The Hygienist’s Role in Permission-Based Treatment Presentation

by Carrie Webber, Owner & Chief Communications Officer, The Jameson Group

Do these statements sound familiar?

  • Discussing treatment with patients makes me feel pushy.
  • I don’t want our patients to feel “sold” to.
  • Our patients would never want to hear above and beyond the minimal care needed.

If you have ever thought any of these phrases, you’re not alone. Supporting optimal treatment, discussing this with your patients with confidence, and working to refine your skills and resources to help patients say yes to treatment is not a disservice to your patients or a negative aspect of your practice. Working under the assumption that your practice is ethical, diagnosing appropriate treatment, clearly communicating the treatment and what it fulfills for the patient, the only thing that improving your skills in supporting diagnosed or recommended treatment does is helps your patients get treatment they either need or want.

But how do we – in a comfortable, ethical, compassionate way – open the doors of communication and presentation with our patients on diagnosed treatment, and even more, elective aesthetic treatment that in turn leads to case acceptance? And what is your role in this journey with your patients? Here-in lies the need and benefit of permission-based case presentation.

In the marketing world, the term “permission-based marketing” lends itself to describing marketing outlets that consumers have entered into willingly. Examples of this are signing up for e-newsletters, following your business on Facebook, subscribing to a blog and so on. Compare this approach to what they call “interruption-based marketing” – advertisements, direct mail, etc., where the marketing effort “interrupts” my day. I am ultimately more engaged in permission-based messaging because somewhere down the line I asked for and gave permission to receive that information.

How does this pertain to you and your role in treatment acceptance? At Jameson, as we teach case presentation to dentists, hygienists and team members across the United States, we find again and again that the greatest obstacle practices need to overcome is their own comfort level and consistency in effective communication skills. Being able to meet a person where they are, listen for goals, concerns, needs – being able to move the conversation ahead in a positive and comfortable way that ultimately leads to higher case acceptance – all falls within the category of communication. Within these communication skills are the times and places when asking permission to proceed becomes imperative.


In your conversations with patients regarding their care, you want to do three things when it comes to diagnosed or desired treatment:

  • Educate the patient
  • Motivate the patient
  • Activate the patient

Are we asking appropriate questions to uncover the patient’s true wants and needs in their dental care? Are we then taking what we learn from the patient and building upon that based upon what they shared? If we see they need two crowns and one of their goals that they shared with us is that they want to keep their teeth healthy for a lifetime – how would we share that diagnosis based upon their ultimate health goals?

Are we as dental professionals asking permission to share any findings we have discovered? Are we asking permission to present the best possible treatment? Are we asking permission to share financial options that are available in our practice? I believe that the path to case acceptance is filled with little “yeses” along the way. For example:

Hygienist: “Carrie, I know that the last time you were here, Dr. Jameson diagnosed some needed treatment that you were considering. At this time, I will be taking some photographs to assess the condition of your teeth now so that the doctor can review that with you. May we have permission to show you any new areas of concern should we discover it in this assessment?”


Hygienist: “Carrie, it does appear that the teeth Dr. Jameson was concerned about at your last visit have deteriorated even more. As you can see from this photograph, I am concerned that this will continue to progress if we don’t address this soon. I know that you have shared ongoing health of your mouth as a top goal for your care and so I will make sure that Dr. Jameson reviews this with you during his evaluation. Do you have any questions for me as we look at this together?”

Do you see the picture I am painting? Every step of the way we are doing three things:

  • Explaining and educating
  • Asking questions and listening
  • Asking permission to proceed

In doing these things, we develop a partnership with our patients – a partnership with the ultimate goal of total health and well-being. By involving the patient in the process, helping them know what to expect, what is next and gaining their permission along the way, we build trust between each other and alleviate the anxiety that comes from misunderstanding, loss of control and confusion.


It’s important that you become more and more comfortable with asking the right questions early on to your patients so that you can build a path to health for you both to take together. By the time it’s all said and done, have you asked the right questions to know the following:

  • What led them to your practice?
  • What are their expectations of you and your team?
  • What are the patient’s goals for their dental care – short-term and long-term?
  • What are their concerns, if any?
  • What questions do they have for you that need to be answered ASAP?
  • What obstacles are in their way for receiving care?
  • Do we have solutions available to help with those obstacles?
  • Are they interested in learning more about those solutions?
  • Do we have permission to share with them any findings during their evaluation?
  • Do they understand your approach to dental care?
  • Do we have permission to present optimal treatment?
  • Do we have permission to have conversations about how to move forward toward accomplishing their goals for their mouth, their teeth and their smile?
  • Who else, if anyone, helps them make decisions on their health and care?

Those are a lot of questions, yes – but many of those questions’ answers are built within a well-communicated conversation. It takes practice, but with time you will find yourself having these clear, effective conversations with ease and putting your patients at ease as they feel connected to the conversation and engaged in the process as well. How could it impact your results? How could it impact your patient-focused practice?

Asking these questions and effectively listening to their responses will take time. Timing your hygiene appointments in a way that supports room for patient education is key to fully uncovering the goals, obstacles and opportunities for a patient to move forward into treatment they want or need. The most successful practices have a strong doctor/hygienist partnership that together educate
their patients to move forward with the type of treatment that is best for them. Building processes in your appointments that support the use of visual aids such as photography and strong verbal skills in your conversations can lead to patients that not only say yes to treatment, they complete the treatment, stay active in your practice, and ultimately refer others because the patient-practice partnership approach you take leads to strength in trust and value for the work you provide.

Asking the right questions and asking for permission along the way – this is where the tide turns, and people are met with what they need and what they are seeking in their healthcare and relationships with their healthcare providers. This is the path forward for your ongoing practice success.

About the Author

Carrie Webber is Chief Communications Officer and co-owner of The Jameson Group, a dental management, marketing and hygiene coaching firm that helps dentists and teams become more productive, more profitable and ultimately more fulfilled in their practicing lives. Carrie creates customer service and business development opportunities both internally for Jameson and for dental practices and leaders across the country. Carrie is an educator and contributing author to multiple organizations and publications on the topics of marketing, customer service and business development and a popular speaker at dental meetings nationwide. For more information on Carrie & Jameson’s portfolio of services, visit

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