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Strengthen the hygiene schedule by focusing on your patients' needs

March 1, 2018
A robust hygiene schedule can seem elusive, but Amber Metro-Sanchez, RDH, BA, says it's closer than you think—you should start by thinking about the patient in your chair. What can you do to make the hygiene appointment a place he or she wants to be, not an inconvenient (or worse, painful) obligation? Read on to find out.

In dental hygiene, one of the biggest disappointments is when your schedule isn’t filled or unexpectedly falls apart, leaving your pocketbook and the practice at a loss. When a patient cancels an appointment with short notice or don’t show up at all, it also means that another patient (the one scheduled or another one who could have taken their place) missed out on an opportunity to receive care that day. And if the schedule is never filled in the first place—the least desirable scenario—there is serious stress and concern for any hygienist. Either situation leaves you questioning what could strengthen the schedule.

Keeping the hygiene schedule full should be one of the top objectives for every dental office, but it can be a challenge to make that goal attainable. Every patient should be seen at least two times a year for preventative care, and too often we do not see this happen. (1) Seventy-five to 80% of proposed restorative work is identified during a hygiene appointment, so a slow schedule for a dental hygienist can translate to a slow schedule in the doctor’s chair also.

The key to this dilemma is to make your dental office the place that your patients want to be, not an undesirable and inconvenient obligation. If you can create an environment where your patients look forward to their dental appointment and it is on the top of their priority list, stress about keeping a schedule full will be a thing of the past.

Be attuned to patient demand

Just as with nearly any other business, dental hygiene has its busy and slow times of year. (2) In dentistry, the summer months (when children are out of school) are easily filled. Also, December tends to be another busy month, as kids are on break from school and patients often want to use up their dental benefits before the end of the year. January may also be yet another productive month with new patients who are inspired by New Year’s resolutions to be proactive with dental care.

During times when dental appointments are in high demand, your office should try to accommodate patient demand as much as possible. One way to do this is to add extra hygiene hours if possible. A part-time hygienist can work extra days. Or if your office has a good substitute hygienist, perhaps the dentist could offer to add this person to a day’s schedule.

The key to this dilemma is to make your dental office the place that your patients want to be, not an undesirable and inconvenient obligation.

The dental office where I have worked for the past 12 years used to close every year between Christmas and New Year’s Day. The staff enjoyed the down time, but the patients absolutely hated it. They wanted to be seen during this time, and they felt we were really letting them down. My boss decided to make a change and closed the office only for Christmas Eve, Christmas Day, and New Year’s Day. As a result, the patients’ needs are being better served and the staff still has some time off to spend with their families.

Conversely, when demand slows down, as it typically does at some point in time, don’t let it be a surprise. You may find yourself ready for a little break, and the money you earned working extra hours during busy times may help cover you financially. The month of May can be slower, as parents are waiting for children to get out of school before they schedule appointments. September tends to be a slower month, as children have all returned to school. Another slower month for Northern states can be February as the weather can get nasty and some patients prefer to wait for spring. Let these slower months leave you feeling refreshed, mentally and physically, so you are fully prepared for the busier times ahead. And remember they are all part of a natural business cycle.

Keep patient comfort a priority

Let’s face it, we have all heard stories about people who dread going to their hygiene appointment because “it hurts!” I cringe every time someone tells me that, whether the issue is a rough hygienist or a lack of home care on the part of the patient. The bottom line is that we need to make our patients look forward to their recare appointments, not be afraid of them. A patient’s comfort must be a top priority if we want our schedule to stay healthy and strong.

Creating this comfort level can sometimes be a challenge, but it all starts with empathy. We must all remember what it feels like to be the person in the treatment chair. Sometimes the comfort zone is reached by talking a patient through his or her fears. And other times. this comfort is created by addressing physical pain with a lighter touch, a smaller instrument, or using topical or local anesthesia as necessary. Patient education also helps to prevent painful tissue conditions in the future. These actions all takes extra time, but the payoff is a highly loyal and grateful patient, which is an extremely valuable asset to any practice.

Oftentimes a hygiene schedule can be further strengthened by scheduling patients with the hygienist that they are most comfortable with. Then when the person comes to the appointment, he or she will know exactly what to expect and will already have a bond formed with the preferred hygienist. The patient may also be reluctant to cancel, as they fear losing time their time reserved with their prized hygienist.

A secondary benefit of keeping patients comfortable is that they will enthusiastically share their dental experiences with others. These are the patients that will help to grow your practice base. These are also the patients that will go out of their way to come your office even when they move or their insurance changes. Comfort is everything when it comes to keeping the hygiene schedule strong.

Don’t let your patients forget about you

Making sure your patients show up to their scheduled appointments is completely essential to keeping the hygiene schedule strong. But sometimes life gets hectic, leaving our patients, even those with the best of intentions, vulnerable to inadvertently forgetting an appointment. This is where appointment reminders—effective ones—kick in.

Being flexible with patient notifications will help prevent missed appointments from wreaking havoc on your schedules. Many automated patient reminder services, such as Solutionreach or DemandForce, offer a variety of options when it comes to contacting your patients, whether it be by text, phone, email, or a combination. Ask your patients how they prefer to be contacted and how often.

I have had patients comment that they are not contacted often enough, and others complain that they are being contacted too many times. Take their concerns seriously! Customization is an essential component to succeeding in this arena, as everyone’s needs are different. Once these reminders are set up for a patient, your office will reap the benefits for years to come.

Timing of the reminders is critical when it comes to getting patients to show up for appointments. A first reminder should be sent out at least two days before the scheduled appointment, so if the patient does cancel, your team has an opportunity to fill it. On the flip side, your office should not send a single reminder too early, as it gives even the best patient an opportunity to forget. Then a second message can be sent 24 hours before the appointment time as a gentle reminder, if the patient requests it.

Another benefit of automated patient reminder services is that it gives you an opportunity to contact patients who are due for recare effortlessly. This is especially useful during slower times of the year. For your patients who have not been in recently, send a friendly reminder every six months to keep in touch. Taking advantage of everything your reminder service has to offer will only improve your hygiene schedule in the end.

The bottom line is that every patient wants to keep his or her teeth healthy for a lifetime, even though there are many obstacles that can get in the way. Your dental office plays an essential part in making your patients’ good intentions a reality. When your dental office is in high demand because your patients’ needs are being fully met, your concerns about keeping a hygiene schedule full will be a thing of the past. You and your patients both become winners!


1. Philhower J. 4 ways to increase your production by $100,000. Dental Economics website. Published February 20, 2014.
2. Rossi B. Seasonality in dentistry. Dental Economics website. Published March 1, 2005.

Editor's note: This article first appeared in RDH eVillage. Click here to subscribe.

Amber Metro-Sanchez, RDH, BA, practices dental hygiene with Dr. Chris Bible at Comfort Dental in Fort Wayne, Indiana. She also works as a professional educator on behalf of Waterpik. Amber was a member of the 2015 Colgate Oral Health Advisor Board. Amber is also a contributing author for the Colgate Oral Health Advisor webpage. She can be reached at [email protected].

About the Author

Amber Metro Sanchez, BA, RDH

Amber Metro-Sanchez, BA, RDH, practices dental hygiene with Dr. Chris Bible at Comfort Dental in Fort Wayne, Indiana. She also works as a professional educator on behalf of Waterpik. Amber was a member of the 2015 Colgate Oral Health Advisor Board. Amber is also a contributing author for the Colgate Oral Health Advisor webpage. She can be reached at [email protected].