By Rachel Wall, RDH, BS
#1 Assuming perio is taken care of
Having a sharp hygiene team is a beautiful thing. But assuming everything is being taken care of is a big mistake. Be sure you know that a complete perio exam is taking place at every hygiene visit AND the data is being recorded. This is a huge area of liability for you and it's your hygienist’s responsibility to collect and analyze this information. One way to find out where you stand is to do an audit of your charts. Randomly pull 20 charts of adults seen in the last 6-12 months. How many have a complete perio exam recorded in the last year? Chances are very good that if the percentage is low, so is the amount of perio treatment.
#2 Starting perio treatment too late
My interpretation of the AAP's Perio Classification system is that Beginning (slight) periodontal disease is 4mm pockets with bleeding and slight bone loss and 1-2mm CAL. This is a huge distinction for many dental teams. Often, these are the "difficult prophies" or the patients that have 3 month prophy intervals. I see it time and time again- teams waiting until pockets are 5-6mm deep before beginning treatment while the patient loses valuable bone that could have been saved.
#3 Too little time for hygiene visits
If you’ve ever read my articles before, you have probably seen me mention this before and I'll say it again. Every time I have ever coached a team to increase their hygiene time, their production has increased as a result. Now that wasn't the only thing they did. They put in place systems to deliver a higher level of service and enroll more treatment. Critical steps that drive production are left out of the hygiene exam when time is short. When you choose to allow 60 minutes for adult recare and perio maintenance, it's important to outline exactly what will take place during that time. If you are going from 40min hygiene visits to 60min, what are you going to add?
#4 Not expecting enrollment of restorative in hygiene
If you are carrying all the load for keeping your book full of comprehensive, productive treatment...STOP! Empower your team to help you! Set up the expectation and then clearly communicate your treatment philosophy. Your team needs to know when you recommend a crown versus an onlay, for instance.
Schedule time to sit down with your team and outline your specific treatment recommendations. Have them create a mock treatment plan and then work through what they got right and what you would do differently. This one step will automatically increase the amount of treatment scheduled out of hygiene.
My free CD “Top 3 Secrets to Increased Hygiene Co-Diagnosis” gives you a step-by- step guide to conducting a Case Review meeting. Go to www.InspiredHygiene.com to get your copy.
#5 Not realizing that a busy hygiene schedule isn’t always a production hygiene schedule
It’s not uncommon for me to get a call from a very busy practice owner that’s worried about hygiene profitability and the level of care being delivered. As your practice grows, it’s critical to reserve time on the hygiene schedule for high quality care such as perio therapy and maintenance.
When hygiene is full of prophies day after day for months at a time, I often see low perio percentage, tired hygienists and a department that hasn’t reached the 3:1 profitability benchmark. When there’s no time for perio therapy on the schedule, it just doesn’t happen. Those procedures turn into ‘difficult prophies’ and that’s not good for the patients or the practice.
Here are a few action steps to help you get started NOW:
• Do a chart audit-look for current perio charts
• Communicate to your hygiene team that you'd like them to do a complete perio exam on every adult patient
• Give your hygiene team the time they need to complete a comprehensive hygiene exam
• Be proactive and get the information you need to really believe that starting perio therapy early is the right thing to do
• Be sure you have a clear, written protocol for perio diagnosis and treatment
• Place blocks on your hygiene schedule for perio therapy and maintenance
• Order your free Co-Diagnosis CD and do a Case Review meeting-get it on the schedule today!
• Set a goal for how much restorative you'd like to see enrolled in hygiene
Do you have specific questions about how to put these action steps into play? That's exactly how we work with our clients and Mastermind members. We help them create specific strategies to tap into hygiene profits! To learn more go to www.InspiredHygiene.com.
By Rachel Wall, RDH, BS