Dental hygiene school teaches you how to assess, codiagnose, treat, educate, and prevent disease, but it seldom teaches you the business of hygiene or how the hygiene department contributes to the health and success of a dental practice. 

This area of our career can feel unfamiliar, overwhelming, and a little scary at first. Contrary to some beliefs, understanding metrics, production, and treatment acceptance doesn’t automatically make you “salesy.” Production doesn’t mean selling night guards or whitening to every patient, regardless of need. Instead, it can simply mean building protocols and systems that allow for the proper diagnosis and treatment of disease while utilizing adjunctive therapies. You can build a career that balances patient centered care and profitability because your job is not to sell things that patients don’t need, it’s to identify disease, educate patients, provide appropriate preventive care, and recommend evidence-informed solutions that support their oral health. 

What are KPIs? 

KPIs, or key performance indicators, are measurable numbers that help a practice understand how well it is performing. For a hygienist, these might include hygiene production, periodontal treatment acceptance, appointment retention, or preventive product recommendations. They can keep you accountable, engaged, and focused on opportunities to provide better care. Let's move past the assumption that paying attention to production and metrics is inherently "salesy” by asking ourselves where opportunities lie to provide more comprehensive preventive care. 

Maybe your practice needs a clearer periodontal protocol. Establishing systems for thorough periodontal assessment, diagnosis, treatment, and proper re-evaluation. This can be achieved through calibrating the dental hygiene team, ensuring everyone is up to date on periodontal staging and grading to properly treatment plan and code. Afterall, if 90% of the population suffers from gingivitis, then we should be treatment planning and utilizing the gingivitis code D4346.^1,2 Incorporating appropriate adjunctive therapies such as desiccation gels or laser therapy, when clinically indicated, also gives your team additional tools to address disease and support positive and more effective treatment outcomes. 

Utilizing KPIs for preventive care 

The same philosophy can apply to more preventative products. We can expand beyond the “watch and wait” approach to caries management and recommend products like silver diamine fluoride (SDF) to support noninvasive caries disease management.

If you routinely recommend certain toothpastes, mouthrinses, or electric toothbrushes because they align with your clinical philosophy, making those products available in the office can remove a barrier for your patients. Instead of sending someone home with a recommendation they may forget to purchase, you can make it convenient for them to follow through. The goal here is to recognize where patients have unmet needs and create systems, protocols, and treatment options that help us address those needs. 

Understanding KPIs can help you become more engaged in your career because you can actually see the impact of the care you're providing. It can help you identify opportunities, measure progress, and hold yourself accountable. It can also help you understand the value you bring to a dental practice. That knowledge becomes especially important when you're ready to have conversations about raises, bonuses, leadership opportunities, or career advancement. Your future self will thank you when you take the steps to understand this aspect of the dental field.  

You don't have to become a “salesy hygienist”; you can become a prevention-focused clinician that understands profitability. Learn the numbers, ask questions, understand your practice's goals, and track your clinical impact. Then use that information to advocate for better systems, better patient care, and a career that is both fulfilling and financially rewarding.

Understanding the business of hygiene doesn't take away from the heart of what we do. Rather, it gives us the tools to do more of it. 

References: 

1. Gasner NS, Schure RS. Periodontal Disease. In: StatPearls [Internet]. StatPearls Publishing; 2025. https://www.ncbi.nlm.nih.gov/books/NBK554590/

2. Guide to reporting D4346. American Dental Association. https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/publications/cdt/v6_adaguidetoreportingd4346_2023jan.pdf?rev=f25186c86eb84d95aef3615c855c136c&hash=5C68E12A2CCC2940E8D90BC1D8583126