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10 Profit Centers Your Practice Should Focus On

Posted Feb 22 2010 7:48pm

The following is a guest post by Debbie Seidel-Bittke. If you are interested in guest posting for Dental Heroes, please sign up here.

When you see the words “the business of dental hygiene” what do you imagine? Perhaps you see a treadmill where high volume and financial reward are the main focus of the dental hygiene department? Or do you see a hygiene department where quality patient care and profitability are congruent, operating with systems and protocols that would not allow one to compromise the other?

During the past ten+ years the goal of helping our patients has now progressed from treating infection and disease into good overall health. One thing that hasn’t changed is the cost of doing the business of dental hygiene. It is important that the team understand the cost of running a business and a hygiene department. It is when the team understands these financial aspects of the business that the members of the dental team will be committed to excellence. It is important to have team meetings that educate every team member of the cost associated with the daily operations of running the business of dentistry and dental hygiene.

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 four times a year with the dental hygienist(s) and because of this ongoing relationship patients are more likely to remain in your practice, accept treatment recommendations and refer patients to the dental office. This makes your hygiene department a business within a business and it makes the executive in this department held accountable for his/her 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 the patients are sure to experience a caring attitude, an ultimate dental experience, the highest level of care and the profits are sure to follow. This provides 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.

There is a list of 10 assessments and patient procedures 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
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 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 have approximately 15% of their adult patients with untreated periodontal disease. If each of these patients continues down this path we know that the research states this disease process will continue and the patient will at some point experience tooth mobility and possible tooth loss.

What will this cost the dental business? 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 after the disease have been halted. We are not talking about money lost but improved 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 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 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 the 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 excellence and the extraordinary. Realizing the potential of 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.

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.


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.

10. Counsel patients on the importance of good nutrition for maintaining good oral hygiene.

Which of these profitability centers currently exist in your practice. Do you plan to introduce any of the others listed here? Would you add any to the list?

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