The Formula for Profitable Hygiene

Wendy Briggs, RDH

Changes in the dental market over the last few years have significantly reduced hygiene profitability in most places. Practices face rising overhead expenses, higher wages, and stagnant or falling reimbursement for hygiene services. Attempts made to address these profitability challenges by shortening or double-booking hygiene appointments have only reduced the quality of care we provide and furthered the growing divide between dentists and hygienists.

How can we provide patients with the best possible care, while also increasing hygiene profitability to a sustainable level for the long-term success of the practice?

The solution to today’s hygiene challenge requires focusing on increasing profitability, effectiveness, and production. These may sound redundant and nearly impossible to achieve, but at The Team Training Institute, we teach specific strategies and solutions that help practices achieve each of these key hygiene goals.

INCREASE PROFITABILITY

With insurance fees remaining low, we have to find a way to continue to provide our patients with the same level of service, or higher, while also increasing our profitability. One of the most impactful ways to increase profitability is to do more same-day dentistry – both preventative and restorative. Combining services that may have been previously provided in 2 separate appointments into 1 reduces your overhead expense and increases profitability per visit. Offering services same-day will also increase your acceptance rate with busy patients who don’t want tomake the time in their schedule to come back for a second visit.

The key to adding more same-day dentistry is to identify every opportunity to serve patients at a higher level and present those opportunities to the patient. We often see team members reluctant to present additional preventative services like fluoride and sealants because they feel as if they don’t have the time needed to complete these procedures. Many also have the misconception that patients won’t pay for what insurance won’t cover. Not only have we seen the evidence in thousands of dental offices that this is not true, but when patients understand the value of the care you are presenting, they appreciate the opportunity to improve their oral health and reduce their risk of needing future, more invasive treatments.

Success in serving patients at a higher level requires us to define and embody our role as a preventive therapist. This focus on prevention is critically needed today as the World Health Organization recognizes the “rapidly changing disease patterns throughout the world are closely linked to changing lifestyles which include a diet rich in sugars, widespread use of tobacco, and increased consumption of alcohol.” With oral disease highly related to these lifestyle factors, patients need us to provide protection for their teeth, in the form of preventive services, that can help offset their risk of oral disease.

We help providers implement key systems for time management that enable many simple preventive services to be completed during the scheduled recall visit. When offering preventive services, or any dental services, most patients prefer fewer visits not more. When you use language like “If possible, would you

like us to take care of this today?”, you’ll be surprised how many patients jump at the chance when offered. Preventive services often extend the appointment time by just a few minutes, if at all. Restorative services should also be offered same-day when feasible, and be upfront with patients about any expected wait time.

SECRET TO SAME-DAY SUCCESS

• No nesting! Be prepared to work out of any room, at any time.

• Every room is equipped and supplied the same.

• Set-ups for fluoride, sealants, and desensitizing agents are always prepped and ready.

RESULTS

Tonya, a hygienist we worked with in Dr. Greg Ayer’s practice, placed 33 sealants using the same-day process that we teach at The Team Training Institute. None of those sealants had been scheduled ahead of time, all were offered and completed that same day! That’s 33 teeth that are more protected now than they would have been without Tonya’s intervention, all of which were completed the day they were diagnosed.

Janet, a hygienist we work with at Downtown Dental Group in Honolulu, is truly excellent at protecting her patients from cavities. Recently, Janet protected more than 90 teeth in one day using the systems we teach.

Many of our providers are also helping patients with early cavities arrest the progression of their incipient lesions and harness new technology to remineralize the enamel. Practices have had as many as 29 of these services provided in one day, again all of which were not on the schedule but completed once diagnosed.

All of these providers are not only improving the profitability of their practice and optimizing their roles as preventive therapists, but they are truly helping patients with their commitment to providing world-class care.

INCREASE EFFECTIVENESS

Our effectiveness as a hygiene provider should be measured by our impact on patient health. Increasing that effectiveness and maximizing our ability to improve patient health requires us to understand the needs of our patients. We need to know what lifestyle factors they have that may increase their risk of oral disease and what systemic health conditions may be impacting their oral health. This deeper understanding of our patients cannot be achieved without a process for risk assessment.

Consistently using a risk assessment tool with patients helps them better understand their risk factors, how their risk can change over time, and how preventive services can reduce their risk. A basic risk assessment, including both a quick scan of the mouth and a few questions for the patient, can typically be completed in less than 2 minutes. The scan of the mouth should note any deep grooves, exposed root surfaces, history of decay, and white spot lesions. Questions for the patient should include medications that might cause dry mouth, vaping, snacking, and soda habits. Education is critical to helping patients understand the connection between these risk factors and their oral health.

Given the prevalence and mass consumption of sugary, low pH beverages, hygienists should be capable of explaining the cavities infection process in non-technical language that patients can understand. Keeping it simple is best, but a clear connection between sugar exposure, harmful bacteria, and pH of the mouth will help move patients to reduce their risk and hopefully make more informed beverage decisions in the future.

SECRETS TO RISK ASSESSMENT SUCCESS

• Graphics that show the pH of popular beverages and sugar content of common products are an extremely effective part of this discussion.

• Use the latest research regarding risk factors that relate to each individual patient.

• Presenting visuals of clinical symptoms with a digital scan or intra-oral camera helps patients accept recommended solutions.

• Request a copy of The Team Training Institute’s Risk Assessment Tool by completing the contact form found at theteamtraininginstitute.com/contact with “Risk Assessment” in the message field.

RESULTS

Sonali, a hygienist with Commerce Village Dentists, increased her fluoride acceptance rate to 85% in her first month after implementing a risk assessment process.

INCREASE PRODUCTION

Higher hygiene wages are a reality that does not appear to be changing anytime soon and hygienists are not going to become less critical to the success of dental practice. The simplest solution to maintaining profitability while paying higher wages is to increase hygienists’ production. Increasing production does not equate to unnecessary procedures, it simply means we are helping patients choose a higher level of care, consistently. We see patients day in and day out who need our help, but often opt out of our assistance. The results of the risk assessment give patients a compelling reason to make good preventive care decisions. These decisions should include services such as fluoride, sealants, bonded protective agents, guided enamel remineralization, and radiographs. Maximizing these services drives hygiene production while delivering a higher level of care for our patients.

When hygienists are using a risk assessment to identify patient needs, providing those needed services same-day to increase acceptance, and growing their production as a result, they should be compensated for their contribution to the practice’s profitability. Rewarding your team’s achievements helps engage and retain your current team and is a great recruiting tool. The key is to reward and compensate in a way that is sustainable for the long-term profitability of the practice. We have found that a production-based compensation model benefits hygienists, the practice, and the patients. Rewarding a higher level of care is one of the secrets to profitable hygiene.

RESULTS

We regularly see hygienists’ production per visit jump to $300$400, depending on their market. Production is not the focus, instead, it is the result of elevating the care we provide day in and day out. The most rewarding part of this is that patients receive a higher level of care.

For help implementing this formula for profitable hygiene in your practice, visit theteamtraininginstitute.com.

Wendy Briggs, RDH is a practicing hygienist, strategic advisor, speaker, consultant, and best-selling author. She is the President and Founder of HygieneDiamonds as well as the President and Co-Founder of The Team Training Institute. Wendy’s excellence as a hygienist and patient care advocate has directly influenced more than 3,718 dental practices in 12 countries. She has a proven track record of supporting dentists, hygienists, and their teams in increasing patient care and doubling hygiene production.

wendybriggs@thetti.com