Dental Practice Solutions

Optimize your dental hygiene department by taking an integrated, team approach

  • Do you feel like you are working hard and your production is not increasing?
  • Do you feel like your hygiene department is under performing?
  • Is your hygiene department producing 25-30% of your total production?
  • Are hygienists in your office treating bloody prophys?
  • Does your hygiene department help enroll implant cases and high-end treatment?
  • Do you have one or more holes in your schedule daily?

I am so happy that you are here because we have answers and solutions to your challenges.

Dental Practice Solutions - Debbie Bittke

A 5 Tip Checklist To Create Value in the Dental Hygiene Appointment

By: Debbie Seidel-Bittke, RDH, BS

August 7, 2014

Do you ever feel like you are leading an army but no one is behind you following your direction? Have you ever wondered: “Why doesn’t anyone else on my team care as much as I do about my practice?!”

Is it possible they don’t know what your vision for the practice is? Have you communicated with your team what you dream of for your dental practice?

I believe in the CANI attitude. CANI means “Constant And Never-ending Improvement. This means that you have an open mind to always wanting to be better than you are today.

In today’s blog I want to share with you some ideas to get you on your way to “Creating More Value in the Dental Hygiene Appointment.” When you can empower your dental hygienist to have a CANI attitude, you will also discover the hygiene appointment becomes more valuable to the patients, the doctor and hygienist enjoy more satisfaction in what they do and patients become aware of the outstanding services you provide them. Profits in your practice will improve when the hygienist takes ownership of their important position in your dental office. Doctor will discover they can come to the office and provide the quality dental care they enjoy and not have to manage a dysfunctional team.

Utilizing some or all of these suggestions means that you will also begin to see your production rise as well as develop raving fans from improved quality patient services provided in your dental office.

Your 5 Tip Checklist to Create Value in the Dental Hygiene Appointment

Team Huddle

1.    Morning Team Huddle

Before the morning team huddle begins the dental hygienist needs to audit his or her charts. This means they will be looking for outstanding patient treatment and necessary services to complete at todays dental hygiene appointment. Examples of this are: appropriate x-rays, blood pressure, fluoride, periodic or even a comprehensive exam (Completed every 3-5 yrs.), outstanding restorative treatment, and any family members who are due for a dental appointment (hygiene or restorative). A lot of this information can be found on the routing slips. No flipping through charts during the team huddle. This needs to be a smooth and succinct process which if you don’t do this today, may take 20 minutes when you first begin. When done properly (Baring no more than 2 dentists and 6 team members reporting), a team huddle should take approximately 10 minutes of team time. For a template of what a morning team huddle looks like, send our office an email:

2.    The Hygienist should  schedule patients’ next visit for hygiene

It works best if the hygienist can always schedule the patient’s next hygiene appointments. Dental Hygienist’s may wondering “Why me?! I am on a treadmill as is and I don’t have time for this!” The reason they are the best person to pre-schedule future hygiene appointments is because they have just looked in the patient’s mouth over the past 45-55 minutes and they are the best person to explain to the patient “WHY” they need to return and what will be completed at the next hygiene appointment.

The hygienist never asks the patient “Would you like to schedule your next appointment?” And the hygienist will not ask the patient “Why can you return for your next hygiene appointment?” The hygienist (and anyone making a patient appointment), needs to take charge of the appointment schedule and not ask patients when they want to return.

Have a goal to schedule at least 90% of all future dental hygiene appointments.

Treatment Planning Creates Your Own Economy

3.    The Hygienist should always tour the patients mouth with the intra-oral camera

“Pictures paint a thousand words.” This is very true with dental patients as well. Tell patients what you see and then show them exactly what you see in their mouth. This means the patients are more likely to take ownership of their mouth. Sit the patient’s upright in the dental chair. Face them knee-to-knee and eye-to-eye to discuss what you see in their mouth. This positioning with the patient is called “proxemics.”  Proxemics builds trust and rapport with your patients.

This sets the stage for a more effective doctor hygiene exam and means the patient will hear about what you see more than one time (from not only the dentists’ perspective but they previously heard it from the hygienist). It can also mean less time for doctor in the hygiene room talking to the patient. Good news for hygienists that feel doctor makes them run behind.

Microsoft Word - TiME MANAGEMENT.doc

4.    Doctor Hygiene Exam

There is no need for doctor to wait until the end of the hygiene appointment to complete the hygiene patient exam. This can be done after the patient information has been completed. The hygienist will collect all of the patient data and explains this to the patient. This usually takes no longer than 25 minutes at the beginning of the hygiene appointment. Doctor should always be notified by their assistant when there is a break with their patient treatment (possibly waiting for impressions or when the assistant is preparing temporaries, etc.), and now leaves their patient to enter the hygiene treatment room to complete the hygiene patient exam.

The hygienist stops their procedure and introduces doctor or says something about the patient to doctor (If doctor already knows the patient there is no need for a formal introduction. The hygienist will always use the patient and doctors name upon doctor entering the hygiene room), and then the doctor will have a very light and simple conversation. Next the hygienist will gently interrupt doctor in the rapport building phase– relationship continuation conversation  (the small chit-chat), with the patient (should not last longer than 90 seconds – no more than 2 mins MAX!).

The hygienist will now proceed reporting to doctor about the services completed and what the patient and hygienist see in the patients’ mouth. The hygienist will report on future x-rays and the necessary appointments (if there are restorative needs, etc.) which include future dental hygiene appointments  The hygienist needs to have x-rays and intra-oral photos available for doctor to easily view.

5.    Hygiene Hand-off

How the patient is handed off at the front office is very important. This will build more trust with the patient and the end goal of this system is for the patient to again, understand that they will be returning to your dental office.

Too often, patients are left to walk alone to the front office. All patients need to be escorted to the front office by the dental hygienist preferably. The hygienist will speak to the front office team member using the patients name and explaining all the services the patient received today. She or he will explain to the front office auxiliary what services are of primary concern which areas of treatment need to be scheduled – while the patient is at the front desk. Best case scenario, the hygienist has scheduled the patients’ next hygiene visit, and the hygienist will also report – in front of the patient – when the next appointment date and time are. She or he will also state what the appointment is scheduled for.

One quick tip: NIX the word “Cleaning” and tell all the team members to stop saying this word as well. Choose to speak to your patients using words that add value. “Dental Hygienists in today’s world – are preventive care specialists.”

Try using some of these words when speaking to patients about a dental hygiene appointment: Dental Hygiene Appointment, Preventive Care, Periodontal Therapy, Scaling and Root Planing, Periodontal Maintenance.


When the dental hygienist is open to the CANI attitude and serving patients at the highest level, your job as the CEO of your dental practice becomes much easier, and more satisfying.

It is possible that you can check off this entire list saying that you are doing all of the above. For some offices, they are only completing a few of these tips and I want to suggest that you just choose one of these to implement this next week. Once you feel comfortable implementing this new system or patient service, go to the next tip and try to implement this one.

Slowly implement them one at a time. Only implement the next tip after you feel that you have the one new service or system “down to a science.” Be patient with yourself and take baby steps to get to your next level of success.

Track and monitor your results to watch your profits improve as you provide that next level of service and patient care. You will also develop patients who are your raving fans!