What if Your Hygienist Leaves?


It’s probably happened at least once in your career. You have a fabulous hygienist on board that is proactive, organized and just gets things done. The hygiene department is moving along nicely. It’s productive and serving patients at a high level. Then WHAM! Out of the blue, your hygienist decides to leave. Whether for professional or personal reasons, this happens from time to time. The good news is all your hygiene protocols CAN stay in place when that hygienists leaves. Providing you’ve completed a few critical steps.

Step 1 – Create a clear Standard of Care-Be sure to have clear standards for everything from how often periodontal diagnostic data will be collected to when you recommend adult fluoride (or other preventive products). Include how you define health versus disease and when you move a patient into active perio treatment. To get you started go to www.InspiredHygiene.com/standardofcare and download a Standard of Care template.

Step 2 – Write it Down-You’ve heard the phrase ‘If it’s not documented, it never happened’. This applies here too. You can talk ‘til your blue in the face but if you don’t develop your standards as a group and write them down, then each team member will create their own. We see this all the time, especially in teams of 3+ hygienists. Each one is doing something different. We help them all get calibrated and create written protocols and systems.

Step 3 – Be Clear When You Hire-When you’re interviewing a new hygienist, present them with your Standard of Care and your perio protocol. Be very clear that you expect them to uphold what’s in place and you can also say ‘And we hope you’ll make this program even stronger’. This gives room for the next hygienist to add his/her own knowledge to your existing program.

I’m assuming that you have a proactive, written perio diagnosis and treatment system in place that is up-to-date and comprehensive. If not, maybe the next hygienist really can take it to the next level. You just never want to go backwards.

Step 4 – Check In-Let your team know that you’ll do periodic chart audits to help keep everyone accountable. Go through 5-10 charts every few months to ensure that the standards are being implemented. And if they’re not, find out what obstacles are in the way and work to clear them.

For example, it might be that you agreed to take one intra-oral photo on every patient but there’s only one IOC in the practice and it’s difficult to get it all set up and ready to use. This is an obstacle.

Step 5 – Track it and Celebrate Your Success-keep track of how well you’re upholding your standards and celebrate your team! If you have a new hygienist that has stepped in and picked right up on your perio protocol, point that out and acknowledge them…big time!

Stay Inspired,

A little inspiration from California


By now we all know the power of positive thinking and proactive behavior!  Henry Ford said, “Whether you think you can, or you think you can’t–you’re right.”  Having a can do attitude is the very first step when endeavoring to make a change.

This high performing team from California certainly thought they could and they were right!  From the moment their first two days of training were over they set their intentions for practice wide change and positive patient response.

What has impressed me the most with this group is watching proactive team members take the lead.  Everyone on the team has stepped up to the plate and taken the lead in one way or another with the result being successful implementation.

Take a moment to appreciate their success and ask yourself if there is a way you could be more proactive in your practice?  Is there an area in your practice where you could lead the way?

Great leaders pull, rather than push!

It’s my pleasure to introduce you to the ‘high energy’ team at Hillsdale Family Dental!

With coaching and full support from their great leadership team in just 3 ½ months this amazing team has:

  • More than tripled the amount of perio therapy performed
  • Incorporated the use of locally applied antibiotics comprehensively to 9x greater than the previous year
  • Increased hygiene production by an average of $50/hour/RDH
  • Refined verbal skills, treatment planning and enrollment within a large team including 3 doctors and 5 hygienists
  • Enrolled an average of 4k/day in restorative out of hygiene
  • Added additional hygiene days and a hygiene assistant (they love you Hector!)

Stay Inspired,

Don’t make me feel guilty!


Think with me for a moment, if you will, about the first few minutes of a typical hygiene visit.  We seat and greet the patient and while doing so we typically ask about their homecare.  In my experience, most of the time that question sounds something like this, “How have you been doing with your brushing?” or “How many times a week do you floss?”

The patient often responds with a confession of sorts; admitting that they don’t floss or brush nearly as much as they know they should.  With that admission, they feel guilty because they really do know they should take better care of their teeth and gums.

Another scenario might be that the patient lies and tells you they brush and floss daily thinking that will buy them a reprieve and you won’t address their homecare.  However, by lying, once again the patient feels guilty, because they were taught, probably by their mother not to lie when they were 3 or 4 years old.  Either way, the golden hygiene hour just started off with a guilty patient who either confessed or lied.

What if we could completely avoid the possibility of the patient feeling guilty and instead create an opportunity for patients to feel good about themselves?  What if we asked a question like this, “Tell me what you do on a daily basis to take care of your teeth and gums?” Now the patient has a chance to brag on their homecare efforts.

Here’s the tricky part! Regardless of what the patient tells you, pay them a compliment and ask another question.  “That’s great, I’m so glad you get flossing in once a week.  Do you every see pink (bleeding) in the sink?”  If no, compliment them again.   “That means you’re doing a great job in all the areas you can effectively reach.  I am going to check the areas you can’t reach to be sure they are healthy too.”

If the answer is yes, “Can you tell me where the bleeding is coming from?  I’m going to be very careful during my evaluation to determine why you are seeing signs of infection in your gums.”

Either way, this is no longer a guilty patient.  This patient is reassured by your professionalism and may even feel proud of their efforts; after all you just paid them a ‘homecare compliment’, which is more rare than you might think.

Stay Inspired,

What if it doesn’t work?


Today, I’m in Canada! The team I’m working with here is already laughing at my winter ‘gear’ and my pseudo-southern accent.  I’m sure I’ll come back saying ‘A-boat’ and will pick up a bit of their charming French-tinged accent. I can already see my husband rolling his eyes.  I’ll be sure and share photos soon.

Now that the holidays are over and you’re back in the routine at the office, I’m sure you’ll agree this thought has crossed your mind a few times when presenting a treatment plan… ‘What if this doesn’t work?’

What if the patient follows your recommendation but you don’t see the healing you expected? I dare say that about 80% of the time, we think it’s OUR fault. Maybe I’m not as skilled as I think I am…maybe my instruments weren’t sharp enough…maybe, no matter what I do, this patient will never heal and this inflammation will never resolve. The other 20% of the time it’s THEIR fault. They will never floss like they should…they will never stay on the maintenance schedule.

What if it was NO ONE’S fault? What if there was no blame attached at all and you really looked at the big picture?  What if you looked at how you could help your patient address all (or at least most) of what is causing the inflammatory process and gave them tools to help their body respond and heal?

On this month’s Hygiene Profits Mastermind call, we’re addressing this very topic. Our own Kim Miller is speaking on the 4 Pronged Approach. This approach gives you some basic concepts of looking at how your treatment plan must include not only treating disease from the bottom of the pocket up, but also from the top down and from the patients body inside and out.

If you’re not already a member, I encourage you to check us out. The first 2 months are free with no obligation. AND, very soon, this membership will be increasing by 30% and now you can LOCK in the price from 2010 for as long as you’re a member. I hope you’ll join us!

The Four Pronged Approach-
Customized Treatment Planning for Successful Periodontal Therapy

with special guest Kim Miller, RDH, BSDH

As scientific evidence evolves, so must our treatment plans. As we learn more about how periodontal disease activity affects the entire body, it’s important to customize all aspects of care when providing periodontal therapy. During this call, you learn about the Four Pronged Approach, which clearly defines the four critical components of successful perio therapy. Remove one prong, and the treatment is compromised. Join us and learn more about this unique and adaptable approach to treatment planning. On the call Kim will share how the Four Pronged Approach:

  • Helps you understand the four fronts from which you must help your patients fight periodontal disease
  • Shows that comprehensive perio therapy must include more than scaling & root planing
  • Increases case acceptance for adjunctive therapies such as antibiotics, nutritionals and home care products

Date: Thursday, January 17

Time: 1:00pm Eastern

CE credits are provided by Inspired Hygiene.
Inspired Hygiene is designated as an Approved PACE Program Provider by the Academy of General Dentistry. The formal continuing dental education programs of this program provider are accepted by the AGD for Fellowship, Mastership and membership maintenance credit. Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement.
The current term of approval extends from 6/1/2010 to 5/31/2014.

If you’re not already a member of our Mastermind group, the first 2 months are FREE.  Click here to sign up.

Stay Inspired,

How do YOU build value for the hygiene visit?


Here at Inspired Hygiene we talk with many dentists and dental professionals each week. One question we hear a lot is ‘How do I get my patients to value the treatment we recommend?’ Or, ‘How can my hygiene team better build value for the hygiene visit?’

As you’ve heard me say many times before, it all starts with YOU. First and foremost, what value do YOU place in the care you recommend?

Ask yourself a few questions:

  • What do I think is the most important thing about the hygiene visit?
  • What is my obligation to my patient?
  • What can I do for/with my patient that will help them save time and/or improve their health and personal confidence?

If you think the most important part of the hygiene visit is the ‘cleaning’ than that’s the same value the patient will have. And it may be hard to convince them otherwise until something changes in how what you DO and SAY during the visit. If you think of the hygiene visit as a dental health evaluation visit or a periodontal therapy visit or a dental health maintenance visit, don’t you think that has stronger implications of VALUE?

Yes, words make a difference and so do actions. If the patient sits in the chair and you go through the motions of scale, polish, chat and then doc comes in a says ‘Everything looks good’ there may not be much value to them in the appointment. The patient will be more likely to delay or cancel future treatment if anything else gets in the way (money, time, fear). When YOU see the value of digging deeper into their medical and dental history and really talking about their health, they will see the value too.

Here are a few tips for increasing the amount of value your patients place in the hygiene visit:

1-Make it all about THEM. I’m going to be very straightforward here. The hygiene visit is not the time to take advantage of a captive audience and spend 20minutes talking about your personal life. The primary focus is on the patient. If you’re working to build a relationship, ask about them and their interests. Ask about their priorities for todays visit and do all you can to see they are met.

2-Tie in their Risk Factors. This is really the same as #1 but more specific. Ask specifically how they are managing their diabetes, high blood pressure, cholesterol levels or other dental/health concerns. As you are scaling and polishing, talk to them about the latest oral-systemic link article you read about their condition or a recent CE program you attended that made you think of them. Remember, it’s all about THEM. This is a great way to tie in product/treatment recommendations.

‘John, I notice you have a lot of stain this time. Have you changed your Sonicare head lately? That would really help you keep the stain and tartar down between your visits with me.’

‘Mary, I see I recorded your HbA1c last time as 7.5 and today you said it was at 7 at your last visit. Even that small change makes a big difference in your health. I also notice that your gums look great and there’s very little bleeding. I just read an article about diabetes and these two things are related. This is great news for you! Keep up the good work and we’re going to check your gums again in 3 months when I see you.”

3-Tell your patients what you’re doing. Even if you don’t use an adjunct technology for oral cancer detection, TELL your patients when you’re doing a visual oral cancer screening. When you’re about to take bitewings, TELL them you and doc will be looking around all the crown margins to be sure there’s not decay starting.

4-Give them a very clear ‘next step’. Again, your patients will often follow your lead on the value of the next visit AND the sense of urgency to move forward. Recently, I was working with a team and one of the hygienists’ frustrations was that they would tee up restorative treatment for the doctor and then he would say to the patient ‘You may want to think about getting this done sometime this year’. How vague is that. His intention was not to pressure the patient but they need some sense of urgency to move forward. It’s a rare patient that wants to do dental work sooner than the dentist recommends. Be very clear on what the next step is and present financial arrangements and a clear plan for the next visit. If the next appointment is for their prophy in 6 months than remind them that you’ll be checking those crown margins again or that you’ll be evaluating how well that Sonicare is keeping the stain down.

Be specific and make it personal. That creates value!

Stay Inspired,