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


By: Debbie Seidel-Bittke, RDH, BS

May 21, 2012

3 Easy steps guide you to increase patient value and thousands of $$$$’s!

Did you know that any time you spend more than 20 minutes scaling on your PROPHY Patient that you are possibly throwing money down the drain? No matter how much time hygienists spend removing plaque and calculus, many dental offices charge the same fee for a more involved treatment — and leave even more money sitting on the table by failing to initiate a new, more appropriate treatment plan. And the patients total health may pay the price in years to come!

“A Prophy Patient is not always a Prophy Patient but a Perio Patient is Always a Perio Patient.”

So, when I tell my clients that today’s dental practices experience a substantial amount of hemorrhaging, I’m not just talking about bleeding gums. Dental practices’ profits are hemorrhaging from countless missed opportunities in the non-surgical periodontal treatment profit center. Far too many patients receive just a prophylaxis when they really need non-surgical periodontal therapy or periodontal maintenance. (also known as Supportive Periodontal Therapy or SPT)

So why is this pattern so rampant across the globe — especially when dental practices need that extra cash to survive today’s economy? First, many hardworking dental professionals are not comfortable stepping off the daily Prophy treadmill. They are not comfortable talking to patients about the science  and communicating the need for non-surgical periodontal therapy. Even the hygienists that do propose Supportive Periodontal Therapy (SPT) to patients often give up because they can’t convince patients to pay more money for just a “cleaning.” Some dental offices will even avoid SPT appointments because they don’t understand how to code the procedure for insurance payment. The biggest reason, however, I believe, why dental offices are unsuccessful at building their SPT programs, is poor communication and patient education. Patients simply do not understand the importance of regular preventive care and routine SPT appointments. Why would someone agree to a seemingly simple, supportive therapy to prevent disease when they don’t understand the far-reaching health consequences of inaction?

That said, let’s explore together three ways you can break these old, unproductive habits and tap into a periodontal maintenance gold mine worth thousands of dollars annually in profits to your dental hygiene department.

1.      Patient Needs

Annually schedule patients for a periodontal screening exam. This is a six-point screening process that all dental hygienists learn to administer and assess for periodontal disease. It takes maybe 10 minutes and this is one time the dental hygiene team needs to plan to slow down the speed on the treadmill — at least once a year. When pocket depths are Within Normal Limits (WNL) and still you find yourself scaling more than 20 minutes, perhaps it is due to how you have inserted the periodontal probe into the sulcus during the screening exam. Many of us when in the dental hygiene program were taught to angle the probe in contact with the root surface, holding the probe parallel with the long axis of the tooth. The original purpose of teaching this method was for the researchers and possibly the dental hygiene educators, to have probing depths that are reproducible. The challenge with holding the probe at this angle is that it will not detect any mid-interproximal pockets. This is one reason periodontal disease is greatly underestimated.

Take time as a team for the hygienists and doctor(s) to calibrate your probing technique so a 4 mm or 5 mm pocket is the same for everyone who will hold a probe.

2.     Fine-tune your patient education.

The latest research behind periodontal disease is your biggest tool to convince a patient to begin — and stick with — preventive and SPT appointments. Make sure you clearly understand the information behind your case and are able to bridge the gap between the hard science and your patients oral health.
First, give patients the disease facts, focusing on tooth/bone loss and systemic health. The bottom line message to patients is, any time bleeding is present, pathological change is occurring that needs to be evaluated and appropriately treated sooner than later. If periodontal disease is present, the potential for bone loss has already begun. Depending upon a patient’s risk factors, bone loss can occur quickly and become aggressive very easily. With this knowledge, a patient will be much more likely to say, “Yes,” to your treatment plan. Assess their risk for disease and treat appropriately.

Point out that your patients’ health and longevity are also at stake if they do not follow the appropriate treatment plan. Cite examples of the link between poor periodontal health and certain diseases. Back up your facts with brochures, posters, iPad apps, etc. Also, highlight specific risk factors. (such as smoking, diabetes, etc.) Explain the complications that arise when periodontal health declines — and how easily this can happen without proper treatment and regular supportive periodontal therapy.

Key: Remember to explain that periodontal disease is episodic. Tell patients that from this point forward, they need to return every twelve weeks, or at frequent, appropriate intervals when SPT is required — even if their teeth and gums begin to look and feel healthy again. This is a disease and once a disease always a disease. The role of all dental professionals is to prevent disease. Communicate, Educate and Prevent.

3.      Practice Philosophy

The practice philosophy is a huge reason for patients receiving a Prophylaxis when in fact they are a periodontal patient. It is the primary role of healthcare providers to prevent disease. Communication of the evidence-based science and educating patients’ about their needs is another important role as a dental professional. When effective communication is implemented we can create a change in patients’ values and what they believe is important to pay for.


The dental hygienist has two important roles. The first role is to determine which type of preventive care is appropriate for each individual patient – and at what interval the preventive treatment is necessary. The second role is to educate and communicate to patients about their oral health conditions and exactly what type of care is appropriate for their overall health. Performing these roles allows us be patient-centered and offer comprehensive care.

Creating a patient-centered comprehensive approach means you have a few keys to unlock a higher level of patient value and increasing profits is automated!

As dental professionals we are concerned about our patients’ overall health. We want the very best for our patients. Educating patients on the difference between health and disease, prevention and treatment, is a huge part of , comprehproviding optimum, patient-centered comprehensive care. Communicate to patients how much you care, and they will most likely follow through with future preventive care providing optimal health. Creating a patient- centered comprehensive dental practice is a win for everyone!