5 Steps to a Superstar Hygiene Team

By Heidi Arndt, RDH, BSDH

The healthiest, most profitable dental practices have a strong and high performing dental hygiene team. Their hygiene team is productive, team focused, they practice to the top of their license and they are highly respected. They are the cornerstones of the practice.

Registered Dental Hygienists do not come by their license easily. Dental Hygiene school is a demanding and rigorous program.,.In just a few short years, dental hygiene students need to reach competency in over 40 skills. When they graduate from hygiene school they take written and practical board examinations to confirm their competency in their dental hygiene skill. These competencies are all skill based, however their path for development is not over.In fact, most of their development needs to happen in the real world, in your practice.

Development of the dental hygiene team is key to the success and health of the practice. Without further development, your dental hygiene team will struggle to understand their role in the success of the business.

  1. Educate your team on the Business of Dental Hygiene. Like dentists, dental hygienists do not received business training of any sort during their dental hygiene education. Many dental hygienists do not understand how the care they provide to their patients is directly correlated to the success of the practice.As a result, when a dental hygienist is involved in a discussion regarding financial information they often times react negatively and may make irrational comments like, “why is it all about the money”.
    The office manager or dentist should educate the dental hygienists on the business of dentistry and how the dental hygiene portion of the business adds to the success and health of the practice. Create clarity as to how the dental hygiene team fits into the overall picture of practice success.
    When having the business discussion with the dental hygiene team, keep it simple and practical. For example, break down hygiene revenue by showing them the impact of hours worked and the fees of each procedure, and how each hour and each day impact revenue of the practice.
    Once the dental hygiene team completely understands the revenue side of the business, layer in the expenditures of the practice, insurance adjustments, etc. so they understand the real margin of the practice. This piece will be difficult for them to process, as well as an eye opener for them.
  2. Lay out clear expectations for the dental hygiene team. Does your dental hygiene team know what is expected of them? How do you track and analyze their performance?
    Most dental hygienists enter the practice understanding that they need to provide dental hygiene care to their patients, follow infection control protocols, be a team player, etc. However, are these the things you monitor in order to measure their success?
    A successful hygiene team needs to connect with clear expectations and goals. Key Success Indicators are the best way to define expectations and goals for your dental hygiene team. There are 8 KSI’s for the dental hygiene team:
    a. Hygiene Productivity – Production per Hour, Production per Patient, Production Per Day
    The best measure of hygiene productivity is to track by hygienist, by practice and by the group total. Putting these measures in place will allow you to see exactly where changes need to be made.
    b. Mix of Services – Periodontal and Preventive
    The hygiene department is not just a cleaning service. This is the first stop in assessing the needs of your patients and providing meaningful care that goes beyond the cleaning.
    c. Scheduling – Schedule Efficiency/Utilization and Supply & Demand Balancing your dental hygiene supply and demand can be tricky. You want to have enough play in the day to accommodate emergencies or appointment over-runs without leaving your hygienists with unproductive time. So how do you achieve that balance?
    d. Profitability – The Ratio of Hygiene Revenue to Total Compensation
    How are you currently measuring your hygiene department’s profitability? The truest measure is hygiene revenue as a % of total compensation.
    e. Hygiene Revenue – Hygiene Revenue as a % of Total Practice/Group Revenue Ideally, 30% of your practice revenue should be coming from the dental hygiene team.
    f. Patient Retention Would it surprise you to know that most dental practices have a mere 30% of their total patients in active care? Do you know what your number is? Do you have the strategies in place to improve these numbers? This is one of the most misunderstood benchmarks in the dental industry.
    g. Treatment Acceptance
    h. Doctor revenue treatment planned from the Hygiene chair. Over 75% of the doctor revenue should be treatment planned in the hygiene operatory.How well is your hygiene team teeing up and presenting restorative and cosmetic treatment for the doctor?
  3. Partner with your dental hygiene team. Aside from the doctor, the dental hygiene team is the care provider in the practice.They make up over 30% of practice revenue and support more than 75% of the doctor revenue in the practice.Do you see why being a PARTNER with your hygiene team is so important?
    What does partnership look like?The doctor and dental hygiene team must speak a common language and have a consistent philosophy of care.The doctor should trust the guidance and recommendation of their hygienists and vice versa. Strong collaboration on each patient and the success of each day is what a true partnership is all about.
    The doctors that take the initiative to openly partner with their dental hygiene teams see a strong commitment to the practice, retention and true ambassadors for a successful business. The dentist cannot afford NOT to partner with these powerful professionals in the office.
  4. Empower your hygiene team. Your dental hygiene team is well educated and has a scope of care that they have been licensed to provide. Successful dental hygiene teams practice to the fullest extent of their license. This means if they are licensed to provide laser treatment, they should do it. If they are licensed to provide non-surgical periodontal therapy, they need to be providing it in the office.
    When you empower and trust them to partner with you, by taking the lead in periodontal and preventive health of your patients, you will inevitably see results. Empowerment = trust = respect. This is a MUST for your team.
  5. Reward and Recognize. It is as simple as this – Reward the behaviors you want repeated.
    Rewarding your team beyond their compensation seems obvious to most; however, some dentists avoid the practice all together.
    The most successful dentists and dental practices are those who recognize and reward their team for their efforts. Recognition and reward will build trust and loyalty. It has been proven that employee retention is higher in teams that have a strong connection and bond with their boss and understand how their performance impacts the practice’s bottom line.
    One of the best ways to keep your team happy and loyal to you is to make sure that their hard work is appreciated. Find a few minutes each day/week/month to recognize people. You, in turn, will reap the rewards of their loyalty and ongoing performance.

Taking the time to develop and partner with your dental hygiene team will help you meet your goals and create ultimate success in your practice.
Dental hygienists want to be successful, but they need the support and guidance from their doctors and managers. Don’t assume your dental hygiene team understands your expectations and goals. Communicate with them and do so regularly. Partner with and empower your hygiene team to master the patient care that falls under their umbrella of their expertise. Create a strong co-diagnosis and your patients will feel the synergy and commitment to total oral health.
These 5 steps have been used over and over in successful dental practices and groups across the country, and they can be used in your practice as well. There is no better time than today to partner with the powerful Dental Hygiene professionals in your practice.


Heidi Arndt has worked in the dental field for 18+ years. Her experience ranges from working as a treatment coordinator, dental assistant, and practice manager before graduating from the University of Minnesota with a bachelor’s degree in Dental Hygiene.

Heidi spent the early part of her dental hygiene career working in private dental practices and at the Mayo Clinic (Department of Dental Specialties). Heidi worked with American Dental Partners, as a dental hygiene mentor/coach later promoted to Director, Dental Hygiene Development. Heidi developed a mentoring and coaching program and led all dental hygiene development activities for American Dental Partners affiliated dental groups (over 200 practices and1,000 hygienists) across the United States, and increased hygiene profits exponentially year after year.

In 2011, Heidi founded Enhanced Hygiene. She is dedicated to helping dental practices realize their total hygiene profit potential through the development of their hygiene team, quality patient care, patient-centric service and by empowering the entire team.

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