Dental Showmanship: Explain the magic trick of a hygiene appointment

Nov. 12, 2014
Efficiency is a priority in the dental office, because, as we all know, time is money. Production, which to some of us is a four-letter word, is what keeps us doing what we love to do.

By Christa Crilley McConaghy, RDH, PHDHP

Efficiency is a priority in the dental office, because, as we all know, time is money. Production, which to some of us is a four-letter word, is what keeps us doing what we love to do. If there was a magic wand that could allow us to slow down, make our professional lives easier, and help us make more money, wouldn’t we jump to get it?

Many of us have been in the profession for many years working on our craft, and we have found ways to cut the time of our procedures and still keep a quality of care that we can be proud of. This efficiency has created a perception that the dentistry we are performing is easy. Patients do not understand that we are creating dental artistry in a dark cavernous hole on a saliva-threatened canvas while our inverted view through a small mirror is continually pushed by a powerful muscle. They see the time on the clock and the money they pull from their wallet.


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Showmanship can be defined as a skill of performing that will appeal to an audience to convey a theme or a message. We perform every day to educate our patients on their oral health. The education we provide will determine if a treatment is accepted or refused. Dental showmanship is an act we need to rehearse to convey the value of the services our patients receive.

I’m not saying that we need to put on a show like pulling a rabbit out of a hat to wow our patients. I’m saying that taking the time to explain how each step of what we are doing can create more value for the dentistry we are asking our patients to invest in. Asking our patients questions regarding their care will allow us to determine what their goals are.

In the hygiene department, many patients visit us to get their teeth cleaned. What they don’t realize is that during that appointment we are performing an oral cancer exam, a periodontal exam, a caries risk assessment and a nontherapeutic prophy along with hygiene instructions, if needed, without additional charges above the oral prophylaxis code (D1110) and periodic exam code (D0120). It is well within our rights to code out oral hygiene instructions (D1330), caries susceptibility tests (D0425), and nutritional counseling (D1310) when we find a high risk for decay.

Asking permission to do these adjunctive procedures instead of going through the motions and doing them without verbalizing the task we are performing will keep our patients engaged. Many may ask why we are doing these additional procedures. This will give us the opportunity to educate our patients on their needs while providing more production for the practice. If a patient declines these opportunities it gives us some insight as to what their dental goals are or are not.

We can also use intraoral photographs to add visual detail to the words we use when educating our patients. If we rush through the appointment to finish the prophy, it denies us the chance to show our patients valuable information. An intraoral photograph of a hemorrhaging periodontal pocket and a large overhang of calculus increases the patient’s ability to understand the periodontal treatment we will talk to them about later.

A picture says a thousand words. Being shocked by bleeding may be what they need to hear and see to get them motivated to accept periodontal therapy. We can also add another shocker. Not do the prophy. Explaining the need for a salivary bacterial test and having the patient accept it is a win-win for both you and the patient. You are not rushed to provide a service the patient doesn’t need, and you can potentially provide more production to the office by getting more data that will create more value for the periodontal services the patient needs.

Dentists can add showmanship to their appointments as well. Adding drama to an appointment by acting shocked that the patient is not in pain when a tooth is cracked puts emphasis on the severity of the problem.

The way we act towards our patients’ dental problems will get a reaction, positively and negatively. It just depends on how our message is delivered. We have invested a lot of time and money to become the educated clinicians we are today. Now is the time to work our magic and make our patient’s respect in what we do reappear.

Christa Crilley McConaghy, RDH, PHDHP has been a licensed registered dental hygienist since her graduation from Montgomery County Community College in 1996, and received her bachelor’s in oral health-care Promotion from O’Hehir University in 2013. Her career goals are to improve oral health-care by implementing disease prevention programs into medical and dental offices and help dentists realize the potential dental hygiene services have on their practice through clinical and consultative services. She can be contacted at [email protected].