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417: Solutions During the Hygienist Drought!

Kiera is forecasting a two-year hygiene drought. You know what that means? It’s time to think outside the box to keep your practice humming! In this Dental A-Team podcast episode, Kiera discusses assisted hygiene — a way to maximize production during the drought.

She shares …

  • What assisted hygiene looks like

  • How long/often to do it

  • How to bonus

  • And even shares a form to get you started on the schedule 

The DAT crew helps practices set up assisted hygiene all the time, so if you’re eager to get it going, don’t hesitate to reach out to us at [email protected] TODAY!

Episode resources:

Check out our assisted hygiene form

Reach out to Kiera

Listen to episode 112: Dental Gold Mine: Rotating Schedules, Assisted Hygiene, and Automated Voicemails

Listen to episode 198: How to Set Up Assisted Hygiene

Listen to episode 372: Filling This Impossible-to-Fill Role

Subscribe to The Dental A-Team podcast

Become Dental A-Team Platinum!

Review the podcast on iTunes

Podcast Transcript:



0:00:05.6 Speaker 1: Hey everyone, welcome to The Dental A Team Podcast. I'm your host, Kiera Dent, and I had this crazy idea that maybe I could combine a doctor and a team member's perspective. Because let's face it, dentistry can be a challenging profession with those two perspectives. I've been a dental assistant, treatment coordinator, scheduler, filler, office manager, regional manager, practice owner, and I have a team of traveling consultants where we have traveled to over a 165 different offices coaching teams. Yep, we don't just understand you, we are you. Our mission is to positively impact the world of dental, and I believe that this podcast is the greatest way I can help elevate teams, grow VIP experiences, reduce stress and create A teams. Welcome to The Dental A Team podcast.


0:00:50.8 S1: Hello, Dental A Team listeners, this is Kiera. Are you guys ready? Who wants to chat assisted hygiene? Oh, I know you do. Let's talk assisted hygiene. We have done a few podcasts on assisted hygiene. Assisted hygiene right now, I think is paramount. I think it is a pressing issue, because guess what, we're in a hygienist drought. How many of you have tried to hire a hygienist, excuse me... How many of you have tried to or have lost a hygienist and you're trying to hire? Don't worry, it's like every single coaching call I'm on is hiring. Yes, I'm getting kind of sick of hiring, I'm getting sick of hiring myself. If you guys didn't hear my other podcast where I do a book club, I talk about the book called "Who." It's a great... Let me tell you the authors, while I'm looking those authors up, this book is really great. I haven't read it yet. I'm going to. The book is called "Who." It's by Geoff Smart and Randy Street, and it helps you identify people to hire. So if you're in the hiring zone, read that book. I'm also gonna read it along with you. We can book club. You can email me [email protected] or you can be a coaching client with us and tell us all about it.


0:01:56.6 S1: We can do coaching with you on books, we love to do this. Guys, we're accepting new offices. So if you've been thinking about it, reach out. We'd love to have you. Dental A Team platinum, we come to your practice. Dental A Team gold, we virtually coach you and your team and Dental A Team silver, get it while it's still here, it's going away soon. That's a teaser for you, it's happening, but that's one-on-one coaching. So if you've been thinking about it, don't wait before it's too late. Can't wait to see you guys there. So with assisted hygiene, trying to hire hygienists, it's hard. I think what happened was we had COVID, a lot of those parents now can't work because kids are still... Guys, rough go, they're all going home. We had a quite a while where we didn't have the hygienist at the office. A lot of people wanted to retire, a lot of people had to retire because they had kids at home, a lot of people got pregnant during COVID, they're COVID babies. It's kinda like the baby boom, it's the COVID boom. So a lot of people are out because they've got kiddos and then we just had a shortage of hygienists. So, I think we're probably in a two-year hygiene drought is my guess.


0:02:56.6 S1: Do I have a crystal ball, no, but I'm guessing this is probably gonna go on for the next two years. So we gotta start thinking outside the box and one of those outside the box thinking is assisted hygiene. So I'm gonna break this down for you. A lot of people ask me, how do you implement assisted hygiene? So basically, you gotta think about, assisted hygiene is where we use an assistant and we use a hygienist to see double the amount of patients. I typically recommend you do it on the half an hour. So we see one patient in column one, you gotta have two chairs for this, you gotta have one patient in column one, they start at 8 o'clock. The next patient starts at 8:30, the next one at 9:00, 9:30, 10:00, 10:30, 11:00, 11:30, okay?


0:03:37.3 S1: You're gonna have an assistant and you're gonna have a hygienist. You guys are welcome to download the form. Alex, make sure you email me on this. I have an assisted hygiene form for you guys. I have yellow for hygienist, blue for assistants. I'm a visual learner, so if it helps you guys, I have kind of made an assisted hygiene document and also where you can pop in your exam, so doctor is maximizing their time and hitting two exams at one time. So with that said, what you guys can do is you can start with the X-rays, then hygienist comes in and does perio charting, scale scale, then the hygienist pops over, the next one has already got their X-rays done, they're gonna go perio chart, scale scale, assistant pops back over with polish, floss and does an exam with doctor. Then you move and it just zigzags back and forth from column to column to column.


0:04:26.8 S1: When you're implementing assisted hygiene hear these words strong, loud and clear, "Don't do a full day." It will get psycho-mania for you. It will get nutso, it'll get crazy town, it's not gonna be anything great. So I recommend you start with a half a day. Also a great benefit that you could do is you can get your assistant, you gotta also make sure that you have a dedicated assistant for each hygienist. It does not work if you have a float assistant who's helping doctor and helping in sterilization. This assistant needs to be dedicated to hygiene. We don't wanna burn our hygienist out, we don't wanna make them frustrated. I also recommend you probably don't do assisted hygiene every single day, unless you have to.


0:05:06.8 S1: How about you just add in half a day. That's four more patients, you typically work four days, or excuse me, four weeks a month, that's 16 patients just by working half a day, one day a week. Doctors can also maximize their production on assisted hygiene days if you have minimal ops. You can literally take a doctor op, turn it into a hygiene op for half a day. Doctors doing implants, doing crowns, doing full mouth during that time, and then they're just popping out to go get those exams. So that way you guys can literally cut down on doctor's production side, but still maximize production and then they hop over and go do the exams, and you are able to see more hygiene patients if you don't have a hygienist. So again, stagger it, start out with half a day, maybe one day a week. And then a lot of people ask me, "How do we bonus these hygienists 'cause now we're paying for an assistant and a hygienist?" Well, I don't know if you guys have done the math but guess what, hygienists are not really easily found.


0:06:00.0 S1: So what you can actually do is you can pay your hygienist more on the day that they are working assisted hygiene. You're going to take the hourly rate of your hygienist plus the hourly rate of your assistant, when you combine those two, it's probably gonna be less than actually hiring two full-time hygienist, but yet you're maximizing it, so that way your hygienist is super happy to do assisted hygiene, because they're making more on their assisted hygiene days. You also have an assistant who's great, they're gonna help with sealants, fluoride, all that can be ramped up, especially with a hygiene assistant, and you're able to win because everybody's winning in the situation. Everybody's happy, you don't burn your hygienist out because they don't have to do assisted hygiene every single day, and you're able to serve more patients without needing to have another hygienist brought in.


0:06:45.3 S1: Guys, I don't make up all these things, I learned this from my awesome clients, I learn a lot of these things from other people that are not myself. This idea of paying a hygienist more, and an assistant, actually was brilliant. It obviously brilliant. Saves the office money. They also are able to get more hygiene patients seen, and the hygienist is happy doing assisted hygiene because they're making more on those days. So guys, get creative, get creative, where can you pop these in? Also strategic scheduling with assisted hygiene is a brilliant way to do this because then doctor's super productive and you're able to run assisted hygiene.


0:07:18.3 S1: Now, another way that you can also throw this in is possibly doing it on a Friday. There tend to be sometimes more hygienist on a Friday, because that's a day a lot of offices are just Monday through Thursday, so if you wanted to, you could actually run assisted hygiene on a Friday, get maybe two hygienists, two assistants, you could run four coms of hygiene. You can also do this on a day where maybe your main doctor doesn't wanna work as much, so maybe do it afternoon of four coms of hygiene, and that doctor can get some admin time done while they're checking four coms of hygiene. You can see a lot of patients in a short amount of time. You can utilize your assistants, you can utilize your hygienist and everybody's happy, and doctor is still super productive because we didn't take much of their time, but they're able to get some admin time in their day. Those are all these different creative ways that you guys can really do assisted hygiene. Also, that's how you guys can bonus. The assistants that are working on the assisted hygiene, they also can be really fantastic at doing more sealants and more fluoride. Teach your assistants, if it's legal in your state, teach your assistants how to place sealants. I have an office that dominates on adult sealants.


0:08:26.2 S1: Hey guys, so I don't know if you've heard the excitement, but you guys, I have become literally obsessed, I'm telling you, I connect 10 clients a month with this company because what they're doing is literally changing their practices, the company is Modento. Modento does forms for patients, they do ringless voicemails to help with your re-care and unscheduled treatment plans, they have patient connection and interaction, their forms go directly into your patient account, plus they also are able to send statements and they have treatment planning. You guys they're like an all-in-one, full encompassing company., you guys need to connect with them today. They will change your practice. They will change your life. You guys, every practice that we connect them with loves, loves, loves them, so you guys connect on over today, let them know The Dental A Team sent you, and I can't wait to hear your incredible experience with them.


0:09:20.0 S1: You guys, I don't know what your philosophy is, I have deep grooves in my teeth, and I wish I would have a dentist recommended to me, I hate catching food in my grooves. Nobody recommend it to me. Now again, if you aren't trained and you don't know how to isolate well, that can actually create more problems than not, so make sure that you teach your team, you could have a sealant day, you guys typodonts are really inexpensive on Amazon. Snag some typodonts or you can pour-it models and have teeth, and you can prep teeth and have everybody practice, you do not have to really practice for sealants, but you could literally take a bunch of models and have everybody practice placing sealants. You guys can look for... You can practice on one another. There's lots of things that you can do to be able to learn how to do this, so I'd say, teach your assistant to be able to place sealants, to be great at closing fluoride, use the verbiage, as the final part of our treatment today, "I recommend a fluoride varnish, fluoride therapy." I don't care what you say, "I recommend a fluoride varnish. It's $35 out of pocket, and I have bubble gum or mint, which do you prefer?"


0:10:20.2 S1: That's it. That's all they have to say. You assumed yes, you assume that they want to do fluoride, you also can do... You can do sealants, you could have them look for which teeth are great for sealants. You can say, most of our patients usually do one side of the mouth today and the other side of the mouth tomorrow. That would be three or four or whatever, however many sealants today and the next time we see you, we'll do the other side. These things can help your patients, also help your hygienist and your assistant, and it's a great way to maximize your practice and to do things in an unconventional way. So number one, you gotta set up your schedule accordingly, you need two operatories, so decide if you have the operatories now or if you need to get it. Also I recommend you set it up on the half an hour, so assistant is gonna start with the X-rays hygienists perio chart, scale scale, assistant finishes with polish, floss and exam. Then what you're gonna do is you are going to have a dedicated assistant for every hygienist that's doing this. Don't go crazy town, gotta make sure this works, otherwise it's not gonna flow well.


0:11:19.2 S1: Then some people are like, "But, Kiera, wait, are patient's gonna like this?" You guys, patients, yes. It's all about how you perceive it. If you're like, "This is so great, we're so excited to have you." Hygienist, I know you weren't used to spending an hour... Say like, "Oh, you're gonna love Kiera. She's gonna come in, she's gonna polish, floss and do the exam with doctor, I can't wait to see you in 6 months again." And off you go, you gotta make sure you... Also another thing to make assisted hygiene work really well, is I recommend you have a laminated sheet that sits in the room so the assistant can check off what they did, hygienist can come in, make notes on this laminated sheet of what they talked to the patient about, so then when the assistant comes back in, the communications are not lost. Otherwise, it gets messy because assistant talks to them about something, then the hygienist comes in, there's not a really great hand-off, then the hygienist leaves to the next room before the assistant gets back in and there's not usually great hand-offs, then doctor's like, "Oh, what happened?" "I don't really know. Sarah was in here scaling and I was over there taking X-rays."


0:12:12.7 S1: So you really gotta make sure that there's a good communication flow, so I really love that laminated sheet that you can leave in each operatory, so that way communication is not missed. Just have it as a checklist, what X-rays were taken, did we perio chart, what were the findings, what did we talk to a patient about for treatment, did we recommend fluoride already, have we discussed sealants already? All those things can be on there and then it's great 'cause when doctor comes in, all the information's already written for doctor, so doctor can see exactly what the exam should be. So it really works insanely well for you guys, if you follow the process.


0:12:43.2 S1: So if you guys need help, we've helped a lot of offices, especially in this hygiene drought, get their assisted hygiene set up. Think outside the box guys, start small, expand out, have an incredible, incredible patient experience and realize how many new patients do you have in the schedule? How many do you need? And if you were to add maybe half a day here or there, could you actually get more of those new patients in? It works like a dream, it does not work well with SRPs, perio maintenance is okay. And new patients are a little trickier to do well within an assisted hygiene. So you still wanna run regular hygiene, it's not always the case, but keep those appointments out of there, you just want regular hygiene in there, no SRPs and no new patients. Otherwise, it gets a little hairy scary.


0:13:30.1 S1: So keep those out of there, start small, let me know, I'm excited to hear. And if you guys need help at all, email us [email protected] We work with this with our clients, so if you guys are wanting help, we are happy to help you guys. Silver, gold or platinum, you guys say what you wanna be, we love to help you guys, we love consulting offices, and we love helping you guys expand what you believe is possible in your personal lives and in your business. As always, guys, thanks so much for listening, I'll catch you next time on The Dental A Team podcast.




0:14:00.0 S1: Alright, Dental A Team listeners. That's a wrap. Thank you so much for listening, and if you loved today's podcast, go leave us a review, it takes you five seconds and your review helps more offices, more practices, more team members just like you find out about The Dental A Team. Thank you guys so much for being part of my Dental A Team family.


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