Four Ways to Improve Hygiene Production

Roger Levin, DDS


The production potential of dental hygienists has been underestimated since the inception of hygiene as a department in dental practices. There are four key ways hygienists can have a powerful impact on total practice production. When these four factors are implemented in a systemized manner, with appropriate scripting, practice production is guaranteed to rise. 

Do More Diagnosis

The first is for hygienists to have a better understanding of diagnosis and treatment options. In an ideal world, the hygienist should be almost as good as the dentist in identifying potential treatment, explaining the treatment to a patient, and closing the case.

We were able to increase practice production by more than 21% for one of our clients through improvements in the hygiene department. There were two hygienists who were seeing patients throughout the day without identifying any treatment opportunities or presenting any of their own findings to their patients. They simply waited for the doctor to conduct an exam.

The hygienists, then, were trained in periodontal and restorative diagnosis and in how to talk to their patients about potential treatment options. This all took place prior to the doctor entering the hygiene room to conduct their exam, make a final evaluation, and confirm the diagnosis.

Within 90 days, the dentistry referred to the doctor by the two hygienists was growing at a rapid rate. At the end of the year, overall practice production had increased largely due to the motivation and training of the hygienists, who were placed on a bonus structure for completed treatment they identified and presented to patients.

A Product Sales Program

The second way to increase hygiene production is to implement a product sales program. Most general practices today have either no or very low home care product sales. Something as simple as fluoride varnish can add thousands of dollars to practice revenue. The same is also true for power brushes, mouth rinses, toothpaste, and other home care products.

The key is to help hygienists understand how to create a package to sell to the patient. Patients are being asked to purchase these products anyway, so why not help them by making the products available in your office?

We recommend that hygienists focus on creating a home care prescription. This is not a legal prescription, but more the definition in a Webster dictionary sense. Hygienists will evaluate what they feel is in the best interest of patients and then explain that they are prescribing a home care regimen to the patient. This is then followed by providing the patient the opportunity to purchase the products while they are in the practice rather than having to go somewhere else where they might never follow the recommendations.

Many dentists and hygienists feel funny about selling products even today. Yet product sales are ubiquitous in ophthalmology, dermatology, and veterinary medicine. Dentists and hygienists need to embrace the idea that patients need homecare products, and selling them in the practice is a win for everyone.

Building Value

The third way to increase hygiene production is for hygienists to build value for the hygiene appointment with every patient. The most powerful way to create that “sense of importance” in patients’ minds toward their hygiene appointment is to explain the benefits of hygiene from a periodontal infection standpoint.

Remind patients that if they want to keep their teeth for a lifetime, then regular hygiene will be critical because bone loss, inflammation, and periodontal disease are all part of the aging process unless addressed preventatively on a regular basis.

Calling Overdue Patients

A fourth method for hygienists to impact practice production is for them to call overdue patients personally to let them know it is past time to come in for an appointment. This shows patients that the practice cares about them and wants them to have optimal oral health.

When the hygienist calls personally, there’s a much higher level of reaction on the part of patients because they typically have their strongest practice relationship with the hygienist.


Dental hygiene is a critical factor in overall practice production. By implementing these four approaches in your hygiene department—the hygienist identifying treatment, offering product sales, building value around the hygiene appointment, and personally calling overdue patients—practice production will certainly improve.

Dr. Levin is the CEO and founder of Levin Group, a leading practice management consulting firm that has worked with over 30,000 practices to increase production. A recognized expert on dental practice management and marketing, he has written 67 books and more than 4,000 articles and regularly presents seminars in the United States and around the world. To contact Dr. Levin or to join the 40,000 dental professionals who receive his Practice Production Tip of the Day, visit or email 

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