By Rhonda Jones, RDH, BS

June 5, 2009 -- When John Donne wrote "no man is an island" in the 1600s, I'm sure the term "dental hygienist" never crossed his thoughts. However, the universal truth -- that human beings do not thrive when isolated from others -- does indeed apply to hygienists.

Often, many professionals see the hygienist as a separate entity from the "heart" -- the restorative aspect -- of the dental practice. To many dentists, the hygienist is a constant interruption of their day-to-day operations. Something like Vatican City existing in the middle of Rome. A completely incased country unto itself that demands the doctor's time every 50 to 60 minutes.

Unfortunately, some hygienists have the reputation of being prima donnas, sitting in their operatories swapping gossip and recipes all day. Truth is, they are so tied to their operatories they appear to have little time for processing instruments or assisting with an emergency toothache patient squeezed into the schedule.

In fact, being a hygienist can be a very lonely job in those practices where they are viewed as a separate entity. And it is important to realize that "separateness" does not lead to profitability for the practice.

A two-way street

The hygienist has multiple roles within a dental practice: revenue producer, oral health educator, dental disease evaluator, and periodontal and preventive therapist. When team members begin to operate as individual silos, not interacting and functioning as a highly efficient machine, the practice suffers financially. Patients are quick to pick up on dental teams that do not have a harmonious working relationship, and this vibe can send them out the door in search of a new dentist. All team members need to be multitasking, working together to create a positive experience for each patient, but the hygienist should be a leader in this process.

Creating a positive professional working relationship with all staff members is a two-way street for the doctor and hygienist. They both have a heightened professional responsibility to create thriving environments. The hygienist should be a reflection of the doctor's practice philosophy. This reflection does not occur by divine intervention. It must be developed though communication. Discussion of philosophy during the interview process does not count. We are just like our patients -- we forget 50% of information we receive. Communication with your hygienist regarding your philosophy of practicing dentistry should be ongoing. Discuss new technology, research articles, and difficult treatment cases within your practice. Encourage continuing education and in-office training sessions for your office. Have monthly lunches with your hygienists to discuss new ideas, issues, or procedures.

One of the most powerful selling tools in the dental practice is consistency and providing a seamless experience for the patient during the dental visit. Never take for granted that your hygienist is fully informed of your wishes and directions, or that she is aware of the new materials, crowns, or procedures you are now incorporating into your services. Dental assistants have a definite advantage by being in the treatment room with the dentist. They can repeat the why, when, and how of your treatment plans in their sleep. Can your hygienist pinpoint the type of treatment you would recommend for any particular case? Are you calibrated on periodontal case types? Do you share a common belief and knowledge of current dental products? Do you use the same terminology when talking about restorative procedures, periodontal disease, bruxism, and cosmetic procedures?

Take a moment and use this scenario to check the periodontal calibration between you and your hygienist. What periodontal case type would you classify this sample patient?

Gingivitis is moderate but localized to the mandibular anterior teeth. Probe readings are 4 mm with bleeding on the lingual of teeth #23 through #26. Tooth #30 and #28 has light subgingival calculus on the mesial surfaces but no pocketing present. There is a 2-mm lingual bar of calculus on the lingual of the mandibular anterior teeth. Tooth #18 has a 5-mm pocket on the mesial surface with moderate calculus present. Classify the type of periodontal disease, and create a treatment plan for this patient.

The art of perception

In evaluating the role of the hygienist in your practice, ask yourself these questions: How do you and your staff define or see your hygiene department? Is your hygienist a vital part of the success of your practice? Is the hygiene department a break-even venture or a loss leader, or does your situation fall somewhere in between?& Unfortunately, many dentists are frustrated with their current hygiene situation, but feel discouraged at the thought of implementing desired change.

Make sure your hygienist is an extension of your philosophy and practice mission. Open the lines of communication with active listening. When you have negative issues, always lead with something positive. Your issues will be heard by more open minds when you accentuate the positive first. Ask for your hygienists' opinions, comments, and concerns, and challenge them to take a leadership role in finding solutions to profitability issues. Ask questions to confirm what you hear.

Yes, all this takes effort and time, but what you get in return could be a more profitable and valuable practice and a long-term employee. Remember what else Donne wrote back in the 1600s: "...never send to know for whom the bell tolls; it tolls for thee."

Rhonda Jones, R.D.H., B.S., is teacher, speaker, and dental hygienist in Canton, GA. She can be reached at Anderson & Associates,

Copyright © 2009


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