Hygiene Time-Saving Tips

Dentistry Today


Time is the one thing that is equal in all of humanity. How one chooses to spend that time, however, is not.

If you often feel the stresses of time, chances are good it is because you feel you just do not have enough time to do what you want to do, at the level of quality to which you are committed. When we combine the decreasing number of dental personnel with increasing service demands, challenges for time are created within the dental office. 
With increasing responsibilities placed on hygienists, such as managed care, insurance dilemmas, the implementation of consultants, incorporation of advanced educational courses, the indoctrination of aesthetic dentistry and its demands, and the ever-expanding state and federal regulations placed upon us, there is more for us to do in the same amount of time, or for the sake of production, in less time.

To get the most out of the time a hygienist has with a patient, it is important to have clearly defined goals and a focused agenda. Here are some key time-saving tips you and your hygiene department can use to help achieve your daily goals for more production and less stress.

The scheduled daily production goal and the scheduled for next hygiene visit goal should no longer be the only considerations in a hygiene day. Today’s progressive hygiene departments have daily sales presentations and sales acceptance goals that we are responsible for as well.

For example, my daily hygiene production goal is $1,800 per day, which I normally meet and usually exceed. My sales presentation goal (aesthetics, quadrant, or comprehensive dentistry that is presented from my hygiene chairs) is $5,000 per day. And my sales acceptance goal (accepted, financials secured and scheduled) is $3,500 per day. I obtained these goals simply by adding my hygiene daily production goals to my doctor’s daily production goals. 
Though sales acceptance goals are often difficult to track because of the patient’s need to consider and organize their budget (both time and money), sales presentations are not. Simply track the treatment plan that was discussed from the hygiene chair by writing it next to the patient’s name on the day sheet. For example: lower left No. 18 MO (inlay—$1,100); No. 19 MOD (porcelain crown—$1,100); No. 20 MOD (inlay—$1,100); No. 21 DO (two-surface direct—$250 or inlay $1,100) yields an estimated total of $4,500.
I make it easy for myself by calling everything a restoration. I say to the patient, “We will be restoring the lower left side on the next visit. If we could have a moment of your time, we’d like to help you with the fee for your treatment and the payment options we have available. Let’s see what’s most convenient for you.” Then I escort them into the private consultation room where the financial coordinator is waiting to complete the process.

At the end of the day have a mini afternoon huddle with the doctors, hygienists, and scheduling coordinators and analyze each patient to see who did or did not schedule, and why. These are very valuable numbers, and everyone should be tracking them. They will reveal staff members’ strengths as well as weaknesses.

Even though this course of action takes time, it is the best time-saver the hygienist can do to prepare for the day. It could be done during downtime or at the end of the day. The information remains fresh in your mind when you do it before the day begins. Reading through the progress notes while reviewing the charts allows us to be familiar with patients before they are seated. It allows us to gain accurate knowledge of what patients will need in hygiene services for the day. For example, the type of hygiene therapy, updating the periodontal charting, which radiographs or photography might be necessary, whether the patient is due for their annual examination, or whether the exam will be necessary because of an already known chief complaint made during confirmation. It also alerts us to some of the other possible time pitfalls, such as the need for premedication or the use of nitrous oxide. Reviewing the patient’s treatment plans and reading the progress notes for past chief complaints, concerns, or comments by both the doctor and hygienist allows both to formulate a presentation that is collectively well focused. The hygiene team will then know in advance what could or will be needed, such as a bite adjustment setup, imaging through a consultation, or possible work-in treatments like sealants or bleaching. Auditing the computer by updating the patient’s real treatment needs gives an accurate projection of the daily production goal and treatment. Instead of using the computer program’s generic codes as your guideline, type the needed treatment, like BWX, Pano, 4910, Exam.

The patient’s name and information from the audit should be transferred to a sticky note and written in black ink to indicate preexisting treatments. Save room for the patient’s current chief complaint or for case acceptance, which should be written in a different color for easy recognition. The sticky note is given to the doctor before he/she leaves their treatment room so they can be familiar with all treatment needs and know what has already been discussed. This in itself will make the exam time quicker, more efficient, and effective.

This is the next best time- saver, and is absolutely necessary for everyone on the team. It averts stress by effective communication and sharing what we learned from the audit and the phone calls too. It is with this information that treatment rooms are delegated.

Have all rooms equipped, stocked, and supplied for whoever needs to use them. The old protocol of “my room …my stuff” should no longer be acceptable as the norm, not in today’s high-paced, high-demand environment. Rooms are where income is made through production. Empty rooms should be considered overhead.

Polishing first with a mild and effective prophy paste compound before the scaling procedures will ensure that you will work in a cleaner, healthier environment. This prevents the massive transmission of bacteria from entering the patient’s bloodstream. It saves the time normally spent rescaling and repolishing tenacious stain, and reduces the hand fatigue commonly associated with heavy-handed stain removal.

Now the hygienist and the doctor can see without the hindrance of plaque, stain, and food all over the patient’s teeth.

Education means taking something that is simple and making it seem more complex. Communication is about taking something that is complex and making it sound simple. Let’s use flossing as an example. For many, flossing is the key, but instead of being the answer, it’s the solution. Few patients are interested in a solution until they truly understand the problem. Once patients comprehend the problem, they will own their disease and will want to know what they can do about it.

Immediately following polishing, ask permission to review the patient’s brushing and flossing routine. If you see a patient might be flossing incorrectly, a great non-confrontational communication might be to pose this type of question: “I see that you floss regularly, however, as part of our treatment today I’d like to show you once again a more effective method of flossing. Is that okay with you?” 
Giving the patient a mirror, begin flossing between the maxillary central incisors. This area of flossing usually causes bleeding, and will open discussions about possible periodontal issues. You can then address any cosmetic concerns and present options for improving older restorations that may still have stain. This prevents the patient from thinking, “Why didn’t they get the stain off again?” 
The doctor can, if convenient, come in anytime after the sticky note has been given to them and be able to see and provide a more thorough examination without the obstacle of debris.

The controlled application of topical anesthetic followed by thorough rinsing throughout the appointment allows for a more comfortable and accurate periodontal probing and scaling. As always, check the medical history for prior allergies, and be alert for any current reactions.

Hand instrumentation should be an important part of your armamentarium because it enables you to feel every surface on every tooth, confirming that the roots have been properly cleaned and planed. It also allows you to feel for decayed surfaces, marginal breakdown of older, worn restorations, and areas of sensitivity. Many times patients will feel these problem areas at the same time as the therapist, which opens the doors to communication about treatment. It also allows you the flexibility to educate and communicate, to help influence the patients into understanding, accepting, and owning their dental disease. Hand instrumentation helps make communication easier and more patient-friendly by overcoming the distractions that occur from the combination of the noises from the use of ultrasonic instrumentation, water, and suction.

Scripting—the study, discussion, and internalizing of words and phrases to use (and words and phrases not to use) along with all the reasons why—is the ideal way to ensure consistent five-star service in your practice. Scripting can and has improved the service, profitability, efficiency, and harmony of countless thousands of businesses. How can a staff member or any of us be expected to “wing” answers on the spot? Studying scripts means studying the reasons behind the scripting. You can’t have one without the other.

Another important aspect of scripting is the elimination of words not to say. For example, the patient has pocketing with inflammation and bleeding, and while you are aggressively scaling, the patient asks that dreaded nightmare question to all hygienists, “How come no one has ever done this to me before?” Imagine if we bumble around and grasp for words, we will at best look unprofessional, and at worst, offend and possibly even lose the patient. 

Imagine the phrases you might hear without scripting—all kinds of things that essentially add up to either bashing other dental offices or dentistry in general, something that sounds like, “Your last dental office didn’t care.”

Patients ask lots of questions, and they are not looking for long drawn-out answers or dozens of questions in return. They want direct, honest answers. 

The response I teach my clients, and the one I use daily is, “That’s a great question. Let me see how I can explain this to you so you can increase your understanding of your oral health. It’s simply been too long since your roots have been cleaned, not your exposed teeth but the roots themselves. Have you ever had your roots cleaned like this before?”

Scripts allow one the freedom to continually educate and communicate, to motivate without much thought, to alert patients to either further dental needs or educate them about today’s more advanced materials that are being offered, while the patient is still in the chair. Patients have found this time-saving tip (scripts combined with hand instrumentation) to be both soothing and more relaxing, often distracting them from the discomfort that can occur during therapeutic scaling procedures. 
This simple trick will allow you to entertain, build a rapport, deliver quality care, motivate, and influence the patient by explaining through education the treatment needed, all in a shorter amount of time. 
Scripting is not about being a robot. Of course, we all need to listen, be compassionate, and use our own words. But scripting is the most efficient and effective way to instill a culture of service, and excel in the busiest place on the planet—the dental office. For example, in my hygiene world I personally could not work as effectively or efficiently as I do without my memorized scripts. In my everyday real-life hygiene position, I have to stay focused. My time with patients is filled with so many thought-provoking and diverse procedures, systems, and protocols, I’d go crazy if I didn’t have my scripts written and edited, practiced and rehearsed to the point where they can be performed like an act in a play. 
I relish when patients tell me they’ve never been told that before (I know they have) and how much they appreciate the time I took helping them understand their problems and the solutions. Oddly, it really was not all that much time. It’s not about the quantity of time but the quality of time that is spent on patient education and rapport. 
For more information about complete scripting resources for your practice visit OfficeMagic.com or call (800) 750-8779.

The hygiene appointment is near completion, the hygienist has found the problems, addressed the patient about probable treatment options, the doctor has confirmed the treatment plan, and now the hygienist must find the time to write an accurate treatment plan in the chart and pass it to the appropriate front desk coordinator for the last final touches. This is where an educational system such as CAESY is invaluable; it provides an educational service to the patient while the hygienist completes the tasks necessary before releasing the patient.


Counting time isn’t nearly as important as making time count. Learning to take advantage of time to its maximum is essential to arriving at your destination in a timely manner, and making the journey an enjoyable one. The point of exploiting time is not to cram more responsibilities into the day, but to use the time we have more effectively, so that it is not squandered but is invested in the people and projects that are most important.

As Dr. Scott Peck says in his book, The Road Less Traveled, “If you value yourself, you will value your time. If you value your time, you will use it more wisely.”

Ms. Dopson-Hartley is widely known for being the most profitable hygienist in the country. As a full-time, hands-on, practicing hygienist for 26 years, she works her own successful business program that not only increases her own hygiene production to over $23,000 per month while working only a 3-day work week, but is instrumental in her ability to help influence and promote ideal comprehensive aesthetic and restorative dentistry for her dentist. For more information on her consulting, seminars, and advanced workshop training series, call (813) 985-5516 or visit her website at DeborahHartley.com.