When Should a Dental Office Hire a Dental Hygienist?

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When Should Hire Dental Hygienist Dental Practice

Help. Who needs it?

Well, probably you, if you’ve got anything resembling a healthy dental office. Once you’ve hung your diploma, and got some people coming through the door, you might find yourself a little overwhelmed. As in backed up so much people can’t make appointments when they want. And when they go elsewhere, you’re leaving money on the table.

How do you fix this? By hiring a dental hygienist for your dental office, with whom you’re most certainly familiar but haven’t taken the leap to hire. And it makes sense: When you’re just starting out their median salary of about $70,000 can be a major expense. But don’t hire one, and you might be limiting your practice’s growth. So how do you know when it’s time to hire a dental hygienist? Here are some tips to consider.

You’re Not Alone

According to a 2007 study by the Journal of the American Dental Association, about 76% of independent general dentists and 26% of independent specialists employ dental hygienists. About half of those who didn’t cited not being busy enough to warrant hiring one as a main factor, and over 40% cited the cost. But that cost can be an investment.

In an article from Dentistryiq.com, Kristine A. Hodsdon RDH, MSEC, suggests that if you find yourself with seven or eight continuing care patients per week in the schedule, you should bring in a hygienist one day per week. Then extrapolate that formula out for however many you’re seeing, up to full time. If you’re doing five cleanings a day, you’re going to need a hygienist there every day.

The Stress Relief is Just the Beginning

Now you might be crunching the numbers and thinking “There is no way my dental office is going to be doing enough cleanings a year to justify a $70,000 salary plus benefits.” And in a way, you’re right: The sheer number of cleanings a hygienist does probably won’t bring in enough cash to cover the salary. But that’s vastly oversimplifying the issue, and understating the benefit.

With a hygienist doing cleanings and continuing care, it frees you up to do more restorative and cosmetic dentistry. Doing these higher-priced procedures is a more valuable use of your time, and will expand your practice into more lucrative areas. Similarly, with a seasoned hygienist working with your patients, he or she can diagnose and recommend procedures beyond what they perform.

Patients often develop relationships with regular hygienists, and see them as a “second opinion” to your recommendation. So asking the hygienist what they’ve found when you come in to meet a patient is a great way to get that additional procedure train rolling.

Basically, if you find yourself doing a lot of cleanings, and passing up restorative procedures because you can’t fit it in your schedule, you might want to look at hiring a hygienist.

Cash In vs. Cash Out

Ideally, you want your total employee wages to be between 19-22% of your gross income. Bringing in a well-paid employee is going to increase that considerably, about 27% on average. And that’s a big financial hit. Ideally it won’t be permanent, and within two months your hygienist should be bringing in enough additional revenue to get those numbers back down to normal. But until they are, budget to be down about 5% of your gross. And if that’s not financially feasible, you may need to hold off until it is.

Eventually, a skilled hygienist should bring in $1500 a day, or about $300,000 annually based on a 4.5 day work week over 45 weeks. The average, as we said, is about $600-$900 a week, but that doesn’t mean you can’t push for more. On your balance sheet, your hygienist should account for one quarter to one third of your overall production, and should bring in at minimum three times their gross production.  That, of course, doesn’t include the added revenue you’ll get from performing more advanced procedures.

Things to Consider When Hiring a Hygienist

Obviously a less-experienced hygienist will be cheaper, but will probably also generate less revenue. So look at experience like an investment: you’ll have to spend money to make money. More importantly than that, look for people who are social, and do things like make eye contact and give thorough answers in interviews. The hygienist will have contact with upwards of 98% of your patients, and many will spend infinitely more time with him or her than with you.

You patients need to like your hygienist more than they like you, because that is who they spend most of their time with. That relationship is key to your success, and while you want to hire someone who knows what they’re doing, more so you need someone who is good with people and offers great customer service. When screening candidates for your dental practice, it is more important to ask questions about how they interact with people than their technical knowhow. Skills can always be taught. Personality cannot.

Hiring a hygienist is a big step in growing your dental office. But if you want to expand, and make the most of the skills you’ve learned, you need help. It’s a considerable financial commitment, and maybe not one you’re in a financial position to make just yet. But hiring a hygienist is a sound business objective, and an investment that will be a great benefit to your practice and your patients in the long run.


Matt Meltzer

Matt Meltzer is a professor of business communication at the University of Miami. He is a veteran of the United States Marine Corps and holds a bachelors degree in business administration from UM, as well as a Masters of Mass Communication from the University of Florida.