Exceptional Dental Practice Management

Holy Hygiene

Actually, I meant holey hygiene.  I hear more and more dentists and staff members wondering aloud about where this economy is going to take us.  And they're right to wonder.  What's not right is sitting around waiting for it to happen to you or your practice.  Like I said in my last post, What are you waiting for?  Don't wait for the tides of fate to wash in and drag your hard earned success away, meet it head on and swim with it, don't drown because of it.  And don't let it wash away any of your team members, either.  Team members; don't sit around waiting to be rescued, you can take these tips back to your offices and get things moving yourself.

The way I see it, people are responding to high gas prices, high food prices, lay-offs and the terrible housing market buy cutting costs.  They are looking for things that they think are not that important and putting them off.  For some reason, bi-annual recall visits seem to be falling into that category.  I do notice that the same person will not dream of pushing her hair appointment back a week though.  That's because so much of how we think others perceive us is all about how we look.  They don't realize that good, timely dental care can preserve a youthful, healthy appearance and ward off gum disease and tooth deterioration.  The first thing I did when I noticed some holes in our hygiene schedule was to use that time to our advantage.  I lengthened appointments so that the hygienists could take extra time educating their patients and answering their questions.  A hygienist who has a good manner while educating patients can be an awesome marketing tool. They can make the patient understand that pushing off hygiene appointments can end up costing the patient more in the long run than it saves for the moment.

Next, I looked at it from the patient's point of view.  What can we do to help them and to help them save money.  Not every patient needs to be examined by the dentist at every 6 month interval if they have been decay free, have a low plaque score and keep regular appointments.  So, on these individuals, if the hygienist does not see any problems and the patient asks to skip the exam, we do, but he will examine at the next appointment and he will review any x-rays that were taken.  It's better for someone to see them, than to lose them for the prophy, too.  For others, who seem to have endless decay and breaking down teeth, we try to help them prioritize and work with them to get the work done by using an in-office payment plan or a lending company like Capitol One or Care Credit. 

We also developed a few very individualized appointment types.  We noticed that a lot of our patients in braces were not doing such a great job with their home care.  We offer an oral hygiene instruction appointment with the hygienist.  She will demonstrate floss threading, proxabrushing, proper brushing and flossing technique, give a fluoride treatment and talk to the Mom about products that can help.  It's a 20 minute appointment that gets the child's and parent's notice.  We usually see improvement when they return.

We offer a caries control/xerostomia control appointment for our older patients.  We have them come in three months after their regular prophy and do a prophy cup polish, proxabrushing, fluoride treatment, and again go over homecare and products that can help.  We give them a Collis Curve toothbrush if it will help or a battery-operated spinbrush if that seems better suited to them, depending on dexterity.  We also give a very nice sample of Biotene, that we receive free for the asking from Biotene. 

We/ve just added a sensitivity control appointment.  With so many patients bleaching their teeth these days, we noticed that many are dealing with sensitivity.  At this appointment the hygienist will do a fluoride treatment and apply desensitizer.  She will also go over some Omni products that we carry that can help with sensitivity.  We've had a great response with Soothe Rx.  Patients have told us that it's the first thing that's really worked for them.

When times are challenging, it's time to think outside of the box.  You can't keep doing what you've always done, because it just won't work anymore.  Respond with win-win ideas and the patients, the staff and the practice will benefit.

The Front Line

    Dental hygienists spend more time looking at the patients teeth than anyone else in the practice.  They basically go over the teeth with a fine-toothed comb, examining every pit and groove and checking margins.  If the dentist is the captain, they are the lieutenants  when it comes to patient education and treatment acceptance. 
    It's great for the hygienist to talk to patients about what they are seeing while they are performing the prophy.  As a matter of fact, at least 60-70% of the appointment time should be spent talking about the patient's oral health.  You have to achieve a good mix of personal relationship building and patient education.  During the time you are scaling, you have a captive audience.  Use that time wisely.  Rather than talking about your love life or your cute cat, tell the patient what you are seeing in their mouth and how it can be improved.  If they have absolutely great oral health, congratulate them and encourage them to keep it up. 
    It's important to develop relationships with our patients and there are times when it's easy to get so involved in talking about our lives that we can forget that part of our jobs is to educate our patients.  Everyone in the office should be ready to do that whenever the opportunity arises.  Spending as much time as they do exploring the mouth, hygienists are the front line in treatment presentation and acceptance.
    Talking to the patient about what you see and what can be done to improve conditions is an important step in being an educator and treatment presenter.  The next step is letting the dentist know what you talked about with the patient, what treatment was discussed and how the patient reacted.  Then, it's basically a matter of the dentist coming into the room, doing his exam, and confirming the conditions and giving his recommendations.  Hearing both the hygienist and dentist express the same opinion, helps the patient understand and appreciate the need for treatment.   A hygienist that can do that is a true partner  in providing care for the patient.

Appreciation For Our Hygienists

    I realized that I've been bragging about our new dental assistant and our receptionist a lot lately and I  haven't mentioned our fantastic dental hygienists.  I certainly don't take them for granted and am very proud of having such great people on our team.  What makes them great?  Let me tell you.
    They are team players.  They do whatever needs to be done.  They don't think they are on a different or higher level than the rest of us.  They work hard and cheerfully.  When we run late, they never grumble and they stay as late as everyone helping others finish even after their chores are done.  They take out the garbage and help set up the dentist's operatories.
    They care about their patients.  They spend time thinking about ways to help them improve their oral health.  They consider what their patients are going through in their lives and they try to help them.  One man called the office the other day to cancel his wife's appointment.  His wife has Lou Gehrig's disease and she can't make it to appointments anymore.  He said he'd keep his appointment, but he was obviously distraught on the phone.  I relayed this to his hygienist at morning huddle.  When he came in she began his prophy and he started to cry.  She stopped what she was doing and held his hand until he was composed.  She let him know she was sad for him and gave him some caretaker information she had gotten together in advance.  That's how you treat the whole patient.  For a minute, someone shared his burden. 
    One of our hygienists has been going through a health crisis regarding her husband who was diagnosed with lung cancer.  You'd never know it.  She finds refuge and escape in caring for her patients.  It is a time when she can put aside her worries and focus on caring for her patients.  She is pleasant to work with and the definition of grace. 
    I could go on and on.  We have a great team and we work for a great person.  We inspire each other to be our best and keep the bar high.  How can you get what we have?  Develop your vision and state your intention.  Keep doing it.  Some will fall away and new ones will arrive that will want what you want.  You just have to start.

What A Great Rep!

    We had a great lunch and learn with our Omni rep Amanda Hatfield today.  She has a master's degree in hygiene and was full of great advice and really got the team interested in what she had to say.  She was full of enthusiasm for what she was doing.  Talk about great patterns!  She cared as much about our practice as she did about getting a sale.  I see a great relationship between Amanda and our practice.  That's because she listened to what we wanted and needed and responded appropriately. 
    That's how to succeed with people.  Listen and hear and then respond in a way that shows that you understand what's important to them.  She was smart enough to realize that by walking away without an order today, she was setting herself up for many orders in the future.  We need time to sit down and decide what to do with what she told us today.  Think about Amanda when you are dealing with employees or patients.  If you are an employee, apply the same to feedback you are getting from your manager.  Listen to what they are saying they want you to do.  That is what is important for them to get from you.  Show them you understand by taking the appropriate action in response to their request.  One key to success is discernment.  Figure out what's important and go from there.  It makes what you're doing more exciting and satisfying and makes working with you invigorating.

Be Good For Everything

    I've read a lot these days about how to get dental hygienists to present treatment to patients.  It seems that many dentists are finding that their hygienists are reluctant to talk to patients about operative procedures and restorative needs.  I don't think it has anything to do with whether the hygienist is a recent graduate or has been practicing for years.  I think it has to do with the hygienists' confidence in their knowledge of operative dentistry.  If you asked me, as a dental assistant, to discuss scaling and root planing, I have to tell you I would be much more comfortable talking to the patient about a root canal treatment or crown prep.  On the other hand, if my dentist told me that he was going to begin requiring me to be able to expertly discuss scaling and root planing, I would find a way to make myself very familiar with the treatment.  I would do this by asking our hygienists about it and by reading about it. 
    I think hygiene is such a specific discipline in dentistry that to expect hygienists to feel very comfortable discussing operative needs without educating them about it and letting them observe procedures is self-defeating and frustrating.  Our hygienists are learning to assist with some procedures and that helps them feel more comfortable and knowledgeable about those procedures.  I think it is wise for hygienists to show an interest in learning about other areas of the dental practice.  As a matter of fact, everyone should try to find ways to be useful and knowledgeable about all areas of the practice.  This makes a more cohesive team and ramps up the value of each employee.  A hygienist that can and is willing to educate patients about all aspects of oral health is a great asset to her practice and the rest of the team.  It is also good for the dentist's treatment recommendations to be supported by every member of the team.  It is especially helpful to have morning huddles where the team reviews the patients for the day.  Then if anyone does not understand a patient's treatment plan they can ask for more information.  It helps to ensure that patient's are spoken to regarding the treatment that is in their best interest.  Documenting conversations with the patient about treatment is vital.  It let's everyone know what the patient has been told and what their response was.  Hygienists who involve themselves in all aspects of patient care can feel greater inclusion in the team and in the effort to keep the patient in good oral health.  Everyone is great at something, but everyone can be good for everything.