Is Your Hygiene Department Working With You Or Against You?

From what you put in it to how well you care for it, oral hygiene is vital to the overall health of your patients. I hope we’re all on the same page. What if I said, “A dental hygienist is crucial to the success of any dental practice.” Are you still with me? Maybe if I reword the sentence by saying, “a healthy hygiene department is best for the overall health of your practice.” Are you back? Man, I hope so. 

The hygiene department in your dental practice should account for 25-35% of your total practice production. Your dental hygienist should produce three times their wage. The median annual wage for hygienists was $77,090 reported May 2020. These benchmarks have been around for decades. Between soft diagnosis of restorative treatment needs for patients receiving routine care, the hygienist can account for a high percentage of doctor production as well. Patients do spend more time with the hygienist than with the dentist – or their physicians I might add.  According to the Bureau of Labor Statistics, “Employment of dental hygienists is projected to grow 6 percent from 2019 to 2029, faster than the average for all occupations.” 

The Elephant In The Room

Ok, I’ll bring it up. You can’t find any hygienists that want to work? You are not alone – at least that’s what the consensus would like to tell you. Fact is, there are plenty of hygienists who want to work, they just need a safe environment to work. Personal protective equipment (PPE) is, of course, the most obvious way to keep your hygienists safe. But, there are certainly other concerns that need to be addressed.  

What do your hygienists need in order to produce three times their salary? Ask them! Do you provide a safe place for them to offer feedback? 

They may be working with dull instruments. Every time a scaler is used, the blade dulls. The use of dull instruments is inefficient and ineffective. “Increased lateral pressure and number of strokes are required to remove deposits which affects both the patient’s comfort as well as fatiguing the clinician’s hands, wrist, arm and shoulder.” While some hygienists prefer to sharpen instruments before every patient, others don’t like sharpening at all. This can cause tension within your hygiene department and strain on the practice. I’ve seen hygienists bring instruments they had in hygiene school or buy new instruments themselves. This is the beginning of the end! Which leads right into ergonomics. 

Let’s assess. Take a look at Table 1 below Risk Assessment Checklist for Oral Health Professionals. By the way, this is good for all clinical staff. For providers, the answer is always neutral: neutral forearm, neutral shoulder, neutral neck. Do you have the right chair? Loupes? Lighting? Access to monitors? 

The Need For Training

I don’t care if you hired a hygienist 20 years your senior, they still need training. Don’t assume that hiring a seasoned hygienist equates to skill or knowledge. In fact, many hygienists I work with prefer a detailed job description, an onboarding checklist and clear expectations of their role in the practice. 

Standard operating procedures are important in your hygiene department. What does a New Patient appointment look like? How many units are scheduled for routine/recare dental visits? I’ve worked with hundreds of dental practices and this question comes up often. Why is it that some dental hygienists consistently fall behind schedule while others in the same practice tend to stay on time? This is where SOP’s come in handy! Is the hygienist adding value for every unit of time your patient is in the chair? At a recent Reboot Training, I had a candid conversation with the dentist about her six full-time hygienists. She was fascinated by the thought of adding in-operatory check-out to routine dental visits – preventing that bottleneck at the front desk but two hygienists consistently run behind. “Adding another task will put them even further behind schedule,” she said. 

The Onus Is Not Always On You

All six hygienists provide exceptional care for their patients. Your hygienists should want to know how to stay on time. If the majority of hygienists in the practice are able to complete the patient appointment and fulfill all tasks associated with that appointment (room turnover, sterilization, and maybe in-operatory check-out), then your hygienist is responsible for figuring out what might be holding them up. What is it that the other hygienists do differently? Conversely…. 

But the onus IS on you. 

I suggested shadowing. Discovering a new way of doing things might be the answer. Contrary to what you might think, shadowing is not punishment. It’s a way to improve the way we work – ergonomics. If your hygienists are open to feedback and want to grow, provide a safe place for them to do so and applaud them for their success. Don’t let up. You still have to follow through. Ask your hygienist what they learned. Are you still following standard operating procedures? What improvements will you make to the current way you’re doing things? How will these changes improve the way you work? How will these changes improve the patient’s overall visit?  

The answers to these questions should always fall back on your practice mission, vision, and core values. 

Remember, every unit of time equates to value – from what a patient is willing to pay for to what you are willing to pay your staff. It’s important to set expectations for everyone in your practice today. You are building/growing a team and everyone participates. 

Reboot Practice Productivity Training (™) is a two-day onsite clinical workshop that focuses on the day-to-day struggles every dental practice faces. Reinvigorate Training is a one-day onsite staff focused workshop where our trainers will develop custom techniques and tools to keep your clinical staff accountable, engaged and motivated to succeed. We do this by implementing Heart Chart (™) training ladders. 

For more information on Heart Chart (™) training ladders, do not hesitate to reach out. abachman@desergo.com.


Author Angie Bachman