There comes a time when every practice owner starts to think about hiring that first hygienist or adding another hygienist to the existing team. Having a hygienist in the office has numerous advantages. Dentists who hire hygienists tend to have larger and busier practices. They can delegate preventative care, giving them more time to do the operative and restorative-type procedures that can't be delegated.
If your practice does not currently employ a hygienist and you have eight or more patients in your chair daily, it's time to add a part-time hygienist. You may have been operating as "lean and mean" as possible, but in order to prosper and expand, you'll need those extra hands.
If you currently have a mature practice with a hygienist on staff, but patients have to wait two or three (or more) weeks for an appointment, you should feel comfortable adding a part-time hygienist. Putting off appointments hurts the practice and the patients. They are more likely to not show, or change their mind altogether. Sometimes they may even go to another practice where they can be seen sooner. Practice consultant Dr. Charles Blair reports that one hygiene day is needed each week for every $115,000 of the doctor's annual collections.
It's important to find a hygienist with the same mindset as the dentist. Having a great smile isn't enough—the hygienist needs to agree on a standard of care for the patients. If the dentist has a goal of implementing a periodontal program and the hygienist isn't comfortable with that, the dentist will not be able to move forward with what is best for the patients. This is why establishing and following an exact hiring process is key in finding that perfect hygienist for your practice.
Step 1: Prepare a list of required skills and duties
Dental hygienists are licensed professionals. Each state has a board that governs the knowledge and skills required for a hygienist to perform within a range of minimal competency. You may require the hygienist to perform a variety of patient treatments, depending on your practice and the state where you are located.
Many times practices hire an employee and discover later that the person can't do—or is unwilling to do—everything in the job description. You can prevent a lot of future stress and potential problems by preparing in advance of the interview a list of the skills and duties the position will require. I suggest that you customize the list I have provided to fit the job requirements of your office. This guarantees that the hygienist, if employed, is aware of what you will expect. This also gives you an opportunity to see his or her reaction when the information is presented.
Sample list of hygiene duties
Step 2: Recommended interview questions
- Greet the patient by name and introduce yourself
- Verify/update the patient's medical history
- Be aware of risk factors
- Take blood pressure
- Get to know the patient
- Inquire about dental problems
- Take X-rays as necessary
- Check the patient for missing teeth, oral lesions and decay
- Probe and document pocket depths. Say the measurements out loud for the patient to hear, after you have explained what the measurements mean
- Check to see that all previously recommended operative work has been completed. If not, encourage the patient to have
- Mention [out loud] to the patient any dental conditions that exist
- Scale and polish the teeth
- Apply fluoride
- Administer anesthesia as requested by the doctor
- Perform root planing and sub-gingival curettage,
- Document all treatment/anesthesia/communication
- Chart any needed treatment as requested
- Schedule the next hygiene appointment
- Escort the patient to the check-out desk after the appointment
- Prepare your room for the next patient
- Promote services, as well as the practice
- Place sealants
- Desensitize teeth
- Take impressions for night guards and bleaching trays
- Sharpen instruments
- During free time, call patients to schedule recall appointments
- Keep your area well stocked with supplies
- Spend chair time educating patients
- Stay on schedule
- Make postoperative treatment calls
Ask questions during the interview that will help you learn more about the candidate. It's interesting to use these questions consistently with each hygiene applicant. As you ask the questions, you will become a master at gauging the responses and soon see the benefits.
Step 3: Utilize an application addendum for hygienists
- How do you feel about our work hours?
- Would it be a problem for you to work late on occasion?
- How would you describe your personality in 10 seconds or less?
- What did you like most about your last job?
- What did you like least about your last job?
- What are your pet peeves?
- How would you handle a patient who arrived late for an appointment?
- Do you mind calling patients who are overdue for hygiene?
- What is your favorite procedure?
- What is your least-favorite procedure?
- Do you think it is important to stay on schedule?
- What stresses you out?
- How could you help
- How many sick days will you need each year?
The following Application Addendum (see p. 44) will require the applicant to answer some very important questions that will help you learn more about him or her and how he or she would fit into your practice.
Step 4: Prepare an ad and advertise the job opening
When writing your employment ad, be sure to keep it short and to the point. The most common mistake in ads is that most of them are telling the applicant what qualifications to adhere to and what to do, instead of promoting the practice as a great place to work.
The following websites are great resources for finding a hygienist:
Step 5: The interview
Once you start receiving résumés, schedule the interviews as soon as possible. The best applicants get hired quickly. The following list of required skills and abilities will greatly improve your chances of hiring a hygienist who will be a better fit for your practice.
Other important areas to be covered in the interview are pay rate and benefits, including specifics about how continuing education will be handled. Always document your conversation.
- Good vision
- Physical stamina
- Meticulous to detail
- Steady hand
- Positive attitude
- Good personality
- Great smile
- Strong interpersonal skills
- Required motor skills
- Professional actions and appearance
- Good communicator
- People person
- Able to multitask
Whether on a written employment application or in person, legally you are not allowed to ask about an applicant's age, marital status, children, sexual orientation, religious affiliation or race. Questions pertaining to the nature of a physical, emotional or mental handicap can only be asked if an applicant will need special accommodations for performing a specific job. For more information on federal hiring guidelines, visit the websites for the U.S Department of Labor (www.dol.gov) and the Equal Employment Opportunity Commission (www.eeoc.gov).
If you follow these guidelines for hiring, chances are good you will find your special hygienist. The hygienist is the right hand of the dentist. A pleasant and productive hygienist can be a valuable asset. She or he must possess excellent clinical skills, but more importantly, good people skills. The hygienist is in a position to promote good oral health, raise a patient's dental I.Q. and recommend quality dentistry. You can't have a great practice without a great hygienist—and if you do it right and take the time, you'll find that great hygienist who will become an indispensable part of your team.
Sandy Pardue is an author, practice-management consultant and an internationally recognized
lecturer. For 25 years, she has assisted hundreds of doctors with practice expansion and staff development. She is known for her comprehensive and interesting approach to dental office systems, and offers a refreshing point of view on how to make a dental practice more efficient and productive.