Do you believe the following statement? “Hygienists are the key to healthy patients and a thriving, successful dental practice.”   

 Believe it or not, extensive historical data tells us this statement is valid. Hygienists have a greater impact on the health of patients and overall success of a practice than any other team member, dentists included. It makes perfect sense if you think about it. An experienced, engaged hygienist identifies and evaluates different conditions and either treats those issues themself or shares with a doctor to diagnose and address. The hygienist is also often the most trusted clinician in the practice and is the person most patients look to for guidance when making decisions about needed treatment.  

Data also confirms that the rapport a hygienist builds with patients directly impacts case acceptance. Patients spend more time with you than with any other provider. Because of this, a hygienist is also at the heart of practice production and profitability. Like a hub in a wheel, the hygienist’s role is central to everything else everyone else does in a practice. Their work makes everything else possible. For these reasons, “I’m  just a hygienist” are words that should never be said or thought. A hygienist’s impact and importance cannot be overstated.  

 However, to validate and act on these statements, data is required. But where to start? There are so many things to pay attention to! How can a clinician know which metrics to track and, more importantly, how to correctly interpret what those numbers mean? This can be a great challenge and deterrent to a hygienist’s efforts to impact patient health and practice growth. Just keeping up with a demanding schedule can quickly overwhelm. Finding the right system that informs but doesn’t overload a busy clinician is critical.  

 In an insightful recent article about this subject in RDH Magazine, Kathryn Gilliam shared how understanding the business of dentistry positively impacted how she cared for her patients:  

 “[I learned] that the financial health of the dental practice is vital for being able to provide this level of care to our patients. We needed a certain level of productivity and profit to be able to pay the rent on our building, keep the lights on, afford the supplies necessary to do our jobs, purchase and maintain new technology, and regularly attend advanced continuing education courses. This was basic business education that I had not received in my four-year undergraduate studies nor in my two years in dental hygiene school."

"It was a real eye-opener to learn about supply and demand, profit and loss, my personal profitability, and other business basics. I became keenly aware of my position as a business partner to my owner-dentist. I felt a responsibility to produce at least three times my compensation and create a profit so we could cover the expense of my assistant, as well as be able to afford the microscope and laser we wanted to implement to treat our patients at a higher level.”  

 How well do you understand the business of dentistry? Are you content with letting someone else handle that, or do you have a voice in the management of the practice?   

 Here at Dental Intelligence, we work every day with over 8,000 dental practices that use the insights found in their practice management software to provide more and better dentistry to their patients. Our data reinforces the important role that hygienists play in the overall success of a practice in addition to the critical impact they have on patient health.  

 For example, Grove Creek Dental in Pleasant Grove, Utah did the following in 2021:    

• 224 crowns (which represented over $180,000 in production.)  
• 1,800 prophys (which resulted in over $116,000 in production.)  

All  this restorative production started in the hygiene department, which, on average, is the source of 80-85% of all production in a typical practice. If $300,000 in production (not including all the other treatment coming from hygiene) doesn’t validate the impact of this department on a practice, nothing will. This practice uses Dental Intelligence to measure all their KPIs (key performance indicators). Instead of manually trying to track everything, Grove Creek has found that Analytics does all that work for them and enables the team to easily understand and effectively act on this data.  

Hopefully the message here is clear — data helps hygienists to take better care of their patients, which directly impacts the growth of the practice. Or as RDH Sarah Varney so succinctly put it, “An objective look at numbers is never punitive. They tell a story about how we are serving patients — and where we need to grow.”  

Now for the fun part! Here are some of those KPIs that hygienists should be keeping track of. These are all included in the Dental Intelligence Performance Board  for easy access. Consider starting with one or two of these and  then spending the next few weeks keeping track of each one. It should only take a few minutes each day, but the impact will be significant.   

 Perio Diagnostic % - The ‘how much perio is there?’ Metric  

 What is this?  

 Perio Diagnostic % divides the total number of patients diagnosed with perio treatment into the total number of patients seen who are 30 years or older and have not previously been treated for periodontitis.  

 Why is this Important?  

 According to the CDC, we know that the national average of periodontal disease in America is 47.2%. Granted, depending on where you practice, this number will swing either higher or lower. Knowing your perio diagnostic % allows you to see where you are among the national Average and even among other hygienists in your area or practice. This can help you decide if you or your practice has a blind spot in diagnosing periodontitis.   

 Perio Acceptance % - The ‘does the patient understand the treatment?’ Metric  

 What is this?  

 Perio Acceptance % is the percentage of patients seen in the practice that are 30 years or older and not currently in perio, who were diagnosed with perio treatment and said yes to all or a portion of that treatment on the day of their appointment. This is identified by the treatment that was added to their treatment planner and scheduled or by unscheduled treatment that was completed the same day. If a team member was part of this patient’s appointment, this team member will get credit for the patient accepting the treatment.  

 Why is this important?  

 We know that every team member plays an integral part in patients accepting our recommended treatment. How big is their impact? Without seeing who was with the dentist when these cases were presented, it’s difficult to know the impact team members are having on the patient saying, yes or no. When looking at acceptance by individual team members and by the Treatment Teams, you can quickly identify the top presenters and the top presenting teams. Use this data to identify these top performers, learn what they are doing, and replicate their delivery.  

 Perio Visit % - The ‘did they complete the treatment?’ Metric  

 What is this?  

 Perio Visit % divides the total number of patients that were seen for perio into the total number of Hygiene Patients seen in the period. To be counted as a patient seen for perio, one or more perio procedure codes need to have been completed on the day of the patient’s appointment.   

 Hygiene Visits per Hour – The ‘how much is my time worth?’ Metric  

 What is this?  

 Hygiene Visits Per Hour is calculated by taking the provider's total visits (Not Patients Seen) divided by the actual Clinical Hours.   

 Why is this important?  

 All providers want their production per hour to increase. If this number is lower than desired or expected, one of the first metrics to look at is the Hygiene Visits Per Hour. The cause of low production per hour could simply be a consequence of not seeing enough patients in the hour. If patient visits are not the cause, then begin looking at the Average Treatment Presented, Treatment $ Acceptance % and Average Accepted $ Per Patient.  

 Hygiene Re-Appointment % - The ‘did I get them to schedule back’ Metric  

 What is this?  

 The percentage of hygiene visits that on the same day of the hygiene visit have scheduled a subsequent hygiene appointment before leaving the dental office. Hygiene visits are the number of patients being seen for hygiene care.  

 Why is this important?  

 By reappointing a higher percentage of your continuing-care patients, you'll help ensure a stable and growing patient base. This provides your patients with the possibility of two exams per year, resulting in needed treatment being diagnosed. The hygiene department will grow at a much faster rate, increasing the number of scheduled appointments without the cost and hassle of your front desk making numerous calls to reschedule. By focusing and improving the performance of same-day reappointing, the practice will increase overall production, collections, and value. Currently the alternative method to measure the re-appointment % in the practice is through manual efforts that are time-consuming and often inaccurate.  

 NP Hygiene Re-Appointment % - The ‘how did the first appointment go’ Metric  

 What is this?  

 The percentage of the provider's new hygiene patients that have scheduled a future hygiene appointment.  

 Why is this important?  

 Adding or not adding new patients into your continuing care program is a key factor in the number of new patients your practice will need to grow based on your priorities. 

 Fluoride Treatment % - The ‘risk of decay’ Metric  

 What is this?  

 The percentage of patients who had fluoride completed during their hygiene visit, based off whether these codes were put on the patient's ledger.  

 Why is this important?  

 Oftentimes, as hygienists, we allow insurance companies to dictate what we prescribe. It's been reported by the NIH  that 92% of adults 20-65 have active caries in their mouth. This being true, it is safe to say that virtually all patients would benefit from fluoride treatment regardless of insurance reimbursement.    

 Expanding on that idea, if your practice does not currently offer silver diamine fluoride, learn more about it and speak with the doctor about allowing you to perform that fluoride treatment on pediatric patients. This is the only fluoride that can arrest caries, and very few practices have begun using it. This service is a double win, improving oral health and improving your value in the practice.  

The Data-Driven Hygienist  

 For these and so many other reasons, you make a difference. If you have learned nothing else, hopefully, you’ve learned this: the numbers (and patients!) do not lie. You have a vital role to play not only in patient health, but also in the health of a practice. Hygiene is at the heart of any successful office. 

 As a “thank you” for taking time to read this article, we have a gift for you. It is a simple Hygiene Patient & Practice Impact Tracker you can use to discover your impact on patient health and practice growth. It includes daily, weekly, and monthly steps you can take. Click here to download your free copy today.