The Rush Hour: Time to Get Off the Hygiene Hamster Wheel

by Chrissy Ford, RDH, Advanced Hygiene Solutions

Photo: iStock

Some days, the life of a dental hygienist is like running on a hamster wheel. The race of the clock, running around in circles as you frantically try to stay on time.

In hygiene school, we were given three hours to provide comprehensive patient care. When we compare this to the traditional 60 minute-model given in private practice, it really does seem daunting when we break down the responsibilities that are expected.

“How long should a hygiene appointment be?” I hear this question all the time from dentists and hygienists across Canada. So, what is the proper appointment length to treat an adult patient? The answer is simple, we need to customize scheduling based on the specific patients’ needs.

Many hygienists are struggling to provide complete care with a standardized 60 minute-model. We are missing critical steps to create value in our treatment plans, and hygiene departments are not living up to their true potential.

I see hygienists skipping head and neck exams, not collecting vital signs or periodontal charting because they do not have enough time. Something needs to change; our patient’s oral health and the health of the hygiene department depends on it!

Time = Case Acceptance = Healthy Patients

Would we schedule the dentist the same amount of time for a difficult root canal as a small buccal class 5 filling? Of course not!  Then why do we expect this in the hygiene department? A periodontally involved patient is going to have much greater needs than a healthy mouth and require a longer appointment to treat them comprehensively.

Some adults require very little in the way of scaling, have great home care and healthy mouths. Others have heavy calculus deposits and deep periodontal pockets that require time to treat effectively.

Each patient needs to be assessed and scheduled appropriately. In the 60 minute scheduling model, I often see young healthy mouths booked too much time and periodontally involved patients are not booked enough time to complete thorough care. A twenty-year-old healthy mouth will not have the same needs as a 65-year-old Stage 3 Grade C periodontal patient. Our appointment lengths need to reflect this.

The typical 60 minute appointment has been shown to be insufficient to achieve the goals of a comprehensive periodontal maintenance appointment.

The Journal of Dental Hygiene did a  Breakdown of a perio maintenance appointment. Notice the average time needed was 1 hour and 24 minutes.

These findings reiterate the need to utilize a more customized model for scheduling, to achieve time allocations that are individualized to address patients’ needs.

I believe hygienists should have some autonomy in deciding how much time is needed. The only standardized scheduling times should be for children and new patient first visits. All other appointments should be scheduled based off the procedures the patient requires to assess and treat them comprehensively. Each procedure should have a time allotment attached.

Are they due for full mouth charting, do they require an exam and x-rays, how many units of scaling and root planing does their mouth require to treat them effectively? Having a calibrated time allotment attached to each procedure will ensure enough time is given to complete the necessary treatment, as well as calibrate the team in booking – which keeps the hygiene department productive.

It’s like Goldilocks and the Three Bears. You’ll never have too much time or not enough time, you’ll always have just the right amount of time that each patient requires. This translates into healthier patients, happier hygienists, and a more productive hygiene department.

Many doctors think squeezing more patients in a day will increase production, but it does the opposite. If a hygienist does not have enough time to complete periodontal charting or educate on the need for treatment, we will underdiagnose periodontal disease, have poor case acceptance and the office’s bottom line will suffer.

I see many hygienists starting to lose their love for our profession and they feel they’re not making a difference. Running on the hygiene hamster wheel, day in and day out, will burn out even the best clinicians eventually.

Let’s get off the hygiene hamster wheel and find passion in our profession again! Individualized scheduling based off the patient’s need is a benefit for all involved. It’s a simple concept and I’ve helped transform many offices by introducing this small but key concept. You will see better clinical outcomes, increased production, and a healthier work environment for everyone.

If I could see less patients a day, provide a higher standard of care and help increase production, that’s a win-win in my books!

About the Author

Chrissy Ford is a registered dental hygienist, practice manager, speaker, published author and founder of Advanced Hygiene Solutions. She is committed to empowering dental hygienists to find passion in their careers and enjoys coaching dental teams on how to integrate strong and profitable hygiene programs into their practice. Her coaching and continuing education company is PACE approved and provides online courses, hands-on workshops and in office private coaching. Chrissy can be reached at or follow-on Instagram @advancedhygiene

RELATED ARTICLE: The Schedule Squeeze Play