Empowering your hygienist

by Roger P. Levin, DDS, MBA

It doesn’t have to be that way in your practice. With the right training, systems and motivation, you can transform your hygiene department into a high-performance team. Hygienists play a major role in the success of the practice. When hygienists have the opportunity to observe potential problems, educate patients and provide non-routine hygiene services, their excitement and commitment to the practice will grow.

Your hygiene department should set an expansion goal of 15 percent per year. If more than 98 percent of all patients are scheduled for their next appointments, hygienists can focus on identifying patients who will benefit from additional services, such as:

1. soft tissue therapy

2. whitening

3. sealants

4. panorex x-rays

5. plant dentistry

6. amalgams, composites and crowns.

Soft tissue therapy

Soft tissue therapy is the first step in treating periodontal disease, which is the number one cause of adult tooth loss. If your hygienist identifies any type of periodontal disease, the initiation of a soft tissue therapy program will increase your hygiene production while providing the proper first level of treatment for your patients.


Many patients are interested in whitening, thanks in part to the popularity of over-the-counter whitening products. This built-in interest creates a tremendous production opportunity for your hygiene department. Your hygienist can introduce patients to professional whitening, which is stronger and more effective than the types found in supermarkets. Whitening is a gateway service that may lead patients to choose other cosmetic procedures, such as bonding and veneers.


Sealants are a critical component of preventive care especially for younger patients. The likelihood of developing pit and fissure decay begins early in life, making children and teenagers obvious candidates for this treatment, but adults can benefit from sealants as well.

Your hygienist can begin to increase sealant applications by fully educating patients about preventing tooth decay and maintaining a healthy mouth. Be sure you have incorporated sealants into what patients consider “routine” dental care, such as:

* brushing twice-daily with an ADA-accepted fluoride toothpaste

* flossing daily

* eating a balanced diet and limiting snacks

* visiting your office regularly

* and, of course, having dental sealants applied.

Panorex x-rays

Hygiene patients should receive panorex x-rays every 3-5 years. These x-rays can be extremely beneficial in identifying additional treatment that may not have been previously diagnosed.

Implant dentistry

Every patient with missing teeth should be a candidate for implants. However, only a small percentage of general dentists are currently performing implant dentistry. Based on this lack of participation, implant dentistry represents a huge opportunity for forward-thinking practices.

A better smile is more than a dream for patients missing one or more teeth — an improved appearance can be a reality, thanks to dental implants. Many people have adapted a number of ways to hide the gaps caused by their missing teeth and have grown accustomed to not having fully functional teeth. The majority of patients do not know how significantly dental implants can change their lives.

Every practice that is seriously interested in building its implant dentistry needs to take dramatic steps to increase patient awareness. It is not enough to merely ask patients how they feel about their smile as if that suddenly creates tremendous awareness and interest in implant treatment. Patients with missing teeth don’t believe that correction is possible. They have grown accustomed to not having the smile or fit they want. They simply do not know about dental implants or do not know enough about them. Consequently, patients must be shown and educated how they can benefit from implants.

Empowering your hygienist is one of the best strategies to increase patient awareness about implants. Implants feel, look and function like natural teeth. Unlike dentures, implants do not have to be removed at night. Implants can enhance the quality of your patients’ lives. You, your hygienist and the rest of your staff should emphasize the many benefits of implants to your patients. Be sure to have many before-and-after visuals and patient testimonials available throughout the office. If a staff member has implants, that person can serve as a “walking testimonial” for patients.

Amalgams, composite, and crowns

Many patients have older dental work in need of repair. These problems should be fixed immediately. Unfortunately, many practices choose the “Let’s watch it,” method, which often results in further deterioration of the older dental work. During scaling and root planing procedures, the hygienist can identify older dental work that needs repair. Upon this determination, the practice should build value for repairing or replacing older dental work.


There are many opportunities to expand the role of the dental hygienist and provide patients with better oral health care. The hygiene department has tremendous potential to increase production and profits. Practices should provide hygienists with the necessary skills to educate and motivate patients to accept comprehensive treatment. Beginning with one service and adding others as each becomes familiar to the hygienist is an excellent start to increasing hygiene production.

Roger P. Levin, DDS is founder and CEO of Levin Group, a U.S.-based dental practice management consulting firm. Since the company’s inception in 1985, Dr. Levin has worked to bring the business world to dentistry.