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Have You Analyzed Your Hygiene Department Lately?

The dental hygiene department is one of the biggest parts of every successful dental practice! Many dental practices have dental hygiene departments that do not produce at least 30% of the total office production. Why does this occur? Does the hygiene department have numerous cancellations each day? Does the hygiene department co-diagnose non-surgical periodontal treatment? Does the hygiene team suggest same-day services to patients? Do they recommend home-care products? The following are only a few examples of protocols, which add to increased profits in the dental hygiene department and add to the bottom line of every dental practice.

New Patients

New patients are also a crucial part of every successful and profitable dental practice. What does it cost for you to schedule a new patient in your dental practice? What is a new patient worth to your dental practice? There is a normal attrition of new patients annually. This can mean that 10-15% or your patients move or decide to go somewhere else due to finances, loss of insurance plans or other unknown reasons. What are you currently doing to keep the patients continually entering through the front door of your dental office?

Patient Retention

It costs the office less money to add value at the time patients are in the office. This is the easiest and most cost effective way to market your dental practice. You will find you can easily increase referrals by word-of-mouth. Why do patients choose your office over another? Think of your heart, how it beats and the fact that your blood has a constant, steady flow. This is the same constant beat and flow of patients you want to have coming into the front door of your dental practice. The patient flow should never stop. Patients need your dental office just as they need their heart to beat and the blood to constantly flow through their body. You will find when patients value the services that you provide for them they are most likely to accept your recommendations. They are more likely to pay for treatment before and when services are rendered. When patients understand the value that your dental practice brings to them, they contribute to the success of your dental practice. When you communicate the importance of good oral health and its relationship to their overall health they will take action. These are your patients who will be the main source of referrals and they are most likely to be on time for their dental appointments.

The dental hygienist (Including the dental hygiene team – hygiene assistants, if you have them) is the one auxiliary on your team who sees patients at least twice a year. Sometimes, it is recommended that a patient return to see the hygienist three to four times a year. The continuing preventive care appointments are where patients have a chance to establish an intimate relationship with the entire dental office. This is how the hygienist (And the hygiene team) play a key role in building and maintaining the active patient base. This is where patients build life-long relationships.

Keeping the Pulse

The dental hygienist is the dental practice preventive specialist. Dental hygienists are the primary oral health educators in the office. It is very important that not only the dental hygienist but also the entire team consistently educate patients about the importance of good oral health, and how it contributes to the overall health of the body. This is communicated in everything to do with the office: everything written; brochures, the website, plaques on walls, and verbally communicated on a consistent basis.

The practices who communicate this important scientific knowledge are the offices that keep patients coming in their front door. In other words, they retain their active patient base and new patients constantly call to schedule appointments throughout the lifetime of the dental practice. These are the people who understand and feel how much you really care about them.

It is important that patients understand the oral health/systemic health relationship because this is where patients become highly motivated to be involved in and take ownership of their disease and overall health. How many patients have told you they don’t want to live a healthy and longer life?!

A new study recently reported by the Centers for Disease Control (CDC) and the American Academy of Periodontology (AAP) suggests the prevalence of periodontal disease in US (Northern American) adults has been underestimated by up to 50%. The underestimate was attributed to data from partial – rather than full-mouth periodontal exams used in recent National Health Nutrition Examination Surveys (NHANES).*

Scheduling Preventive Care

Ninety percent of all hygiene appointments need to be prescheduled. It is helpful for the hygienist (Or auxiliary who just treated the patient and understands the patients’ disease process, etc.) to be the one in charge of scheduling the patients next hygiene appointment. If the office has a hygiene assistant, this person will be scheduling and dismissing the hygiene patients. When the hygiene team is fully engaged in scheduling you will find that patient compliance improves and they are most likely to have a positive attitude towards preventive care appointments. There is symmetry in the communication process when scheduling and communication are a team effort. This is when the hygiene patient flow is most likely to constantly occur. It helps patients continue their schedule for preventive care and not lose track of their routine appointments.

Scheduling for the next hygiene appointment is most effective when scheduled in the hygiene room prior to the dismissal of the patient.


Everyone on the team needs to be held accountable. At monthly team meetings, the person who is responsible for hygiene scheduling, will give a report of cancellations, openings in the hygiene schedule and how many patients have not scheduled their necessary hygiene appointments. These patients need to be followed up on with a phone call as soon as possible. The phone call is the first step to contacting a patient for a dental appointment. An email, letter or postcard is too passive to begin contact with a patient who needs an appointment or some form of follow-up.

With computers and electronic charts, audits can be a more effective process. Chart audits and patient follow up needs to be an ongoing system in the office – daily. Everyone on the team has an important role and someone from the hygiene team needs to be designated as the scheduling coordinator. This is the one team member who will not only report on these statistics (At monthly team meetings.) but will be responsible and accountable for a daily hygiene schedule that is booked solid. When discussing the scheduling effectiveness at the team meetings, everyone needs to be able to give suggestions about what can be changed if the schedule and patient retention is not successful or challenges occur. Everyone on the dental team can be a part of all problem-solving solutions when challenges occur.

Putting it all together

Each month on the same day and same week of each month, schedule a two-hour team meeting. This should always begin with the entire team together and can include breakout sessions for each of the various departments of the dental team. Examples of these breakout sessions can include Dental Assistant training to provide improved and effective digital x-rays. Front Office: Phone communication skills and the Dental Hygiene team can learn new local anesthesia techniques for example the “Gow-Gates” injection or use of the CCLAD local anesthesia device.

Always allow an open pathway to communication for the entire team. This is just one way, which creates mutual respect and admiration. A positive and open pathway to communication will be reflected by an increase in productivity and net-profits. A happy team will lead to healthy patients and long-term success of the dental business.

Final Thoughts

Create a new and clear path moving in a direction to future successes. There are numerous high-performance systems and strategies to implement and only a few of these are listed above. These are only a few strategies that will generate positive results to improve quality of life and patient care, create higher productivity, increase net-profits and reduce stress. Every successful leader has a mentor who can lead them down a clear path and hold them accountable for their goals. This is how your vision becomes success in your life professionally as well as personally.

* Reference: Eke Pl, Thornton-Evans Go, Wei L, et al. Accuracy of the NHANES periodontal examination protocols. J Dent Res 2010 Nov; 89(11): 1208-1213.

Your Thoughts

Are you effectively utilizing your Hygiene Department? What challenges have you faced while trying to drive your practice’s profitability with your Hygiene Department?

Reader Comments

  1. David February 10th

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    What verbiage would you suggest for a office that is trying to introduce perio after several years of referring “everything” out? What do you say to encourage patients to schedule their perio maint appt with us now.
    Thank you so much for your help!

  2. Cory Kemp February 21st

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    Hi David,

    I’ve forwarded your question directly to Debbie. She will contact you with her response as soon as possible. Thanks!


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    Dear David,
    Congratulations on providing this important service to your patients!
    You can download information about words and scripts to use here:

    Thank you for the inquiry.
    Debbie Seidel-Bittke, RDH, BS
    President: Dental Practice Solutions

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    Dear David,

    To answer your question about scheduling perio maint please go to:

    There are a few articles there to address this.

    Best wishes in your transition.
    Please let me know if I can further support you or answer questions.


  5. Swampscott dentist April 19th

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    Debbie, thank you for the details. Definitely, accountability is something that has been missing in my practice…it is interesting that the responsibility is not necessarily on the manager for the hygiene schedule and reporting.

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