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?
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References.
- Comprehensive Periodontal Evaluation. https://tinyurl.com/23atrxm2 Accessed October 1, 2023.
- Motivational Interviewing. https://tinyurl.com/yappeexh Accessed October 9, 2023.
In the ever-evolving realm of dentistry, the dental hygiene department stands as a pivotal force in transforming patient care.
