Hygiene Hotspot: Executing The Ultimate Doctor Hygiene Patient Exam

Executing the Ultimate Doctor-Hygiene Patient Exam

By: Karen Davis, RDH, BSDH

The doctor examination portion of the hygiene visit often lends itself to increased stress, as it emerges as an interruption for dentists and an easy way to run behind for dental hygienists. However, this 5 to 7 minute examination does not have to be stressful! Dentists, your words are “magical” to patients, so be certain to make a clear and concise diagnosis.

Dental hygienists, your time is precious, so prioritize and individualize procedures to suit the patient’s needs. Executing an ultimate experience is realistic, and implementation of these 5 tips will assist in achieving desired outcomes.

1. Rely on diagnosis to direct dental hygiene care

In dental practices across the country, dental hygienists are desperately attempting to educate the patient, change behavior, scale all calculus, remove all stain and biofilm, perform and record periodontal evaluations, update radiographs, apply fluoride, and identify restorative concerns all in ONE prophylaxis appointment that lasts 45 – 60 minutes… IF you get started on time! Sound impossible? It often is.

The American Dental Association has clearly defined the difference between a prophylaxis, scaling and root planing, and periodontal maintenance. Bloody prophys are counterproductive, and do not arrest disease. Early in the appointment, if data collected reveals a periodontal diagnosis, it is easy to determine the need for additional therapy. Informing existing patients of the need for nonsurgical treatment to arrest the disease can be accomplished with clear communication. “We now know that bleeding tissue is an indication of chronic inflammation that can be destructive to your teeth and gums, and can adversely affect your overall health. The good news is that with early diagnosis, periodontal disease can be successfully treated. I’d like to discuss how...”

2. Use visuals to replace wordy descriptions

Patients will understand and retain information significantly better if audible and visual learning take place together. Clinicians should intentionally let “pictures speak 1000 words.” Intraoral photographs, before and after images, radiographs, periodontal records, and educational videos all assist in the co-discovery process necessary for patients to understand and desire treatment recommendations. Use of a hand mirror or an intraoral camera can generate interest and create ownership during screenings by using the phrases such as, “Do you see how this area bleeds easily compared to other areas?” or “Do you see the crack and worn enamel on this tooth?” Patients naturally tend to wait until conditions are worsening or symptomatic before proceeding with treatment, yet we know that is almost a guarantee for treatment to be more extensive and more expensive. The use of visuals can help patients value and desire treatment prior to symptoms.

3. Sit the patient upright for communication

When we are willing to pause, sit the patient upright to describe conditions, use visuals and discuss possible treatment, we actually need to say less because the patient’s ability to hear and retain information is significantly greater with the use of good eye contact and body positioning. Sitting the patient upright also allows the patient to feel more comfortable and ask questions, allowing us to become the listener. Utilize an open-ended question such as, “What concerns do you have about proceeding with this treatment?” to discover objections. Most patients will not proceed until they value treatment and their questions have been answered.

4. Don’t wait until the last five minutes of the appointment to have the exam

In most busy dental practices, waiting until the appointment is finished before notifying the doctor for an exam is nearly a guarantee of running behind. Notifying the doctor once data has been collected and potential treatment discussed enables the dentist to look for a natural break in a procedure, pause the hygienist during his or her treatment, perform the examination, then both return to completion of their treatments. Utilizing a computer messaging system or light system is advantageous in notifying the dentist for the exam without abandoning the patient to go find him or her. Ideally, the doctor’s exam will happen approximately halfway through the hygiene appointment, not at the end. Patients should hear the doctor asking for a synopsis of findings from the dental hygienist, and his or her findings should be a summary of Data collected, Discussion related to potential treatment, and Response from the patient (DDR). This enables a thorough and efficient relay of information and examination.

5. Ask for a commitment to treatment

In the treatment room, where value is created and treatment recommendations are made, prior to handing the patient off to an administrator, clinicians need to ask a closing question such as, “So, James are you ready to get started?” Even when the product we are “selling” is optimal oral health, asking the patient to make a commitment fosters ownership of their health.

ABOUT THE AUTHOR

Karen Davis is founder of her own continuing education company, Cutting Edge Concepts®, and currently practices dental hygiene in Dallas, Texas. Her background as a clinician, consultant, coach, and speaker enable her to identify with challenges facing dentistry and offer innovative solutions vital to success in today’s marketplace. Dentistry Today has consecutively recognized Karen as a “Leader in Continuing Education” since 2006. Karen received her Bachelor of Science in Dental Hygiene from Midwestern State University. She is an accomplished author, maintains memberships in numerous professional associations, is a key opinion leader to various dental corporations, and currently serves on several advisory boards. Karen is a native of Texas, and enjoys sharing her passion with audiences to practice On The Cutting Edge.