ReD Hot Hygiene, Part 3: D is for Dynamic

Dentistry Today


By now you should be well on your way to creating a ReD Hot hygiene team! In the previous two articles you discovered the difference between educating and communicating, and how the platinum rule applies to your practice. You also learned how to be a business partner and a resource for others within the practice. In this article, we will focus on increasing your DQ (dynamic quotient). 

Being a dynamic hygienist means that each patient feels as if he is your first and only patient for the day. That does not mean that you take all day with their care. It means that you are fully present and focused on discovering what is most important, and delivering it to them. Your goal is to create a brand; an appreciation so deep that people actually ask for you by name and respond to your suggestions without resistance. When you have created a trusted brand, you will no longer need to “sell” your patients on treatment.
Think of it this way: How many sales clerks are in a supermarket? None. Because people don’t like to be sold, they like to buy, and they buy based on brand. Once you position yourself and your practice as the brand of choice, and people clearly see the difference, they will be reluctant to switch providers. Why would they? They would have to retrain the new office to take care of them the way that you did. 
For those of you shrinking in the corner at the thought of being “dynamic,” take heart. This does not mean that you have to be loud, bubbly, or chatty. It simply means you have to be yourself, be interested in others, and always focus on how you can contribute. Being dynamic is a learned skill, and thank goodness for that or most of us would not have it. Here are four things you can do to raise your DQ:
(1) Review your charts the night before. Get familiar with your patients long before they enter the treatment room.

(2) Help patients identify their own problems. Work with them to provide the solutions.
(3) Really listen to what they are saying. Discover what is most important, and help patients transition from your operatory to the next person they encounter within the practice.
(4) Always offer your business card and invite patients to call any time they have questions. 


Chart review prior to morning huddle is one of the most important aspects of patient care. Some offices have the administrators review the charts and report necessary information to the team. While this is valuable, I think it robs the provider of a tremendous opportunity. 

Have you ever had the pleasure of staying at a Ritz-Carlton Hotel? If you have, you know the attention to detail their staff provides. (If you haven’t, put it on your list of treats for yourself!) The Ritz-Carlton and other fine hotels have a system for knowing exactly what each repeat customer desires. They practice “platinum level service,” providing the things that each person uniquely desires. For example, the typical newspaper provided for guests in various hotels is USA Today. If you were to stay in a Ritz-Carlton and request a New York Times, it would be noted in your profile and you would have a New York Times waiting for you upon your next visit to a Ritz-Carlton Hotel, anywhere in the world. Now that’s service. 


Each patient record should have a specific area to log personal information and preferences. This can either be a separate sheet within the chart or a special notes field in the computer chart. Either way, key information should be noted. This might include:  

Comfort items: blankets, pillows, headphones, DVD movie types, anesthetic preferences
Personal interests: hobbies, vacations, favorite colors, gifts, automobiles, favorite stores, restaurants, etc
Family events: children, grandchildren, anniversaries, upcoming special events, trips.

To gain even more knowledge of how to take outstanding care of your patients and meet their unique desires, I recommend you read Ken Blanchards’s Raving Fans and Harvey McKay’s Swim With the Sharks

As you move past the patient’s personal information sheet, review the medical history, making note of medical/dental links and precautions. Next, turn your attention to pending restorative treatment needs or elective procedures that have not been completed. You’ll want to mention this during the appointment. Finally, review the progress of treatment notes for concerns presented during the last visit, or referrals to specialists. Do we need to update radiographs, periodontal charting, or other documentation? The financial coordinator should check the patient account balance and make the team aware of any concerns in this area. 

There are basically two methods for identifying problems and relating them to the patient: the “Atilla the Hun” method and the “Dynamic Personality” method. Which do you think we should choose? 

Do you remember your mother saying, “It’s not what you say, it’s how you say it!” No statement could be truer than when delivering news to your patients. Most authorities agree that during one-on-one communication, words represent only 7% to 10% of the message, tonality 38% to 40%, and body language 50% to 55%. Often, we get hung up on memorizing the latest scripts or trying to become just like some notable authority we hear at a conference. While this may prove to be a great starting point, ultimately you must develop your own winning style within certain guidelines. Let’s work together to develop your dynamic style.
Before you can begin to identify dental, needs you must examine your own core beliefs about patient care. Have you ever said one thing while thinking another? Did you notice that people didn’t believe you? (“No really, I love brussel sprouts, I’m just not very hungry at the moment!”) How did your host know you were lying through your teeth? Perhaps your body language or tonality gave you away. Suppose you have core beliefs within dentistry like these: “I’m too rushed to do anything else for my patients”; “I don’t have time to complete the x-rays today”; “Patients can’t afford ideal care.”
What notation will be made in the chart? Perhaps something like: “Patient requests x-rays on next visit,” or “Patient requests pretreatment estimate from insurance.” 

As you can see, the first step in identifying patient needs is to identify your own limiting beliefs and remove as many barriers to care as possible. If you truly have “no time” then you must address this with your team and rework systems and protocol so that this is not an issue. Once personal and office limitations are identified and dealt with, you can proceed in helping patients discover ways to take care of themselves.

Since most patients learn visually, the intraoral camera is your most valuable tool. Combine this with a DVD educational program like CAESY and you will substantially increase enrollment of needs-based dentistry. Add visual imaging that allows you to show patients how they would look with smile enhancement, and you will increase enrollment of elective aesthetic services.
Involving patients in their treatment planning is a must. By asking patients questions like, “What is most important to you about your teeth/smile/dental care/visit with us today?” you can begin to discover their values and what they are interested in learning more about. By encouraging their questions and active involvement you empower them to take ownership of their problems. 
One of the most powerful questions you can ask is permission to share. Try this technique. Ask, “Mrs. Jones, do I have your permission to share everything I find during our examination? I will be looking for three things: areas that can cause you immediate pain, areas that need to be addressed to keep you healthy for a lifetime, and areas that can be enhanced through cosmetic dentistry and are purely elective in nature. Do I have your permission to address each of these areas?” You’ll be amazed—almost everyone says yes. Why wouldn’t they? You’re talking about a very interesting subject—them! 
The next most powerful statement you can make is to include the word “nothing” in your options presentation. “Mrs. Jones, based on our findings I recommend we strengthen these areas by doing ________. I want you to also know you have the option to do nothing. I must tell you that by exercising this option you are putting yourself at risk for _____.” Having the patient fully understand all the options and risks is one of your primary duties as a clinician. Rarely do patients opt to do “nothing” once they know the consequences. 

There is a difference between hearing a person’s words and listening to their intent and meaning. True listening requires that you turn off the chatter in your own head. You must become actively engaged in the conversation and be fully present at that moment in time with your patient. Not an easy task when the light system is flashing, beepers are beeping, and the autoclave goes “ding.” Nevertheless, your patients deserve 100% of your attention when you are with them. 

Listening with intention requires that you become more focused on your patient than you are on yourself. To develop this skill, try this exercise. Pick a partner and agree to speak and listen to one another for 2 minutes. During the time you are speaking you must not use the word “I.” Your listening partner will time your conversation and let you know when time is up. You can talk about any topic, you simply cannot use the word “I.” If you are like most people, you will have to repeat this exercise several times before mastering it. 
Listening also requires reading body language and listening for subtle tonality in the patient’s voice. Many of you are doing this already. Can you think of a time when a patient scheduled for treatment, and immediately after the patient left you turned to a co-worker and made bets on whether they would keep the appointment? That was your sensory acuity in action telling you their words and body language did not match. The challenge is having the courage to address this with the patient in a way that makes them feel comfortable. 
By listening to the patient’s body language, you can go a little further with questioning, asking, “Mrs. Jones, you seem a little uncomfortable with this, is there anything I can do?” Keeping the conversation open until you feel certain about their commitment will save many hours of time for the patient and the practice. 

One of my pet peeves, and I’m sure one of many patients, is having to repeat myself several times during the same visit. The receptionist takes down the information, only to be asked again by the hygienist, and then again by the doctor. Hello! Doesn’t anyone speak to each other?

Guiding patients through care is much like running a relay race. The baton must be passed each step of the way. My friend Sandy Richardson taught me a great way to elegantly hand-off. It’s called RAP: Review, Acknowledge, Pre-frame. Review why the patient is here, acknowledge them in some way, and pre-frame what’s next. This works as you enter the operatory and also as you escort them and transition to the business office. 
Here’s an example of a RAP hand-off to business administrator from hygienist: “Mary Beth, Mrs. Jones has completed her treatment with us today and was a terrific patient. She is looking forward to seeing Doctor again to strengthen the teeth on the left side and complete her treatment. Could you please help her schedule the next series of visits?” Assuming documentation and treatment plans are in the chart and/or computer, complete information can be given to the business administrator in a very patient-friendly manner.


Being dynamic is the ability to make patients feel special, as if they are the most important person you see today. A really great way to tie a ribbon around the entire appointment is to offer the patient your business card. Let them know that if they have any questions to please call you directly. I practiced this routinely for years, and rarely did I receive calls. Somehow, just knowing that someone cares lessens the “complaint factor” among patients. 

When passing on your business card, consider giving two. Recommend they keep one on hand for emergencies and questions, and feel free to share the other with a friend or co-worker. After all, any friend of theirs is a friend of yours!


In previous articles you learned how to be resourceful. This required opening your mind to new possibilities and strategies. Being dynamic encourages you to open your heart and begin to listen in a new, more compassionate way. Opening your heart to patients’ concerns and your mind to new, creative options helps you move closer to becoming a ReD Hot hygienist.

Ms. McManus is the director of Hygiene Mastery and a coach with Fortune Management. She is on faculty with PAC~live, and is the author of the collaborative book FUNdamentals of Outstanding Dental Teams. To receive a complimentary Hygiene Mastery analysis call (888) 347-4785 or e-mail