Practicing dental hygiene during the last several years has been more emotionally and physically challenging than ever before. Patients are presenting with greater oral disease, and teams are feeling the squeeze. To prevent burnout in clinicians, it is critical for us to learn how to win the battle against the clock.
- Audit charts
One of the best ways to reduce work stress is to prepare for the day. Reviewing your charts the previous day or prior to when your first patient arrives can set up your day for success. The easiest way to do this is to schedule appointment times with the service codes attached. This allows you to quickly look at the schedule book and know what films the patient needs, if they are a periodontal maintenance or prophy, or if they need a full periodontal chart.
Each time you audit, determine if they need a perio chart, what films they need, what treatment was recommended but not completed, and if there are any areas of concern. This will help you pace yourself during the appointment as well as collaborate more effectively with the team. An example of this is if the patient needs a full-mouth series, then the dentist will want to provide a comprehensive exam that day. Preauditing the charts will allow the business team to plan accordingly and schedule the patient for additional times in the dentist’s chair.More by Amber Auger
- The rule of 20
When the hygiene appointment is scheduled for one hour, you can divide the appointment into three 20-minute increments. The first 20 minutes should include the initial assessment with the patient. This includes medical history updates, x-rays, oral cancer screening, and the periodontal assessment. After the first 20 minutes, you should know your soft and hard tissue concerns.
If the patient needs nonsurgical periodontal therapy, the appointment focus should be education and working supragingivally. The next 20-minute segment should focus on scaling. Remember, if you are scaling more than 20 minutes it is not a prophy. If there is more deposit to remove the patient is either a gingivitis patient or in need of scaling and root planing. The final 20-minute segment is for stain removal, education, reappointing the patient, the doctor exam, and escorting the patient to the business team to obtain their pretreatment estimate.
If you haven’t already done so, create a hygiene template. Not only will it save you time, it will also allow you to quickly locate information. I love using the subjective, objective, assessment, and plan (SOAP) format. I include products that patients are currently using as well as recommended changes. This enables me or another clinician to reinforce the messaging at the next visit. Listing the next appointments and their sequence is another important communication tool for the entire team. An example of this would NV1, NV2, NV3. Having the appointment information readily available empowers the business team to expedite treatment plans and answer patient questions regarding multiple appointments.
- Align with the dentist
I find the best way to improve time management is to convince the dentist to check your patient any time after the first 20 minutes of the appointment. By the first 20 minutes, all films or periodontal charting should be collected, the chief concern should be identified, and evaluation of the tissue should be achieved. Reducing the wait time for the doctor will allow you to have more time to rebook the patient, answer additional questions, document your services, and escort the patient to the business team to review costs.
- Assume the best
Assume that a previous clinician, whether in your office or not, did the best they could with the time and resources they were given. I recently treated a patient who was extremely upset that she had gingivitis. She told me that she was using exactly what another provider had recommended for her interproximal care. I had the product with me chairside and asked her to show me how she was flossing. She quickly snapped the floss down and moved on. I demonstrated flossing in a C-shape, stressed the importance of using a fresh segment of the floss as she moved around the mouth, and then had her show me what I had just taught her.
It seems so simple, but the patient was impressed. She expressed her disappointment in the last provider she saw. I explained how much information the dental hygienist had gathered in the last visit—an FMX and a meticulously completed full periodontal chart. I shared with her how she had experienced improvement from the last visit, how I was confident in the clinician she saw, and how the last clinician had enabled me to fully understand her risk factors and current periodontal condition. She looked at me and said, “It is nice to see a woman supporting another woman.”
As a profession, we represent one another. Owning your clinical day starts with managing your mindset toward your peers, employer, patients, and life’s obstacles. Remember, you cannot control what happens in your day, but you can control how you show up for it. Implementing these five tips will allow you to show up much happier, less stressed, and more impactful.
Editor's note: Originally posted in 2020 and updated regularly