Inside Dentistry
June 2006
Volume 2, Issue 5

Finding the Hidden Profit in Your Hygiene Department

Roger P. Levin, DDS

Most practices have 2 core revenue streams—doctor production and hygiene production. For many practices, however, the hygiene department is often an undeveloped source of revenue. The question is: Are you maximizing this resource?

As business authors Chris Zook and James Allen state in their best-selling book, Profit from the Core,1 “The key to unlocking hidden sources of growth and profits is not to abandon the core business but to focus on it with renewed vigor and a new level of creativity.” Many practices take the hygiene department for granted, underestimating its potential value as a generator of increased practice production.

Hygienists spend more time with patients on average than anyone else in the practice. They are often the public face of the practice even more so than front desk personnel. Hygienists interact with almost every patient, observe potential problems, and educate patients about optimal oral health care. For a practice to reach its profitability potential, the hygiene team should also educate and motivate patients about all practice services, including esthetic and elective procedures.


There are 7 action steps that can help develop the hidden profit in your hygiene department.

1. Communicate Your Vision.
Vision is about looking ahead 3 to 5 years or even farther. All good leaders have vision. A vision statement is not about where you are today or even where you will be in the near future. Instead,it is focused on where the practice willbe several years down the road. Oncethe practice vision has been created,it must be communicated. For example, if the dentist wants to increase estheticprocedure production by 30% within 3 years, he or she must share that vision with team members.

2. Expand the Service Mix.
Practices need to offer the right mix of need-based dentistry and elective ser-vices to increase production. Because ofdecreasing insurance reimbursements,practices should look toward implants, whitening, veneers, and other elective services as ways of increasing profitability and customer satisfaction. The hygienist plays a critical role in educating patients about the elective and esthetic services offered by the practice. Ancillary services and products are excellent ways to address patient needs while improving overall quality of care and hygiene department productivity. For example, professional whitening kits and powered toothbrushes can be purchased at a professional rate and made available to patients at a reasonable price. These types of products can lead to greater patient participation in oral health as well as a greater receptiveness to considering other esthetic and restorative dental treatment at a later time.

3. Promote Comprehensive Dentistry.
All practice systems should be geared toward building value for comprehensive quality dental care. Promoting comprehensive dentistry should be included as part of the new patient exam, recare hygiene appointments, and restorative care appointments. Comprehensive dentistry requires that all team members, both clinical and administrative, support high-quality care and reinforce the value of treatment to all patients. As the main point of patient contact, the hygienist can help patients make informed decisions about potential treatment.

4. Improve Case Presentation Skills.
Scripting can help hygienists and other team members improve their case presentation skills. As staff members role-play and learn their scripts during meetings, the team becomes more knowledgeable about all the practice’s services. Scripting keeps all team members on the same page. When patients have concerns or ask questions, team members can provide consistent and accurate answers. When the team is well trained and fully understand and communicate the benefits of treatment, staff members reinforce the recommendations of the dentist, resulting in increased case acceptance. To motivate patients, team members need to emphasize emotional benefits rather than just provide clinical descriptions of procedures. When patients understand how they will benefit, they are more likely to accept recommendations for treatment.

5. Enhance Practice Communication.
Daily morning meetings and monthly staff meetings are 2 critical communication vehicles that help dentists build high-performance hygiene departments and practices. Morning meetings are 10- to 15-minute huddles designed to prepare the staff for the day and ensure the best quality care for patients. Review daily goals. Examine the schedule to determine if any issues exist, including emergencies. Identify opportunities for case presentation and increased production. Use monthly staff meetings to review more in-depth issues, including progress toward yearly goals, customer service challenges, and case presentation scripts.

6. Perform Procedural Time Studies and Communicate the Results.
Practices should conduct procedural time studies on the dentist, hygienists, and assistants to have an accurate indication of how long procedures take to perform. Many practices incorporate new materials and techniques from time to time, which can decrease the amount of time needed to perform a given procedure. In many instances, however, the treatment team never informs the front office team that less time is required on that certain procedure. When procedures are inaccurately scheduled, valuable treatment time is lost each day. By performing annual procedural time studies on hygiene and other services, everyone will have updated information on the amount of time needed to perform a given procedure.

7. Schedule the Next Recare Appointment Now.
Patients often cancel or fail to show up for hygiene appointments. Levin Group has found that some practices lose at least 20% of their recare patients each year. Stated differently, every 5 years, the practice has an entirely new recare patient base. Such a loss of patients poses a serious threat to achieving maximum production and profitability.

Considering the high costs of acquiring new dental patients, practices should design effective strategies to retain patients. One of the best methods for doing so is to establish an effective hygiene recare system. Scheduling all patients for their next recare appointments and using appropriate scripts to build value for each appointment are powerful tools to maintain the practice’s current patient base.

One way to build value for the recare appointment is to call it the “periodontal maintenance and oral cancer exam.” Emphasizing these additional benefits makes patients aware of the importance of the recare appointment. When properly handled, scheduling all recare patients in advance reduces patient attrition and significantly increases patient retention.


Hygienists are valuable assets to dental practices. They can be even more valuable with the correct training, tools, and encouragement. These 7 tips will help you find the hidden profitability in your hygiene department and build a more successful practice.


1. Zook C, Allen J. Profit from the Core: Growth Strategy in an Era of Turbulence. Boston, Mass: Harvard Business School Press; 2001.

About the Author
Roger P. Levin, DDS
CEO, Levin Group, Inc.
Owings Mills, Maryland

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