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Hygienists, it’s time to drive change within your dental practice

May 19, 2023
Dental hygienists hold unique characteristics that can lead to significant changes in a practice. But what's the best way to push things forward?

Dental hygienists hold unique characteristics that can lead to significant changes in a practice. They are organized, ambitious, fearless, and, most importantly, passionate about making a difference in their patients’ lives. However, many have yet to tap into their profession’s endless possibilities. Instead, they’re focused on what isn’t working within their clinical practice and need guidance on how to go about implementing much-needed change. After all, is change even possible? How can dental hygienists position themselves as leaders who can implement systems that allow them to provide comprehensive care?

Newfound purpose

One way to change the course of one’s profession is through out-of-the-box thinking. It is easy to become complacent in clocking in at the start of the day, then going through the motions of patient care. Seat the patient, greet them, perform assessments, probe, scale, polish, and be done. But what happens when hygienists start viewing their role through a different lens? When that “aha!” moment happens, it becomes clear that providing comprehensive care to a patient with a family history of Alzheimer’s, heart disease, or diabetes can actually help them avoid developing these conditions. When dental hygienists finally make the connection that poor oral health can be detrimental to overall health, this realization propels their thinking. Suddenly, they are ready to change how they practice. Unfortunately, despite their newfound desire to drive change, hygienists often find themselves in unfavorable situations. Practices don’t seem to be interested in letting them run with their passion. Their instruments are outdated, they have less than adequate time to provide comprehensive care, and they begin to question if they will ever be able to make a difference.

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Don’t give up

When faced with these situations, it’s essential not to lose heart. Instead, it’s time to start thinking like a business owner. While we may believe that dental practice owners only focus on their success, it’s important to understand that running a practice comes with many stressors. Many business owners are responsible for paying their employees, purchasing supplies, covering lab costs, keeping up with facility costs, and investing in marketing efforts to contribute to continued practice growth. These stressors can push business owners into a mindset where they believe that investing in new instruments or equipment may push them beyond the overhead threshold. To add to these stressors, many practices are knee-deep in insurance participation, where they have to, at times, write off more than 50% of what they charge for a typical dental hygiene visit. Yes, you heard this correctly; according to United Concordia, reimbursement is a whopping $49.23 for prophylaxis or $72.11 for a periodontal maintenance visit (fee schedule, January 1, 2023). Those interested in helping their practice grow need to start learning how to approach the practice owner in ways that help the owner understand that the ideas proposed will only lead to further practice growth. Dental hygienists have to speak the language dentists want to hear!

From knowledge to implementation

Dental hygienists are highly organized and ambitious when it comes to learning about the latest treatment modalities. Many invest countless hours in attending national conferences where they sit through informative courses and spend time with companies on the exhibit floor to learn about products that would best help them provide care. So, how do we convince practice owners to implement new systems and products? We need to learn how to discuss ROI (return on investment). How can these new products solidify patient care and lead to practice growth? When we approach business owners with requests to implement systems that will facilitate our treatment, we must also come prepared to present a clear and solid plan. For instance, how can implementing a phase microscope at an investment of about $2,700 in practice help increase production? This is an easy one to argue; showing a patient on a computer monitor motile rods, spirochetes, amoebas, or maybe even trichomonas, absolutely helps to educate and reinforce treatment recommendations. After all, patients can’t argue with samples that came directly from their periodontal pockets. This leads to greater case acceptance that will improve the nonsurgical procedures provided within the practice.

Once we tap into what is most important to business owners, we can implement solid systems to help us render the best care for patients. Yes, systems! If there are numerous hygienists working together in one practice, are you all on the same page? Do you have specific criteria for when you would recommend nonsurgical therapies? When patients present with disease, what adjuncts have you agreed upon for helping to treat such disease? Are all hygienists consistent in their recommendations and patient care? If you answered no to any of these questions, it is time to unite in creating solid systems that can be presented to your business owners. If you need additional instruments or therapies to help treat your patients, this is the perfect opportunity to create a solid presentation on how investing in products or tools can help grow your hygiene practice. Be sure to approach your business owners confidently, and most importantly, let your passion show in your presentation.

The issue of time

Upon convincing practice owners to invest in your dental hygiene department, the elephant in the room must be addressed. Many dental hygienists are restricted by shortened appointment times. This, by far, is one of the most contentious topics on social media pages. Many hygienists share that they are not interested in implementing further processes because they already struggle with providing care within the time given. When discussing increased time for hygiene appointments, dental hygienists must once again discuss ROI. How can increasing patient appointment times help with practice growth? Can adding time help dental hygienists convince patients to follow through with restorative needs, thus contributing to practice growth? It’s imperative to convince practice owners of the need to increase appointment times. By sharing your passion for providing life-saving care, you can help to push for increased appointment times. Convince your practice owners that adequate time can lead to more recommendations, increasing practice production.

Team buy-in

While winning the time argument is exciting, it doesn’t solve the entire problem. Practice owners must support you in your drive to implement new systems. This won’t be successful if the entire team isn’t on board. Practice owners and dental hygienists must help the team buy into this new practice philosophy. The management, administrative, and clinical teams must be on board. The only way to do this is to educate them thoroughly on all things hygiene. This means explaining the benefits of phase microscopy, air flow therapy, nonsurgical therapies, and the oral-systemic connection. We must give them the full “why” and educate on how to reverse disease. Often, appointment times are shortened by administrative team members who don’t understand the entire cycle of a dental hygiene visit, so help them understand. Draw them in and let them know that the newly implemented systems will not be successful without the whole team working together.


Dental hygienists who are fully dedicated to their practices want to feel appreciated for their efforts. While I am all for dental hygienists being rewarded for a job well done, I am absolutely opposed to those who demand high salaries and incentives yet do not put in the effort to improve practice systems and patient care. We entered this profession because we wanted to be health-care providers who make a difference in our patients’ lives. Hygienists who practice with this mentality will naturally enjoy growth within their departments. When this happens, it’s time to ensure that practice owners reward you. It is important that dental hygienists ask for monthly reports that show production and collection numbers. What should you look for in these reports? First, do your nonsurgical therapies make up 33% or more of your overall production? Are you producing three times the amount of your monthly salary? If you can answer yes to these questions, then your practice can come up with innovative ways to reward you.

You’re in control

Dental hygienists need to realize that they have control over their own success. This success will come when they take charge and stand up to drive change within their practices. Then, one day, they will wake up with a rekindled love for their profession. 

Editor's note: This article appeared in the May 2023 print edition of RDH magazine. Dental hygienists in North America are eligible for a complimentary print subscription. Sign up here.