12.01.06 - Issue # 247 Forward This Newsletter To A Colleague


Jean Gallienne RDH BS
Hygiene Consultant
McKenzie Management
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Developing or Modifying Your Hygiene Department

You have been cleaning and root planing your patient’s teeth since you opened the doors to your practice. Now you are looking at hiring a hygienist because your schedule is booked out three weeks with restorative needs.

Starting a hygiene department is more than hiring a hygienist. It is buying the dental equipment and instruments, setting up the operatory, deciding on what probing system you want to use, and appointing patients.

Protocols need to be established, goals set, documents need to be created, and training needs to take place before the hygiene department is able to be the profit center you want and not just a prophylaxis oriented hygiene department.

Here are some of the protocols you will want to set up, and a few questions that you will need to answer:

    Periodontal protocol:
  • When do you refer to the periodontist?
  • When do you root plane?
  • What code is going to be used?
  • How often do you probe?
  • What computer probing system do you want to use?

There are so many computer probing systems out there that it is hard to find the time to really test them all. However, it is important to make your decisions based on knowledge and performance. Not all software and probing systems are created equal. It is recommended to use a system that will help with co-diagnosis, allows for the operators to be calibrated, and is user-friendly, regardless of the environment.

    X-ray protocol:
  • What x-rays will be taken?
  • At what age do you take the recommended x-rays?
  • How often do you take the x-rays?

The office protocol may be developed by the doctor or doctor and staff based on guidelines posted by the American Dental Association. The guidelines for prescribing dental radiographs can be found on their web page at WWW.ADA.Org. These guidelines are to be used as an adjunct to the dentist’s clinical and professional opinion on how and when to take radiographs on their patients. 

Appointment protocol:
  • What is to be done at each appointment?
  • Who is accountable for different procedures?
  • How much time does the hygienist need to complete the appointment?

    Document protocol:
  • When will the financials be gone over?
  • Who will go over the financials?
  • What informed consent form will you use?

    General questions:
  • How many days of hygiene do you really need?
  • How is the recall system going to be set up?
  • Who is going to work the recall system?

The recall system is one of the most important systems in a practice, and is also one of the most overlooked systems. Many offices prefer to have the recall system managed by the hygienist when she/he has open time. It is recommended that a specific person be responsible and accountable for management of the recall system. We will call this position the Patient Coordinator. How much time do they need to be employed based on your patients of record? What will their responsibilities be, and how will they be held accountable?

What are you going to pay the hygienist? Is she going to work commission, a base pay plus commission, or an hourly rate? Usually, it is not that the hygienist is paid too much, it is that the hygienist is not producing enough. So, it is recommended that the hygienist have daily, weekly, and monthly goals.

It is the industry standard that the hygienist’s salary should not exceed 33% of their production, and 33% of total hygiene production should come from ancillary services such as an interceptive periodontal program, and 33% of practice production should come from the hygiene department.

These standards should be monitored on a regular basis by the hygienist and brought to either the monthly business meeting or the morning business meeting, depending on if it is daily information or monthly.

Not only do the questions above need to be answered, there is also more to consider when it comes to starting a hygiene department for the first time, or modifying your existing hygiene department. Then everything should be included in an office policy and procedure book, in order, to have it in the future when you need to look at hiring another hygienist.

Interested in knowing more about how to improve your hygiene department? Email hygiene@mckenziemgmt.com.

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McKenzie Management
A Division of the McKenzie Company, Inc.
3252 Holiday Court Suite 110
La Jolla, CA 92037
Email info@mckenziemgmt.com
1.877.777.6151
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