Dental Practice Heroes
Where dentists learn how to cut clinical days while increasing profits - without sacrificing patient care, cutting corners, or cranking volume. We teach you how to grow a scalable practice through communication, leadership, and effective management.
Hosted by Dr. Paul Etchison, author of two books on dental practice management, dental coach, and owner of a $6M collections group practice in the south suburbs of Chicago, we provide actionable advice for practice owners who want to intentionally create more time to enjoy their families, wealth, and deep personal fulfillment.
If you want to build a scalable practice framework that no longer stresses, drains, or relies on you for every little thing, we will teach you how and share stories of other dentists who have done it!
Dental Practice Heroes
The REAL Profit from the Hygiene Department
Dental practice owners across the country face a mounting challenge—skyrocketing hygienist wages that strain traditional production-focused models. But what if obsessing over hourly production metrics is actually holding your practice back from its true potential?
In this transformative episode, I reveal why the real value of your hygiene department extends far beyond cleaning teeth and covering overhead. Your hygienists aren't just maintenance workers—they're relationship architects creating memorable patient experiences, treatment acceptance facilitators preparing patients for necessary care, and health consultants offering solutions that improve lives.
When patients spend 40-60 minutes with your hygienists but only 2-5 minutes with you as the doctor, those hygiene appointments become the defining experience of your practice. Patients form their strongest impressions and build their trusting relationships during hygiene visits. The loyalty this creates drives retention and word-of-mouth referrals that no marketing campaign can match.
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with dental hygienist wages being higher than ever, we as the practice owners are sometimes sitting there saying, oh my gosh, how do I make this model work? And we're wondering am I giving my hygienist too much time? Should I shorten the times that I'm paying them so much and are they producing enough? And that's what came up recently in our last online mastermind meeting on the dph hero collective. We had somebody asked they were starting a practice. They said, hey, I'm about to open a practice. I wanna make sure that I start with the right appointment times as far as recalls, srps and new patients go. Because he didn't want to give his hygienist too much time because it would be hard to take away. But then again he didn't wanna give them insufficient time. So he asked the group and we discussed it and what I noticed is that most dentists they really think the hygiene department is all about cranking out cleanings, covering the hygienist wages and making sure that there's enough production so that it makes sense. And we're entering an era where it's starting to not make as much sense in that regard. But what if I told you that that mindset is actually holding your practice back? Today I'm going to break down the real high-level function of the hygiene department and how, when you see it differently, it can transform your patient loyalty, your treatment acceptance and even your profits. Let's get into it Now.
Speaker 1:You are listening to the Dental Practice Heroes podcast, where we teach dentists how to work less, earn more and build practices that run themselves. I'm your host, dr Paul Etchison. I'm the author of two books on dental practice management and a dentist who more or less went from burnout to building a multi-million dollar practice while working just one clinical day each week now. So if you want more time, more income and more life outside of your dental practice, you are in the right place. I think the true value of the hygiene department it's just not in profitable appointments. It's so much deeper than that. It comes in those non-tangibles. It's so easy for us to look at dollar per hour production of a hygienist and say this hygienist is worth it to the practice, this hygienist is making a profit, and I think we're completely missing the big point. Although they are a revenue center, I want you to really look a different way about what the goals of the hygiene department are and when I look at them, I think it's so important for them to create an unforgettable patient experience and that really builds loyalty and referrals with your patients. I want them to set the stage and tee up the doctors to diagnose and get better treatment acceptance. Think about how poor treatment acceptance is in dentistry and if you can improve that a little bit, that is much more valuable to practice than them seeing an extra patient a day so they can get one extra prophyon. And, lastly, they are there to improve the patient health by offering meaningful adjunct services, things that the patients need, that they might not know about and things that the patients can really benefit from if somebody offers it to them. So let's talk about this. Let's talk about your hygiene department really providing an experience for your patients.
Speaker 1:Now we've got to realize that hygienists, they're going to spend the most time out of anybody else at your practice with the patients. For the most part, most patients, patients that come in as new patients. They might have a few fillings, maybe a crown to do, and then they're going to go into the hygiene recall system and they're going to see the hygienist and guess what? You as the doc, you're going to pop in there for like two to five minutes and all your friends are going to tell you man, you don't even do anything at the practice. I mean, the hygienist does all the work and then you just pop in there for like two minutes because they think that you know you're not doing anything. You're just sitting in your office farting around on the internet. They don't realize that you're over in your operatories and you're producing two thirds of the revenue of the office. So the patients are going to associate how their dental experience is so much more with the hygienist than they are with you.
Speaker 1:So we need to pay attention to this and we need to make this a focus of our office. A great hygienist is going to be friendly. They're going to be personal. They're going to make that patient feel cared for. They're going to make them feel known and understood. So this is all these communication skills they need. They need to be good listeners, they need to be good communicators and when you can create a hygiene patient experience that makes the patient feel all those things, you're going to get better patient retention, you're going to have more word of mouth referrals and you're going to have more patients feeling comfortable because they trust you and like you, which leads to them saying yes. So the hygienists aren't just cleaning teeth, they're building brand loyalty.
Speaker 1:So what do we do to help them do this? Well, first we need to have our team keeping relational notes. This is somewhere in the chart. I can tell you where we put it in our charts. In Open Dental we put it in the com log. I don't think it's the best place for it. In Open Dental I think there's a little ortho chart that we don't use on hygiene patients. That would be such a perfect place to put it in. But my team has fought me on that tooth and nail and I've decided that is not a hill I want to die on. So we keep it in the com log, but check out that ortho chart in. So you got to make sure that they're keeping those notes so that when the patient comes in they remember things about them. Did they go to Vegas? Do they watch their grandkids? Because the fact of the matter is, you might have people on your team that remember every one of your patients. I know you have one, I have some too, but for me, I'm never going to remember that stuff. So we keep notes on the patient because we want them to feel valued and there's nothing shallow about that at all.
Speaker 1:I remember back when I was in dental school, I saw a new eye doctor. I went, I saw him one time and I didn't go back there for probably like three years. Now. When I came back there for my second visit three years later, he came in and he was like hey, paul, he's like, oh my gosh, last time I saw you, you, and I knew that there was somewhere written in the chart that I was in dental school. There's no way this guy remembered me. It was a total uneventful appointment. I hadn't seen him in three years. I wasn't going there my whole life. But it didn't matter to me.
Speaker 1:The fact that they took the effort and they made those notes because they wanted to provide an experience. That's what mattered to me was the intention behind it. I didn't care that if I saw him at the store he would have said, hey, paul, you must be a dentist now. He probably wouldn't even recognize me. So it is part of the patient experience. We've got to keep those notes. So we've got to make sure that's part of our culture.
Speaker 1:All right, now the hygienist I talked about. They need to tee up treatment. This is like one of the most important things they can do for you, because, if you think about it, they are like that unbiased person that's going to tell the patient what they need. There is this view with patients and it's awful, but it's true they feel like dentists are out there to rip them off. I don't know, I'm sure there are dentists that actually do that. I think it's such a small percentage and I think a lot of us get blamed for things like that and we don't really do that. But the fact of the matter is is that's part of the psyche of the patient? They think that we might be making things up that they don't need because we got to pay for our boat or pay for our vacation house, stuff like that.
Speaker 1:So we want the hygienist to be the first opinion. They are going to spend 40 minutes or so doing the prophy, taking x-rays, taking diagnostics, and it's kind of weird if they see all these things in the patient's mouth and they don't say anything. And then you, as the dentist, walk in and say, hey, you've got all these issues. The patient's sitting there like, hmm, why didn't the hygienist mention any of it? And then what do they do? When you walk out of the room, they look at your hygienist and they say do I really need all that stuff? It happens every time.
Speaker 1:Ask your hygiene team. You want your hygienist, when they're doing the prophy, when they're doing the diagnostics, to look at the teeth and say you know what? This tooth's got a crack in it. And they tell explain what the crack is, explain why it's a problem, and say the doctor may recommend a crown on this tooth. Or you know what? See this on your x-ray, this dark area here, this kind of looks like this might be some decay. We'll see what doctor says about it, but you might need a filling. There it's.
Speaker 1:They don't have to diagnose because legally they can't diagnose, but they can at least be the first opinion for the patient. So how do we do this with our team? We have two things we have to do with our hygienists. First, we got to give them the blessing. We got to say hey, this is how I want my practice to operate. I want you to be the first opinion. I want you to be able to be comfortable talking to the patients about treatment. Okay, that's the first step. The second step is you've got to do calibration meetings. So that means you've got to sit down with your hygiene team and you've got to go through cases and say this is what I'm looking for, this is how I diagnose, this is my treatment philosophy and this is how I explain it to patients. Because when you get everybody on your team on the same page, you're all recommending the same things. And now you're a team that is working for the best good of the patient.
Speaker 1:And let me be honest with you You're hygienists. They don't want to sit there and just scrape teeth all day. They want to play a more active role in the patient's health. So give that to them. Ask them if they're comfortable doing that. If they're not comfortable doing that, work with them until they are, because if they are uncomfortable doing it, it's because they just need training and they don't feel confident in what they're seeing. But that can change, just like it changed for you when you showed up for dental school. You didn't know crap and I guarantee you it doesn't take four years of dental school to be able to diagnose problems in teeth. Oh, do you see this hole in here? It's all sticky and soft. That's probably a cavite. You, as the doctor, you want to be the closer, not the cold caller. Okay, so you need to work with your team. Got to do this case calibration meetings with your hygiene team, all right, at the beginning of this episode we talked about how, when this person was talking in our online mastermind meeting, which, if you're interested, it's the DPH Hero Collective. It's a very low monthly rate and you can find out more about that at dentalpracticeheroescom. But this person was asking how much time should I give, because I want to make sure that I'm still profitable with my hygienist.
Speaker 1:Now, the third thing that's important for the hygiene department is that they're not just maintenance workers. They're health consultants. They are there to help the patients. So they are there to monitor the patient's perio to make sure they're getting all the right diagnostics on a schedule that you determine. What kind of x-rays do you want every year? So these are things that you'll establish with your hygiene team, but they're responsible to make sure that you're not missing it, like they're your backstop, to make sure that we're doing the best thing for the patients, because you, as the owner doctor, you've got a lot to juggle, so they're there for that. They are there to recommend fluoride topical fluoride for anyone who is high caries risk, to do laser gum therapy for anyone who's got perio risk or just some inflammation, some gingivitis. They are there to talk about adjuncts like PerioProtect, talk about rinses that you can offer. Maybe some desensitizers talk about a night guard for somebody who's bruxing. They are there to serve the patient and help them have the best dental health. They can Now guess what this benefits everyone.
Speaker 1:Right, this benefits the patients. They get healthier outcomes. It benefits the hygienist because they feel like they're improving lives, not just scraping teeth. They are feeling like they're making a difference. And, lastly, it benefits the practice because it builds additional revenue ethically. So I said that we're not focusing on what they're producing, but this is an opportunity for them to really produce when they're offering additional treatments that can be done in the hygiene chair.
Speaker 1:To me, that's a very different thing than shortening appointment times so they can see more people. No hygienist wants to shorten appointment times to see more people. They want to be able to spend enough time so that they can serve the patient because, let's face it, guys, that's what we're doing in dentistry we're serving. So hygiene not just about production goals, it's not about seeing enough patients to offset their salary. It's about building relationships, providing a patient experience, teeing up case acceptance and offering better health solutions for our patients.
Speaker 1:So, coming back to what we talked about and this person was asking, I will share with you what we do as far as times at my office. We do 60 minutes for a recall, we do 90 minutes for a new patient and we do 90 minutes for two quads of SRP. That is what we have settled on. We used to have less time, but we added more time when COVID happened because we had additional protocols and what we discovered serendipitously, when we gave the hygienist more time, they had more time to talk with the patients, to build relationships, to talk about treatment and to offer other products that the patient could benefit from. This is all material from our online training, our seven-phase OmniPractice program that we have online. This is part of phase three teaching your hygiene department how to do all these things and giving them the training that they need.
Speaker 1:Check that out, dentalpracticeheroescom, if you're looking to build a better practice that has systems and is profitable and teaches you how to set it up in a way that you can take more time off. Go check that out. I know you'll be really happy with it. So this week when you're doing a hygiene check, I want you to ask yourself did this patient have an experience or just an appointment? Which was it and what can you improve on? Involve your hygiene team, get a discussion going, start talking about it and create the best patient experience that serves your patients, unlike any other office in your community. Thank you so much for listening and we will talk to you next time.
