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Extreme Makeover: Dental Hygiene Department Edition

Posted Mar 06 2012 8:54pm

I don’t know about you, but I love the “Extreme Makeover” reality TV shows. To watch, for example, a family members move from a house in which they are barely squeaking by to the house of their dreams is inspiring. When I see shows like this, I imagine how the Extreme Makeover concept can apply your dental practice. If you’re up for making some awesome improvements to your workplace, I recommend starting with the dental hygiene department . Imagine that you are on the set of your very own Extreme Makeover TV show – Dental Practice Edition!

As you know, Extreme Makeover home edition starts out with the bare bones – no fancy movie sets to be seen! However, these shows uncover lots of hidden potential with these real-life sets. So don’t be discouraged if you are starting from scratch. Are you ready to see what potential your hygiene department has?
The hygiene department is one very important department of a dental practice. It is one area of huge profitability in every dental practice. You may not see this fact in action yet at your own practice, but the potential is true for every dental practice in the 21st Century. No longer do we consider the dental hygiene department a loss leader.

We used to think the main purpose of a dental hygienist was to perform a prophylaxis and limited adjunctive services. In fact, in at least half of general practices, dental hygienists spend most of their time exclusively focused on prophylaxis, x-rays, fluoride treatments for children, and occasionally periodontal probing. It is a rare occasion where the hygiene department provides other services. The keystone to your makeover is to change this paradigm. The entire dental team must view the hygiene department as an opportunity to increase patient care and production by adding more hygiene-related services.

The paradigm shift must begin with the lead role, the practice owner, or dentist. Once the dentist is willing to restructure the practice’s hygiene department, the dental practice can begin providing the highest level of patient care. At the same time, the practice will experience an increase in practice production.
The other “cast members” must follow suit. Every team member, including hygienists, dental assistants, financial coordinators, and administrative assistants, must play a supporting role in advancing practice production, with the two main profit centers of being unquestionably the doctor (restorative dentistry, implants, etc.) and dental hygiene department.

Patients are your final, key players, and how you communicate to them (and how they respond) depends on how well your team “glues” your set together.

What does your dream practice look like? Does your team share a common vision? If not, discuss this during your next team meeting. Items to consider in your vision are great management skills, team harmony, organized and structured business systems, quality patient treatment, and increased production and profits.
To truly make over your hygiene department, your vision must include every member of your team advocating and acting upon the idea that your hygiene team provides more than ‘just a cleaning’ (prophylaxis). Most successful general dental practices provide comprehensive, patient-centered preventive care.

Monitoring four key areas of a dental hygiene department that will provide success for every dental practice. Make these your priority during your makeover:

When the dental practice embraces the philosophy that the dental hygiene department provides more than cleanings, x-rays and fluoride treatments for children, the service menu will allow for higher production. Additional services for the hygiene department menu can include the following: Fluoride varnish for adult root exposure and use of Caries Management by Risk Assessmen,( usually called: CAMBRA) whitening impressions, occlusal guard impressions, periodontal probing and maintenance, etc. Sit down with your team and agree to start expanding these services – and see if you can come up with more ideas to add to the hygiene department.

The dental hygiene appointment is typically 40-60 minutes in length. Not every hygiene patient needs 40 minutes or 60 minutes, but a tiered and pre-blocked schedule will allow appropriate time for individual patients and their specific needs.

Throughout the appointment the hygiene conversation needs to be focused on the patient’s oral health and benefits of optimal oral health. Many times hygienists find themselves in a friend-type of relationship instead of a more professional, patient-healthcare provider relationship. Ideally, your conversation with patients should be 80 percent professional and 20 percent social. This will allow more time to discuss important treatment concerns before the doctor arrives for the examination. It is most important to communicate the oral health-systemic health relationship and how important optimal oral health is for a healthy lifestyle. When patients trust their dental professional and understand they need to schedule in advance for their next hygiene appointment, they are likely to take action, not only in scheduling their next appointment but making the appointment a priority. Many dental experts can provide information about effective communication to help you convince patients to make oral health a priority.

Dental hygienists spend the most amount of one-on-one time with patients – and here’s where that 20 percent social conversation comes into play. In many offices you will find that patients build lasting relationships with their hygienist and they request to see the same hygienist each successive appointment. Use this to your advantage! Once the hygienist communicates effectively and builds a professional and trusting relationship, most patients look forward to returning for their hygiene appointment. This is a great way to combat those costly cancellations! (And not only costly to the dental practice!)

Extreme makeovers are all about discovering new ideas, as well as hidden treasures and then turning them into something remarkable. Make sure you know every opportunity where you can improve and expand. Schedule a training time with the entire team so that everyone understands what services are available for patients, such as comprehensive dentistry, comprehensive exams and full-mouth x-rays, cosmetic dentistry services, implants, and periodontal therapy (including referrals to a local periodontist). Your entire team – not just hygienists – must effectively communicate these services to patients. Idea: Develop scripts for communication with patients, and practice these scripts at another team meeting.

Also know your hygiene department’s diagnostic potential. Check with your state or country to understand if it is legal for a dental hygienist to make a clinical diagnosis and yet at the very least the hygienist can identify potential areas of concern for treatment and diagnosis by the dentist. The dental hygienist is in the perfect environment to explain what services the practice offers, and the hygiene appointment is the best time to have positive discussions with patients about the benefits of treatment prior to the doctor examining the patient.

Each 32 hours of hygiene a week, 50 weeks a year, the hygiene department has the potential to contribute hundreds of thousands of dollars (Euros, pounds, etc.) to the dental practice. The kicker: This production and the potential profits depend upon how well the hygienist is trained to identify, educate, and motivate patients to complete treatment. Once the dentist enters the hygiene room for the patient exam the hygiene-dentist collaboration must be maximized. The hygienist should open conversation with the dentist with a brief overview of the appointment. Then, the hygienist should present his or her treatment recommendations, as well as patient concerns. It is O.K. and often beneficial for the hygienist to step outside the hygiene room to have a discussion with the dentist aout any patient challenges (emotional, financial, or dental) before the collaborative exam begins. Doing so provides the best opportunity to increase your practice profits. There are occasional opportunities where the hygienist may need to discuss a challenging or personal patient situation outside of the treatment room and in the presence of the patient.

While you won’t be on live TV showcasing your practice makeover, you will certainly be live with the public. Be sure to awe them! The dental hygiene department should be the second largest profit center in every successful dental practice, yet it is one of THE most underutilized departments in most offices. However, when the dental hygienists are able to offer a diverse range of services to patients, provide a variety of services, and identify and communicate treatment plans, the dental hygiene department will create practice success and build huge profits for the dental practice. In turn, the dental hygienists will appear as respected colleagues and become extremely valuable to the dental practice. No longer will your hygiene team be thought to live in the “prophy palace.” There’s a whole new world left unexplored in most dental hygiene departments, so make it a point to pioneer it in your “Extreme

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