Hiring a dental hygienist? Avoid these common pitfalls

Mistake # 1 Missing the moment

Timing, as they say, is everything. Hiring too soon can create a bumpy onboarding process, leaving a great hygienist feeling underutilized. Waiting too long, on the other hand, can make you feel desperate to “fill the seat” and possibly less objective about job applicants.

So what’s the right time to bring on a dental hygienist? This is a very complex question, and it depends on a number of related factors. How many continuing care patients do you see per week? How long do your patients usually wait to see you? What is your annual practice revenue?

While there is no definite threshold at which you should bring on a hygienist, analysts have suggested several different rules of thumb. Kristine A. Hodsdon, RDH, MSEC, writes in this DentistryIQ article that for every seven or eight continuing care patients you see per week, you should bring in a dental hygienist for one day.

Wait time is also a factor to consider. If your patients are waiting more than two to three weeks to get in your office, writes Sandy Pardue for Dentaltown, you might consider bringing on (and gradually ramping up) a part-time hygienist. Similarly, you can benchmark to annual collections: Dr. Charles Blair suggests adding one hygiene day per week for every $115,000 in revenue your practice makes.

There’s also a workflow analysis to bear in mind. Are you spending a lot of your own time on cleaning work? Delegating these patients to a hygienist can allow you to focus on higher-margin procedures, like restorative and cosmetic dentistry. This can be a boon to your practice revenue - and of course, many dentists find it satisfying to do the work for which they’re especially qualified.

Again, this is a complex assessment that only you can make. Whenever you decide to hire, act decisively with a clear timeline in mind - and bear in mind that you can’t control every variable.

Mistake # 2 Neglecting the pre-work

Who exactly are you trying to hire? What will they do for your practice?

You probably have strong intuitive responses to these questions, but the full answers may be more subtle and complex than you expect. For this reason, itemizing your practice’s needs and expectations is an extremely valuable exercise.

Start by enumerating the new hygienist’s responsibilities. Here’s a sample list, courtesy of Sandy Pardue:

• Greet the patient by name and introduce yourself
• Verify/update the patient's medical history
• Be aware of risk factors
• Take blood pressure
• Get to know the patient
• Inquire about dental problems
• Take X-rays as necessary
• Check the patient for missing teeth, oral lesions and decay
• Probe and document pocket depths. Say the measurements out loud for the patient to hear, after you have explained what the measurements mean
• Check to see that all previously recommended operative work has been completed. If not, encourage the patient to have it done
• Scale and polish the teeth
• Apply fluoride
• Administer anesthesia as requested by the doctor (if legal)
• Perform root planing and sub-gingival curettage, as necessary
• Document all treatment/anesthesia/communication
• Chart any needed treatment as requested by doctor
• Schedule the next hygiene appointment
• Escort the patient to the check-out desk after the appointment
• Prepare your room for the next patient
• Promote services, as well as the practice
• Place sealants
• Desensitize teeth

This list could continue. And while it may seem excessively detailed, this exercise will help you create a thorough job description and ensure that applicants are willing and able to perform their duties.

You should also spend a fair amount of time determining the less-quantifiable aspects of your ideal hire. Are they extroverted and communicative? Detail-oriented and thoughtful? Perceptive and helpful? All of these are positive qualities. The goal is to identify for yourself which are the most important. Know who you’re looking for before the interview, rather than feeling it out afterwards.

Finally - and this should go without saying - preparing to hire means knowing the law. There are strict codes regulating how employees are hired and paid, and what sort of questions you can (and cannot) ask during a job interview. For details about federal employment law, check out the U.S Department of Labor and the U.S. Equal Employment Opportunity Commission. You may also need to consult with your lawyer or accountant.

Mistake # 3 Botching the first impression

As you size up dental hygienist candidates, it’s easy to forget that they’re doing the very same thing. The best applicants are searching for a healthy, supportive environment where they can learn and grow. Are you helping them see these great qualities in your practice?

First impressions begin with the job description you place. Do not “do what everyone else is doing,” says Ginny Hegarty in this archived issue of Dental Practice Success. “Don’t let your ad blend in with all the rest of the no-name ads. Whether seasoned or a startup, you are offering a unique and exciting opportunity. Tell a bit of your story, share your dream, include your name and website. You’ll attract someone who wants to help you build that dream.”

What if you’re not confident in your ability to write such a standout job description? Just hire a freelance writer via Upwork or Fiverr. The fee for such a small job will likely be nominal, and it’s worth it to get the edge in a chaotic marketplace. (It’s also a small price to pay for the assurance that your ad is free of typos and grammatical errors.)

Of course, a good first impression also includes your in-person interview. What kind of experience does the candidate have when they arrive at your office? How are they welcomed and treated by other employees? How do you follow up with them after the fact? These questions are crucial, and often overlooked.

As for the interview itself, there’s no objectively right or wrong way to conduct it. But there is a huge (and contentious) literature about the best philosophy and approach to these high-stakes conversations. Skim the literature and see what feels right. If you need to, block off time on your calendar. Look over the interview questions suggested online, decide which are most important to you, and be diligent about asking them of every candidate. Again, there’s no wrong way to conduct an interview - except by coming underprepared.

Mistake # 4 Not following through

When your newly-signed dental hygienist shows up for their first day of work, what kind of environment are they stepping into? Delivering a thoughtful onboarding experience is essential to keeping your new hire enthusiastic and well-adjusted.

The rest of your staff - who have ideally been involved in the search, perhaps even interviewing candidates alongside you - should be ready to welcome the new hygienist. The tone you set in these first days will have a huge effect on the team’s reception of the new hire. Consider taking the team out for an introductory meal to help everyone get acquainted.

Make sure also that your new hygienist knows which staff members to rely on for help settling in and learning their responsibilities. Small, symbolic gestures - such as ensuring that a clean, new workstation is ready before your hygienist arrives - can hold serious significance.

Be deliberate, especially in the early days, about making time for one-on-one discussions with the new hygienist. Are they enjoying the work? Do they have interesting insights or criticism to give? What do they need to do their job more effectively? This is also the right time to offer your own feedback, and coach the new hire toward better performance. Don’t forget to schedule employee reviews! Make sure the new hygienist understands how they’re advancing along the career path you’ve previously discussed.

Finally, a note on finances: Expect a bit of sticker shock in the early days. This article by BFS Capital estimates that it will take about two months for a new, well-paid employee to offset the costs of their own salary. Before this break-even point, your gross office budget will likely dip by about 5%. Don’t be spooked, but do watch the numbers. Eventually, a skilled dental hygienist should create about $1500 per day in additional revenue.

The Bottom Line

A new dental hygienist can be a wonderful and valuable addition to your team. But remember that hiring is an art, not a science. When and how you bring on this new employee will depend on a myriad of unique factors. By timing your new hire correctly, preparing adequately for the search, making a positive first impression, and being deliberate about your follow-through, you can avoid common mistakes and increase your chances of finding the right dental hygienist for your practice.

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