During the 1980’s, a concept known as “accelerated hygiene,” still embraced today, became popular.  It was based upon the principle that, like the dentist, the hygienist’s activities and services should be limited for maximum profitability to only those the hygienist was licensed to perform.  All others should be delegated.

To be clear, I’m a firm believer in appropriate delegation.  Empowering employees to contribute to the success of the practice at the highest level not only builds their self-esteem but contributes to practice efficiency and productivity which helps reduce the overall cost of providing patient services.  But this concept takes delegation to the extreme, and – I believe – adversely impacts both the practice and the dental hygienist.

In short, an accelerated hygiene program limits the hygienist’s duties to probing and scaling teeth or providing periodontal services including root planing and scaling and placement of subgingival therapeutic medications.  An assistant does all the rest, including reviewing the patient’s health history, obtaining the radiographs, and – in some states – polishing the teeth.  It’s my opinion that compartmentalizing services in this regard has multiple adverse consequences.

First, practitioners who believe in this concept fail to appreciate the greatest contribution the hygienist makes to the practice, which is establishing a long-term personal relationship with each patient.  It’s that relationship, established over time through education and compassionate care, that contributes to treatment acceptance and patient retention.  Additionally, updating the medical history should be done by the hygienist who best knows each patient.

Second, accelerated hygiene can lead to carpal-tunnel issues and burnout which often abbreviates the career of a highly trained and valued professional.  Finally, it contributes to high-turnover which eliminates the established hygiene-patient relationship and increases the cost of doing business.

Accelerated hygiene is a concept that sounds great on paper but, in my humble opinion, is bad in practice.  Avoid it at all costs.

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Dr. Kerr

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