5 Sep 2019  •  Practice Management, HR & Employment Law  •  8min read

How to maximise the value of hygienists and therapists

Fliss McCalmont speaks to Diane Rochford and Lesley Morgan-Barlow about how to utilise dental hygienists and therapists to best effect…

The number of dental hygienists and dental therapists registered with the GDC has risen by 12.5% and 65% respectively between 2013 and 2017, according to research by Christie & Co. They are increasingly becoming a familiar part of practice teams.

However, it is not always the case that they are being used to best effect which can impact on the services offered to patients, their own job satisfaction and practice income.

To find out more about how practices can make the most of having dental hygienists and dental therapists in their team, I spoke to Diane Rochford, a dental hygienist and President Elect of the British Society of Dental Hygiene and Therapy (BSDHT), and Lesley Morgan-Barlow, a dental practice business director and advocate for using dental therapists.

Fliss McCalmont (FM): Do you think the full scope of practice of hygienists and therapists is being fully utilised?

Diane Rochford (DR): There are many practices that utilise the role of the dental therapist very successfully to the benefit of the patient and the business. However, promoting the full use of a dental therapist’s skillset seems to be more of an issue compared to dental hygienists, who are also often under utilised, and something that the BSDHT is trying to address.

This can be for a number of reasons; patients – and sometimes dentists – not understanding how to fully integrate dental therapists, which can lead to dental therapists being utilised more in a dental hygiene role often leading to them losing their therapy skills or lacking in confidence. Utilising the full skills of the dental hygienist and dental therapist will be beneficial to the patient and allows the dentist to focus on more complex treatments, understanding their scope is vital to their utilisation in practice.

Lesley Morgan-Barlow (LMB): I would agree that they are not used to the full scope of their practise. When I first started recruiting these kinds of roles to our practice, someone gave me some really good advice, which was that if you take a therapist you should use them as a therapist and not as a hygienist.

In the past, therapists might have been used for things like scale and polishes but now with advances in therapy treatment, they are more likely to want to use their skillsets and find their niche. We have therapists who are really passionate about gum health and others who are more focused on the restorative side of treatment. The key to using them well is finding out what their specific skillset is, what their passion is and to work with that.

FM: Do you think the patients’ perception of hygiene and therapy is changing?

LMB: I think to some extent patients still view it as just a ‘scale and polish’. Which I think is due to a lack of education in the industry and a lack of understanding among patients about the need for gum health. We find a lot of patients are focused on the ‘sexier’ stuff like cosmetics or restoration, which may well be because traditionally we’ve been quite bad about talking about things like gum health.

One of my passions is making sure that we communicate to patients in a language they understand and start a conversation about the way they look after their teeth. We use techniques to encourage patients to take responsibility for their dental health. Telling, or rather explaining, the best ways of improving gum health, showing them how to use the right tools in the right way and then working with them to improve their techniques to achieve maximum results.

DR: I think it is definitely changing with dental hygiene. Patients are much more accepting of the role of a dental hygienist now, but it still feels like there is less knowledge amongst the general public about dental therapists and their role in the dental team, building their public profile is important.

FM: Is there anything professional bodies can do to increase awareness of these roles?

DR: The BSDHT continues to support and promote dental hygienists and works on promoting dental therapists within the profession and the general public. Many dental therapists use social media as a way to engage with the profession and the public to increase awareness of their role within the dental team and the dental care they provide. As a Society we are trying to engage with the dental corporate groups to help them utilise their dental therapists more – I think this will be the start of improving patients’ understanding too. That is what happened in hygiene – the more dentists understood about what dental hygienists could do, the more it was promoted and communicated to patients, and then it spread by word-of-mouth among patients.

FM: How can therapists and hygienists be used more effectively to improve the practice’s finances?

LMB: The key is educating the profession and the public to value an appointment with a hygienist or therapist. That will help to reduce rates of cancellation, which always seem to be higher than appointments with the dentist.

One of the ways we do this is by giving patients a report that gives them a score for the number of bleeding areas in their mouth, and explaining what that means. It makes it real for them, it’s easier for them to understand what you’re talking about and they really engage with it and are invested in trying to improve that score.

Alongside that, as we’ve mentioned, is utilising their full scope of practise – which should free up the dentist to perform more high-value treatments. It’s part of the balance of maximising your surgeries effectively and doing the right types of treatments in the right number, by the right clinicians.

DR: The key to full utilisation of a dental hygienist and dental therapist in a dental practice is to look at the bigger picture, educate patients so that they understand the benefits of attending their appointments and the risks involved if they don’t. One of the ways we encourage patients to keep their appointments is to schedule the next visit before they leave the practice and understanding the reasons why they need to come back at the appropriate interval.

In terms of helping the business to be profitable, it is vital that all team members carry out their roles to their full potential. Dental hygienists, often feel like they are scaling machines, but if they can take impressions for tooth whitening trays or apply fissure sealants – then why not let them? It will ensure the practice runs efficiently, which is not only good for the bottom line but will also create a positive team atmosphere, win-win.

FM: Thank you both for sharing your thoughts, and advice, on this issue, it’s been a great discussion.    

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