Dental Practice Solutions

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

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

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

Dental Practice Solutions - Debbie Bittke

Dental Practice Consultant | Use it or Lose it!

By: Debbie Seidel-Bittke, RDH, BS

August 14, 2018

It’s hard to believe but the end of 2018 is near.

This is the best time of year to contact your patients about their unscheduled dental treatment and/or dental hygiene appointment.

Your message to your patients’ needs to say, “Use it, or lose it!”


Why now?

I am certain if you work in the front office of your dental practice, you have a long list of “to-dos’” every day and this only compounds your work!

The reason August is an important month to send out this message is because your patients will possibly not be able to schedule their appointment until September.

Calling overdue hygiene patients can mean there is a lot of work for them to schedule and time is running out!

For your patients who do have insurance benefits, these benefits typically run out on December 31st. This means if they can’t get their treatment completed by December 31st they will lose their benefits this year.

Last week our I wrote in the blog about texting your overdue hygiene patients to come in for their appointment.

You may want to refer back to this blog for more information about this topic.

As a dental consultant, it is my goal to bring out clients and the dental profession, new and up-to-date information.

I wrote about a system I created called the R2R.


What is R2R?

R2R means Reason to Return.

Why did your patient leave the office without scheduling their important restorative care?

Now that you have run your report of patients with outstanding treatment, I recommend that you send a text message.

Your Text Message.

Your 1st text message must only say, “Please call our office about your dental appointment.”

When you only text this message it does peak a patients’ curiosity. Most patients will call your office and they will be curious about this message since they know they don’t have a dental appointment.

What to do when the patient calls your office.

  1. Once you answer the phone and you identify this is a patient responding to your text message, place the patient on a very short hold (maybe 10 seconds) letting them know you want to check their patient record.
  2. Check what happened at their last appointment and what they need to schedule an appointment for.
    1. It is possible the patient not only needs restorative care but also, they now need a hygiene appointment.
      1. In this scenario schedule the patient for a hygiene appointment with x-rays and exam as appropriate.
      2. It is possible this patient needs a new exam because the area of concern (area that needs restorative care) may need more extensive care than when first diagnosed.
  • Explain this to the patient so they understand, it’s been too long to schedule for the same treatment they need X months ago. At this point, you don’t know exactly what is needed until the hygienist and doctor re-examine this area in need of care.
  1. Once these patients do return begin to write your R2R.
    1. Ex: Mr. Williams had large decay (MOB) on the upper left first molar (Tooth #14) at his appointment eight months ago.
    2. He comes in for his hygiene appointment and the hygienist completes new x-rays (Last x-rays were over 12 mos. ago) and doctor completes an exam.
      1. The x-rays show this upper left first molar (Tooth #14) needs an onlay and the hygienist completed a gingivitis treatment today.
      2. The patient also has high blood pressure.
  • In the R2R the hygienist writes in the notes (Last line of the notes) R2R: Pt now has high blood pressure and he also has gingivitis today. Doctor and I are concerned about this inflammation in his mouth creating the inflammation in his body—i.e. high blood pressure. Very important to have pt return in two to four weeks to re-evaluate the oral inflammation and if this is improved I will complete a prophy appointment. Pt wants to preserve his teeth, so doctor recommended he schedule for the tooth to be prepped for the onlay at the time of the next hygiene appointment in about two to four weeks.


Value of using the R2R.

This R2R serves numerous purposes. It supports a conversation that will need to be addressed when patient schedules his next appointments and needs to know his financial obligations. Should Mr. Williams not want to “NOW” spend the money to reduce the oral inflammation and preserve his teeth, the financial coordinator will refer to these notes as discussed with the hygienist and doctor.

Most offices we talk to have at least one patient call each day to cancel their appointment and unfortunately, this is a patient calling last minute to change their appointment on the day of their appointment.

Whenever a patient does call about an appointment: Making an appointment or changing an appointment, once your clinicians are documenting the R2R, the person answering these calls will always refer to these notes to understand exactly why the patient needs to schedule.

If the patient is calling to change their appointment, referring to the R2R is very helpful when you refer to these notes and address the value of completing treatment sooner than later and when you know what is valuable to your patient (money, time or fear), you can turn this patient objection into a reason to keep their appointment.

Ex. Of turning around their objection to spending money would be that Mr. Williams would save money if he doesn’t wait to restore a filing. Currently, he can no longer have a filling but will need an onlay, if he waits longer this could mean an infection in his tooth. An infection in his tooth also means this infection goes into his bloodstream causing other health-systemic challenges beyond the high blood pressure.

Talk about how treatment now will save money (and improve their health) now when they complete they keep their appointment.

Mr. Williams is an example of someone who did not understand how keeping his original appointment for a filling would cost less than waiting and in the meantime the decay (Words patient may be more likely to relate to: cavity, hole in the tooth, etc.), became larger and needed more extensive treatment, which costs a lot more money.


Your Words.

When speaking to patients always break-down the dental words into works that your patients can easily understand.

For example:

Periodontal disease say, gum disease

Tooth decay say cavity or actually show the patient the black hole in their mouth and/or on an x-ray

Scaling and root planing say gum treatment

Recall or recare say preventive care or hygiene appointment

Also use pictures as much as possible. If you have the opportunity to take intra-oral pictures, take the pictures. Sit your patient upright in the chair and show them. Ask your patient if they see what you see. Engage them and make them part of this decision-making process.

Your Plan.

When patients do leave your office without scheduling a next appointment, always let them know that you will be contacting them to scheduling later that week.

Urgency is key when scheduling dental appointments.

We should all care enough about our patient’s total health, reducing inflammation and infection in their mouth and body, that we will not allow our patients to not schedule preventive care.

What you are all saying as a team with your patients, while they are in your office, will make or break, the opportunity for patients to pay and schedule before they leave their current dental appointment.

Would you like to learn more about the value of using the R2R for your office? This has been a huge benefit to our clients who use this system.

Let us know how we can help your team to improve your case acceptance and reduce those last-minute changes to your patient appointments.

Drop us a line or email/call our office to schedule a training for your entire team! We offer AGD CE Credits for Virtual or in-office training.

This year all of our clients will make not less than $125,000 more in production and without working harder or more days.

Let us help you be the next dental practice get this type of success.

To schedule a call, it costs doctor nothing except 30 minutes of your time.

How can we help you be the next success story in 2018?

Call us to find out how to get training virtually or in-office. We are here to help!


Your team will receive AGD CE Credits with any training we complete for you. Contact us today. Email: or call our office: 949-351-8741


Need help implementing the R2R or any other systems?

We are here to help you! Call us to find out how to get training virtually or in-office. We are here to help!

Your team will receive AGD CE Credits with any training we complete for you. Contact us today. Email: or call our office: 949-351-8741



Debbie Seidel-Bittke is the CEO of Dental Practice Solutions and has over 15 years of business and consulting experience, as well as 30 plus years of working knowledge as a dental professional.

Having the unique ability to understand dentists’ need, Debbie can help each dental practice grow to be efficient and profitable. The growth occurs by optimizing your dental hygiene department. She has a team of experts that will work in the other areas of your dental practice as necessary. Debbie’s insight allows her to effectively communicate and implement success strategies while strategically addressing productivity challenges in the dental practice.


As a dental hygiene business coach, a former clinician and educator, she is adept at collaborating with dentists and their team to incorporate her expertise to see a dental practice grow to levels beyond their imagination. Debbie and her team of experts will increase the profitability of each dental practice. This year, 2018, no client of Dental Practice Solutions will increase production less than $125,000 and without working more days in the office. Ask us how you can be next to do this!


Call or email our office to schedule for your Free Profit Boosting Session:

Email: or call our office: 949-351-8741