The Effective Doctor–Hygiene Evaluation


Doctor finds it difficult to get in the hygiene room, do an exam and stay on-time.

Desired Result:

The doctor and hygienist collaborate on the patient evaluation and co-diagnosis, resulting in a more thorough exam and a higher acceptance of treatment recommendations.

How To:

The doctor’s goal is to arrive in the hygiene operatory during the first 20–30 minutes of the patient appointment.  Do not wait until the last 10 minutes of the appointment or until the hygienist is completely done polishing.

It is very important that the doctor greets the patient with a “Nice to see you!” statement, not a “How are you?” question. Making a statement, rather than asking a question, allows the Doctor to have control of the conversation. For example, the doctor could start with “Good to see you Jim!” and ask the hygienist “How is Jim today?” (This is the cue for the hygiene handoff to begin. Doctor does not say “What did you find today?”) Wash and glove while the hygienist shares information, then sit in the Doctor chair. The Doctor evaluates the patient while the hygienist is speaking.  The hygienist is positioned to assist with air and water during the exam.

The exam begins with the hygienist making a positive comment about the patient’s homecare or visit.  The next step is to update the doctor on new personal information (so the patient does not repeat what they told the hygienist to the doctor, using valuable exam time). The hygienist reports her clinical findings as the doctor evaluates of the mouth.

Jane Hygienist: “Jim’s health history has been updated, his blood pressure reading was 124/79, his last set of radiographs was June of last year, we discussed taking a full mouth view at his next hygiene visit. The gum tissue is healthy, he has been flossing more.  We discussed that you might recommend a crown to replace the large rough and cracked filling on — 30.”  I did a shade check at his last hygiene visit and his color is changing slightly so we may want to consider whitening as well.”

Doctor: “Yes, I see your concern regarding — 30 and I agree with your analysis.  Jim, because I know you have a busy work schedule, I would hate for this tooth to break at an inopportune time. To avoid more complex and more expensive treatment, I recommend that we schedule for the crown on — 30, it is here on the lower right. The longer you wait, the more likely it is that you will need other, more expensive, treatment. Let’s get this taken care of while we can plan it. Jane can you print the picture and explain the crown procedure to Jim. If he wants to begin whitening get him set-up to do that before we begin the crown.  Jim, I would like to see you within the next month for that crown, I don’t want to wait too long.

Also taking the full mouth view x-rays at the next hygiene visit will allow us to check on how the new crown is doing, so let’s plan on that and for me to review those x-rays with Jim at the next hygiene visit.  Thanks Jane.  Good to see you Jim,” (this is the time to make a personal comment or reflect on the personal information the hygienist shared now that the exam/evaluation is complete).