Hygiene department productivity

Aug. 25, 2016
I'm a solo practitioner with two full-time dental hygienists. In your opinion, what is the best way to increase production in dental hygiene?

Dear Dianne,

I'm a solo practitioner with two full-time hygienists. My hygiene department typically produces about 18% to 20% of the overall practice production. This seems low to me, especially when my hygienists' salary-to-production ratio is about 45%. In your opinion, what is the best way to increase production in hygiene?

- Dr. Ed

Dear Dr. Ed,

Typically, a solo practice with two full-time hygienists should see around 33% to 35% of production coming from hygiene. The typical salary-to-production ratio should be around 33%. You need to determine what is causing the low production numbers. Some possible causes are too much downtime in hygiene, an insufficient number of new or existing patients, lack of a cohesive periodontal program, or scheduling issues. Also, if your practice has a niche in the cosmetic dentistry market (less than 5% of practices), overall hygiene department production might appear lower due to inordinately high doctor production.

Some offices have inadequate front office systems and do not prioritize keeping the hygiene schedule full. The reality is that there is nothing more important than the schedule, and it is the scheduling coordinator's primary responsibility to maintain the schedule. The hygiene schedule has to be maintained daily by someone working the recall system, which includes calling patients to invite them in, sending reminders, and effectively handling disappointments.

After you determine what is causing your hygiene productivity to be low, you should take the necessary steps to correct the problem. After all, you can't correct a problem until you clearly identify it.

In my opinion, the best way to increase hygiene department productivity is to implement an assisted model. A key question to consider is this: How productive would you be if you had to do everything by yourself? If you didn't have qualified assistants to help you, it's likely your production would be cut by half or maybe more. The same is true for dental hygienists.

There are many elements of a dental or dental hygiene visit that are necessary but unproductive, such as operatory setup and turnover, seating and dismissing the patient, scheduling the patient's next visit, and sterilization. All of these elements take time and can be delegated to a qualified assistant.

The typical solo hygienist will see one patient per hour, or about eight patients per day. The typical assisted hygienist will see 12 to 13 patients per day, an increase of 30% to 50%. And the benefits do not stop there. There are two more invaluable benefits with assisted hygiene. First, the hygienist always has assistance in performing those all-important periodontal chartings and recordings. As a result, the hygienist will identify more periodontal problems and schedule more definitive periodontal care. Second, the hygienist never has to wait for the doctor exam but can simply move on to the next patient while the assistant waits with the patient for the exam. This alone makes the model invaluable.

There are a few prerequisites that must be in place in order to implement assisted hygiene. First, you must have two mirrored hygiene operatories that are properly equipped and stocked. Second, you must hire a qualified assistant who is dedicated to the hygiene department only. Third, your schedule must be on 10-minute increments. Fourth, your scheduling coordinator must understand how to engineer an assisted day, and finally, you must be patient with implementation until the model runs smoothly.

Since you have two full-time hygienists, you need to ascertain if you have sufficient demand to keep them both busy. It takes 800 to 1,000 patients to keep one full-time hygienist busy.

Your challenge is to clarify what is causing the problem of low hygiene productivity and then to implement a workable solution.

All the best,


Dianne Glasscoe Watterson, MBA, RDH, is a consultant, speaker, and author. She helps good practices become better through practical on-site consulting. Please visit Dianne's website at wattersonspeaks.com. For consulting or speaking inquiries, contact Dianne at [email protected] or call her at (336) 472-3515.

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