Five Mistakes in Dental Hygiene That Could Be Costing You Thousands

Fri, Dec 20, 2013

rachelThis guest blog post is written by Rachel Wall, an expert in maximizing the earning potential of dental practices through better use of hygienists.

#1 Assuming Perio is Taken Care Of

Having a sharp hygiene team is a beautiful thing. But assuming everything is being taken care of is a big mistake. Be sure you know that a complete perio exam is taking place at every hygiene visit AND the data is being recorded. This is a huge area of liability for you and it’s your hygienists responsibility to collect and analyze this information. One way to find out where you stand is to do an audit of your charts. Randomly pull 20 charts of adults seen in the last 6-12 months. How many have a complete perio exam recorded in the last year? Chances are very good that if the percentage is low, so is the amount of perio treatment.

#2 Starting Perio Treatment Too Late

My interpretation of the AAP’s Perio Classification system is that Beginning (slight) periodontal disease is 4mm pockets with bleeding and slight bone loss and 1-2mm CAL. This is a huge distinction for many dental teams. Often, these are the “difficult prophies” or the patients that have 3 month prophy intervals. I see it time and time again- teams waiting until pockets are 5-6mm deep before beginning treatment while valuable the patient loses valuable bone that could have been saved.

#3 Too Little Time for Hygiene Visits

I’ve mentioned this before and I’ll say it again. Every time I have ever coached a team to increase their hygiene time, their production has increased as a result. Now that wasn’t they only thing they did. They put in place systems to deliver a higher level of service and enroll more treatment. Critical steps that drive production are left out of the hygiene exam when time is short. When you choose to allow 60 minutes for adult recare and perio maintenance, it’s important to outline exactly what will take place during that time. If you are going from 40min hygiene visits to 60min, what are you going to add?

#4- Not expecting enrollment of restorative in hygiene.

If you are carrying all the load for keeping your book full of comprehensive, productive treatment…STOP! Empower your team to help you! Set up the expectation and then clearly communicate your treatment philosophy. Your team needs to know when you recommend a crown versus an onlay, for instance. Schedule time to sit down with your team and outline your specific treatment recommendations. Have them create a mock treatment plan and then work through what they got right and what you would do differently. This one step will automatically increase the amount of treatment scheduled out of hygiene.

My article in Dentistry Today, “Dynamite Diagnosis...Empowered Performance“ gives you a step-by- step guide to conducting a Case Review meeting. Click here to find the article link on our website.

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#5- Not offering patients the option of at-home or in-office fluoride therapy.

I see thousands of dollars walk out the door of dental offices every month when I hear that they are not offering adult fluoride. The truth is, there are very few patients in your practice who WOULDN’T benefit from the application of fluoride varnish and/or a fluoride appliance for home use. Think about it. What percent of your patients have crowns, bridges, onlays, abfraction, recession, interproximal fillings, sensitivity? Educating patients about the value of fluoride therapy and it’s protective benefits will get them on board and guess what? They’ll pay for it!

For a practice that has 1500 active re-care patients, not doing adult fluoride therapy is costing them at least $100K per year in lost revenue!!

Action Steps:

  • Print and read my Dentistry Today article
  • Do a Case Review meeting-get it on the schedule today!
  • Set a goal for how much restorative you’d like to see enrolled in hygiene
  • Meet with your team to discuss adding a fluoride therapy protocol
  • Put the protocol into action

Do you have specific questions about how to put these action steps into play? That’s exactly how we work with our Mastermind members. We help them create specific strategies to boost hygiene productivity! To learn more about the Hygiene Mastermind, click here.

Wait! Here are a few action steps to help you get started NOW:

  • Do a chart audit-look for current periodontal charts
  • Communicate to your hygiene team that you’d like them to do a complete periodontal exam on every adult patient
  • Give your hygiene team the time they need to complete a comprehensive hygiene exam
  • Be proactive and get the information you need to really believe that starting periodontal therapy early is the right thing to do

Owner of Inspired Hygiene, Rachel Wall helps dentists tap into hygiene’s profit potential. Rachel’s articles have been published in numerous industry journals including The Profitable Dentist, Dental Practice Report, Dentistry Today, RDH, and Modern Hygiene. Inspired Hygiene’s programs include in-office coaching, a free weekly e-zine, the High Performance Hygiene Mastermind group and the new High Performance Perio webinar series. To contact Rachel, email her at or call 877-237-7230.

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Topics: Financial Planning