Hygiene benchmarks

March 1, 2004
In my January column, I outlined several benchmarks for hygiene goals, such as a mix of services, types of patient, and productivity ratios.

Annette Ashley Linder, BS, RDH

In my January column, I outlined several benchmarks for hygiene goals, such as a mix of services, types of patient, and productivity ratios.

Another important goal is the hygienist's role in case acceptance.

While each member on the dental team needs to be enthusiastic and well-versed in discussing the benefits of contemporary dentistry, the hygienist plays a pivotal and important role. Trust, confidence, and mutual respect are built over time, and it is the hygienist who sees the patient on a continuum every three, four, or six months.

Patients often look to the hygienist for help in decision-making, asking for feedback after the dentist presents a treatment recommendation. "Do I really need this? What would you do?" are frequently asked questions. It is estimated that 50 to 75 percent of dentistry is generated at the hygiene (recall) appointment. Nevertheless, this cannot happen without clearly defined doctor expectations. It is all about communication.

Here are some ideas to consider if this is an area in your practice that needs improvement:

* Communication between doctor and hygienist. Many hygienists tell me they are not sure of the doctor's expectations when discussing dentistry with patients. Overcome this obstacle by meeting with your hygienist in a comfortable and supportive setting to answer questions and clarify doctor expectations. Hold staff meetings to review the latest in dental techniques and materials. Regularly scheduled meetings (not a rushed 20-second conversation in the hallway between patients) provide opportunities to explore new ideas, encourage initiative, and revisit goals.

* Communication between hygienist and patient. Hygienists continually work to educate the patient about optimum oral health. In the same way, the hygienist may prompt a restorative/aesthetic treatment discussion by asking open-ended questions, such as: "If you could change anything about your smile, what would it be?" or "I am so excited about the dentistry that we are able to provide. It is changing our patients' lives."

* Communicating with visual aids, such as the intra-oral camera, digital imaging, professional brochures, before-and-after photos, and computer-based patient education programs. If you have technology in the office, is it being used in every situation where appropriate? In many practices I visit, the intraoral camera is typically used at the new-patient comprehensive examination ... and then it gets buried. Two common reasons hygienists don't use both high-tech and low-tech marketing tools are:

1) "No time."
2) "I'm not really sure how to use it. We learned when we first got the camera, but since I don't use it regularly ..."

These situations are easily remedied with staff meetings in which the team role-plays, with each person having a chance to be "the patient." When was the last time you sat in the dental chair? How does it feel to be the patient?

Once they are comfortable with its utilization, most hygienists will not part with the camera. It's the best tool for educating, motivating, and case presentation, and it builds compliance.

A picture is worth a thousand words. Are the before and after pictures of the exquisite dentistry you perform out in front of your patients' eyes? Daily audit reviews of the patients' records enable the hygienist (and the entire team) to identify treatment plans that have not been started or completed. Orchestrate and plan the day so all tools (camera, visual aids, staff, etc.) are in the treatment room, ready to go, to proceed with discussion that day .

* Audiovisual patient education programs (such as CAESY) with voice commentary and pictures. These programs are effective because patients "listen" even when they are not "watching." Again, you are setting the stage for discussion and commentary. When the doctor arrives for the exam, the hygienist reports preliminary findings, patient concerns, and then reviews any suggestions that are made. As a result, the doctor knows exactly what has occurred and can continue the dialogue in a timely fashion. If you have these systems in your practice, are they being used continually ... or is the monitor running television shows?

Throughout the country, the most successful and productive practices are those in which the hygienist is an ambassador for the practice and a cheerleader for the team. Working in concert with the doctor and sharing and promoting the same vision results in maximum personal, professional, and productive rewards for everyone. Once the lines of communication are open, it is easy to achieve these goals.

Annette Ashley Linder, BS, RDH, is a recognized leader in the field and an award-winning speaker and consultant. Since 1989, she has presented more than 350 seminars and consulted in dental practices throughout the world. She is a featured speaker at dental meetings and provides in--office consulting services with her team of business and clinical consultants. She may be reached at her Web site at AnnetteLinder.com, via email at [email protected], or by phone at (804) 745-6015.

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