Increase Hygiene Production in the Dental Office

Hygienists accomplish vast patient care in their allotted appointment time, but sometimes we struggle with reaching productivity goals. When one-on-one with a patient, we're not always thinking about our "Revenue Generator" capes blowing in the wind. Sometimes that "R" stands for "ran out of time." The industry standard is that the hygiene department will produce at least 30% of total office production. Common productivity goals to achieve 30% production include adequate X-rays, implementation of add-on treatments, and in-house retail. However, the issue of time, planning, and tools may hinder achieving this goal. 

What Are the Reasons for Poor Hygiene Production?

Hygienists accomplish vast patient care in their allotted appointment time, but sometimes we struggle with reaching productivity goals. When one-on-one with a patient, we're not always thinking about our "Revenue Generator" capes blowing in the wind. Sometimes that "R" stands for "ran out of time." The industry standard is that the hygiene department will produce at least 30% of total office production. Common productivity goals to achieve 30% production include adequate X-rays, implementation of add-on treatments, and in-house retail. However, the issue of time, planning, and tools may hinder achieving this goal.

1. Not enough time for X-rays

When unplanned, we can be stuck wondering at the last moment, Is there a sensor available? Who has the Nomad?  Is this patient going to gag the whole time? Will their insurance cover this? (because I know they'll ask). X-rays not only increase day-of productivity but future productivity in the way it reveals issues we wouldn't have otherwise seen. Depending on the patient's dental health, full mouth series are recommended every 3-5 years and offer the full capability of assessing bone levels and every tooth. 
Taking the time to review the schedule ahead will identify which patients are due. Insurance coordinators can confirm ahead of time what their coverage is so that the patient can be informed when told the treatment plan for the appointment. Simply having the X-ray equipment set up prior to seating the patient can save a hygienist the few minutes that would otherwise hinder the opportunity. Make an effort to be aware of when a patient is due for an updated full mouth series and schedule them with an extra 10 minutes in their hygiene appointment, or see if an assistant can do this prior to the patient's scheduled hygiene time.  

2. Dull instruments

To sharpen, or not to sharpen, that is the question. (To sharpen, or to take a lunch, that is the other question). There is an undeniable necessity to work with sharpened instruments for the following reasons:
•    Better calculus removal.
•    Patient comfort.
•    Rapid efficiency.
•    Reduced operator strain and fatigue.
•    Reduction of the need to refer patients out. (When calculus isn't removed, it can contribute to or exacerbate periodontal problems).

Sold. However, I really do need my lunch break.

The solution may be time-saving instruments. Instruments such as American Eagle XP® Sharpen-Free Instruments (you know, the GOLD ones) are both ergonomically and economically friendly. The patented technology used on these blades eliminates the need to sharpen these instruments throughout their usable lifespan, which is at least as long as, if not longer, than traditional stainless steel instruments. Not only does this save time (time is money), but it spares the chance of sharpening an instrument incorrectly resulting in the need for replacement. Otherwise, diamond stone sharpeners are the fastest method of sharpening and are great for stainless steel instruments. 

3. Poor ergonomics

If you're set up like an obstacle course rather than a functional operatory, it's going to take longer to perform hygiene duties and inhibit the opportunity for further production. Make ergonomic adjustments accordingly:

•  In addition to efficient hygiene instruments, cordless equipment like the Infinity by Young® is refreshingly lightweight and easy on the wrist.
•  Use lighted loupes. Loupes allow you to sit up straighter and see much more.
•  Does your patient chair have a lever for swiveling? Use it! Changing positioning by even an inch can make such a difference in your efficiency.
•  Try a saddle chair to sit upright.
•  Arrange furniture and equipment to be within arms reach. 

Implementing these suggestions promotes a more comfortable visit for you and the patient, and when a patient is impressed by the ease and pleasantness of a cleaning, they're more likely to be compliant with treatment recommendations.

4. Same day hygiene

Thanks to the above modifications, there's likely time to provide services that would've otherwise required a separate appointment such as:

•  Sealants.
•  Localized antibiotic therapy.
•  Desensitizing therapy.
•  Fluoride treatment.

By my rough math, performing just three of these services every day can increase annual production by approximately $43,000 per hygienist. Reviewing the schedule can help you identify which patients may benefit from such treatments. Who is a high caries risk? Who has periodontal concerns? Educate these patients about the value of such treatments. At the end of the day, it’s not so much about reaching an economic figure. It’s about ensuring you’re organized enough to provide elevated patient care by tailoring your capabilities to their needs. When we do this, we achieve production goals.

5. Missed opportunity to sell 

Selling the products you've just discussed in your oral hygiene instruction is a great way to boost production.  We’re not salespeople but we are excellent educators and the ease of having your presentation tools available can be all it takes to make an honest sale. Oftentimes, the patient's aspiration to invest in better home care goes out the door with them; create a new level of convenience with appropriate education to give your patient the resources they need for excellent oral health. 
Talk to management about getting retail in the office and build your confidence with educational resources provided by your chosen companies. Electric toothbrushes and water flossers are hygienist favorites that can really improve your patient's plaque control. Choose a unique product you feel excited about, like specialty floss or rinses for xerostomia. We know that using quality hygiene tools at home is essential for your patient's overall health and dental office experience. Plus, the better a patient's plaque control is, the more value there is all around.

You've Leveled Up

Achieving your hygiene production goal is possible with a little planning and the right armamentarium. Team up with your office and discuss how these simple changes can be put into effect. To bridge any gaps in the plan, lean on your trusted companies for additional resources. Set attainable weekly goals to reach your monthly and annual production goals. You're a super hygienist after all and your productivity can be evidence of that. And always, dry clean your super hygienist cape.