By Sally McKenzie, contributing writer

June 5, 2019 -- Are your hygiene production numbers down from last quarter or last year? Are these numbers hurting your bottom line. Yet you look at your schedule and patients are booked out weeks in advance, yet somehow your hygiene department does not meet its numbers.

Lackluster hygiene production also sends your overhead numbers skyrocketing because there's a good chance you're paying your hygienist more than what's being produced. We recommend to our clients that a hygienist's salary should not exceed 33% of production.

Yes, this is all frustrating, but making the right changes will get your hygiene department back on track. To get you started, I've put together the top three reasons hygiene production is low, and tips to help you turn it around.

Sally McKenzie
Sally McKenzie, CEO of McKenzie Management.

1. Your recall system

Even though this system represents the best opportunity to grow practice revenues, many of our clients ignore it. How can you take action? I suggest hiring a patient coordinator.

Task this person with reaching out to and scheduling a certain number of past-due patients every day. Give your employee the information and tools needed to educate patients and address their perceived barriers to care. It's also important to train your coordinator to schedule to do their best to ensure that hygienists produce three times their daily wages.

2. Relying on preappointments

This is a system many dentists use, yet it's both outdated and the reason your hygiene schedule looks like it's full when it really isn't.

The problem is, even though patients schedule six months out, they really have no idea if they'll actually be able to make it. Work and family commitments often come up, and the dental appointment they scheduled months ago moves down to the bottom of the priority list. They cancel at the last minute or just don't show up at all, leaving you to try to fill the open slots and causing you to miss production goals if you don't.

“Don't let low hygiene production hold your practice back.”

In our clients' experience, practices that preappoint only retain about 76% of their patients. I'd like to say it gets better from here, but it doesn't. Our estimates are that these same practices also average a loss of 50% more patients than practices that don't solely rely on this scheduling system. Why? Well, if your schedule appears full, that means patients who are ready to schedule treatment can't get an appointment for weeks. Maybe they'll go ahead and schedule while they're on the phone, but often they're going to start looking for a dentist who can get them in sooner. And when they find one, they'll likely have a new dental home and no need to schedule their next hygiene appointment at your practice.

My suggestion for resolving this issue is to implement a hybrid system. You can still preappoint reliable patients who show up for their appointments, but don't do it for patients who are known for flaking out. Flag these patients and only schedule them a few weeks beforehand. They'll have a much better idea of what their schedule will be, making them more likely to actually show up. This will help reduce your broken appointment rate and increase your hygiene production numbers.

3. No perio program

When we start working with new clients, few of their hygiene departments actually offer interceptive perio therapy. That means they're missing out on a huge opportunity for growth, and it's often because they're afraid patients will react negatively.

While it might be awkward to tell patients about the presence of periodontal disease, it's the hygienist's job to inform them of their condition and to educate them about the risks.

When you're ready to incorporate a periodontal program, there are many ways to approach it. For our clients, I recommend they start at the front (desk). When patients are greeted at the front desk, they should receive an educational brochure and questionnaire that focuses on the signs and symptoms of gum disease. Once patients fill out this paperwork, you'll know about any symptoms they may be experiencing. This can tell you what you should talk about while they are in the chair. Being able to tailor your education will help ensure patients understand their condition, making them more likely to accept the treatment they need.

Don't let low hygiene production hold your practice back. Make the right changes and your numbers will start to rise. And if you need more guidance, don't hesitate to reach out. I'm happy to help.

Sally McKenzie is the CEO of McKenzie Management, a full-service dental practice management company. Contact her directly at 877-777-6151 or at

The comments and observations expressed herein do not necessarily reflect the opinions of, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.

Copyright © 2019

To read this and get access to all of the exclusive content on create a free account or sign-in now.

Member Sign In:
MemberID or email address:  
Do you have a password?
No, I want a free membership.
Yes, I have a password:  
Forgot your password?
Sign in using your social networking account:
Sign in using your social networking