Your dental hygienist should be your top referrer

Jan. 21, 2013
During a typical dental hygiene visit, only the most obvious service needs are identified, usually single-tooth treatments. Dr. Roger Levin explains a new four-step approach that can be a catalyst for a significant increase in production, typically $200,000 or more a year.

In the new economy, dental practices must operate at their maximum potential, and the hygiene department is no exception. In the conventional hygiene scenario, the dental hygienist typically performs a prophylaxis on the patient for 40 to 50 minutes, and then the doctor stops in for four to five minutes. At this point, only the most obvious service needs are identified, usually single-tooth treatments.

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Handled differently, the hygiene visit can be the catalyst for a significant increase in production — typically $200,000 or more a year. This is a direct result of the hygienist using a new four-step approach developed by Levin Group.

The Four Hygiene Factors™ For Increasing Production

In a unique four-step process, the hygienist examines and communicates with the patient.

1. Identify. The dentist and hygienist work together to sharpen the hygienist’s skills in identifying patient needs for basic, comprehensive, and elective dentistry. This step sets the stage for increasing per-patient production.

2. Educate. The hygienist should discuss all the services available in the practice, including elective treatment. The conversation should include both oral health and elective considerations. While describing available treatments — without getting too technical — the hygienist will also stress the benefits of the various services. Levin Group has seen ample evidence that this type of education results in very high case acceptance.

3. Motivate. As the hygienist learns more about the patient’s concerns and desires, the motivational stage begins. Building on a strong relationship and using excellent communication skills, the hygienist makes specific, firm recommendations of dental services that will benefit the patient the most. In many cases, the patient will be motivated to accept treatment and follow through.

4. Close. Once motivation is achieved, the hygienist can close the case. This includes a simple, benefit-based description of the recommendation, including fees, financing options, scheduling — and the statement that the doctor will, of course, need to confirm the findings and recommendations. By the time the doctor walks into the room, the hygienist has already accomplished most of the process. The doctor provides the diagnosis and then possibly treatment, if time permits.

All of this can be accomplished without spending more time or detracting from the usual requirements of the hygiene visit.


Hygiene should account for 25% of practice production. However, by identifying and recommending other services, the hygienist can account for as much as $100,000 to $200,000 in higher production. General practitioners who are trying to grow their practices in the new economy should utilize an existing resource — the hygienist.

To learn how to run a more profitable, efficient and satisfying practice, visit the Levin Group Resource Center at— a free online resource with tips, videos, and other valuable information. You can also connect with Levin Group on Facebook and Twitter (@Levin_Group) to learn strategies and share ideas.

Author bio
Dr. Roger Levin is a third-generation general dentist and the chairman and CEO of Levin Group, Inc., the largest dental practice management and marketing firm in the United States. As a leading authority on dental practice management and marketing, he has developed the scientific systems-based consulting method that will increase practice production and profitability, while lowering stress. Dr. Levin has authored more than 60 books and over 3,000 articles. He presents 100 seminars worldwide each year.