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

Are You Concerned About Telling Your Patients They Have Disease?

By: Debbie Seidel-Bittke, RDH, BS

November 18, 2015

[video_player type=”embed” width=”560″ height=”315″ align=”center” margin_top=”0″ margin_bottom=”20″]PGlmcmFtZSB3aWR0aD0iNTYwIiBoZWlnaHQ9IjMxNSIgc3JjPSJodHRwczovL3d3dy55b3V0dWJlLmNvbS9lbWJlZC8xOU1mU2tyTlI5WSIgZnJhbWVib3JkZXI9IjAiIGFsbG93ZnVsbHNjcmVlbj0iIj48L2lmcmFtZT4=[/video_player]

Are you a hygienist who wonders what to tell your routine prophy patient (who you have been seeing every 6 months for the past 4 years) that at today’s appointment, they now have periodontal disease?

Are you concerned about telling your patients they have disease?

If you are concerned, I want you to know that you are not alone!

This is a very common concern that we hear about every month from doctors and hygienists.

It’s so common that many clients, when we begin working with the hygiene team, they feel overwhelmed and so concerned that they will lose their long time patients if they tell them that they have periodontal disease. These are hygienists who really care about their patients. I mean, they consider these people to be a friend!

Do you have the “What will my patients think if I…” syndrome?

Here is what our team of coaches tells our clients:

You are obligated to tell your patients when they have active disease. You can do this in a way that creates an even deeper relationship with patients whom you care so much about.

Today, I share with you the results of an amazing team that had this very concern and they learned how to overcome this situation which can be so challenging.

Be sure to keep reading below because today I will give you some specific words you can use when you experience this challenge and feel concerned.

“How can I tell my long-time prophy patient today, that they have periodontal disease?”

This is a question the team at Nicosia Dental asked before we really got down to business.

The team has worked really hard to build a a great reputation in their community and close relationships with most of their patients.

The#1 goal for this team when they began working with us was to:

  • have a system for the hygiene department that is turn-key with a step-by-step implementation process,
  • how to make the perio diagnosis (especially when their patients are routine prophys but now have active disease),
  • how to make time for all the services a hygienist needs to complete in their allotted time,
  • enroll patients into high-end treatment plans,
  • update their verbal skills so that now, they will be recommending what is best for their patients while maintaining a trusting relationship

And… the results are in!

Here is the evidence which shows how well they have take action and implemented what they have learned from Hygiene Empowerment:

Here is what they have created in just six months!

Perio Percentage Increased                                425%

Open Hygiene Appts Decreased                          80%

Hygiene Production Increased                              55%

Case Acceptance from Hygiene Increased          40%

Here are the tips you can use to enroll prophy patients into perio:

1. Explain to patients before a bib is placed and the chair reclined “Do you have any areas of concern? Any bleeding gums?” Now tell patients: “Mr. Patient, today we will do X, Y and Z (An example of this: “checking for any abnormalities”) so that you don’t have any inflammation, infection, tooth loss or loss of life. I will use this ruler (Show your perio probe) and take some measurements. You will hear me call out some numbers; 1-3 is healthy. A 4 means inflammation and anything 5 or higher means infection. Now, not to be concerned if you hear a 5 or higher because when I am finished with the numbers I will sit you up and we will create a plan to get you back to health. Now, Mr. Patient, I will be asking you at the end to tell me what the lowest and the highest number I call out is.”

  • Can you imagine how this conversation will bring your patient into a partnership vs. you, telling patients “What you found”?

2. Look together at what you “see.” Show your patient their previous past perio charts, take pictures of bleeding gums, calculus, etc., with the intraoral camera or have them hold up a mirror and look with you.

3. Use words you know your patient understands. Do you know for sure that your patient understands what the word “Periodontal” means? Try using words and phrases such as: gum or bone infection, inflammation. Don’t be afraid to say “bleeding and bleeding gums.” Nix that word “Cleaning” and never use the phrase “Deep cleaning.” Tell your patients they will need some gum treatments and if they do understand the word periodontal, explain this is non-surgical periodontal treatment.

4. Explain that gum (or periodontal) disease can cause other systemic diesases.  If your patient does have high blood pressure or diabetes, etc., explain how this can exacerbate their current inflammatory disease(s) and explain that treatment of their gum infection can help improve their systemic disease. Talk about gum therapy or gum treatments as a way to prevent other diseases such as heart disease, Alzheimers, various cancers, etc., etc.

5. Tell patients: “I care about your total health!” What impact will this sentence have on your  patients (some who already consider you a friend)?

How smoothly is your treatment planning process going today?

– – Are hygienists helping to enroll 70%+ of all treatment plans?

How is your case acceptance from hygiene appointments?

Do all the hygiene clinicians agree when a patient is healthy or has disease?

– – Does one hygienist say the patient is healthy and there are no probing depths above 4 mms while other clinicians (Maybe doctor) say the patient has 5 and 6 mm probing depths?

– – What do you do in this situation? Do you know the cost of hiring a new hygienist vs. asking for help from an expert to work with your existing hygiene team?  Typically, it is much more expensive to go out and hire a new hygienist!

Are you satisfied with your answers above?

Check out our Hygiene Empowerment Program and then enroll in our no-cost 3-Part Hygiene Empowerment Video Series, EBOOK about treating gingival diseases and get access to our most recent webinar “5 Steps to Creating a More Productive and Profitable Hygiene Department.” Register here and get started today!


In 1984 Debbie Graduated from the University of Southern California with a bachelor’s degree in dental hygiene.

She is also a former clinical assistant from the University of Southern California and co-taught the senior dental students Practice Management course until the school went to a PBL learning format.

In 2000, she founded Dental Practice Solutions and works with dental practices world-wide to:

  • create profitable and sustainable dental hygiene departments
  • known for reactivating and retaining patients for dental practices world-wide
  • organically grow new patient numbers

Dental Practice Solutions creates:

  • sustainable dental hygiene departments throughout the world
  • a “team-driven” practice, where the employees feel like leaders vs. employees

All of this means that the doctor can come to the office to do their job as a Dentist and not worry about managing people!