Hygienists Who Hate Assisted Hygiene Are Often Right…But I’d Never Work Any Other Way

Assisted hygiene gets a bad rep, I understand. Clinicians in dentistry assume that assisted hygiene means working faster, working harder, and eventually burning out. After twenty years practicing in an assisted hygiene model, I can tell you that my experience has been exactly the opposite. In fact, if it weren't for assisted hygiene, I don't know if I'd still be a hygienist.

Here's the part most people misunderstand: while I'm only with each patient for about thirty minutes, I'm actually spending MORE time on the parts of care that require a hygienist.

Assisted hygiene isn't about doing double the work. It's about removing the work that doesn't require a hygienist so you can spend more of your time doing the things that do.

I've heard stories of hygienists who were double-booked all day with no support and no workflow—simply expected to "figure it out." I've also heard of compensation plans where the incentive for managing two columns was tied to hitting a monthly production goal (rather than daily). Those ‘models’ aren't motivating, they're exhausting!

Many hygienists assume that if you’re working in an assisted model, that you must be rushing, you must be skipping services, and, for those of us working on a production based income, we must be pushing services that the patient doesn’t need. Not a single one of these statements is true in my practice. If any of these were true, I would hate assisted hygiene, too.

But..when assisted hygiene is structured to serve the practice, the dentist, the hygienist, AND the patient (and I promise you, this is possible), it serves everyone. Hygiene doesn’t have to be a ‘loss leader’, and growth doesn't have to come at the expense of the clinical team.

Structurally, in my office, we could accommodate 15–16 patients a day. But I've found that 12 is my sweet spot. It's the number that allows me to provide exceptional care, maintain strong relationships with patients, produce at a high level, and still leave work without feeling depleted.

The thing is - while I’m only with each patient for thirty minutes - I’m actually spending MORE time on the parts of care that require a hygienist. I’m talking to patients every day about how their clenching and grinding is likely a symptom of a greater problem - it’s not the diagnosis. And I’m sharing with them the correlations between sleep disordered breathing and facial growth and development. I’m sending them screenings to help assess them for sleep apnea. Do hygienist’s that book one patient an hour have time to serve their patients in this way? They don’t. Because they’re spending twenty minutes of every hour waiting for a doctor’s exam. Don’t believe me? Read this blog here.

I still build relationships with patients. I had patients at my fortieth birthday party whom I originally met in the operatory. I have patients who have become friends. We text. We talk about their families. That rapport is not lost - if anything, I have more time to catch up with them because I’m spending thirty whole minutes on instrumentation, patient education, and catching up. That’s a lot more time than most hygienists have to do those three tasks!

From a practice perspective, twelve patients a day represents significantly more hygiene production than seeing one patient per hour. But the benefit goes beyond hygiene production. More hygiene visits mean more exams, more diagnosed treatment, and more opportunities to help patients receive the care they need.

I’ve given you examples of the comprehensive care that I have time to provide to my patients.

So yes, the practice benefits. The patients benefit. But the biggest surprise may be how much the system has benefited me personally.

I've practiced this model for TWENTY years. No burnout. No countdown to retirement. No desire to leave clinical hygiene behind. In fact, I love this profession more today than I did when I entered it in 2006. Sure on occasion my neck my bother me, or my forearm feels tight. My neck is usually from me putting myself into a ridiculous position that it so opposite of ergonomics, it’s stupid for me to do - but sometimes - we do what we have to. And my wrist and forearm? Usually that means I need to sharpen my instruments. It almost never fails that it feels better after that. But for the 95% of time I practice, I have no work associated areas of discomfort.

Financially - I produce at a very high level. I average something around $330-$350 a clinical hour. Being paid on production means that three clinical days each week provide an income that many hygienists need a full week to earn. The quality of life that this has given me cannot adequately be put into words. Working three days a week has allowed me to be there when my kids were young for their sports, it’s allowed me to work endlessly in my garden, and it’s allowed me to start other businesses.

For all of these reasons, it’s why I’d never work any other way. I still love hygiene. I work three clinical days a week. I provide a level of care that I’m proud of. I have meaningful relationships with patients, and after twenty years of clinical practice - I still love going to work every day.

And it’s possible for this to work in your practice, too.

Whether you’re a dentist, office manager, or hygienist, and want to simply talk through whether this is something that could work in your office, I invite you to schedule a call with me here.