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Dental Practice Solutions - Debbie Bittke

Got Profits? 10 Facts of the Matter.

By: Debbie

March 27, 2012

The Dental Hygiene Department needs to be and should be the 2nd highest profit center in your dental practice. Imagine this now! Possibly, when you see the words “INCREASE and PROFITS” together, you see a treadmill where high volume and financial reward are the main focus of the dental hygiene department. I hope you see quality patient-centered care when you put the words increase and profits together in the same sentence. These 2 words can be congruent with operating the successful systems in your dental practice.

A Paradigm Shift

During the twenty-first century, the goal of helping our patients has now progressed from treating infection to providing good health. It is very important that your team understand the cost of running a dental practice. It is when the team understands the financial aspects of a dental practice that the members of the dental team will be committed to excellence. It is important to have team meetings to educate every team member of the cost associated with the daily operations of running the business of dentistry and dental hygiene. One important time to deliver this information is the morning team-huddle.

The Facts

The fact is, the hygiene department is the second largest profit center in the dental practice and provides support for the practice as a whole. Within the hygiene department are several other areas of profitability for the dental practice.

Most of your patients spend one hour–two to possibly four times a year with the dental hygienist(s) and because of this ongoing relationship patients are more likely to remain committed to your practice, accept treatment recommendations and refer patients to your dental office. This makes your dental hygiene department a business within a business and it makes the dental hygiene executive in this department held accountable for the success. When the dental hygienist is held accountable for the department success and when he/she understands the vision and principles of the dental practice, success will follow. You will find the team working in harmony when they understand the vision for the practice, share the same code of patient ethics and take ownership for the way patients are treated.

When every team member takes ownership of their role in the dental practice the patients are sure to experience a caring attitude, a superior dental experience, the highest level of care and the profits are certain to follow. This is what creates a win-win situation.

One of the most important aspects of the dental hygiene treatment that is often overlooked is the list of assessments. Dental hygienists feel as if they are on a treadmill but when the team plans the day effectively these assessments can really make the day run smoothly, allow patients to feel they received the highest level of care and now allows for a more comprehensive treatment plan to occur. The treatment plan now moves to a higher level of care. Profits will follow.

New Treatment Heights

There are approximately 10 assessments that stimulate profitability in the dental hygiene department. These ten are all important aspects of the patients’ oral and total health. Not all offices participate in this list of 10 and this is where untapped potential can be easily missing.

If you take a look at the list below and notice a missing piece choose to just implement 1 or 2 within the next month. Make an appointment this month to discuss with your team how to implement these ten successfully into the dental hygiene patient appointment time. Be patient with these changes and take time to discuss how to effectively implement these with full participation from the entire team.

The most overlooked assessments are the annual full-mouth periodontal screening exam. Still in the 21st century many hygienists who see a patient every six months, neglect to pick up a periodontal probe prior to picking up a curette. Most dental offices assessed during an initial consultation for practice management services, are found to have approximately 15% of their adult patients lacking early intervention and preventive procedures for periodontal disease. If each of these patients continues down this path we know that research states this disease process will continue and the patient will at some point experience tooth mobility and most likely tooth loss.

When disease goes untreated, imagine what this will cost the dental practice? Take into account that most non-surgical periodontal treatment plans are approximately $1,000.00 for four quadrants of just scaling and root planing not taking into account the use of antimicrobials or laser therapy. Now take into account the frequency of the periodontal maintenance appointments that follow about every 90 days.

Once a periodontal patient, always a periodontal patient. It is the same as a patient with diabetes or high blood pressure. These patients are seen frequently and always at risk for future disease even after the disease has been halted. These diseases are all episodic. We are not talking about the almighty dollar but a gain of our patients’ overall health!

Another new area of treatment that is overlooked at this time is the pediatric patient – first visit. CAMBRA is a new evidence-based protocol for assessing caries. It is now the standard of care for the pediatric patient to have their first visit when the first primary tooth erupts. This appointment can be done in a consult room with the child seated on the mothers lap. This is an appointment to assess the tooth structure, biofilm and any suspicious areas of the child’s oral cavity. If you are concerned about receiving payment the CDT codes have you covered.

How many patients qualify for this preventive measure? How will this benefit your patients and your bottom line?

When the dental hygienist and team all understand the need to prevent and intervene at an early stage vs. wait and watch; not only does the patient gain an improved level of health but the dental hygiene production will automatically increase. Establish periodontal and the various preventive protocols today. Now is the time to cease treating the periodontal patient with a prophy appointment and begin to utilize the
preventive measures according to the new CAMBRA guidelines.

Another area in dentistry that has changed in the past decade or more is selling home care products. Many decades ago we wrote a prescription or sent our patients to a pharmacy with names of products written on a piece of paper. Our knowledge and research over the past few decades states that 70% of these patients returned to our dental office and never took time to get the prescription filled. Patients seldom took that piece of paper with them to purchase the specific product recommended. When patients have the toothbrush they are to use and shown in the dental office how to use that new power toothbrush they are more likely to use the brush effectively.

This is the one area of your dental practice that has a net profit of about a 70%. You can spend hours preparing a crown or bridge and you have lab fees to pay at the end. The ROI (return on investment) for home care products sold in the dental office is about 70%. We want patients to buy their home care products from the experts, the people who know which toothpaste, toothbrush, mouth rinse, etc. is appropriate for each individual patient to use at home. The sales person at the local drug store and even the pharmacist is not the person to educate a patient about xylitol and its benefits, let alone what type of silica is appropriate to use on the expensive restorations the dental patient just paid for.

By engaging and empowering the entire team your dental business is certain to excel. You will create a cohesive team and a dental practice based on patient-centered care, excellence and the extraordinary. Realizing your potential for the dental hygiene team and creating a thriving profit center inside this valuable department of your business is essential to building the dental practice you have always dreamed of. This assures you long-term relationships along side your success.

Your team and the dental hygiene department are all very important assets to the health, profitability and success of the dental practice.

The 10 FACTS for Profitability:

  1. Perform oral health care assessments that include the review of patients’ health history, dental charting, oral cancer screening, periodontal assessments, biofilm assessment, saliva pH test, smile analysis, xerostomia, etc.
  2. Expose and interpret dental radiographs (x-rays); co-diagnose
  3. Non-surgical periodontal procedures, antimicrobial agents, laser therapy, etc.
  4. CAMBRA
  5. Apply cavity-preventive agents such as fluorides varnish and sealants to the teeth;
  6. Administer local anesthetic and / or nitrous oxide analgesia;
  7. Educate patients on proper oral hygiene techniques to maintain healthy teeth and gums and recommend home care products
  8. Discuss whitening treatment and take impressions when applicable
  9. Administer smoking cessation programs; and
  10. Counsel patients on the importance of good nutrition for maintaining

Debra Seidel-Bittke, RDH, BS is founder of Dental Practice Solutions a full-service dental consulting, coaching and speaking business. Ms Seidel-Bittke is considered a leader in the field of dental hygiene and named one of Dentistry Today’s top consultants. Dental Practice Solutions is focused on increasing the profitability of your dental practice quickly through 4 areas of the dental hygiene department. Research and technological advances have created more opportunities to deliver a higher level of non-surgical periodontal care. An important component of any successful dental business is the function and profitability of the dental hygiene department.