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Trojan Today Classic: “Consultant’s Corner: Dental Hygienists” by Lisa Philp

Trojan Today Classic: "Consultant’s Corner: Dental Hygienists" by Lisa Philip

Originally published December 2008 in Trojan Today.

It’s time for dental hygienists to play a larger role in the dental team. In order for a dental practice to play (and earn) in the big leagues, dental hygienists need to be recognized and honored as highly valued members of the team… 

This isn’t always the case. For far too long, dental hygienists have been viewed as “cleaning ladies” not only by patients but also, too often, by the dentists they work with. This shortsighted attitude leaves dental hygienists stuck on first base, with low morale, high levels of burnout and heavy turnover, and maybe seething resentment to boot. It’s not the formula a successful dental practice is looking for.

The attitude of patients toward dental hygienists is a simple reflection of the prevailing view of the dental profession as a whole. Those in the profession have been trained to think in terms of a hierarchy, with the hygienists sharing space with the receptionist at the very bottom of the totem pole.

Patients don’t think twice about canceling an appointment with their dental “cleaning lady,” and it’s demoralizing for the hygienist when yet another patient cancels yet another hygiene appointment at the last minute with a lame excuse.

It’s also bad for the dental practice as a whole.

The skills a good hygienist uses on a daily basis are undervalued. Those skills include critical thinking, problem solving, goal setting, and helping patients achieve those goals. 

Fortunately, with a clear vision and a few simple steps, this entire paradigm can be turned around.

Imagine, for a moment, having such a clear philosophy and system in place that the hygiene coordinator answers the phone and takes the majority of cancellations. The hygiene department could then communicate from a place of knowledge and say to the patient who is canceling an appointment:

“This is the time you reserved today, Ms. Brown. The sequence of your periodontal maintenance is very important in preventing you from going back to an active state of infection.” Such a comment immediately makes the patient sit up and take notice.

It’s a gentle reminder of the importance of making a commitment to regular dental care, and it’s a comment that commands respect.

To put a highly effective system in place:

1. Define your hygiene philosophy

Starting with a philosophy of prevention, the dental hygienist needs to be part of a coherent and comprehensive philosophy and system. This philosophy and system should be agreed to by each person in the dental practice and be fully supported by the team. The team needs to meet on a regular basis to discuss what’s working and what isn’t and to modify the system whenever necessary. It adds to a practice’s credibility when there’s a consistent team approach. It’s important every member of the dental team be absolutely clear and understands what it is the hygiene department does on a daily basis.

2. Have a clear cancellation philosophy

Part of the overall philosophy should be to have a clear cancellation policy.

  • Does a patient who misses an appointment without sufficient notice get billed?
  • Do you require 24 or 48 hours notice?
  • Is there discretion in these cases? If so, under what circumstances? 

The goal is to have your hygiene department operating at less than 10% downtime. (Many run from 15-30% downtime.)

Your cancellation policy needs to be in writing and explained to your patients regularly. As part of your internal policy, if someone cancels at the last minute and wants to reschedule, don’t reschedule for a minimum of four weeks.

3. Rate your patient

Classify your patients based on their appointment history as an A, B, or C patient. Use this classification system to modify your cancellation policy. In other words, if an A patient cancels an appointment at the last minute for a valid reason, don’t charge that patient.

If a C patient cancels yet again, the patient needs to be clearly informed of your cancellation policy and charged accordingly. It’s probably the C patient that causes the most grief in a dental practice. C patients need to be educated by the dental team so they have the opportunity to become A patients. They may not realize last minute cancellations are not acceptable.

4. Know and care about your patient

Could you or anyone on your team look at your day sheet and know the oral health status of every person coming into your chair? Could you, for example, say, “I have three healthy adults, two active therapy, and three periodontal maintenance.” If patients feel they’re seen as whole people and “not just another mouth,” they’ll take their dental care more seriously. If they feel part of the decision-making process in terms of their oral health, chances are good they’ll be A patients; and the dental hygienist will be perceived as a recognized health care professional who helps adults, children, and teenagers reach their goals for their teeth, mouths, and smiles.

5. Take a team approach

When any member of the dental team can look at the day sheet and know whether this patient is healthy, actively in treatment or periodontal maintenance, then the practice runs much more smoothly. When the patient calls in, everyone on the team will speak the same language and give the same message. This solid team approach means the practice will run much more effectively and can generate a healthy income without increasing the patient load.

Implementing these five steps will ensure dental hygienists will not only step up to the plate but also consistently strike home runs.

FMI about Lisa Philp, visit her profile at


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