As you begin your dental career, chances are you’ll work with a hygienist; if not immediately after graduation, then likely sometime in your future. The hygiene department has been called the ‘Backbone’ of the general dental practice, and the hygienists you work with can have a huge impact on the success of a practice.

Effectively communicating your expectations for how you’d like your hygienists to share information with you during the exam is key to empowering them to help you enroll restorative care.

Here are some specific things you can communicate to your hygienist that will help them make the Doctor/Hygiene exam most effective .

1: You’ve spent anywhere from 20-50 minutes with this patient. I’m walking in cold. Please, bring me up to speed. 
Imagine you’re at a cocktail party, and you see someone that you’ve wanted to meet for a long time. Perhaps it’s a potential new client or someone you really admire. Your friend just had a 20-minute conversation with that person, and so you hope this is your chance. You walk up and they’re both quiet. Your friend introduces you, but beyond that you just stand there in awkward silence. You’ve got to leave the party in about 10 minutes, and you want to find out everything you can about this person, but your friend is offering no help. So you ask a million questions and talk really fast and then take off.

As a new dentist, hygiene checks can feel like you’re walking into an already established conversation and you’re the third wheel? You fumble through an awkward conversation, and then you leave. Or you try to tell them everything about you and find out everything about them while talking quickly, and it’s all very overwhelming.

Now think of the opposite scenario. You walk up to the pair at the cocktail party, and your friend introduces you and brings you right into the conversation telling you all about this person you’ve been wanting to meet. The new friend feels special, and you all feel connected right away.

Developing an empowered hygiene team prevents those awkward exams where you feel like you’re walking in cold to try and figure out the patients needs in 10 minutes or less. Giving your hygienists permission to openly discuss their patient’s treatment needs and share them with you during the exam is a critical step in building trust and treatment acceptance.

To build your hygienist’s confidence in co-diagnosis, tell him/her that you are confident in their dental knowledge and skills. Then set out your specific expectations regarding co-diagnosis. It may sound something like this …
“I respect you as a highly skilled dental professional. To effectively support our patients in staying healthy, I need your help. Patients trust you and your opinions. To work as a team, we must all have the same beliefs in what is best for our patients. I would like to spend time reviewing my personal treatment philosophy and why I make certain treatment recommendations. This will allow us to discuss areas in which we may have different opinions on treatment and resolve them.’
Although it is your job, as the dentist, to make a final diagnosis and treatment plan for your patients, it is perfectly acceptable to expect your team to contribute to that diagnosis process with thorough observation and education of our patients.

Give your hygienist permission to observe restorative needs and to begin educating patients of those conditions. Permission to participate in diagnosis, not only for perio disease, but also for restorative needs, is critical. Give your hygienists permission to think beyond calculus and gingival health and begin to think about what might have caused that abfraction on #11. To think about what you might recommend to strengthen that second molar that is broken. To look at X-rays and analyze the root tips as well as the bone level.

Clearly communicate your treatment philosophy. Often, dentists assume that since their team works with them each day, they are familiar with their treatment philosophy. This may be true but there may be some specific aspects of treatment that the staff is unfamiliar with. Reviewing cases together will build confidence in your treatment recommendations and get everyone on the same page.

2: I’m OK with you taking charge of the exam.
So many times hygienists are timid about directing the doctor in the hygiene exam. At the same time, 95 percent of the hundreds of dentists we’ve worked with WANT the hygienist to guide them through the exam. This presents a great opportunity for learning and open communication. Again, be very clear with your expectations on what how you’d like the information delivered.

Map out the flow of the dialogue and practice. Here’s an example:

Greet patient and connect
Patient’s concerns
Medical/Dental history-risk factors and changes
Perio/Restorative status
Treatment discussed
Patient’s readiness to move forward

Not only is this helpful in hygiene, but the same format can be used by your assistants for emergency or new patient exams. Many of our clients have a checklist in the op next to the computer to remind them of this sequence. This helps calibrate the entire team so the doctor is getting information in the same way from each team member. Can you imagine how receiving this information in a very similar way from every clinical team member can free you up to be more effective at treatment planning and enrollment?

3: If I talk too much about personal stuff, it’s OK to redirect me.
Ok, no one wants to be rudely interrupted, but I’ve found that some hygienists are reluctant to jump in to move you along in the exam. The first step is to give them permission to do so. The next step is to share with your hygienists exactly HOW you’d like them to redirect you. It could be something like, “So Dr. Smith, I’m really concerned about Sue’s old metal fillings.”
Even better, there are two non-verbal cues that your hygienist can give you that will help you immediately know you should connect quickly with the patient and then get down to business:

• Intra-oral photo of a treatment need up on the monitor or printed out
• Perio chart printed in color and handed to the doc upon entering the room

4: Please give me a hint as to how much information the patient needs from me.
Dentists and hygienists can get frustrated with each other when it comes to the balance of patient education. If the hygienist has already talked with the patient about the benefits of a crown and then the doc comes in and does the same thing, someone is going to be annoyed. Especially if it means the appointment runs long.

Have you ever felt that you talked a patient out of treatment that is in their best interest? Perhaps with too much information or too many options? What if your hygiene team let you know what was discussed and the patient’s readiness to move forward? That would give you a cue as to how much you need to educate.

It can be something as simple as, “Dr. Brown, Jane has a few more questions for you about the bite guard we discussed.” Or, “Dr. Brown, Jane is ready to schedule a time to take impressions for the bite guard.” That’s your cue to confirm the plan and move on.

5: I appreciate you.
It’s that simple. Bonuses and benefits are wonderful AND just as important are these simple words. When interviewing our client team members, many of them are yearning for a “good job today” or any words of sincere appreciation. It costs nothing, goes a long way and reinforces the actions you’re looking for.

Would you like more information on how to unlock the untapped potential in your future hygiene department? We are pleased to give you our popular CD, 10 Essentials to Increasing Hygiene Service, Systems and Profits. Please visit www.inspiredhygiene.com to order your free CD and to register for our free weekly e-zine, where we share weekly tips on building a thriving hygiene department. Rachel can be reached at: rachel@inspiredhygiene.com