Every progressive and profitable dental hygiene department has these five characteristics in common: solid clinical protocols, statistics and benchmarks, appropriate service mix, confident communication skills and “A-Team” hygienists I will discuss all five in this article.

Solid clinical protocols

Having solid evidence-based clinical protocols for each hygiene procedure is the cornerstone of a progressive and profitable hygiene department. It’s essential that these protocols are agreed upon and understood by every team member. The doctor(s), as well as the hygiene team, must recognize disease in its earliest stages and diagnose active infection with the same parameters. AAP case typing should be applied to each perio patient and treatment planning for treating periodontal disease follows agreed upon prescribed protocols and parameters.

See an example of what your clinical protocols for a preventive prophy might include below. As you read these protocols, keep in mind the ADA 1110 descriptor states following: Removal of plaque, calculus and stains from the tooth structures in the permanent and transitional dentition. It is intended to control local irritational factors.

Solid clinical protocol for 1110

• Health history and risk factor assessment, every visit
• Blood pressure screening, every visit
• Current radiographs showing alveolar bone, when necessary
• Head and neck exam/oral cancer screening, including the use of visual enhancement technology if available, once per year
• Restorative evaluation and discussion, including pending and new treatment options, using an intra-oral camera and caries detection device if available, every visit
• Periodontal screening, every visit (unless providing a comp perio evaluation)
  • Spot check: record pockets and bleeding only
• Comprehensive periodontal evaluation at least once per year regardless of case type, which includes:
  • Six-point/tooth pocket measurement
  • Bleeding sites
  • Pus
  • Furcation
  • Mobility
  • Recession
  • Clinical attachment loss
  • Tissue response
• Personalized patient education and treatment planning when disease activity is present
• Personalized home care products and techniques, every visit
• Personalized adjunctive therapies as needed:
  • Flouride
  • Sealants
  • Treatment rinses
  • Whitening gel
  • Specialty procedures
• Personalized recall interval, every visit

While these clinical protocols serve as a guideline for every prophy appointment, as clinicians we understand that we must use our clinical care skill and judgment with each patient to customize the appointment and manage our time. The patients’ priorities, chief concerns and needs always come first.