Dental Practice Solutions

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  • 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?

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Dental Practice Solutions - Debbie Bittke

Dental Patients Enroll in Preventive Therapy: How To Create Healthy Patients and Healthy Practice Profits

By: Debbie Seidel-Bittke, RDH, BS

August 20, 2013

Preventive Care

Dentists want healthy profits in their dental practice as well as provide exceptional dental care. Dental Hygienists want to create health for their patients and contribute to the dental practice.

And our patients, they want to save money and spend less time in the dental office. How can we create a positive result for patients and the dental practice today?

How can  we enroll dental patients in Preventive Therapy? With the current research we now have tools to provide optimal health for our patients and in return, our dental practice will have health profits. Read on for tips from one of Dentistry Today’s Top Dental Practice Management Consultants.

The Dental Patient and Our Challenge as Dental Professionals

As a dental practice management consultant, our team at DPS assesses the dental practice’s current patient records.

What we always discover is that for many years patients have presented to their dental hygiene appointment with 4m,5mm and even 6mm (or deeper) pocket depths. Last week in an office the dental practice we assessed had patients with not only periodontal pocket depths in excess of 6mm’s but many patients had generalized BOP with furcation involvement, furcation involvement and mobility.

The dentist – The CEO of the dental practice, believes since his/her patients have been accustomed to this process of care, there is no need to “upset the apple cart.” –No need to make any changes to what the patient was used to coming into the dental hygiene appointment to have completed—“only a cleaning.”

The reality is, while there are many patients who may exist as a patient in your dental practice with greater than 3mm pocket depths, do they have generalized bleeding? Is the this BOP or only when they brush their teeth? Are they a chronic tobacco user? What are their risk factors for disease? (Oral and systemic disease)

Dental Patients Enroll in Preventive Therapy

When a patient seated in your treatment room is scheduled for a prophy and you discover bleeding on probing, pocket depths over 4mms and this patient has risk factors that are associated with oral and systemic disease, what is your treatment plan for this patient?

Do you believe that you have an obligation to complete “what the treatment your patient thinks they came in for?” Do you follow the plan on your schedule for the day? OR do you assess for risk and disease, then speak with your patient (co-diagnosis) about what you both (You – -the dental professional and the patient) see in their oral cavity?

Think to yourself:

  • “What is my purpose for treating a patient?”
  •  “What is my legal and ethical obligation to a dental patient I treat?”
  • “How will my patient feel when a few years from now this tooth with mobility falls out of their mouth and I never mentioned periodontal therapy?”
  • “How will it feel to our dental team to hear our patient died from systemic complications because of compromised oral health?”


  • Do you ever feel like you don’t have enough time for patient care?
  • Are you always running on a treadmill?
  • Are profits down in your dental hygiene department?
  • Are less than 20% of your adult patients only enrolled in Prophy appointments?

Yes, these are all legitimate questions and unfortunately they have all occurred—recently with a dental patient in the office of one of our clients. It happens all the time.

Creating the Paradigm Shift in Your Dental Practice

First, let’s look at the most recent ADA Periodontal Disease Classifications:

Type I Gingivitis: No loss of attachment. Bleeding on probing (BOP) may be present.

Type II Early Periodontitis: Pocket depth or attachment loss: 3-4mms, BOP may be present, localized areas of gingival recession, possible Grade I furcation involvement.

Type III Moderate Periodontitis: Pocket depths or attachment loss of 4-6mms, BOP, Grade II or II furcation involvement, Class II or III mobility.

Type IV Advanced Periodontitis: Pocket depths or attachment loss > 6mms, BOP, Grade II or III involvement, Class II or III mobility.

Type V: Refractory and Juvenile Periodontitis: Periodontitis not responding to conventional therapy or which recurs soon after treatment, Juvenile forms of periodontitis.

When you read the above definitions, how would you classify the patient in your treatment room?

  • Doctor is concerned about overhead and getting paid for the patient appointment.
  • The hygienist is concerned with the patient’s happiness, doesn’t want to scare the patient but wants to get her/his patients teeth cleaned.

How can everyone be happy with the end result of this patient appointment?

What is the best treatment plan for your patient?

What will provide profits to the patient and a satisfied patient who returns to your office?

Today’s dentistry is about total health not just treating a tooth or cleaning teeth. This is also how we can add consistent profits to the dental practice. If you build trusting relationships with your patients, (Trust begins with the 1st phone call a patient makes to your office.) they are most likely to view your diagnosis as the Gospel Truth and say “YES” to any treatment plan you present to them.

Communication with Your Dental Patient

Telling your patient the hard facts about what you see (Not what you found. The vernacular is another topic of discussion!) is usually not a fun topic of conversation. On the flip side, how will your patient feel when they lose a tooth and you (The dental expert) never told them this was about to happen to them?!

Solutions to the Not-so-fun-topic of Conversation

  • Before you pick up a probe hand your patient a mirror to view their mouth along side of you.
  • Ask you patient before you begin your perio exam, to listen when you call out the numbers. Ask your patient to remember the highest and lowest number you will call out. (Important that you have another auxiliary present to write down the numbers recorded during a perio exam. This not only involves patients in the process but saves valuable time that can be used for education, communication, treatment planning and doctor exam time, etc.)
  • Sit your patient upright after the periodontal exam to discuss what you (Patient and hygienist) see in the patient’s oral cavity.
  • Involve your patient in the treatment planning process by asking open-ended questions and setting realistic goals
  • Use visuals (brochures, diagrams, photos, intra-oral camera, etc.)
  • Be enthusiastic about their outcome, providing hope for total health

How Do Your Involve Your Patient In the Treatment Planning Process?

Your dental patients will enroll in perio therapy when you understand how to build trusting patient relationships. They are a patient in your office because they really do want to be healthy.

How many times have you spoken to someone who said they don’t want to live a longer – healthy life?

We have the research at our fingertips. Thousands of research articles about the oral-health/systemic-health link. It is our ethical, legal responsibility to understand the specific ways in which we can deliver the message of total health.

Insurance is only a benefit – -it is not the solution to a health patient and practice!

Understanding how to deliver your message to treat patients at the highest level may take some work to become more successful but in the end – — wouldn’t you agree that it is worth the time to get to these results?

Healthy Patient’s = Health Dental Practice Profits


ME not too high jpegDebbie Seidel-Bittke, RDH, BS is founder of Dental Practice Solutions, and has successfully designed efficient dental hygiene departments that result in high performance dental teams for over 13 years. Her focus is providing optimal patient health while consistently increasing profits for the dental practice.

Debbie is an accomplished author who speaks internationally about her signature systems and services for the dental hygiene department. She utilizes the most recent science and research to prevent disease while increasing the teams’ enthusiasm and guiding the dental team to consistently increase profits.

In 1984 she graduated from the University of Southern California (USC) in Los Angeles, California with a Bachelors Degree in Dental Hygiene. She is a former clinical assistant professor from USC in Los Angeles, CA. In 2000-2002 Debbie co-taught the practice management course for the dental students at USC. Debbie is also a former dental hygiene program director for a school in Portland, Oregon where she wrote the accreditation, hired the teachers, purchased equipment and managed a 2 million dollar budget.

Debbie works with dental practices throughout the world implementing her signature dental hygiene systems and is considered one of the Top Leaders in Consulting for Dentistry Today. She can be reached at: or call: 888-816-1511.