Volume 5, Issue 5

If you have a hard time reading this e-newsletter, hit this link and you will be taken to our website for easier readability.

The Hygienists Role in Creating Value for Restorative Treatment

This issue of Practice Prosperity is the 3rd in a series that explores the concept that a slight shift in the role of a dental hygienist could lead to a significant increase in effectiveness, productivity and job satisfaction. This issue will focus on how an effectively orchestrated recall exam can help the patient, whom we will call Mrs. Jones, better understand the value of the proposed treatment. This ultimately will make a huge impact on the practice’s bottom line.

Mrs. Jones was in 6 months ago for hygiene, her last recall exam and hygiene treatment was 12 months ago, and her new patient exam and initial hygiene therapy was 24 months ago. Her new patient exam consisted of an intra/extra oral assessment, panorex, two horizontal bitewings, charting of current conditions and recommended treatment, complete with discussion of which area to focus on first. This was a comprehensive, well planned exam.

Mrs. Jones completed the recommended hygiene therapy and has been a committed hygiene patient for the last two years. However, she has never proceeded with treatment. Unfortunately, this scenario is very common in dental practices and often results in pages of pending appointments and unscheduled treatment plans. How do we change this?

Chart Review

Most hygienists do a basic chart review each morning. Doing a more thorough chart review the day before uncovers issues that may have gone unnoticed such as unscheduled treatment, chronic disease, missed appointments, etc. This information can then be shared with the rest of the team at a morning meeting, better preparing all team members to meet their patient’s needs.

Let’s look at what’s working well with Mrs. Jones:

• At the beginning of her relationship with us, Mrs. Jones committed to 3 month appointments to get the gingivitis and periodontal disease under control
  

• As Mrs. Jones diligently follows our oral hygiene recommendations, we are now able to maintain her periodontal health with 6 month visits

• Mrs. Jones has not missed a hygiene appointment in the two years she’s been our patient

• As a diabetic, Mrs. Jones is keenly aware of the role her gingival health plays in her overall health.

Let’s begin by looking in depth at a hygiene appointment. Regardless of the appointment length, we recommend breaking the appointment into 3 segments. For the purpose of this newsletter we are using a 60 minute appointment as a template.

Segment 1

Allow 5-15 minutes for this first segment of the hygiene appointment.

The components of this appointment include:

• Seating the patient
  
  
• Briefly catching up socially
  
  
• Inquiring about health history changes
  
  
• Ensuring pre-medication was taken if required
  
  
• Completing diagnostic records
  
  
• Having the most recent x-rays ready to be viewed.

The Power of the Intra Oral Camera

Inquiring about health changes, taking x-rays, and doing a periodontal assessment as required are likely habitual components of the hygiene appointment. Doing an intra oral video tour and taking photographs is less likely to be performed.

Traditionally, patients relied on the opinion of the dentist as the deciding factor in committing to restorative treatment. People are faced with many choices when considering where to spend their discretionary dollars. It’s our responsibility to help our patients see the value in the dental care we are recommending.

The intra oral camera can help us do that. When a patient sees what we see, they become more comfortable in making a buying decision. They can rely on their own judgment coupled with our knowledge and expertise. Perhaps this is what was missing during Mrs. Jones new patient exam…she couldn’t see what we were talking about so didn’t have the confidence to go ahead with treatment.

The photos we take are a crucial component of the
co-diagnosis/co-discovery process. A patient will become more curious about possibilities for improved health, function and aesthetics when they can see what exists in their mouth. Ask relevant and thought provoking questions. A patient will feel that you are working with them rather then pressuring them into making a decision they don’t feel ready to make. Give your opinion, constantly referring back to the photos as you speak. Establishing yourself as the patient’s advocate allows them to feel more comfortable asking questions and sharing concerns.

Segment 2

Allow 30-50 minutes for this second segment of the appointment.

The components of this appointment include:

• Continue discussion about possibilities for restorative treatment
  
  
• Scaling and root planning
  
  
• Oral hygiene education
  
  
• Polishing
  
  
• Medicaments, fluoride treatment
  
  
• Recall exam
  
  
• Enter treatment and notes into chart/computer
  
  
• Provide relevant information regarding treatment recommendations as you continue hygiene therapy and show Casey or other learning aids.

The Recall Exam

At any point during this segment of the appointment the dentist can enter the room to do the recall exam. The exam should only take 4-6 minutes. The hygienist begins with a concise transfer of information to the dentist, including Mrs. Jones concerns, and then charts all treatment recommendations made.

Once the exam has been completed, the hygienist can resume hygiene therapy. This time can be used to provide further information for the patient on the recommended treatment. If there is an overhead monitor available, the recommended treatment can be shown on Casey.

Segment 3

Allow 5-10 minutes for this third segment of the appointment.

The components of this appointment include:

• Answer any further questions the patient might have about what they have seen or heard
  
  
• Schedule next hygiene appointment
  
  
• Schedule  restorative treatment appointments or transfer that information to the appropriate person
  
  
• Establish a follow up plan if they don’t schedule today
  
  
• Reassure the patient that you are available to help them through this process
  
  
• Review treatment and notes in chart/computer and add additional information
  
  
• Give patient home care aides.

A dental hygienist has the skills and education to improve the health of gingival and periodontal tissues. What if they also embraced the role of patient advocate, helping patients better understand and commit to getting comprehensive dentistry performed? Knowing that each person that was seen in their hygiene chair left more knowledgeable and empowered would make their role even more fulfilling.  Imagine the possibilities this would provide for your practice… 

The next issue of Practice Prosperity will address Patient C, a patient who has not been in for 5 years, and ‘just wants a cleaning’. We will focus on reconnecting with this patient, helping him discover the possibilities for health.

Learn more about creating the ideal recall exam
by calling our office for a complimentary
30 minute phone consultation.

Co-authored by CoraMarie Clark and Mitch Peters

About the Author

CoraMarie Clark, BSDH MBA is recognized as a highly effective dental practice strategist. She works with dentists that want to optimize their potential both personally and professionally. Her collaborative approach has helped teams develop dynamic competitive strategies and achieve high impact sustainable results.

If you would like to explore the possibility of having CoraMarie work with your Dental Practice or speak for your Association or Group, contact us today.

CoraMarie Clark
phone 403.686.6136
email coramarie@strategix-ltd.com
web strategix-ltd.com

Please feel free to forward this newsletter to your friends.