Selling ancillary products is just one more way that a Hygienist can help increase their production. It is also another way for your practice to provide “knock your socks off” customer service. What exactly is an ancillary product when it comes to dentistry? It is a product that is sold in addition to the treatment or product initially sought. Some of the products that may be considered ancillary when it comes to a hygiene appointment would be fluoride, take home products, and bleaching. In today’s society, where our lives are just getting busier, one stop shopping is a very important attribute.
It is erroneously assumed that fluorides are only beneficial during childhood. Professional fluoride applications, although not routinely recommended for every adult patient, are appropriate for moderate and high-risk individuals.
What makes an adult at moderate risk when it comes to caries? According to the American Dental Association Council on Access, Prevention and International Relations any of the following would be qualifying factors:
- One to two new, incipient, or recurrent carious lesions in the past three years
- History of numerous or severe caries
- Decreased salivary flow
- Malformed enamel or dentin
- Compromised oral hygiene
- Frequent consumption of refined carbohydrates.
Then to be considered at high risk as an adult the only additions would be:
- Active dental caries
- Three or more carious lesions in the past three years, or two or more of the following:
- History of numerous or severe cavities
- Frequent consumption of refined carbohydrates
- Inadequate fluoride exposure
- Root surface exposed by gingival recession
Caries risk assessment is difficult because it attempts to account for multiple factors. There are many different models that have been developed in order to assess risk. Those models that include the most factors predict risk most accurately. One thing you must remember when assessing a patient’s risk factor is that caries risk can vary over time, perhaps many times during a person’s lifetime. Therefore, the patient’s caries risk will need to be determined at every hygiene appointment.
According to the Center for Disease Control (CDC) if you are uncertain of what classification a person falls into, treating a patient, as high risk is best until proven otherwise. Now, keep in mind that the CDC recommends that people ages six to nineteen should receive professional topical fluoride applications twice per year regardless of risk.
So, when we really look at the patients in our practices, according to the CDC guidelines, the minimal treatment we should be providing is a professionally applied fluoride treatment on our patients that are at high risk. We should even be sending them home with a prescription strength rinse or toothpaste. Notice I said sending them home with a prescription strength rinse or toothpaste. Not writing a prescription or telling them to go get a specific product. The reason is they probably won’t go buy it. It is best that the ancillary products not be available to the patient in the store.
Another ancillary product is bleaching. Why not have the bleaching appointments scheduled in hygiene? The hygiene curriculum includes dental materials and we all learned how to do impressions in college.
Some of you are thinking she must be nuts, I have not taken an impression in twenty or thirty years. Why would I want to start doing them now? Well, industry standards say that hygiene salaries should be no more than 33% of their adjusted production not including doctor’s exam fee. Usually, it’s not the salaries that are too high, but the production that is too low. This is one more way to help increase the hygiene production. Seeing how everything in dentistry is a team effort. I am sure the assistant or doctor would be thrilled to have the opportunity to teach you how to take an impression, pour up the models, fill out the necessary paperwork, and clean up after yourself.
There will need to be an office protocol established when it comes to how much time will be allotted in hygiene for this appointment. If your office does whitening check appointments, it will have to be determined where and who will do them.
Adult fluorides, take home fluoride products, and bleaching are just three ancillary products that can help to increase your hygiene department’s production.
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