Assisted Dental Hygiene

Written by Heather Siler

Assisted hygiene refers to a schedule in which a hygienist operates out of two operatories and sees patients every 30 minutes with the help of a designated assistant. The assistant stays with the hygienist the entire day, and the two switch off between operatories treating patients. The hygienist performs therapeutic scaling, irrigates periodontal pockets, measures gingival and periodontal health and disease (pocketing, recession, bleeding points, and exudate), removes plaque, calculus, and stains, applies antimicrobial agents, provides patient education, and administers other treatment deemed necessary. The assistant seats patients, updates medical histories, takes x-rays, polishes teeth, makes recare appointments, applies fluoride, dismisses patients, and performs other duties within the scope of state law.  Many practices operate successfully on an assisted hygiene schedule, but before transitioning, explore why the change may benefit your practice.

First, assisted hygiene shouldn’t be used to offset missed or last-minute cancellations. Holes in the hygiene schedule are usually due to problems with patient management. When patients begin de-valuing your services by missing appointments, it’s time to reevaluate how easy it is for them to reschedule. Never be dishonest with patients, but allowing multiple choices after they repeatedly cancel or no-show sets the stage for more of this behavior. There are valid reasons patients miss appointments, but with a chronic offender, it’s best to limit choices for rescheduling. Also, make staying on schedule a priority and don’t make a habit of keeping patients waiting. If patients are kept waiting on a continuous basis, they will no longer respect your time because you’re failing to respect their time.

Second, evaluate your patient base. Many generational practices have patients who have been with them for fifty years or more. It may be very difficult to transition from the hygienist spending the entire appointment with the patient to the appointment being split between the hygienist and an assistant. It’s not impossible, but tradition plays a role in this scenario, and certain patients will expect an explanation as to why there’s a new appointment protocol. Patients are accustomed to spending time with an assistant while seeing the dentist, but many don’t expect to see an assistant during their prophylaxis.

Third, are you incorporating assisted hygiene to increase hygiene production? Using assisted hygiene to help increase production while practicing as a DMO can be tricky. It’s very difficult to make a decent profit while participating in reduced fees programs. However, increasing production by incorporating a soft tissue management program and stressing more frequent recalls for patients with certain conditions can benefit from assisted hygiene. Also keep in mind that converting to assisted hygiene means that a dedicated assistant for the hygienist is imperative, and more instruments and supplies will be necessary.

The most important part of whether assisted hygiene will work in your practice depends on the hygienist and the assistant. Is the hygienist willing and capable of handling such a schedule? Will there be an assistant who is dedicated to the hygienist? A hygiene assistant is different than a dental assistant. The hygiene assistant can’t be “borrowed” to assist the doctor because this type of schedule is extremely tight, and getting off schedule is disastrous. As long as you’re honest with yourself and adopt assisted hygiene for the right reasons, it can be beneficial for your practice.