The Best Ways Of Preventing Patients From Slipping Through The Cracks In Hygiene

Six Month Recalls.

Hygiene visits.

Hygiene maintenance.

Call them what you will.

What’s the best way of making sure your patients make these appointments and keep these appointments?

Gone are the days when dentists didn’t need to worry about a “recall” programme in their Dental Offices.

You know what I mean?

In the olden days when there was so much relief of pain dentistry to do and restorative dentistry to do that we just simply didn’t have the time to be cleaning teeth for people with good teeth, did we?

And in those days there weren’t many of those patients.

All roads led to dentures….

But now with education, fluoride, awareness, prevention and the oral care industry, people are now taking more teeth to their grave with them rather than sending their teeth off to an early grave.

And of course, in this day and age it’s definitely considered below standard of care to treat the teeth and not the gums and supporting structures.

So what are the best ways of increasing hygiene appointment attendances?

Well, in the olden days, the cleaning, as it was called, used to be simply tacked on at the end as the last appointment in a series of appointments that the patient had to bring their mouth to a state of health.

Almost like an afterthought.

Like the after dinner mint, or the fortune cookie.


Except that the patient was billed for it…

And so it was never really promoted for what it really was.

And so it became regarded as an unnecessary annoyance, or an unnecessary evil that the patient “gifted” to the dentist after he had restored all the teeth that he needed to restore.

Nowadays, things are different.

And even more different in the fee for service dental practice.

The educated and motivated patient understands that regular hygiene visits are necessary to reduce the effects of irreversible periodontitis.

Because that plaque and tartar ain’t going away by themselves any time soon…

The most significant improvement we made to hygiene attendance rates in my practice was to promote the role of the hygienist within the Dental Office.

I always wanted my patients to believe that the hygienist could see everything and discuss everything that the dentist could, in most instances, and that the only thing she could not do was drill teeth.

Because some patients believed [incorrectly] that a hygienist was at the other end of the spectrum and was simply a dental assistant who could clean teeth.

Always have the hygienist schedule the patients’ next hygiene visit right there, in the hygiene room, with the hygienist.

This is the number one most influencing factor in gaining that commitment to the next hygiene appointment with this patient.

The patient is making a face-to-face commitment there and then with the hygienist, who has just spent the past thirty to forty minutes or more in their mouth gently removing plaque, tartar and debris, and also alerting them to any areas of concern that require ongoing attention.

Appointing at this moment gains far greater commitment to the next appointment from the patient. Much more than if the appointment is scheduled some ten to thirty minutes later at the front desk.

It is important that the next hygiene appointment is scheduled immediately following the hygienist’s treatment, and not later on after any unnecessary or poorly timed interruptions.

And this means the dentist.

We always scheduled the next hygiene visit with the patient before the dentist came in to do the dental examination.

Thus we were able to close the hygiene chapter in the patient’s mind and then open the restorative chapter with them.

When we did not follow this order, and the hygienist booked the patient’s next hygiene appointment *after* the dentist had completed the restorative examination, we found all we were doing was confusing the patient.

“He said I need two crowns and you’re trying to book me in for a cleaning??”

Making sure we had separation of purpose at this time added to our attendances for both hygiene appointments and restorative appointments.

So how did we make contact with our patients as their pre-made hygiene visits were approaching?

What did we find worked best for us?

Well obviously, in the olden days, sending patients a card or a letter telling or asking them to call our office because their RECALL appointment was now DUE or OVERDUE was what we used to do.

First of the month, out came the cards.

Those dentists back then who were customer service focused even had a dotted line where they could write the patient’s name:

Dear …..Mrs. Brown…….

You are now due for your regular recall appointment… 


Here’s what we do now:

Two weeks before their scheduled appointment we send them an SMS text message:

“Your Preventive Care Appointment with your hygienist Emily is coming up in about 2 weeks on Thursday 18 February at 10:30am. We are looking forward to seeing you. Kind Regards, Jayne-Active Dental”

There’s no call to action here. It’s simply a heads up for the patient that their upcoming visit is about two weeks away.

If the regular motivated patient has an issue and needs to change this time they would contact us and do so.

There was no reason for us to use the words *remind* or *confirm*.

Adults hate to be reminded and confirmed…

Two or three days before their scheduled appointment we would send them this SMS text message:

“We are looking forward to seeing you at your appointment with Emily on Monday 10th September at 10:30am. Could you please reply to this message so I know you have received it. Kind regards. Jayne-Active Dental”

This message would be sent before 10:00am. This then gave us the remainder of that day to follow up with the patient should we not hear from them, and if need be, make amendments to their appointment time and then bring other patients forward if required.

Additional follow up and contact would be made by phone:

“Hi Betty, this is Jayne from Active Dental, Just calling to let you know that Emily is really looking forward to seeing you on Monday at 10:30am.”

Patients would often say, tongue in cheek, “I bet she is!”

When we left this as a message on their service we would add:

“Please call me back on 9876-5432 to let me know that you received this message OK.”

At all times when making contact with our patients we would make sure that we understood exactly what was each patient’s specific and valid and rememberable Reason To Return for their appointment.

Patients keep appointments for their reasons not yours and not ours.

They will attend their hygiene appointment so that Emily can check on things she’d seen and told them about last time:

  • that recession
  • that pocket
  • that bone loss
  • that area of bleeding
  • that area of food trapping
  • those teeth that are loosening up

These are things concerned patients do not want to deteriorate or get any worse.

Patients don’t like returning so much for:

  • their regular hygiene
  • their routine maintenance
  • their recall appointment
  • their check-up

Which all sound a lot more like our reasons for them to come rather than being actually for their reasons.

Confused patients who are unclear will delay or defer important and essential hygiene visits because they do not understand.

The use of better systems and best language will go a long way towards creating clarity and reducing that confusion.

And providing that clarity is in itself a world-class service for our customers…


My upcoming two day workshops will be held  in Manhattan in April.

You can reserve your places here: Click Link To Order


Have you read my book , How To Build The Dental Practice of Your Dreams [Without Killing Yourself!] In Less Than Sixty Days.

You can order your copy here: Click Link To Order


The Ultimate Patient Experience is a simple to build complete Customer Service system in itself that I developed that allowed me to create an extraordinary dental office in an ordinary Sydney suburb. If you’d like to know more, ask me about my free special report.

Email me at

Did you like this blog article? If you did then hit the share buttons below and share it with your friends and colleagues. Share it via email, Facebook and twitter!!