Dental Hygiene Treatment | Dental Practice Solutions

After Scaling and Root Planing Should we Bill a Prophy or Perio Maintenance?

By: Debbie Seidel-Bittke, RDH, BS

June 26, 2024

After performing Scaling and Root Planing, the question arises: can we bill for a Prophy or do we need to continue billing for Perio Maintenance?

In some cases, the choices may seem straightforward, such as billing for a Prophy when a patient has healthy gingiva, however, determining the correct code to bill after Scaling and Root Planing can be a bit more nuanced, as it depends on the specific needs and circumstances of the patient.

Never should we diagnose or bill simply because the patients insurance will or will not cover a specific procedure or service.

First, let’s break down the two options:

Prophy (D1110)

A Prophy is a routine dental cleaning that is recommended for patients with healthy gums and minimal plaque or tartar buildup. This type of cleaning is typically performed every six months to maintain good oral health and prevent periodontal disease.

Perio Maintenance (D4910)

Perio Maintenance (D4910) is more than just a cleaning. When a patient has been treated for active gum disease with scaling and root planing this procedure is typically performed every three to four months to help manage and stabilize the disease.

Our overarching goal is to halt oral inflammation which will also support total health.

*Read the AAP Parameter for Periodontal Maintenance in resources listed below.

When a patient has oral inflammation, year-after-year, we know (evidence based research) that this patient is now at high risk for other systemic diseases such as, high cholesterol, high blood pressure, heart attack, stroke, diabetes, rheumatoid arthritis, Crohn’s disease, Parkinsons and Alzheimers disease, etc.

The Question

Which CDT code should we bill after a patient has completed a D4341 or D4342 (Scaling and Root Planing)?

The answer to this question largely depends on the total health of each individual patient.

In general, if a patient has completed Phase I therapy (D4341 or D4342), and ‘if” they have high blood pressure (or any systemic inflammatory condition), diabetes, etc, – any systemic inflammatory disease, you will have the patient return in three months for D4910 if they present healthy at the 4-6 week re-evaluation appointment (AKA: Periodontal Maintenance D4910).

When a patient has systemic risk factors, i.e. high blood pressure, high cholesterol, diabetes, etc, this indicates that they are at risk for life-altering conditions such as: stroke or heart attack, Parkinsons, Alzheimers, etc, etc.

Imagine, in today’s world of dentistry, we no longer “treat a tooth,” we are treating the whole body and our goal must be “halt oral inflammation” and “help patients live a longer-healthier life.”

“Inflammation in the oral cavity year after year, typically creates a cascade of other systemic diseases.”1

In order to accomplish this goal of total health, closely monitor patients and schedule more frequent preventive care – hygiene appointments. It is beneficial to the patient when you include laser bacterial reduction (LBR) at routine preventive care appointments. LBR affects the cells at the mitochondrial level. It is one important piece to helping our patients live a longer – healthier life.

When your patient has a history of inflammatory systemic disease use code D4910, Perio Maintenance and LBR (If legal for a hygienist to use) to ensure that your patient receives the necessary care to manage complete health.

On the other hand, if a patient has completed a D4341 procedure but does not have a history of gum disease or other systemic health issues, it may can be appropriate to bill for a Prophy D1110.

It’s important to note that dental billing can be complex, and it’s crucial for dental providers to accurately code and bill for services to ensure proper reimbursement and compliance with insurance guidelines. As such, it’s recommended to thoroughly review the patient’s treatment plan, medical history, and oral health status before determining the appropriate billing code.

In addition to considering the patient’s individual needs, it’s also essential to communicate openly and transparently with the patient about their treatment and benefits to routine preventive care maintenance. Communicate and continue educating patients about optimal oral health will lead to a longer, healthier life.

Consistently communicate to your patients, “Prevention costs a little money and treating disease costs a lot of money. Oral disease affects your total health!”

Speak with empathy and passion/enthusiasm to help them live a longer, healthier life. Understand your patient’s values. Is money an objection?

If you don’t believe you can help them live a longer, healthier life, neither will they!

Help your patients who use money as an objection, understand that spending money to treat their disease means less money spent in the future when they return for preventive services. Help patients understand the value of spending money on prevention to save money on treating oral and systemic disease.

Discuss the importance and the benefits of ongoing preventive maintenance so your patients will better understand the value of preventive care, and the significance of routine hygiene (AKA: “preventive care”) appointments in maintaining their total health.

Conclusion

Determine the appropriate billing code after a patient has completed Scaling and Root Planing (D4341/D4342), at the next appointment, when they return for the 4-6 week re-evaluation.

Your 4-6 week re-evaluation will be billed as D4910. If you have treated your patient using soft-tissue diode laser, include LBR in the Periodontal Maintenance appointment. If you are able to use soft-tissue diode laser (LBR/D9997) in your state, you will use this all future hygiene preventive care appointments.

Should we bill a Prophy (D1110) or Perio Maintenance (D4910) after our patient completes SRP, really depends upon:

Your patients total health
What your patient’s insurance will pay for

And as always, know that we have an ethical responsibility to do what is in the best interest of our patient; not what their insurance will pay for!

At Dental Practice Solutions we recommend Perio Assisted Laser Therapy when treating patients with SRP. At the 1st appointment (D4355) Gross Debridement and the 1st Periodontal Maintenance Appointment (4-6 week re-evaluation) we recommend including Laser Bacteria Reduction.

The Scaling and Root Planing procedure includes careful consideration of the patient’s total health status. While both a Prophy and a Perio Maintenance are valid options at the end of Phase I therapy, it’s essential to select the appropriate service and CDT code that best aligns with the patient’s individual circumstances to ensure they receive the necessary care and support to maintain their total health.

By prioritizing patient-centered care and clear communication, dental providers can improve patient outcomes and overall satisfaction with their dental experience.

Does your office feel challenged by the sequencing and billing of gingivitis and periodontitis treatment?
Do you have questions about this blog? We understand it can be confusing and we are hear to clear up any confusion.

Consider booking a quick call. We can help!

Check out our most popular 30 Day Hygiene Department Training Here.

Resources

Grow Cosmetic Cases in Your Dental Practice

By: Debbie Seidel-Bittke, RDH, BS

June 1, 2024

Boosting Case Acceptance and Per Patient Production

Dental offices that experience high profitability from cosmetic procedures typically have a substantial patient base originating from general practitioner (GP) services. This extensive patient base is crucial for generating cosmetic cases.

The emphasis is on “generating” these cosmetic cases because they won’t be magically scheduled. While cosmetic cases may naturally be scheduled, you miss out on many opportunities when you aren’t proactively discovering that your current patients want a more beautiful and confident smile..

The first priority is to increase general patient volume through hygiene appointments, hygiene patient reactivation, and attracting new patients. This increased volume provides a larger pool to present your cosmetic services. Presenting cosmetic cases to your existing patients is more cost-effective and yields better results than marketing to find more new patients.

This blog will delve into ways to more effectively grow cosmetic cases in your dental practice.

Present Cosmetic Services to Existing Patients

Don’t Assume Patients Know What Services You Offer

Many dentists are surprised to find that loyal, long-term patients often go elsewhere for services like clear aligners or veneers simply because they didn’t know these services were available at their usual practice. It’s ironic to see dentists spend heavily on community advertising while neglecting to inform their own patients about their offerings.

Increase Cosmetic Case Acceptance

Your Hygiene Department is the Mitochondria of Your Dental Practice

Most patients spend more time with their dental hygienist than any other clinician in your dental practice. Make certain your hygiene department is optimized to effectively communicate treatment needs and truly understand what your patients’ smile goals are.

It’s ironic to see dentists spend huge amounts of money on community advertising while neglecting to understand what they current patients’ smile goals are. Did you know?

Teeth whitening is an 11 Billion Dollar industry however, few people search for a dental office to buy teeth whitening.1

Dentists are missing out on easy profit solutions and a way to have more patients accept cosmetic dentistry.

Strategies to Boost Cosmetic Cases to Existing Patients

The Smile Evaluation. Cosmetic Questionnaires

Introduce a smile evaluation – a cosmetic questionnaire for all new patients and annually to every patient.

Learn what your patients’ smile goals are. People are more likely to pay money for what they want so find an easy what to know what your patient wants.

In-Office Promotions

Display promotional materials throughout your office—posters, flyers, videos, and before-and-after photos. Place these in high-visibility areas like the waiting room, in front of dental chairs, at the front desk, in hallways, and even restrooms.

Consider offering patients a patient rewards program like The Smile Club.

Patient Engagement

Encourage your patients of record to follow your practice on social media. Post informative videos, patient testimonials, plus, before-and-after photos. Always include a compelling offer such as The Smile Club where patients receive free whitening pens.

Give patients a reason to keep their dental appointments. Make dental appointments fun, not dreadful.

Team Training

Ensure your employees are well-informed about the cosmetic services you offer so they can educate patients effectively. Consider scheduling “lunch & learns” and implement consistent training with your team. Get everyone on your team, the same page.

It takes a patient 7 times to hear something new like information about ‘Gum disease and gum treatment.” Break down the words you use into words your patients easily understand. Understand your patients values and know how to attach a benefit to their values or objections.

Use words such as gum disease over periodontal disease. Explain they have infection, inflammation, a hole in their tooth or bleeding gums.

Consider scheduling a team training to elevate your cosmetic case acceptance. Your hygiene department is key to successfully getting patients to “YES!” and boost cosmetic cases.

New Patients

While marketing cosmetic services to new patients can be effective, it can also be costly and tricky. Using Google ads, targeted social media ads, implant marketing funnels, and direct mail can be expensive.

There are effective ways to use your website to attract more new patients looking for cosmetic dentistry such as: Teeth whitening, Invisalign, and implants, etc.

Reach out to us and ask for our template to use on your website – proven to attract more new patients.

Keys to Successful Marketing of Cosmetic Services

1. Manage and Track New Patient Leads

How you manage new patient leads is crucial. Make sure your front office employees promptly and repeatedly follow up with online form submissions and phone calls from potential new patients. Train your team to handle these calls effectively, and use call recording systems to monitor and improve performance.

2. Invest in Training

Never cut corners or expenses when building a strong-seamless team. Invest in training your team, consistently optimizing your patient care, services and technology. Ensure the best patient and practice outcomes. Understand your key performance indicators and train your team to drive their specific metrics. Doctor’s job is not to micro-manage but when your team understands what’s expected and how to monitor their expectations everyone stops working so hard!

3. Track and Manage Results Closely

Successful dental practices monitor their progress and growth or lack-of. Track cost per new patient lead, appointment scheduling rates, case acceptance rates, overdue hygiene patients, cancellations, etc, etc.

With our no-cost snapshot we will show you and your team exactly what opportunities lie in from of you and each team member understands their responsibility to drive profitability without working hard.

The doctor and entire team must stay actively involved in your success strategy. Doctor’s role is to inspect what they expect of their employees. We consistently hear that many employees simply do not know what their employer, the dentist, expects of them!

Conclusion

Boost Cosmetic Cases: Focus on reactivating overdue hygiene patients and market your cosmetic services to these existing patients first. When you reactivate many overdue hygiene patients, many will have restorative and cosmetic cases that are unscheduled. Now is your chance to get them scheduled.
Invest Wisely: Be prepared to invest on effective strategies to grow high-value patient services.
Monitor Results: Understand your key performance indicators and Track your progress. Train your team to ensure you have systems in place that will to help you work SMART and stop running on a treadmill.

Implementing these strategies will significantly boost (cosmetic) case acceptance rates, enhance your per patient production, ultimately growing your practice and profitability.

For personalized direction on your practice growth, book a no cost opportunity ZOOM call with us. We’re here for you and want to see you get to your next level of success.

Contact us to grab our Smile Evaluation or Schedule a Team Training so your team knows exactly what’s expected.

Oral Inflammation: A Journey Treating Disease to Total Health

By: Debbie Seidel-Bittke, RDH, BS

March 11, 2024

In the realm of healthcare, the mouth often serves as a gateway to understanding the broader state of one’s overall health. The journey from oral inflammation to total health is not merely about treating dental diseases; it’s about recognizing the interconnectedness between oral health and systemic well-being. In recent years, the scientific community has unearthed compelling evidence linking oral inflammation to a myriad of systemic conditions, underscoring the importance of holistic approaches in healthcare.

Oral inflammation, often manifested as gum disease (gingivitis and periodontitis), can be insidious. It begins as a seemingly innocuous condition characterized by swollen, bleeding gums but can escalate into a serious health threat if left unchecked. What many fail to realize is that oral inflammation is not confined to the mouth; it can serve as a precursor to more severe systemic diseases.

Research has demonstrated a clear association between oral inflammation and conditions such as cardiovascular disease, diabetes, respiratory infections, and even adverse pregnancy outcomes. The mechanisms underlying this relationship are complex but primarily revolve around the inflammatory nature of gum disease. Chronic inflammation in the oral cavity can trigger systemic inflammation, setting the stage for the development or exacerbation of various health issues.

Addressing oral inflammation entails more than routine dental care; it requires a paradigm shift towards a comprehensive approach to health and wellness. Dentists are increasingly adopting a holistic mindset, recognizing the interconnectedness between oral health and overall well-being. This shift is reflected in the emergence of integrative dental practices that prioritize preventive care, patient education, and collaboration with other healthcare professionals.

At the forefront of this movement is the recognition that oral health is not an isolated concern but an integral component of systemic health. Dental professionals are now delving deeper into the root causes of oral inflammation, exploring factors such as diet, lifestyle, genetics, and systemic health conditions. By understanding the underlying drivers of inflammation, clinicians can tailor treatment plans that address the root cause rather than merely managing symptoms.

Central to the journey from treating disease to achieving total health is the concept of personalized medicine. No two individuals are alike, and as such, their healthcare needs vary. Personalized oral health care involves a thorough assessment of each patient’s unique risk factors, health goals, and genetic predispositions. Leveraging advances in technology and diagnostics, allows clinicians to develop targeted interventions that optimize oral and systemic health outcomes.

Prevention lies at the heart of holistic oral healthcare. Empowering patients with knowledge and tools to maintain optimal oral hygiene and make informed lifestyle choices is paramount. From proper brushing and flossing techniques to mindful nutrition and stress management, patients play a proactive role in preserving their oral and systemic health.

In the pursuit of total health, collaboration among healthcare professionals is essential. Dentists, physicians, nutritionists, and other specialists must work together to address the multifaceted nature of health and disease. Integrated care models facilitate seamless communication and coordination, ensuring that patients receive comprehensive, evidence-based care that addresses their unique needs.

Beyond the confines of traditional healthcare settings, community engagement and education are instrumental in promoting oral health equity. Access to dental care remains a significant challenge for many underserved populations, exacerbating oral health disparities. By advocating for policies that prioritize preventive care and expand access to dental services, we can strive towards a future where oral health is a fundamental right for all.

In conclusion, the journey from treating oral inflammation to achieving total health is a multifaceted endeavor that transcends the boundaries of traditional healthcare. By adopting a holistic approach that addresses the root causes of inflammation, prioritizes prevention, embraces personalized medicine, and fosters collaboration, we can pave the way towards a healthier future for individuals and communities alike. Through collective effort and unwavering commitment, we can harness the transformative power of oral health to enrich lives and elevate overall well-being.

As we embark on this journey, let us not forget that oral health is not merely the absence of disease but a cornerstone of vitality and vitality and total health.

Check out our 7-Day Hygiene Department training which includes a webinar about Biologic Dentistry.

LEARN MORE HERE.

The Smile Club: Enhanced Patient Care and Dental Practice Growth

By: Debbie Seidel-Bittke, RDH, BS

February 27, 2024

Ensuring a healthy, beautiful smile is not just about routine dental hygiene appointments; it’s about fostering lasting relationships between patients and dental care providers. At Dental Practice Solutions, we’re committed to revolutionizing the way patients experience dental care through our innovative Smile Club patient loyalty program.

The Smile Club isn’t just another patient membership program but it’s a gateway to a comprehensive dental experience designed to benefit both patients and dental practices alike. Let’s delve into how The Smile Club can transform your dental practice into a thriving business and elevate your patient care.

Less Last-Minute Cancellations

Last-minute cancellations not only disrupt your schedule but also the efficiency of your dental practices. Implementing The Smile Club, less open holes in your schedule. Members ofThe Smile Club agree to 1. Pre-schedule their future hygiene appointments and, 2. They agree to call during business hours 72 hours in advance when they do need to change an appointment.

In return patients receive one free whitening pen at their routine hygiene appointment and a discount on all other whitening products they may buy.

This proactive approach not only reduces the occurrence of cancellations but also fosters a sense of accountability and mutual respect between patients and dental professionals. Your patients are most likely looking for a way to brighten their smile so why not accommodate this desire by offering teeth whitening products as an incentive.

More Hygiene Appointments Scheduled

Maintaining optimal oral hygiene is paramount to preserving the health and appearance of your smile. Patients who become members of The Smile Club are prioritizing preventive care, which minimizes the need for invasive restorative procedures in the future.

Your patients enrolled in The Smile Club feel like a VIP. These are patients who feel loyalty to your dental practice. They are happy to be a part of your dental family. Happy patients remain patients for many years. Happy patients refer their friends and family to your office.

More Cosmetic Cases

Your patients’ smile is their signature, and as a provider of The Smile Club, you have an opportunity to understand your patient’s smile desires. A 1st step to helping your patients enroll in The Smile Club is having every new patient complete a Smile Evaluation. Every adult patient should also complete the Smile Evaluation annually.

Seldom does anyone see their dentist and they are asked, for example: “Mr. Jones, What is one thing you want to change about your smile?” Do you offer a smile evaluation to each patient so you understand their smile desire?

Usually, offices “think” they are too busy to “ask” patients what they would like their smile to look like.

Let’s flip this negative connotation of “My dentist always finds something!” or “It costs a lot of money every time I see my dentist!” into a positive experience where patients enjoy coming to your dental office.

“Let’s make dental appointments a pleasure not a pain!”

In addition to these tangible benefits, when your patients join The Smile Club they become part of a supportive community dedicated to promoting oral health and overall well-being. Your proactive approach gives patients a special feeling like you care about them as a person and not just a tooth or a way to make money! How many times do patients “think” doctor is funding their next vacation home or European vacation?!

Use The Smile Club as a way to help patients take control of their total health and embrace the transformative power of a beautiful smile.

At Dental Practice Solutions, we believe that every smile has the potential to light up the world.

Benefits of The Smile Club:

Grows New Patient Numbers
Builds Loyal Patients
Reduces Last-Minute Cancellations
BOOSTS Cosmetic Cases
Adds a 70k + Net Profit Annually (No additional patients or overhead!)
More Teeth Whitening Services Without the Chair time

*Let us show you how to grow your dental practice at least 70k this year without working more days, see more patients or increase your overhead!

Book a call today or inquire about The Smile Club.

Your Dental Hygiene Department Profit Formula: Six Guiding Principles

By: Debbie Seidel-Bittke, RDH, BS

January 17, 2024

A streamlined dental hygiene department with strategic systems plays a pivotal role in driving practice production; however, many practices fall short of harnessing the full potential of their hygiene department.

In a typical day, a hygienist may treat seven or eight patients, offering essential services like prophylaxis and radiographs. While this is a common practice, it doesn’t fully leverage the hygiene department to deliver comprehensive, and periodontal care, as well as drive patients to schedule for cosmetic dentistry. In today’s economic landscape, optimizing all resources, including the hygiene department, is crucial for a dental practice.

When over 60% of Americans age 35 or older have some level of gum disease it’s imperative to treat this starting with non-surgical periodontal therapy and even use the ADA gingivitis code provided for early intervention of disease.

Continuing reading this to elevate your hygiene department by learning about The Profit Formula and 6 guiding principles.

The Profit Formula

The Profit Formula is an innovative approach created by Dental Practice Solutions and designed to elevate dental hygiene productivity, aiming to unlock the true production potential of hygienists, elevate clinical care, and generate increased production for the hygiene department.1

Implementing The Profit Formula has demonstrated the capability to boost annual hygiene production by over $100,000 per hygienist, a proven success in numerous practices and adaptable to various settings. Explore six key principles of The Profit Formula to revolutionize dental hygiene productivity, enhance overall practice production and elevate patient care.

2. Future Hygiene Appointments

During the initial discovery phase, when working with clients, Dental Practice Solutions usually discovers practices usually have fewer than 80% of active patients scheduled for a next appointment. If patients aren’t scheduled, you can’t provide them optimal oral health care.

Plan a goal of 90% pre-scheduled hygiene appointments. Every patient (Preventive care and restorative) will leave with a next appointment. This means all patients of record (Even edentulous patients. Another topic, another day!) will have a pre-scheduled hygiene appointment.

Most hygiene patients receive basic hygiene care (cleanings/”Preventive Care Appointment”) and are assessed for any obvious dental needs and/or abnormalities. For a dental practice to reach their hygiene profit potential, hygienists need to understand how to deliver treatment needs to patients that puts the patient in the driver’s seat, ultimately allowing the patient to “take ownership of their disease.”

It’s imperative that we never allow insurance benefits (or lack of a benefit) dictate our treatment plan!

The hygiene department should be a major profit center for a dental practice., This can only occur when patients are routinely scheduled for dental hygiene appointments.

3. Promote Comprehensive Dentistry

There are different strategies and systems for the hygiene department to drive comprehensive, periodontal and cosmetic dental services. In most offices, this is not happening. One reason is that the dentist is so busy with restorative patients that the hygiene appointment is more of an interruption than anything else.

Some dentists may not take the time to complete a six month periodic exam and many offices have not learned a way to streamline the hygiene-patient-doctor exam to optimize case acceptance. Many offices think that they only time a patient will receive a comprehensive exam is when they are a new patient.

Not true!

Using The Profit Formula (Taught by Dental Practice Solutions) the dental hygienist will do a complete evaluation (hygienists are not legally allowed to diagnosis in most states) of the patients’ oral condition. Once hygienists become educated to find all potential hygiene need-based and elective (cosmetic and adjunctive) treatment opportunities, the entire outcome of the hygiene – preventive care appointments is elevated and you experience a more productive dental practice. This is how your hygiene department will drive productivity for the entire dental practice.

Using The Profit Formula the dental hygienist will use the oral evaluation to introduce discussions about comprehensive care, cosmetic dentistry and of course non-surgical periodontal care. The dental hygienist will initiate (discuss, introduce) the services while (in most states legally) the dentist will make the final diagnosis.

The hygienist is there as a patient-advocate and mini-associate to the dentist. This supports case acceptance and saves time during the hygiene patient exam.

This outcome is the reason why the hygiene department is very important to the dental practice. It’s the main blood vessel or the mitochondria of the dental practice. The hygiene department should operate like a powerhouse cell!

4. Build Strong Patient Relationships

The Profit Formula has a process that includes learning specific information about each patient, building patient rapport, understanding the patients values and their smile desires. Each hygiene appointment represents an opportunity to build a stronger relationship with the patient. It provides an opportunity to do more than treat a tooth.

Patients enjoy coming to a dental office where they feel valued and appreciated. This is part of the 5-star patient experience and one simple way to organically grow your dental practice.

A strong focus on the smile evaluation can be an effective way to learn what your patient desires for their smile. This takes away the dental clinicians always “finding” something in the patient’s mouth. It puts patients in the driver’s seat where they tell the office and dentist what they want. Provide a simple way for patients to whiten their teeth. The Smile Club is great way to save time and build your cosmetic cases this year.2

5. Enhanced Hygiene-Patient-Doctor-Exams

Dentists need to stop thinking of the hygiene patient exams as an interruption, and stop putting off this important exam. During a 10-minute team huddle the team should learn which hygiene patients need a doctor exam. The dental assistants will make note of this and be aware of a time when the doctor can more easily break-away from their patient to complete the hygiene patient exam.

When utilizing The Profit Formula hygienists will prepare the patient for any potential treatment needs which saves the doctor time during that hygiene patient exam. The hygiene patient exam should not take longer than 5-7 minutes. If the patient needs a comprehensive exam, this must be scheduled in another operatory and for 20 minutes of time with the doctor. The timing and strategy of this comprehensive exam must be completed at the time the patients hygiene appointment is scheduled.

6. Hygiene Department Production

Many hygienists think of hygiene production as “cleaning teeth,” bite-wings, FMX and panoramic radiographs. Today’s dental hygiene appointment includes “preventive care” including various adjunctive services such as laser bacterial reduction (LBR), fluoride varnish, Perio Protect Trays, Arestin, sealants, etc, etc.

A pain-point for many employees is knowing that the doctor-practice owner, has production goals. Let’s flip this negative thought process into a positive one. We must all think of production goals and meeting the practice production goals as “job security.”

When a large majority of Americans age 35 and older have some level of gum disease the hygiene production should not be difficult to reach three times the hygienists salary. The twenty-first century dental hygienist has a lot of exciting adjunctive services to implement that elevate patient care! Patients WILL pay for these adjunctive services when we share about the value and benefits they offer.

Since the 2020 pandemic, dental hygienists demand more money per hour when working as a dental hygienist in the dental office so it becomes imperative that dental hygienists are aware of their productivity and not JUST clean teeth.

Doctors must look at their practice numbers and end-of-day reports. The Profit Formula taught by Dental Practice Solutions, brings profit to the forefront of the dental practice, in a way that makes looking at the practice metrics and daily opportunities fun for all!.

Numbers tell a story and when the team looks at production goals in a positive light, accomplishing the goals as a team can be fun. When we accomplish the practice goals now we can talk about bonuses, salary raises, and fun team events!

Conclusion

The dental hygiene department is one of the best opportunities in a dental practice to increase overall practice production and elevate patient care, especially in today’s economy. The Profit Formula created by Dental Practice Solutions, will immediately set your practice on a growth path as well as, create more value for your patients.

Hygienists following The Profit Formula protocol receive higher patient satisfaction reviews than those who simply see patients for “just a cleaning” and basic preventive care services. Dentistry is constantly changing. Hygiene department adjunctive services are a fun and exciting way to practice dentistry as a dental hygienist in 2024.

These 6 principles discussed serve as guide to reframe your hygiene department and take your practice to the next level.

When you’re ready to optimize your hygiene department, implement The Profit Formula, and elevate your patient care, consider a quick call to learn more about Dental Practice Solutions hygiene department coaching program Hygiene Department MAX Revenue (a hybrid of online and personalized coaching) here.

References.

The Profit Formula. Book a call and ask us about the Profit Formula taught by Debbie Seidel-Bittke, RDH, BS, Founder of Dental Practice Solutions. *Currently taught in all of our coaching programs.
Ask us about The Smile Club and see your cosmetic cases grow. We will show you how to also have more new patient phone calls and reduce last-minute cancellations. Book a quick time to chat and learn. When you book a call we will mail you a SMILE CLUB whitening kit with the LED Blue and Red Lights (Similar nano watts as the ZOOM in-office light). There is no chair time to use this system. BOOK HERE —https://calendly.com/debbie-111/caseacceptance

The Mouth-Body Connection: Gum Disease, and Overall Health

By: Debbie Seidel-Bittke, RDH, BS

December 11, 2023

When you think about overall health, high blood pressure, heart attack, Alzheimer’s disease, etc, many patients consider that gum disease is worlds apart from these other systemic diseases.

How many patients sit in your dental chair each day, week or month, and have underlying health conditions that may be associated with gum disease?

Dental hygienists do not “clean teeth”, we identify abnormalities and put a halt to the disease process. Our professional goal should be to provide patients with optimal oral health. Dental hygienists have a perfect opportunity to empower patients with information that will positively impact their overall health.

Today, let’s explore the intricate relationship between high blood pressure, heart attack, stroke, and Alzheimer’s disease, etc, etc, which are associated with gum disease, while shedding light on the journey towards a longer-healthier life.

Connecting the Dots. Inflammatory Markers:

As we dive into this topic, let’s start with the basics. Gum disease, or periodontal disease, isn’t just a local issue affecting the teeth and gums, it’s a dynamic process involving inflammation that extends beyond the oral cavity. It will impact the entire body if there is no end to the inflammation.

Research has uncovered a strong link between gum disease and systemic conditions like high blood pressure, heart attack, stroke, crohn’s disease, Parkinsons and even Alzheimer’s disease.

Inflammatory markers, substances that increase during inflammation, play a crucial role in systemic disease. When a patient has gum disease, these inflammatory markers enter the bloodstream through the mouth, triggering a cascade of reactions throughout the body. High blood pressure is only one of the systemic consequences, highlighting the importance of addressing oral health as an integral part of overall wellness.

Understanding the Domino Effect:

Imagine your body as a finely tuned instrument, with each note influencing the others. When gum disease enters the picture, it’s like a rogue element disrupting what once was a harmonious environment.

Inflammatory markers contribute to the development of arterial plaque, narrowing blood vessels and making your heart work harder to pump blood. This increased strain can elevate your blood pressure, setting the stage for cardiovascular problems and other systemic issues. This is only one example of what happens with inflammatory markers invade our body.

Now, the question arises: How can addressing gum disease impact this domino effect and potentially improve your overall health?

The Empowering Journey: Treatment and Prevention:

Here’s the good news: As dental hygienists, and dental professionals, we have the power to interrupt this cascade of events. Treating gum disease involves a multi-faceted approach that not only revitalizes your oral health but also contributes to a healthier you.

Professional Dental Hygiene Appointments. Guided biofilm therapy, scaling, root planing, soft-tissue diode laser, etc:

The foundation for treatment of gum disease lies in removing the source of inflammation – the plaque and tartar/calculus buildup on the teeth. A professional hygienist delivered -preventive care appointment can target these inflammatory markers, providing a chance for the inflamed gingiva to heal.

Home Care:

Maintaining good oral hygiene at home is our superpower in the fight against gum disease. Brushing, flossing, and using an antiseptic (non-alcohol) mouthwash support the frontline defense against plaque, and bacteria, preventing its return between dental visits.

This superpower also requires routine preventive care by a dental hygienist.

Lifestyle Changes:

The overall health journey isn’t just confined to the dental chair. Adopting a heart-healthy lifestyle – incorporating a balanced diet, regular exercise, and stress management – complements the efforts we make in the dental office.

Dental hygienists must know the basics to support proper nutrition and supplementation with their patients.

Inspiring a Desire for Wellness:

Now that we’ve unraveled the connection between high blood pressure, various systemic diseases, gum disease, and outlined the path to recovery, let’s shift our focus to why we want to have our patients “want” what they need when there is an unhealthy oral condition such as gingival inflammation: gingivitis or periodontitis.

Consider this: by motivating our patients to take charge of their oral health, we are not just helping them prevent tooth loss or malodor but we are actively contributing to our patients overall well-being, reducing the risk of systemic diseases, and helping them to live a longer and healthier life.

The journey towards creating healthier patients (and populations around the world) is not just a necessity; it’s an opportunity for dental hygienists to empower their patients and level-up their patients’ self-care routine.

Conclusion:

In the chair of each dental hygienist lies a unique space where oral health and overall wellness intersect. Understanding the connection between high blood pressure, heart attack, stroke, Crohn’s disease, Alzheimers, gum disease, and inflammatory markers equips patients with the knowledge needed to make informed decisions about their total health.

As we embark on this journey to empower our patients to make the best decisions, let’s remember that treating gum disease isn’t just about preserving our patients smile; it’s about safeguarding the heart, blood vessels, and our patients overall vitality.

Let’s embrace the journey, let’s work together as a team of dental professionals to help conquer this disease process.

Let’s create healthier and happier patients. Dental hygienists no longer CLEAN teeth! We are in the business and profession of creating healthier, longer lives.

Do you wish your entire team knew how to educate your patients about total health?
Do you wish your dental hygiene department was more profitable?
Does your team know how to effectively communicate this message about optimal health and living a longer, healthier life?

If you want to level-up your hygiene department, book a quick hygiene department discovery call. Debbie will share with you where you have the “Low-Hanging” fruit– the easiest way to tap into more productivity. On the call Debbie will share the hygiene department training if you are interested in group hygiene department coaching.

The next cohort begins February 6 and ends May 5, 2024. If you join in December 2023, or January 2024, you begin 1:1 with Debbie and your team asap. The tuition will be the same as it is for the 3-month program. You receive a huge bonus when you raise your hand to be a part of this training now.

There will only be 10 offices accepted in this next cohort so don’t delay applying today!

BOOK YOUR HYGIENE CALL HERE.

Transforming Dental Practices With A Dental Hygiene Department Consultant

By: Debbie Seidel-Bittke, RDH, BS

November 6, 2023

Efficiency is the bedrock of a thriving dental practice. Dental hygiene department consultants, also known as dental practice management consultants, serve as vital assets in streamlining dental clinics’ operations, elevating patient care, and boosting overall productivity.

In this blog, we’ll explore the invaluable role of these consultants in reshaping dental practices for success.

Navigating the Dental Landscape with a Consultant’s Expertise

Dental practices are complex entities with various moving parts. Managing patient appointments, updating current hygiene services and technology, compliance with the dental hygiene process of care, sequencing and billing of specific dental hygiene treatment and delivering high-quality patient care are just a few of the many challenges that dental professionals face.

This is where dental hygiene department consultants step in with their specialized expertise.

Optimizing Operational Efficiency

One of the primary responsibilities of a dental hygiene department consultant is to optimize the hygiene patient appointment. Dental hygienists in today’s world do more than clean teeth.

How can dental hygienists do it all?! This is where a dental hygiene coach and consultant can become a valuable resource.

Dental hygiene department consultants assess the current workflow, identify bottlenecks, and propose strategies to streamline processes. This can lead to significant time and cost savings for the entire dental practice. Consultants may suggest improvements in appointment scheduling, hygienist- clinician – patient verbiage, and the adoption of various technologies to enhance efficiency. The hygiene department is your main artery to keep patients on the schedule and increase case acceptance.

Think of the dental hygienist as an associate to the dentist. They do a lot more than just clean teeth! The dental hygienist can and should drive productivity over to the doctors schedule. What happens during the dental hygiene appointment will make or break patients rescheduling and actually showing up for (at the very least) preventive care appointments.

Elevating Patient Care

Providing exceptional patient-centered care must be a cornerstone of every dental practice. An effective dental hygiene consultant works closely with the entire team to improve patient care protocols and ensures that each patient receives individualized, quality care.

It’s important the entire team knows what is happening in the hygiene department. Every team member must work in harmony. Just like an orchestra plays in harmony, the dental employees must all work well together; supporting one another.

Dental hygiene consultants provide training on the latest dental hygiene services, including clinical instrumentation, patient communication skills to improve case acceptance, and properly sequencing the various hygiene patient appointments. They should also be able to advise how to bill correctly for patient the hygiene services and they know what “should” and “must” be billed for private pay and insurance reimbursement.

By doing so, they help enhance the overall patient experience, leading to increased practice production, creating efficiencies, improving patient satisfaction and loyalty. You will also keep loyal employees a long time when you have a well-oiled system!

Boosting Team Morale and Productivity

A harmonious and motivated team is essential for a successful dental practice. Dental hygiene department consultants also focus on team dynamics and morale. They can provide guidance with team-building activities, and professional development opportunities. By fostering a positive work environment, consultants help improve employee retention rates and overall productivity. Think working smarter, not so hard. Hygiene consultants understand how to get more done with less time!

Navigating Regulatory Compliance

Staying abreast of ever-evolving healthcare regulations and compliance standards is a daunting task. Dental hygiene consultants are well-versed in the latest regulations for dental hygienists and help dental practices navigate this complex landscape. Their expertise ensures that the practice adheres to all legal requirements, minimizing the risk of regulatory violations and potential legal issues.

Implementing Technology Solutions

In today’s digital age, technology plays a pivotal role in the efficiency of dental practices. Consultants often recommend and help implement technology solutions, such as electronic health records (EHR) systems, supporting dental hygienists to use digital scanners and even the latest AI Dental Smile apps.

These technological advancements not only improve efficiency but also enhance data security and accuracy.

Measuring Success and Ongoing Support

Dental hygiene department consultants don’t just provide recommendations and disappear; they are committed to the long-term success of the dental practice. The best choice for a dental hygiene consultant is one who will measure the office (team members, hygiene department, appointments scheduled and cancelled, etc), performance through various metrics to measure the impact of their strategies and provide ongoing support and guidance to address emerging challenges.

The numbers do matter.

It’s important when hiring any consultant that you look at where you are today and evaluate your growth while you are working with the consultant. Numbers don’t change overnight but a well-thought out plan of action with the dentist- dental practice owner- and the hygiene department consultant will provide sustainable success.

Know that it’s what you commit to implementing day after day and month after month that will create a difference in your dental practice success.

In conclusion, dental hygiene department consultants are unsung heroes in the world of dental practice management. Their expertise in optimizing the dental hygiene department (and integrating the entire team during the process), elevating patient care, and ensuring compliance is invaluable for dental practices looking to thrive in today’s competitive healthcare landscape.

By harnessing the skills and guidance of the hygiene department consultant, dental practices will pave the way for a brighter and more efficient future.

Today is the best time to begin putting together your success strategy for 2024. How can we support your 2024 success strategy?

There is no one-size fits all!

Debbie Seidel Bittke, RDH, BS, founder and CEO of Dental Practice Solutions will host a group Dental Hygiene Department training starting Jan 3, 2024. This will run for 3 months during Q1 in 2024. Only 10 offices who will be accepted into the hygiene department training.

This training with 10 ONLY offices is by application only! Applications will be send out on November 20th. Book your Coffee Chat and if you are a fit, you will be admitted early (AND Pay Less money for the training when you are accepted early) into the dental hygiene dept training.

BOOK a coffee chat to find out more and discover if this is a fit for your dental practice.

Do you want to be considered?

If you don’t think a group coaching program is a good fit, plan to chat with Debbie a few minutes to discover what will work to optimize your dental hygiene department and achieve your highest potential in 2024! Now is the time.

BOOK a Coffee Chat HERE .

Take a few minutes to find out more.

Nothing ventured, nothing gained.

Holistic Patient Care and Case Acceptance in the Dental Hygiene Department.

By: Debbie Seidel-Bittke, RDH, BS

October 30, 2023

In the ever-evolving realm of dentistry, the dental hygiene department stands as a pivotal force in transforming patient care.

This blog delves into the transformative role of dental hygienists within the dental hygiene department, focusing on their contribution to enhancing case acceptance and overall patient well-being. Continue reading and explore how dental hygienists play a central role in providing holistic care, identifying conditions like sleep apnea, TMD, empowering patients with knowledge about the mouth-body connection, fostering a strong patient-clinician partnership.

Discover how these strategic measures are shaping a new paradigm in dentistry, ultimately driving higher case acceptance rates and improving the quality of patient care.

Our overarching message must be, “Optimal Oral Health Leads to a Longer, Healthier Life.”

From early identification of conditions like sleep apnea to empowering patients with knowledge about oral inflammation and how it plays a key role in their total health, the contributions of the dental hygiene department are shaping a new paradigm shift in our dental profession.

Continue reading about the transformative impact of the dental hygienist department to in enhance patient care, improve patients total health, and boost case acceptance.

Dental hygienists in the twenty first century no longer JUST clean teeth! They are a partner with their patients in the early detection and treatment of oral inflammation, offering patients a holistic approach to oral care. They are like a mini-associate to the dentist helping to increase case acceptance.

First Line of Defense: “Creating a Longer, Healthier Life:”

Dental hygienists often serve as the patients’ initial point of contact during dental appointments. Their unique position allows for close interaction with patients, enabling them to gather vital information and conduct preliminary assessments.

This initial interaction is crucial for identifying potential abnormalities such as sleep apnea, oral inflammation that causes gingivitis, and periodontitis, etc. Dental hygienists are often the 1st person to learn about a patient’s cosmetic dental concerns.

Through meaningful conversations and motivational interviewing 1, dental hygienists can collect valuable information about symptoms like snoring, daytime fatigue, breathing difficulties, bleeding gums, localized mild to generalized severe gingivitis, periodontitis and even soft and hard tissue abnormalities; all of these which affect numerous oral conditions affecting patients overall health.

Visual Examinations:

Dental hygienists possess the ability to conduct visual examinations of patients’ oral health, which is a distinctive advantage for the dentist. In the context of sleep apnea, telltale signs such as a narrow airway, enlarged tonsils, etc, can often be observed during these examinations.

Dental hygienists have a legal and ethical responsibility to annually complete a Comprehensive Periodontal Exam (CPE) 2.

Moreover, dental hygienists are skilled at identifying dental issues that could lead to cosmetic concerns, such as malalignment of teeth, stained enamel, or missing teeth. They also detect oral inflammation, which includes, gingivitis and periodontitis. By fostering a patient partnership, they boost case acceptance for necessary and adjunctive treatment.

The dental hygiene department must be the mitochondria that supports patients overall well being and supports adjunctive (restorative and cosmetic) dental care for the dentist’s schedule.

The Dental Professional-Patient Partnership:

Dental hygienists have a unique opportunity to establish a partnership with their patients by involving them in the initial examination process. Utilizing intraoral cameras, cutting-edge scanners like Adite 3 as well as the latest dental AI app (See resources below), PrestoSmile 4, dental hygienists become a partner with their patient to review their oral conditions in real-time.

These technologies help the patient make a wise decision about their oral cavity and total health. Before the doctor completes the hygiene exam, the patients have seen potential smile capabilities they may never have thought possible.

While the dental hygienist has the patient in their chair, as they take a tour of the patient’s mouth. Dental hygienists are in a position to empower patients to own their disease and want specific care and adjunctive cosmetic services.

This active involvement motivates patients to take ownership of their oral health, it leads to increased engagement and patient compliance.The end result is higher case acceptance and patient loyalty to their dental office.

These technological advancements available today make it easier for dental professionals to convey the importance of required treatments.

They seeing is believing and today’s world of dental technology combined with dental AI, will help get more patients to accept our care. This is one easy way to get patients to “yes” more easily to high-end dental care such as veneers, implants, crowns, bridges, etc.

Patient Education:

Dental hygienists, in the initial appointment, diagnose oral inflammation, discuss cosmetic dentistry, and identify sleep apnea and TMD risks. They clarify complex concepts, enhancing patient understanding before the dentist examines them.

Dental hygienists have a responsibility to inform patients about the potential risks of untreated conditions, including active disease such as gingivitis, periodontitis, broken teeth and occlusal wear. They can also discuss the aesthetic and functional benefits of various treatment options, aiding patients to make informed decisions.

This saves time for the dentist completing the hygiene patient exam. Imagine the dental hygienist and entire dental hygiene department as a mini-associate to the dentist. The dental hygiene department is the foundation to get patient to want what they need.

Seamless Transition of Hygiene Patient During Dental Exams:

Before the dentist arrives to complete the hygiene patient examination, dental hygienists have already laid a strong foundation about any oral abnormalities. At this point in the dental hygiene appointment the patient is well-informed about their oral health condition, potential concerns, and available treatment options.

This smooth transition ensures that the patient is prepared for a productive conversation with the doctor.

In this patient-doctor interaction, dental hygienists play a crucial role, providing information about the patient’s oral health, any medical changes, and the completion of oral abnormality screenings. They ensure that the dentist is aware of the patient’s concerns, the need for x-rays, unscheduled treatment, etc.

At this point in the dental hygiene appointment the patient has time to understand their oral condition and any future care needed. This takes away from the dentist spending a lot time during the exam to explain what is needed and how the procedure will be completed, etc.

Elevating Patient Consent and Compliance:

When patients have a clear understanding of their oral health conditions, they are more likely to accept the recommended care. This increased transparency significantly contributes to higher patient compliance rates, as patients recognize the importance of addressing sleep apnea, oral inflammation, and cosmetic dental concerns promptly.

Show patients what you see. Invite patient’s to participate in the discovery process and a plan for their total health.

Patient participation in the assessment and diagnosis process also enhances their commitment to treatment. Case acceptance will improve.

Holistic Patient-Centered Care:

The collaborative efforts of dental hygienists and dentists promote a patient-centered approach to overall wellness. Neglecting optimal oral health will affect a patient’s overall well-being. Addressing oral inflammation, cosmetic issues, airway abnormalities, and TMD enhances a patient’s quality of life and confidence.

The dental hygiene department and team are advancing dentistry through a patient-centered care with a holistic approach, providing comprehensive care beyond JUST cleaning teeth.

References.

Motivational interviewing. https://bit.ly/MotivationalInterviewRDH Accessed October 30. 2023.
Comprehensive Periodontal Evaluation (CPE). https://bit.ly/CPECkList Accessed October 30. 2023.
Adite Intra Oral Scanner. https://bit.ly/DigitalScannerAdite Accessed October 30. 2023.
PrestoSmile. Dental AI app. https://www.prestosmile.com/sneekpeak Accessed October 30. 2023.

Please note the author of this blog and founder of Dental Practice Solutions, Debbie Seidel Bittke, RDH, BS, is NOT financially affiliated with any of the above links or companies mentioned.

Do you feel like you are drowning in a sea of patients? Do you see too many holes in your schedule? Do you see mostly Prophy patients and/or, do you wish your hygiene department could “Set up” their patients to accept more cosmetic dentistry?

If you said “Yes,” to one or all of the above questions, we have answers to help you optimize your hygiene department without working harder or increasing your overhead.

Consider a No-Cost Discovery Call. BOOK HERE

It’s 30 minutes of time and you will walk away knowing what your true potential is with a roadmap to quickly arrive where your true potential awaits you.

The Keys to a Successful Hygiene Patient Appointment: A Team Approach

By: Debbie Seidel-Bittke, RDH, BS

October 9, 2023

A successful dental hygiene appointment is more than just a routine check-up; it’s the result of a well-coordinated effort that includes the patient, the dental hygienist, the dentist, and the entire team.

Each clinician plays a unique role, in ensuring that oral health concerns, such as gingivitis and periodontitis, etc, are effectively addressed.

This blog delves into the distinct contributions of each dental professional in your dental office, emphasizing the importance of their collaboration in fostering patient acceptance of care and maintaining optimal oral health.

Let’s make dental hygiene appointments patient-centered, enjoyable for the patients and the entire team.

Read on!

The Role of the Dental Hygienist:

The dental hygienist, often the first point of contact for patients, holds a crucial role in setting the tone for the hygiene appointment. We must begin by creating a comfortable environment, easing patient anxieties, and taking various oral and systemic health assessments. Initial rapport, at the beginning of dental appointments helps build trust between the patient and the dental team.

During the hygiene appointment, dental hygienists’ complete various assessments to identify the patient’s total health, identify areas of concern and any abnormalities.

Dental hygienists are preventive care specialists and not just a tooth cleaner! The main goal during dental hygiene appointments is to assess oral conditions and educate patients about the risks for oral inflammation. Our goal is to halt oral inflammation.

Our overarching message to patients should be, “Optimal oral health is key to helping you live a longer, healthier life.”

Dental hygienists must strive to provide a partnership with their patients. When we collaborate with patients rather than tell them what we find, we are more likely to have patients who “Take ownership of their disease” and “want what they need.”

Collaboration is key to case acceptance.

The Dentist’s Role:

Dentists play a pivotal role in the success of the hygiene patient appointment. During the hygiene patient exam, dental hygienists have a perfect opportunity to bring the doctor into the loop on exactly what has been discussed and what they have identified with the patient up to this point.

It’s helpful to provide positive feedback to the dentist during the hygiene exam; not always talking about “what’s wrong with the patient’s oral condition.” Remember to compliment patients when they have improved their oral health, positive outcomes, great oral health, etc.

When hygienists become a partner with the dentist during the hygiene patient exam, it’s much easier for the patient to accept all necessary dental care. The partnership between hygienist and dentist combined with patient collaboration, will create a higher level of case acceptance.

Since the hygienist has been looking around the patient’s mouth for the past thirty plus minutes, they have a great opportunity to support the patient in making the best decisions after dentist has made a diagnosis.

When the dentist arrives to complete the hygiene patient exam it is beneficial to have x-rays and intra-oral images available for the doctor to quickly review and confirm any diagnosis.

During the treatment planning phase of the hygiene appointment (See above image), hygienists must take time to review with their patient what they see happening in the patient’s oral cavity. This is where the patient and hygienist collaboration begin. This makes case acceptance much easier for the patient.

“Seeing is believing!”

This treatment planning phase is vital for creating a positive response for patients to accept proper care. Refer to the above diagram for timing of the various phases during the hygiene preventive care appointment.

Dental Assistants Role:

Dental Assistants play an important role in supporting the hygiene appointment. Imagine the dental assistants as the air-traffic controllers in a dental office.

There is no need for a dentist to wait until the end of a hygiene appointment to complete the hygiene patient exam. About half-way through a dental hygiene appointment, the hygienist should have completed the assessments and taken time to discuss treatment with the patient.

The dental assistants must be aware of which hygiene patients need an exam. While the dental assistants are with the dentist, and when they know the dentist can take a break from working on their patient, the dental assistant will request the dentist goes to the hygiene room and complete the hygiene patient exam.

*See the above Time Management image to support this process during hygiene preventive care appointments.

Examples of opportunities for doctor to complete a hygiene patient exam:

Waiting for local anesthesia
Waiting for an impression
Dental Assistants can scan the patient while doctor completes the hygiene patient exam
What else can you add to this list?

Since the hygienist has taken time to review any abnormal oral conditions (gingivitis, periodontitis, cracked or worn out fillings, crowns, abfractions, occlusal wear, etc, etc) and/or discussed unscheduled restorative care, the hygiene patient exam should not take longer than seven minutes.

Waiting until the end of a hygiene appointment can mean waiting for the dentist to take time away from their patient to complete the hygiene patient exam. Waiting for the doctor leaves the hygiene patient waiting and hygienists will run behind for their next patient.

Collaboration is key during the hygiene patient exam and therefore, hygienists play a valuable role in sharing with their doctor what has been discussed with the patient during the hygiene appointment.

Effective Communication:

During the hygiene patient exam, the hygienist will report on the following:

Personal updates, rapport
Medical history update
Oral abnormality (Soft and hard tissue screening)
Comprehensive Periodontal Evaluation (Annual). 1
TMD: Occlusal wear, abractions, etc.
Sleep Apena (report on tonsils, tongue, lack of sleep, snoring, etc)
Restorative Unscheduled and any new cracks, leaky fillings, crowns and/or open margins
Gingival health, BOP, gingivitis, periodontitis, localized inflammation, etc.
What you have completed today: preventive care, polish, gingivitis, gross debridement, LBR (soft-tissue laser), fluoride treatment, etc.
When will the patient return? Example: 4-6 weeks re-evaluation for gingivitis or starting gum treatment ASAP, etc.

Every clinician must use the same words and phrases when speaking with the patient. Break down the words and phrases into words the patient can easily understand.

Use words that are descriptive such as: bleeding, infection, inflammation, hole in the tooth or discoloration, etc. Stop telling patients they will have their teeth cleaned. Dental hygiene appointments are about the prevention of disease not about cleaning teeth. 2

Collaboration Between Clinicians:

The synergy between the dental hygienist, the assistants, and the dentist, are vital in providing the patient with a well-rounded and effective treatment plan. Their collaboration allows for a thorough assessment and diagnosis, ensuring that no oral health issues are overlooked.

This teamwork fosters trust and confidence in the patient, knowing that their dental care is in capable hands. When the dental assistants guide the dentist through their day, it makes the day run more smoothly.

Consider a ten-minute team huddle before your day begins so all the clinicians know where they must be and when they must be there. The front office team should also know this information to prevent bottlenecks at the front office as well as who will need to make payment and other valuable information for a successful day.

The front office is also part of this collaboration.

Once the patient has completed their hygiene appointment it’s imperative for the patient to be personally walked up to the front desk.

If there is a hygiene assistant they can schedule the patients next hygiene appointment and walk them to the front desk where the hygiene assistant will share the important information about what occured during the patients appointment, if they have a next hygiene appointment and what they must be scheduled for if there is restorative treatment needed.

When there is a financial arrangement to be made the front office must have a private area to discuss flexible financial options, personal information.

Case Acceptance:

Clinicians must present a united front when discussing treatment and future appointments. Enthusiasm and expressing urgency when there is necessary care are very important pieces to case acceptance. When patients understand how well the team works together for their well-being, and how much their healthcare providers care about their total health, patients are more likely to comply with recommended treatment and maintain consistent preventive care.

Hygienists should know what type of care the dentist will most likely recommend for the patient and be able to discuss the various types of treatment; risks and benefits. If hygienists are not able to properly speak with patients about the type of treatment doctor completes such as implants, veneers, etc., it’s time to schedule an in-service with doctor and the hygienist(s) so everyone is on the same page.

You may want to consider bringing in an expert to help train the hygienists and the doctor so everyone can speak about optimal oral care options with patients. It is imperative that the entire team understands how to effectively communicate the types of dental services available.

There are experts who can guide doctors, hygienists, and the entire team so your dental practice achieves 75% or higher case acceptance each month.

Conclusion:

During a successful hygiene patient appointment, each clinician’s role is distinct and equally crucial. The dental hygienist’s skill treating disease, utilizing preventive care modalities and technology, communicating restorative and cosmetic care options, educating patients about optimal oral health benefits, coupled with the dentist’s expertise in diagnosis and treatment planning, creates a harmonious hygiene team.

This collaboration promotes higher case acceptance and contributes to maintaining the patient’s oral health. Optimal oral health will lead to a longer, healthier life.

By understanding the unique contributions of each clinician and working together as a cohesive unit, dental professionals can ensure that patients receive the highest level of care and support. This approach not only addresses immediate oral health concerns but also promotes a lifelong commitment to prevention of disease and overall well-being.

Do you want to learn about the un-tapped potential in your dental hygiene department?

I have a few open spots for a quick overview of your hygiene department.

Book your complimentary hygiene productivity call here.

References.

Comprehensive Periodontal Evaluation. https://tinyurl.com/23atrxm2 Accessed October 1, 2023.
Motivational Interviewing. https://tinyurl.com/yappeexh Accessed October 9, 2023.

A Dental Hygienists Guide to Treating Oral Inflammation

By: Debbie Seidel-Bittke, RDH, BS

September 26, 2023

Periodontal disease is a prevalent oral health issue that affects millions of people worldwide. If left untreated, it can lead to tooth loss and other systemic health problems.

In the battle to conquer this disease process, dental professionals employ various techniques and tools to provide effective treatment. One service that has revolutionized treatment of oral inflammation and one that has a significant result in our total health and well being is use of the soft tissue diode laser.

In this blog, we will explore how diode lasers are used in the treatment of periodontal disease, their effectiveness in targeting aerobic cells, and the ability to boost cellular mitochondria.

This blog will also explain the hygienist’s responsibility to determine health or disease in the oral cavity, how to sequence appointments when a patient has various levels of gingival inflammation and you will learn about the benefits of using soft tissue diode lasers.

At the end of reading this blog you will have information to help your patients better understand the importance of optimal oral health and how this will help them live a longer, healthier life!

Diagnosis of Gingivitis and Periodontitis:

The journey towards treating periodontal disease begins with a comprehensive examination of the oral cavity and a diagnosis. When your patient is seated in the chair for a dental hygiene preventive care appointment it’s imperative for the dental hygienist to evaluate for any abnormalities.

An annual comprehensive periodontal examination (CPE) must be performed at the beginning of a dental hygiene appointment to determine if the patient has active periodontal (“gum”) disease: Gingivitis or Periodontitis. Our goal is to determine optimal oral health.

When the dental hygienist recognizes generalized moderate to severe gingival inflammation, with or without radiographic bone loss, the hygienist and dentist will make a diagnosis for treatment of gingivitis or periodontitis.

When there is a diagnosis of generalized moderate to severe gingivitis or periodontitis, the clinician will properly plan a sequence of appointments to treat the disease which will also include scheduling a 4-6 week re-evaluation, to determine an end-point of the disease.

At the time of a diagnosis and when the patient has active gum disease, a sequence of appointments to treat the disease will be scheduled.

Periodontal Disease Etiology:

Bacterial plaque is the primary etiologic factor associated with periodontitis, yet there are several other variables that may place an individual at risk for developing disease. Two of these variables are clearly defined risk factors: tobacco smoking and diabetes.

Periodontitis is considered the sixth complication of diabetes. Periodontitis and diabetes (DM) have a two-way relationship. DM increases the risk of periodontitis, and severe periodontitis coexists with severe DM.

It’s mandatory for diabetic patients to receive adequate treatment for periodontitis.

The basic treatment modality for periodontitis is scaling and root planing. The conventional periodontal procedure includes scaling and root planing (SRP), which consists of debridement of contaminated root surfaces as well as the elimination of bacteria and their endotoxins from the cementum and from the adjacent periodontal tissues.

Scaling, root planing and curettage procedure creates a long junctional epithelium with no connective tissue attachment.

During the InitialAppointment, the Dental Hygienist Will:

Conduct a comprehensive oral health assessment with comprehensive periodontal evaluation (CPE). CPE includes measuring pocket depths, assessing bleeding upon probing, recording recession, mucogingival involvement, furcation, occlusal disease, etc.
Recent full mouth x-rays are used to determine the extent of disease.
Identify any contributing factors such as tobacco use, medical conditions such as diabetes, high blood pressure, RA, Crohn’s disease, etc, and/or poor oral hygiene habits.
Formulate an individualized treatment plan tailored to the patients specific needs.

The Role of Soft Tissue Diode Laser

Soft tissue diode lasers have become indispensable in modern dentistry, particularly in treating gingivitis and periodontal disease. Diode lasers emit specific wavelengths of light that are absorbed by pigmented bacteria and inflamed tissues, making them highly effective in eradicating bad cells and promoting healing.

Soft Tissue Diode Laser Therapy

Let’s delve into how the soft tissue diode laser becomes a crucial component in the treatment of oral inflammation. Use of the diode laser targets the bacteria and inflamed tissues in the periodontal pockets.

Reduction of Inflammation: Diode lasers also promote the reduction of inflamed tissues, creating a more conducive environment for healing.
Stimulation of Mitochondria: Research suggests that diode laser therapy may stimulate the mitochondria of cells, enhancing their energy production and overall cellular health.

Practice Management/Communication Tip: “What happens inside the mouth transfers through the saliva and blood stream and eventually happens inside the body. Year after year of bleeding gums year after year, can create various systemic diseases such as: heart attack, stroke, high cholesterol, Crohn’s Disease, Parkinson’s Disease, Low Birth Weight Babies, and even Alzheimer’s Disease, etc.”

The enhanced reduction of inflammation induced by laser therapy is also due to the effective bacterial reduction property of diode lasers. In previous research it was demonstrated that diode laser light at 805 nm eliminated Aggregatibacter actinomycetumcomitans and Porphyromonas gingivalis in periodontal pockets.

Lin et al, demonstrated that subgingival treatment with the diode laser effectively inhibited recolonization of A. actinomycetumcomitans for up to 28 days than in root planing.

Note. Read below about the end-point and re-evaluation appointment for more information on the importance of this 4-6 weeks re-evaluation appointment.

Pick et al. showed that diode laser light not only eliminates bacteria but also inactivates bacterial toxins diffused within root cementum. A study by Moritz et al. showed that Gram-negative species showed immediate structural damage when exposed to the laser. Diode laser at 810 nm causes bacterial damage without injury to periodontal tissues.

Soft Tissue Diode Laser Therapy Advantages:

Minimally invasive: It requires no incisions, minimizing patient discomfort and reducing the need for sutures.
Precision: The laser can precisely target infected areas, leaving healthy tissues unaffected.
Reduced healing time: Patients typically experience faster recovery compared to traditional methods.
Improved outcomes: Laser therapy can lead to better results and long-term periodontal health.

Re-Evaluation, Periodontal Maintenance, and End-Point

The final phase of Phase I therapy involves 4-6 weeks re-evaluation. This is also known as (in the case of using a CDT code) the patient’s 1st periodontal maintenance appointment.

This appointment is essential for long-term success in managing periodontal disease. The 4-6 week re-evaluation is very important because we must identify an end-point of the disease process.

When we see a physician for treatment of a disease there is always a re-evaluation appointment to be certain the disease process has ended.

In terms of treating dental patients, we will have the same sequence of appointments: re-evaluate to determine an end to the disease process. Only when you have a patient return after treatment of active disease can you can clearly determine the next interval for preventive care (Periodontal Maintenance).

Never do we treat disease and hope for a positive outcome. We must always have patients return for an evaluation to determine the state of the disease.

Our goal is to halt bleeding gums and gingival inflammation. Only when we know there is an end point to active gingival disease can we truly help our patients live a longer, healthier life!

The Dental Hygienist Will:

1. Complete the CPE

2. Determine if there is a halt of the disease process or if the patients will need referral to a periodontist, etc,

3. If periodontal disease is no longer in an active stage the hygienist will:

Complete LBR full mouth
Scale any new calculus
Polish
Re-cap mouth-body connection, perio process (episodic and cyclic, etc.), review homecare and
schedule regular follow-up preventive care appointments, typically every 3-4 months, to monitor periodontal (“gum”) health.

Conclusion

Periodontal disease is a chronic gingival disease in populations around the world. Treatment of this disease requires meticulous care and attention.

Soft tissue diode lasers have emerged as powerful tools in the battle against gingivitis and periodontal disease, offering precision, reduced invasiveness, and the potential to stimulate cellular mitochondria.

By following a comprehensive treatment plan that includes diagnosis, gross debridement, soft tissue diode laser therapy, scaling and root planing, end-point re-evaluation and ongoing maintenance, patients can achieve optimal total health.

Our overarching message to patients is that optimal oral health will help us live a longer, healthier life.

Do you have questions about this?

Would you like to learn more about treating gingivitis and periodontitis patients?

I have opened my calendar for 30 minute complimentary coaching sessions. Book yours today. Doctors and hygienists must be present for this un-interrupted 30 minutes!

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Resources.

Löe H. Periodontal disease. The sixth complication of diabetes mellitus. Diabetes Care. 1993;16:329–34. Accessed September 21, 2023.
Preshaw PM, Alba AL, Herrera D, Jepsen S, Konstantinidis A, Makrilakis K, et al. Periodontitis and diabetes: A two-way relationship. Diabetologia. 2012;55:21–31. Accessed September 21, 2023.
Adriaens PA, Edwards CA, De Boever JA, Loesche WJ. Ultrastructural observations on bacterial invasion in cementum and radicular dentin of periodontally diseased human teeth. J Periodontol. 1988;59:493–503. Accessed September 21, 2023.
J Pharm Bioallied Sci2015 Aug; 7(Suppl 2): S636–S642. doi https://tinyurl.com/LBRPTRDIODE . Accessed September 21, 2023.
Laser curettage as adjunct to SRP, compared to SRP alone, in patients with periodontitis and controlled type 2 diabetes mellitus: A comparative clinical study. Accessed September 21, 2023.