Dental Practice Solutions

Optimize your dental hygiene department by taking an integrated, team approach

  • Do you feel like you are working hard and your production is not increasing?
  • Do you feel like your hygiene department is under performing?
  • Is your hygiene department producing 25-30% of your total production?
  • Are hygienists in your office treating bloody prophys?
  • Does your hygiene department help enroll implant cases and high-end treatment?
  • Do you have one or more holes in your schedule daily?

I am so happy that you are here because we have answers and solutions to your challenges.

Dental Practice Solutions - Debbie Bittke

7 Tips for Dental Hygiene Appointment Success: Staying on Time, Keep it Down to a Science

By: Debbie

July 24, 2013

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Let’s face it, working in a dental office and managing to stay on time for your patients can be a stressful event!

The dental office team members need to take charge and manage the daily schedule.

How can your dental team take charge and reduce the potential threat of stress of “Staying on Time”?

The dental hygiene appointment can be stress-free is you follow these 7 tips.

Step 1 Set Goals

Break down your goals according the each department, and each treatment room in your dental office. For example, a typical dental hygiene appointment should provide profits to the dental practice not a loss leader.

If you plan accordingly the profit potential can happen with the feeling of stress. Waiting for doctor to examine the patient is often a huge stressor. Even patients become anxious waiting for doctor to arrive. Have you had patients who had to wait for the doctor exam and they became impatient? Read on for some more tips to stay on time.

Step 2 Time Your Procedures

I am almost positive that you have a good idea how long each procedure will take. Time your procedures; doctor / hygiene exams, assistant time, fluoride treatments, sealants, even doctor prep time, on and on. Write down a list of services you provide patients. Write them down, include the treatment room available for the procedure (Maybe you can move a patient who needs impressions, etc., after the routine hygiene procedures) write down available rooms, which can additionally provide this service. (Within their scope of practice) This will help you gather a lot of information about how to schedule more productively and with less stress.

Have you taken time to “time” your procedures? If you have not done so, schedule a monthly team “timing meeting.” Your timing can become easily disrupting with various factors. Some of these factors are employee turnover, what to do in the case of a late patient, how do you make up for time if patient anesthesia is a challenge, etc? There are so many more topics regarding timing so sit down and create a success plan around this topic.

Step 3 Break Down the Time

Break down each appointment into primary, secondary or doctor/assistant time. When you schedule around the primary providers time, your practice will drive a health level of revenue.

I want to ask that you write down and share what type of dental procedures you enjoy providing. Include the entire team: dental hygienists and assistants as well. As a dental hygienist, I have enjoyed treating the periodontal patients. Many of my dental practice management clients have a hygienist that prefers to see the periodontal patients. In many offices one hygienist will see a large majority of the pediatric patients or the new patients. Another hygienist is best at treating the more difficult patients; stressed out patients and more difficult periodontal cases. Discover which services each provider enjoys most and then schedule in “special” times for these types of services in each provider’s schedule.

Block your schedule in 10-minute increments. If you choose 15 minutes, you will lose thousands of dollars over a year of appointments. It just doesn’t round up when you have 15 minute increments of time in your daily schedule.

Here are a few examples:

Scaling and Root Planing (SRP) – 2 quadrants. This may take only 90 minutes. There will be 3 – ten minute increments of time left after this block of time.

A patient who is at moderate to extremely high risk for caries will be returning to your office every three to four months for about 10= 20 minutes of time. (CAMBRA – CARIES MANAGEMENT BY RISK ASSESSMENT guidelines)

If you have a 90-minute block of time for two quadrants of SRP, the block of time after this service is a great time to schedule an appointment for a patient at moderate to high risk for caries. (Fluoride Varnish, homcare instructions, etc.)

Possibly a small child can be seen for a prophy/fluoride appointment. Sealants or impressions for night guards or bleach trays can fit in these thirty minutes of time as well. When you strategize and look over the doctor’s schedule, you may have the prep of a crown scheduled for 80 minutes. The doctor’s time should be blocked off during the exact time he/she must be in the room. (Examples: anesthesia time, preparing the crown, seat time, etc.)

Think outside the box of purely blocking patient dental hygiene appointments for exactly 60 minutes for a hygiene appointment. Block out the assistant time as well in this situation.

Many offices are implementing assisted hygiene, (Not to be confused with Accelerated Hygiene!) and I enjoy guiding teams through the process of creating a stress-free, success schedule of time with assisted hygiene. Always block for doctor, assistant time and hygienist time.

Step 4 Use a Schedule with Blocked Templates

Once you have established your daily production goal for each treatment room, work with your team to create and visually layout a best schedule to create quality dentistry, delivering impeccable care and that personal touch.

Do you prefer to see your high-end aesthetic cases in the morning? Do you want children in the office early morning? Block out these times exactly when you want them to be in your schedule.

I always requested that my patient appointments for scaling and root-planing be scheduled in the morning. Occasionally, I would have one after lunch but I definitely enjoyed seeing the more difficult cases in the mornings when I was fresh.

Step 5 Decide Who Will Schedule Next Appointments 

The success of a full schedule really has a lot to do with the clinical team. If you have a couple of administrative team members at the front desk, you may want to have one of them in charge of scheduling doctors’ appointments.

The hygienist (or someone on the hygiene team) is the very best person to schedule future hygiene appointments. I have found over the years as a clinical hygienist and working with my clients, that the hygienist is in a good position to educate patients about their need for specific types of appointments and the necessary intervals  to maintain optimal health. This is in line with how communication works best. It also eliminates patients going to the front desk with any confusion about why they need a next visit for “x, y, or z.”

The one time it is not efficient for the hygienist (or someone on the hygiene team) is when the patient needs multiple appointments scheduled. An example of this is a patient who was diagnosed today for four quadrants of scaling and root planing and will need to return for 4 appointments plus a perio maintenance appointment, four to six weeks later.

It can be a good idea to have one person at the front desk also is in charge of the hygiene schedule. This is one person who can make follow up calls to overdue hygiene patients as well as schedule these multiple appointments as necessary.

Step 6 Hygiene Exams

It works best for everyone, (patient, doctor and team members) if doctor enters the hygiene treatment room to complete the exam after the hygienist has completed her/his assessments and before the last 10 minutes of the hygiene appointment. I will share a diagram at the top of this blog and below is an explanation of how this should flow.

**See the photo at the top of this blog for a break-down and science of time management. Doctor should come into the hygiene room to complete the patient exam after 2nd interval – (See the time management pie chart) which is the hygienist’s initial case presentation. The hygienist completes his/her assessments and then presents his/her findings in an initial case presentation. This is a couple of minutes to explain what the hygienist and patient saw in the patient’s mouth. Doctor should not enter the hygiene room to begin the exam later than 15 minutes before the hygiene appointment is supposed to end.

Step 7 Communication Saves Time

Many offices today use radio devices, communication lights in the treatment room, or instant messaging on their computer software to communicate if a patient has arrived to the office.

Many sports teams have a high level of communication skills, moving from one play to another. This is the same level of communication you will want to have in your dental office.

One More Stress relief Management Tool

Imagine your time management skills as rewarding and stress free.

Understanding the value of your time, how it can be used and a commitment to effective communication are your keys to manifesting your goals and increasing profits in your practice!

Do you have a time stressor during your day in the dental office? What might that be? I would enjoy hearing about your time stressor.

Maybe it will be another topic here for another week’s blog. It is possible that I have a solution. If you write it in the comment below, you never know, someone else may have a great solution.

Looking forward to supporting you!


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Debbie Seidel-Bittke, RDH, BS, is founder of Dental Practice Solutions and for over 20 years she has been committed to creating a dental hygiene department that works enthusiastically, creating a high performance teams, improving patients’ total health and consistent profits to the dental practice.

She is an author for journals such as Dentistry Today, Hygiene Town and RDH. Debbie speaks internationally about systems and services in the dental hygiene department to create a team that works like a well-oiled machine, improving the total health of patients’, utilizing the most recent science to prevent disease and consistently increase profits.

In 1984 she graduated from USC in Los Angeles in with a Bachelors Degree in Dental Hygiene. She is a former clinical assistant professor from USC. In 2000-2002 Debbie co-taught the practice management course for the dental students. Debbie is also a former dental hygiene program director for a school in Portland, Oregon where she wrote the accreditation, hired the instructors, purchased all the equipment, worked with project managers on the building of the school while managing a 2 million dollar budget.
Debbie works with dental practices throughout the world and is considered a leader in creating consistent profits to a dental practice through services and systems in the dental hygiene department.

Check out her new program for 30 Days of information to increase profits in your dental hygiene department: 30 Days of Profit to Your Dental Hygiene Department