No More ‘Just a Cleaning, Please’

Are you struggling with the challenges of remaining viable in this economy while keeping your patients committed to a lifetime of ideal oral health despite real and perceived obstacles?

If the answer is yes — and I suspect it is for all dental practices — the problem becomes how to establish strategic priorities. What do you and your team need to focus on first to reduce stress, increase efficiency, and create the best results for the practice and your patients?

It’s important to realize that you can’t be productive and profitable without the commitment and support of your patients. And patient relationships don’t deepen without a continuous effort to raise the bar when it comes to “high-touch” service.

Continuing care beyond a prophy

In analyzing the successes and challenges of practices nationwide, the biggest missed opportunity for enhancing patient relationships has been the lack of a unified focus on creating an ideal “continuing care” department that goes far beyond the delivery of a prophy.

We all know the traditional hygiene recall appointment has changed; even the term recall sounds like: “I’m not human — I’m a car with a part that isn’t working, so I’m scheduled for maintenance.” In that maintenance visit, the frustration is that the mechanic always finds many other parts to fix, costing much more than planned.

No hygienist or dentist wants to be perceived in the same role as that of a car mechanic! Today’s continuing care appointment is more than just a cleaning; it’s the practice’s primary tool to:

• Ensure patients receive the most comprehensive dentistry possible.
• Reinforce patient loyalty and commitment to the practice’s vision and values.
• Create an experience that exceeds expectations so your patients enthusiastically serve as ambassadors for your level of service and care.

The essentials of continuing care

So, what would an ideal continuing care department need to look like to get the outcomes just described?

An empowered, responsible hygiene team

First and foremost, the hygienists in your practice must, as part of their job description, know they’re your co-pilots in each patient’s quest for long-term oral health. This means they’re responsible for efficient, effective, and profitable delivery of clinical hygiene care, and also accountable for supporting and promoting the restorative and esthetic needs that will benefit the patient and support the practice’s long-term goals and strategies.

Think about the last interview you may have conducted with a potential new hygienist. Were your questions all about periodontal maintenance and expanded clinical skills, or did you place as high of an emphasis on customer service, self-direction, teamwork, and influencing? Inadvertently, we can create a limited job scope that reduces the effectiveness of that potential hygienist more than 50% when we only focus on the delivery of direct hygiene production.

Once you have a hygienist hired, you want that hygienist to be aware of delivering state-of-the-art continuing care processes that exceed clinical expectations. This can include focusing on interview questions like:

• Is the hygienist actively involved in soft-tissue management?
• Do they use Arestin?
• Are they using the intraoral camera?
• Do they do sealants?
• Are they inspiring patients to explore esthetic and functional alternatives when it comes to ongoing care?

A culture of purposeful conversations

Beyond direct hygiene production, the most important factor in creating a “high-touch” continuing care department is conducting purposeful conversations throughout every hygiene visit. Purposeful conversations:

• Identify and address the patient’s motivators and concerns.
• Educate them about periodontal disease, oral health issues, and aesthetic alternatives.
• Support the patient’s self-esteem and success.
• Encourage them to refer new patients.

What could a hygienist say to identify motivators and concerns? It could sound like:

When you last saw Dr. Smith, you said that keeping your teeth healthy and beautiful was very important to you. As your hygienist, how would you like me to support that goal?

What would it sound like to educate a patient about periodontal disease and overall oral health and esthetic issues so you could recommend restorative and esthetic solutions? It could sound as simple as:

“I’m about to call out a series of numbers that measure bone loss and gum erosion and signal potential aggressive periodontal infections that would need to be handled with assertive therapeutic solutions. Anytime you hear me call out a number higher than a 4, keep track on your hands because we’re going to discuss which plan of action we’ll need to take to address your health concerns.”

Define your hygiene philosophy first

The first step to begin to create a stronger, “high-touch” continuing care department is to have a hygiene philosophy meeting with your hygienists and team. Discuss the following questions:

• What’s our vision in continuing care, and does it reflect the outcomes we most desire? Is it a vision of periodontal therapy and long-term support of function and appearance concerns?
  • If yes, this means that a random analysis of continuing care charts would show proactive disease prevention and intervention happening on most of our patients through individualized plans customized to meet their unique needs, right?
  • Or are we a “just a cleaning”-based practice?
• Are 90% of our visits just for prophys?
• How much scaling and root planing are we doing?
• How much time do we devote to periodontal disease as well as patient education on long-term health and function?
• Do patients’ charts and radiographs reflect continual deterioration?
• Do we see an abundance of emergencies from patients of record who may or may not have been diagnosed with prevention steps during a hygiene visit?

Having a deep discussion, problem analysis and solutions to address the above is a clear mandate for new, upgraded processes for enhancing the hygiene experience. So when the economy has you confused on what to do first, the secret is continuing care.