Creating World Class Dental Hygiene Service In Your Dental Practice. Part II.

Last week I discussed the important role that a dental hygienist plays in the creation of an EXPERIENCE for their patient so that the hygiene visit for the regular loyal dental patient is not simply “just another cleaning” or “it’s only a clean”.

This regularly scheduled visit truly can be an ULTIMATE PATIENT EXPERIENCE each and every time.

Last week I talked about the important role that the dental hygienist plays at the beginning of every patient’s hygiene appointment.

Last week we looked at the important role of Emily the hygienist in creating a perfect platform at the start of Mrs Smith’s hygiene appointment, truly “setting the stage” for the remainder of the visit to be a World Class Experience.

Today I’m going to look at the dental examination process in Dr Brown’s office and the crucial role that Emily the hygienist has in that examination.

Firstly, it is imperative in creating an experience for the hygiene patient that the dentist performs the dental examination AFTER all of the hygiene has been completed.

And I mean ALL.

And I mean AFTER.

I know dentists who like to do hygiene examinations when it suits the dentist, irrespective of whether the hygiene patient has a clean mouth, a dirty mouth a half-cleaned mouth, a bloody mouth…. or whatever…. 

Just imagine, the regular patient has an examination this time [this visit] before the clean. Next visit, the examination is done after the clean. And the following visit, the dentist does the examination in the middle of the cleaning process.

Do you think that might create a little confusion in the eyes of the regular hygiene patient?

Do you think that the regular hygiene patient may feel a little less valued if their examination is done when “it suits”  the dentist, rather than at a clearly ordained and “logical” time?

And how does it look to the patient when the dentist walks in and says to the hygienist:

“I have a moment now. [Get out of my way and] let me do that examination now….”

Does this scenario build any respect for the role of the hygienist?

I’ve been to dental practices where the dentist doesn’t have time to do the examination and the hygienist leaves the patient sitting alone like “a shag on a rock”, waiting alone for the dentist, and goes off into another treatment room to start treating their next hygiene patient.

When the dentist visits the hygiene room at a specific regular time to do the examination following the completion of all hygiene, the patient has been able to build a very strong bond with the hygienist.

A very strong bond.

Of trust.

A strong bond of trust.

And it is this bond of trust that the dentist and the hygienist can then build upon to perform the thorough dental examination and to present a complete and detailed treatment plan of all necessary treatment.

You see, when the dentist arrives into the hygiene room at this pre-determined designated moment, and the hygienist has all of the photographic records and all of the radiographic records that were taken now up and instantly available for viewing on the monitors within that treatment room, this allows the dentist to perform an examination that is primarily framed as a “review” of findings.

As opposed to the dental examination that is conducted at “any old time”.

The “any old time” examination, or the “get out of my way, I’m here now” examination, can only be conducted as a “full discovery” examination.

Although a “full discovery” examination will take longer to perform than a “review of findings” examination, we know it will uncover ALL pathology.

We know nothing is ever missed by a dentist doing a “full discovery” examination.

Whereas a dentist who relies on the eyes of the hygienist and does a “review” of findings examination, because of its brevity, may miss discovering some critical dental pathology?


[For an interesting perspective on this examination “timing” ask a hygienist whether they have ever seen obvious pathology during one of their cleanings that the dentist doing the full discovery examination has failed to see and failed to notify the patient about…. And subsequently the necessary treatment has not been presented to the patient and therefore the pathology remains?]

My belief was that four eyed examinations were always better than two eyed dental examinations.

I believed that a dental hygienist who thoroughly cleaned all teeth and all surfaces of her hygiene patient had the knowledge and the “authority” to make note of all restorations present in the patient’s mouth.

I believed that a good dental hygienist could identify areas of concern ahead of time for the dentist, and have these listed as areas for the dentist to take a look at when the dentist arrived for the examination. These areas of concern could include any failing margins on restorations, any loose fillings, any caries, and any significant fracture lines, amongst others.

Here is what I used to have my hygienist do.…I used to have her start at the 18 tooth [tooth number 1 for my American friends] and let me know exactly what she had seen, if anything, on each and every tooth as I conducted the examination.

Together then, the hygienist and I would examine the patient’s mouth, and in conjunction, review each tooth and each surface AND all of the hygienist’s findings and concerns.

The important perspective that occurred because of this process, conducted in this well thought out way, was that it allowed the dentist to become the respected second opinion on any areas of concern that the hygienist had already discovered and explained to the patient.

Because of the level of trust established between the hygienist and the patient already during the previous forty minutes of this well-structured hygiene appointment, what we found was that the time taken by the dentist to do this examination and explain treatment inside the hygiene room was significantly less than when the hygienist took no part in any uncovering and discovery of areas of concern prior to the arrival of the dentist.

The second thing we found was that the amount of diagnosed restorative treatment coming from the hygiene rooms that was explained and proposed, and subsequently scheduled and completed, was significantly more in each of those four categories, than when the dentist played the role of SOLO DIAGNOSTICIAN arriving when and where he felt like it.

And so, if patients are having more detailed examinations that result in more pathology being identified, is that better for the patient?

If patients are leaving the hygiene room with a greater understanding of the treatment they need to have done, and are scheduling those appointments and are KEEPING those appointments, is that better for the patient?

In the next article in this series, I will discuss the dental examination process in more detail and explain how that detailed examination involving the hygienist at the completion of all the patient’s hygiene resulted in more thorough examinations and treatment plans for the patient.


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