Balanced service mix is a reflection of your clinical philosophy. Looking at service mix is essentially looking at the variety of services, beyond a basic prophy, that are being offered and delivered in your dental hygiene department.

There really are no industry standards for dental hygiene department service mix, which makes this statistic driven completely by philosophy and protocol. I’d like to make the assumption that if you are reading this article, you have also watched the Principle-Based Dental Hygiene course available through Spear’s Course Library in the Staff Training section. Your principles of care will drive your service mix.

For example, if one of your principles includes eliminating sub-gingival bacteria, then your statistics would reveal the regular use of a locally applied antibiotic (LAA) such as Arestin. Typically, I would expect to see at least one site of LAA per quad of therapy (4341/2) and at least 30 percent of periodontal maintenance patients’ receiving one, two or three sites of LAA.

Additionally, if you believe that adult fluoride application can lower caries rates, decrease root sensitivity for those with recession and help your patients protect their investment in restorative dentistry, then your statistics would reflect the regular application of adult fluoride varnish. For an office that has adopted this philosophy I would expect at least 50 percent of adult patients would be receiving fluoride. To achieve that percentage, all adults would have to be offered the opportunity to take advantage of a fluoride varnish application.

Radiographs are another area you should evaluate. What is the frequency of PANOs and FMX being sourced from your dental hygiene department? Visualizing alveolar bone is a key component of periodontal diagnosis and risk evaluation for future periodontal disease. The use of seven Vertical BWs rather than four Horizontal BWs can help you visualize all areas of alveolar bone. When radiographs are neglected, disease will be missed.