the most common complaint from dental offices was about cancellations and no-shows. Most reported 2-3 openings in the hygiene schedule daily.

First let’s take a look through a critical eye and dig into this very common situation. Why do you think your patients cancel or no-show for their appointments? Why do hygiene schedules have so many openings? And what can you do about it now?

Have you assessed the reasons why your patients are cancelling short-notice? What are they not showing for their appointment? When you have a clear

Understanding of your patients’ behavior and when you know that you are communicating the benefits or your care, now you can develop an effective plan to reduce cancellations.

At a team meeting this month, review how many short-notice cancellations and no-shows occurred in the past 30 days. Write down the top three reasons patients call to cancel. Do you understand why they neglected to show for their appointment? These answers will shed some light on the problem you have at hand and now you can create working solutions.

Perhaps you have thought about charging or, maybe, you currently charge a cancellation/ no-show fee. I don’t recommend this. First of all, you can’t legally charge for a service that was not rendered. This will also not change the patients’ negative behavior.

There will be a lot of cancellations in the dental hygiene department when patients believe they are coming in for “just a cleaning” and they do not understand how important oral health is to their overall body wellness.

Set a goal of no more than a 5% cancellation rate.

Make sure that your patients understand the urgency of preventive care vs. the urgency of emergency after hour calls to resolve a tooth problem!

Your Appointment Change Policy

The most effective policy to stop the last minute cancellations and no-shows is to ask for 72 hours notice should your patient need to change the day and time of an appointment. I recommend that if patients need to change their dental appointment that they give you 72 hours notice. The reason I suggest this is to stop anyone from scrambling to fill a hole in your schedule last minute and if you don’t work on Fridays this means a patient can’t cancel after Thursday.

When you are out of the office the phone message needs to alert patients that your answering service/machine does not accept appointment changes and they are to call back during your business hours. State your business hours on the phone message.

If you are setting a new policy in place make sure that your patients read and sign acknowledgment of this at their dental visit to your office. You may want to have this posted in treatment rooms, on postcards sent to patients confirming their hygiene appointment and definitely post in the reception area. Include this in your financial policy especially what you charge for missed or last minute cancellations. Do attempt to charge for this fee if patients are not following your policy. I am not going to say that in a court of law you can legally collect on this but I believe patients need to have respect for your time and your business policies.

Always document no-shows and last minute cancellations as well as the reason they have cancelled or no-showed.

One proven method to stop last minute cancellations and no-shows is to use Forever White™. This is a patient incentive program utilizing whitening for your patients. Forever White™ is the same premium whitening product that many offices use today however, Dental Practice Solutions can offer this to dental offices at wholesale prices. There are no hidden monthly fees to order. If you are whitening patient’s teeth for the first time, the take-home trays and whitening gel cost to your office is less than $8.00. Typically patients pay a lot of money to whiten their teeth whether it is take home trays and/or laser whitening. If you can purchase tooth bleaching products for very little cost you can pass this savings over to your patients. When a patient comes in without short-notice cancellation or without failing to show for their appointment, twice a year, at their dental hygiene appointment, patients qualify for a free syringe to whiten their teeth. The cost-benefit ratio of giving a patient two syringes of gel, (1 syringe two times a year) vs. the cost of an open hole in the schedule is a WIN!

Most people work off that mentality of WIIFM?! (What’s in it for me?!)

If a patient understands they can get free touch-ups for whitening how likely are they to miss their dental appointment? Not likely. Isn’t that correct?

I have been in offices and heard the patients calling to cancel because they have a hair appointment. This means the patient never really did value their appointment.

How can you build value for optimal overall health and give patients something they really want? It takes effective and consistent communication about the important  benefits of optimal oral health that will create urgency with patients over time.

It is all in your hands. What will you do differently today?




Check Your Dental Hygiene Department Pulse and Increase Your Profit Potential

By: Debbie Seidel-Bittke, RDH, BS

May 21, 2013

Dental RDH an intraoral camera

Is your dental hygiene department the second highest profit center of your dental practice? What do profitable hygiene departments have in place that will allow them to work like a well-oiled machine and be their most profitable? Why does one hygiene department create more treatment plan success from their dental hygiene department than many others? Do these hygiene departments see more patients to create these higher results? Do they perform more dental hygiene services? Do these auxiliaries work longer hours?

Strategic Systems

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 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.

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 8am. 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.


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.

Create a plan of action when there is a crack in the system. Ask for suggestions to overcome these challenges which may occur and when you are feeling like a hemorrhaging is occurring in your dental hygiene schedule you may want to consider the advise of a dental expert who is knowledgeable in overcoming these challenges, especially during these stressful economic times.

Scheduling effectively for today and the future

To achieve and assure a full and productive schedule (for all providers), the team should always prepare for the day by auditing patient records. The hygienist reviews patient records for incomplete dental treatment, updated X-rays, status exams, perio, update the medical history, etc. The hygienist needs to be prepared to discuss, demonstrate (with an intraoral camera), answer questions, and provide the facts and findings, risks and benefits, when the doctor enters the treatment room to provide the patient exam. Ideally, a brief meeting (the morning huddle) enables the entire team to communicate, delegate, and maximize the day. One of the most important topics reviewed at huddles with my consulting clients is having the clinical assistants audit their records and identify patients who are seeing the doctor that day that are overdue for hygiene care.

Picture Paint

When patients are in for the appointment with doctor and overdue or need a dental hygiene appointment ask them to stay for the dental hygiene appointment using words such as: “save you-time missing work another day, Save you time returning to the office, etc. Create statements that are certain to benefit the patient. The hygienist does the same if the doctor has an opening and the hygienist has a patient with undone dentistry.


Finally, 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/systemic health care, everyone on the team is committed to the vision of the practice, proudly recommends dental treatment, and refers family and friends to the doctor.

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. Open pathways for communication will lead to mutual respect and admiration and will be reflected in increased profits, a harmonious dental team, and most importantly, healthier patients. It’s a win for all!


By: Debbie Seidel-Bittke, RDH, BS

May 14, 2013

SUMMARY: Many dental offices prefer to use a product with natural ingredients to bleach their patients’ teeth. Hydrogen Peroxide is a natural and safe ingredient to whiten your patients’ teeth. Forever White™ is a system that not only whitens your patients’ teeth but it will add profits to your dental practice.

The most requested service patients ask for in a dental office is “whiter teeth.” We hear more offices asking for a whitening system that is “holistic” or “natural”.

You may be asking: Why a product that includes Hydrogen Peroxide?

The answer is very simple. Patients are asking for a “holistic” approach to have whiter teeth. They want the security of knowing they are using something natural.

Hydrogen peroxide is an effective and safe ingredient for whitening your patients’ teeth.

These are naturally occurring ingredients from our planet earth: Hydrogen and Oxygen.

There are various differences between Carbamide Peroxide and Hydrogen Peroxide. Hydrogen Peroxide is used more often, it is stronger, more effective and it can speed up the whitening process. Carbamide peroxide is safe as long as it is used at a lower dosage; however, it is not as effective when it is used at a lower dosage. (Lower percentage)

One benefit of using the Forever White™ product is that it will not cause tooth sensitivity. The reason for this is because the product does not contain a thickening agent like the majority of whitening products do. The thickening agent is what dehydrates the tooth and causes tooth sensitivity. If you are using the Forever White™ product, you will not use block out to make the patient trays. This saves time and makes for a more pleasant patient experience when they whiten without tooth sensitivity.

Hydrogen Peroxide has a gradual degeneration process and will not break down during its shelf-life. If Hydrogen Peroxide is immediately refrigerated after being made, it can maintain its potency over a longer period of time. And, once it’s removed from refrigeration and used on the teeth, the Hydrogen Peroxide will completely disassociate and provide a very effective bleaching of the tooth enamel.

When you use the Forever White™ system effectively you are certain to discover that your office will not be storing whitening syringes on a shelf for long periods of time. This system is intended to not only increase the number of patients who enroll in whitening their teeth, but you will find it opens doors to schedule more aesthetic treatment, reduce cancellations and so much more.

Hydrogen Peroxide is a useful ingredient for dental health and can be a superior ingredient for most dental offices who want to use a natural tooth whitening system. Including the Forever White™ system as a part of your dental services is another profit center worth hundreds of thousands of dollars to the life of your dental practice.