One dental practice goal is to provide comprehensive care to every patient. The dental hygiene patient-doctor exam is a crucial opportunity to assess your patient’s oral health, discuss treatment options, and foster a strong patient-dentist relationship.

Dental hygienists, you can boost case acceptance by building a strong foundation during the first part of each dental hygiene appointment.

In this blog, you will learn five steps to effectively complete the hygiene patient-doctor exam, ensuring your patients receive the utmost care and attention they deserve.

The bottom line is a boost in your case acceptance and keeping patients returning to your dental office.

Step 1: Review the patient’s clinical record.

Before seating patients, at the beginning of the day, it’s imperative to gather your team for a quick team huddle.

Before the team huddle begins, hygienists must thoroughly review notes in each patient’s clinical record and during the team huddle, they must communicate important patient information about patients being seen that day.

This does not mean flipping through patient charts or scanning the online schedule! *Preparation before the team huddle is imperative to make this an efficient huddle.

Every team member comes to the morning huddle prepared to communicate important information. Coming prepared means your huddle will take approximately ten minutes.

If you are not currently holding morning team huddles this will take practice. You must have a huddle strategy and you will create a quick huddle and the result is an amazing day! Think less stress and more productivity!

** Time Management Example

Example of huddle hygienist communication:

1. Any health issues the team should be aware of? Ex: pre-med? Etc.
2. Does the patient need X-rays today?
   1. What type of x-rays do they need?
3. What type of exam is the patient scheduled for?
   1. Comprehensive exam (more than a quick 5 mins exam)
   2. Periodic exam
4. Does the patient have unscheduled restorative needs?
5. Etc.

Step 2: Seat and greet the patient:

This is a time for rapport and discovering what the patient wants their smile to look like.

• Does the patient have any areas of concern?
• If the patient has unscheduled treatment, this is a great time to use motivational interviewing to discover how you can get the patient to schedule for necessary care.

This is your time to review the medical history, ask about surgeries, new medications, etc. See the above image. During the first 15-20 minutes of the hygiene appointment, this is your time to collect all the important data.

Always explain to the patient what they can expect during their time in your chair.

Make your patient a part of the data collection and treatment process. This also alleviates any confusion around what they are seating in your chair for.

True story! Once I started teaching this one thing, patients were stating they thought they were coming to the office for “A” when they were scheduled for “Z”!

Examples of data collection: RMH, blood pressure screening, “cavity detecting x-rays”, “gum exam using a ruler to look for any abnormalities of the gums”, etc., etc.

Step 3: Treatment planning.

Show the patient any abnormalities you discover during the exam process. Use an intra-oral camera or an iTero scan to show patients what is happening in their mouth and with their total health. Collaborate with your patient. Make them part of the process.

Now is the time to communicate the risks and benefits for accepting your care. Explain if, and when your patient does have oral inflammation, that inflammation (“gingivitis and gum inflammation”) can cause other systemic diseases such as stroke, heart attack, high blood pressure, diabetes, and even Alzheimer’s disease.

Use words that are descriptive and easy for the patient to understand what is happening in their mouth.

Examples of words to use: inflammation, infection, bleeding, pus, hole, bacteria, prevention, gum disease, etc.

Step 4: Timing of the hygiene patient-doctor exam

At about 30 minutes into a sixty-minute hygiene appointment, the hygienist should have completed all the patient assessments and reviewed a plan of care with the patient.

This is the perfect time for the hygiene patient-doctor exam. There is no need to wait until the end of a dental hygiene appointment to complete the patient exam.

Refer to step 1. The morning huddle is the best time to orchestrate which hygiene patients need an exam and the doctors assistant knows ahead of time when they will direct/lead the doctor in to the hygiene room for an exam.

The doctor’s assistants are responsible for guiding the doctor to be where they need to be, when they need to be there. Think about hygienists as the air traffic controllers.

Example: The doctor is prepping a crown and waits for an impression. The assistant will direct doctor to complete the hygiene patient exam while the assistant is finishing up the impressions.

Step 5: Doctor-hygiene patient exam process

Collaboration is one key to building trust and accomplishing patient engagement. When the doctor walks into the hygiene treatment room to complete the patient exam, it’s possible the hygienist is polishing or scaling the patient’s teeth.

At this point, the hygienist will move to the side of the patient and bring the doctor into the loop of what has been discussed, etc.

Example: What did the hygienist discover during the seat and greet with their patient? Maybe Mrs. Jones is going to Europe for vacation next week. This is all part of rapport. Personal connection builds trust and patient loyalty.

The hygienist will report to the doctor all that has been completed up to this point and what the patient will return for in the future.

Example when doctor enters to do the hygiene patient exam: “Hi Doctor Good Tooth, I just found out that Mrs. Jones is going to Europe for six weeks this summer!

Doctor can respond as they are washing their hands, putting on their gloves, etc.

We reviewed her medical history and there are no changes, no significant findings. I asked her about one thing she would like to improve about her smile and she said she wants to whiten her teeth!

Doctor can respond as they are looking around the patients mouth.

I told her about our new Smile Club and she would like to get started whitening today! We checked her blood pressure and it’s great! It was 120/70. I completed an oral abnormality screening and her hard and soft tissues look healthy. Next, we checked the health of her gums and we did talk about a few areas of inflammation and bleeding. I am going to review her floss technique and next time she returns I think these areas will be much healthier.

Doctor can respond as appropriate.

Next time she returns in six months for her preventive care with me, she will need a full series of the x-rays and I will have her see you for a comprehensive exam in six months. I think that everything else looks great!”

Doctor can now look at the patient and respond accordingly.

• Do you see how this communication can be completed while the doctor is visually looking around the patient’s mouth?
• The hygienist made this super simple for the doctor to sit down, look in the patient’s mouth, have a quick, run conversation about Mrs. Jones’ trip to Europe and then the doctor is gone!

No one is waiting for the hygiene patient exam to be completed. The doctor left in five minutes to return and complete that prep patient in their other room and the hygienist finished up the patient on time.

**See above image which shows an example of how the hygienist can facilitate ease of the doctor- hygiene patient exam to increase case acceptance.

Conclusion:

Effectively completing the hygiene patient-doctor exam requires a seamless transition from the dental hygienist’s initial assessment to the treatment discussion.

By following these five steps—pre-planning patient care at the beginning of each day (the team huddle), simple discovery sessions between the hygienist and patient, treatment planning using visual aids prior to the hygiene patient–doctor exam, breaking down the words into what the patient understands and then using those same words during the doctor-patient exam, means you will more efficiently and effectively engage your patients to ensure they receive the highest level of care.

Remember, this approach enhances patient satisfaction and contributes to a thriving dental practice built on trust. This will allow patients to be in charge of their care.

This is one important method to get patients to “want what they need.”

Breaking down the words you use when communicating with patients and having everyone on the team use the same words will build trust, and help patients understand the value for completing necessary care- even preventive care.

The bottom line is happy patients, a boost in case acceptance and patient retention in your dental practice.

If you would like to learn more about integrating this process or other systems to optimize your hygiene department schedule a complimentary discovery call here.

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