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Profile in Oral Health Trisha E. O’Hehir, RDH, MS Editorial Director, Hygienetown

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I recently had the opportunity to interview two independent practice consultants who are also Townies. Sarah Cottingham owns BCS Leadership, LLC, and Rachel Wall owns Inspired Hygiene. Both are committed to helping others reach their potential by providing leadership and systems to provide high quality dental hygiene care. Sarah and Rachel have a lot in common. They both graduated from dental hygiene in 1991, have young families, own their consulting companies, are speakers and also fit clinical practice into their busy schedules. They strive to do their best and to help other hygienists and dentists provide the best possible care for their patients. The dental hygiene profession is lucky to have young, dedicated and innovative hygienists like Sarah and Rachel blazing the trail that will move our profession ahead.

How did you get started in consulting?
Cottingham: My first involvement with consulting was not planned; it just evolved and snowballed into my current BCS Leadership position. Besides providing clinical dental hygiene back in the early 1990s, I started managing a dentist's practice and learned about various aspects of the business. During these early years, I had the pleasure of being on a team receiving coaching from consultant Patty Hill. Later, I joined Patty in the BCS Leadership consulting company and worked with her for several happy and productive years before her recent passing. With her blessing and encouragement, I purchased the company and carry on the company's work.

Wall: Sometimes circumstances in life just line up and the result becomes perfectly clear. It started with the "seven year itch" in my hygiene career after working clinically and as a manager in both private and university practices, when I was sure I knew it all, had seen it all and dental school was the next logical step. I completed all the prerequisites, had great letters of recommendation, yet was rejected three years in a row! Getting ready for another round of dental school applications, my best friend, running buddy and hygiene colleague was diagnosed with osteosarcoma. As she went through chemotherapy, our days of running turned into lunch in her hospital room. She knew my lifelong goal was not to become a dentist, but to be able to do more as a dental professional. She could see I was miserable, and encouraged me to take time off from applying to dental schools and instead take an honest look at the career and personal growth opportunities available to me as a hygienist. I focused my energy on learning as much as I could about advanced hygiene duties, the perio-systemic link and personal development. In 2000, I began working as a trainer for a practice management coach and I loved it! In 2004 I started my own company, Inspired Hygiene.

What is the primary focus of your DH consulting?
Cottingham: BCS Leadership works with dental practices from the ground up. The dental hygiene department is a passion of mine since that is where my roots are. Our primary focus is to get dental hygienists, doctors and teams to really look at, understand and value the hygiene department to the overall financial wellness of the practice. The financial wellness of the practice is impacted by first getting the hygiene department to understand, accurately assess, enroll and inspire patients to make the right decisions about their periodontal health. I encourage hygienists to take a much more serious approach to being a front line health-care provider and wellness specialist!

Wall: Although we occasionally touch on general practice management issues, I am a hygiene profitability expert and coach. We help dentists, hygienists and entire teams recognize their power to positively impact their own careers, their patients' well-being and to reap financial rewards as a result of delivering high quality care.

Who is your primary market?
Cottingham: BCS Leadership works with medical and dental practices. We have worked with dentists, specialists, chiropractors and naturopaths to name a few.

Wall: We work exclusively in the dental market with dentists, hygienists and dental teams who are not tapping into their full potential for patient service and profitability in hygiene.

What services do you provide?
Cottingham: Our services include: Practice analysis – understanding all aspects of the practice, the good, the bad and the sometimes ugly!

Leadership programs – ranging from one-day Success in Motion to 12- to 24-month intensive training and mentoring programs.

Hygiene success programs – involving on site evaluations of the hygiene department and hands-on, over-the-shoulder style coaching; programs can range in length from one day to 12 months. The training is customized based on the skill level and development of the current hygiene department.

Mentoring – one-on-one programs for those professionals who are inspired to achieve greater levels of personal success.

Training DVDs, CDs and Webinars – providing science, information and coaching to help teams achieve their very best.

Wall: I believe that every client has different needs and learns differently, so Inspired Hygiene offers a variety of training opportunities at all price points. We provide:

Coaching and consulting services – private, in-office consulting following my 10-step Hygiene Productivity System. Training focuses on clinical hygiene skills, perio diagnosis, enrollment and treatment. Our program helps hygienists become partners in building the practice through enrolling patients in needed restorative dental care, bringing in new dental hygiene services to the practice and becoming involved with internal marketing.

Virtual coaching – our Kick Start Program combines in-office, Web and telephone coaching to focus on one or two areas in the hygiene department.

Periodontal education – this eight-week education program provides the science and the protocols necessary to implement or refine a perio program.

Hygiene analysis report – this is a place to start, finding out how the hygiene department is doing and what steps are needed to move forward.

High performance hygiene mastermind – each month teams participate in tele-classes, telephone coaching and access to our resource library.

How is the DH profession doing today compared to when you graduated from school?
Cottingham: Back in the stone ages, when gloves were seen as a nuisance and not a necessity, dental hygienists were working hard to make a mark in the dental community as more than "the person who cleans my teeth," as in many cases they are still trying to do today! The difference is that today we, as a profession, do not have a choice. We now have to own the responsibility that we have with our patients and their entire overall health. Now, the scientific information about the mouth-body connection is so overwhelmingly significant that we can no longer look the other way. The hygienists of today will have to stand up and make a mark in the medical and dental community about our impact on patients' health, and educate the public. The public is now one of educated consumers, and as a profession we must change the way dental hygienists are seen – from "the person who cleans my teeth" into the age of "oral health care wellness providers." The success or failure of a movement like this starts with us!

Wall: The whole oral-systemic link has brought a new level of importance to the oral health profession. I think we are being taken more seriously by our peers and if we want to collaborate with the medical community, we must confidently step into this new role.

What is one of your funniest consulting stories?
Cottingham: When working with a dental hygienist, she took a panoramic radiograph of a patient that had a full upper denture and we had to act like there was nothing weird about the X-ray.

The other one was when a hygienist that I worked with told me she had a elderly patient that she took around the corner to take a pano, and she said "I'll be right back, I need to get the machine ready." He apparently thought that meant he had to "get ready," because when she came back he had dropped his pants around his ankles and was hanging onto the pano machine… She had to continue without a peep. Needless to say, there were tears from laughter after that one!

Wall: Most of my funny stories are related to all the travel I do and getting lost on various expressways across the country!

How about one of your most inspiring consulting stories?
Cottingham: I was working with a hygienist who began to really evaluate X-rays. She uncovered a cyst that the doctor had overlooked. It was a very aggressive-style cyst that was caught at a critical time! Life saving!

Wall: I recently had a dentist client of mine tell me that because of the training we did with him and his team, he now feels "more like a doctor." He's now taking his role as health-care provider more seriously and that has empowered him to have the confidence to diagnose dental and perio disease earlier and keep searching for ways to deliver the highest level of care possible. I routinely have hygienists tell me they've been rejuvenated when we're able to get them out of the "prophy rut" and start using their critical thinking skills in diagnosing and treating perio disease and becoming a partner in enrolling restorative care.

What do you see in the future of dental hygiene – down the road 10 or 20 years?
Cottingham: I see the profession turning into a leveled delivery care system. There will be mastery level hygienists and then there will be technicians with a limited scope of practice. The mastery level hygienists will be performing more wellness checks and being in direct relationship with primary health-care providers and specialists; serving a bigger need than just "cleaning" teeth.

Wall: I think the advanced hygiene practitioner position is an absolute must to reach areas that are underserved. I hope that I and my fellow consultants will be able to empower more doctors and hygienists to see each other as colleagues rather than employer/employee and will decide to partner to continually elevate their level of service and productivity within their practices.

Who coaches you to achieve your best? Since others hire you for your consulting, do you hire a coach or consultant to help focus your career?
Cottingham: I have several times in my career, from working with personal coaches to mastery level Neuro Linguistic Programming (NLP) trainers. If you expect to perform at an elite level, you must train like the elite athletes! It is a journey, never a destination.

Wall: Absolutely! If I'm going to ask a doctor to invest in our coaching program for his/her business, I better be willing to invest just as much time and money in my own business.

I believe it's important to continually learn and improve in clinical and dental business knowledge, but also in innovative ways to work with clients and deliver our speaking, coaching and training products.

I've worked with many coaches over the years, some in dentistry, and some not. I seek advice from experts in the areas of coaching, speaking, leadership, business development and marketing. This has helped me develop a business that offers a wide range of services at various price points, and to be aware of the elements within a practice that affect the success of the hygiene department. So while I might not coach a dentist on his/her marketing, I know how marketing affects hygiene and I'm able to analyze that for my clients.

What message would you like to leave with our readers?
Cottingham: Each of us has the ability to alter and enhance each and every person that we interact with every day. It is time that we take this responsibility extremely seriously and get the training we need to take our own skill and knowledge to the next level. The better we become, the bigger impact we make for others. You are the instrument of change, go use your gifts!

Wall: My message would just be for dentists and hygienists to keep an open mind when it comes to developing your practice and your careers. Look where you can support each other and your patients. Docs – empower your hygienists to help you build your practice by supporting them in their personal and career development. Hygienists – supporting the health of your practice through high-level service, education and co-diagnosis is the best path there is to job security.
Author Bios
Sarah Cottingham, RDH, BS, graduated from Northern Arizona University in 1991. Her passion for helping people achieve optimum wellness has led her down a path of continuing education, including the use of the perioscope and lasers. She now shares her skills and expertise as a writer, speaker and practice consultant in BSC Leadership, LLC. To contact Sarah, e-mail sarah@bcsleadership.com or visit BSC Leadership's Web site at www.bcsleadership.com.

Rachel Wall, RDH, BS, draws from her 20 years of experience as a hygienist and practice administrator to deliver to-the-point consulting, articles and speaking programs. Inspired Hygiene's programs include in-office coaching, a free weekly e-zine, the High Performance Hygiene Mastermind group and the new High Performance Perio Webinar series. To contact Rachel, e-mail rachel@inspiredhygiene.com or visit Inspired Hygiene's Web site at www.inspiredhygiene.com.
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September 2025
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