What Is Your Hygiene Department Really Doing?
Dr. Mike’s practice is running great. Mary the hygienist has been working there for many years and the patients are happy with her. She has been probing and taking any x-rays that have been put into her schedule. Dr. Mike recently decided to add one more day of hygiene. He hired Susie the new hygienist, and has allowed her the autonomy to revamp the hygiene department.
After working only one day, Susie discovered a lot of work that needs to be done. There have not been any probings recorded for the last six years on the patients in Dr. Mike’s practice. There are notes here and there about individual pocket depths, but the probing charts do not reflect those changes over the years. There are clinical notes about #5 having a deeper 5mm pocket, but there is no written permanent record of what is going on with all of the other teeth in the dentition.
Susie does not know if these teeth have been probed at every visit, or not probed in the last six years. All she can go by is the six point probings last written and recorded in the patient record. She has to start probing all of the patients in order to bring their records up to date.
She has the front desk staff and assistants help her with the probings, dictating them so patients can co-diagnose their periodontal disease. Unfortunately, she finds that many of the patients need to have root planing. Patients are asking questions such as, “Why didn’t anyone tell me about this earlier?” and “How did this just happen?”
Going over periodontal disease, what the probings are and what they mean before you probe will help patients with co-diagnosing their disease. In addition to the probings, Susie also finds that it has been the protocol of the practice to refer all of the scaling and root planing to the periodontist. Luckily for the practice, Susie would prefer to do the scaling and root planing herself, before determining the need to refer the patient out to a periodontist for possible surgery.
Many general dentists refer scaling and root planing. This results in a lot of lost production that your hygiene department could be producing. It is recommended to keep as much of the scaling and root planing in-office as possible. Some patients will need multiple extractions, and in these cases a periodontist may need to do an evaluation before any treatment is completed. The office should have a protocol in place of when to refer patients when root planing is performed in your office. Of course, the doctor will make the final decision.
As Susie continues to look at patient records, she finds there has been no system for recording patients’ x-rays, and there are no specific notes in the charts outlining individual patient needs. A large number of patients have not had a full mouth series taken in the last 6 years. The office should have a standard x-ray protocol in place that the staff is able to work from, and individual needs should always be noted in the patient’s records.
These are two of the major areas where production is lost in hygiene. Be aware of what is going on in your hygiene department to help prevent lost production.
Interested in improving your hygiene department? Email firstname.lastname@example.org and ask us about our 1-Day Hygiene Training Program or call 877-777-6151
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