By Deborah Dopson-Hartley, RDH

Ok doctors, you've done it all. You've taken the courses and workshops, you have hired the consultants, and bought all of the materials and toys. You're way past ready to start doing lots of comprehensive cosmetic dentistry, but the cases aren't coming often or fast enough to off set your costs. The hard truth is that getting ready to do the work was the simplest part.

Learning how to perform comprehensive cosmetic dentistry is just the first step. Actually getting to do the work takes a plan of action that involves your entire staff, especially your hygiene team.

When you consider the fact that your hygienist spends more time with your patients than any other person in your practice -- yourself included -- then you really owe it to the business, the hygienist and the patients to help your hygienist understand all aspects of dentistry, both patient care and technical. You can guide her growth towards the type of hygienist, you and your practice wants and needs.

In 1995, at the Profitable Dentist Conference in Keystone and Destin, I earned recognition as the most productive and profitable hygienist in America. This citation, conferred by Drs. Woody Oakes, Travis McFee, Larry Rosenthal, Bill Dickerson, Ken James, Howard Farren and Walter Hailey, was certainly a high point of my career, and yet I have learned and grown tremendously since then.

Back then I could be quite specific on how to develop and implement a highly productive hygiene department. My hygiene department's yearly production was closing in on $300,000 in just hygiene production alone, in addition to marketing and selling over $375,000 in doctor's revenues. My doctor was a well-trained salesman and a savvy businessman, and he made sure that I became one too. I enthusiastically did everything he instructed me to do. I eagerly took the courses, read the materials and listened over and over again to the tapes. I wanted growth.

He did normal complete treatment plans consisting mostly of PRM in both crown and bridge, cosmetics consisting of some maxillary anterior crowns and bleaching, plus lots of emergency endo / build ups, PFM crowns and bite guards.

I was instructed to sell a minimum of two crowns per patient per recall or was not to even bother calling him. This plan kept us at the million dollar mark for five years, and the entire time I was his only hygienist.

He did not do porcelain laminates or onlays because he found them to be difficult, unpredictable and not cost effective. He claimed PFM crowns were easier and more profitable. Every patient, however, knows about and dislikes crowns, and that makes them much harder to sell.

After listening to Drs. Larry Rosenthal and Bill Dickerson at the Profitable Dentist conference, I sensed a new order. I realized a new and better way of doing things, and that gave me an incredible educational high. This was the dentistry I had always dreamed about for my own mouth.

These two dental gurus invited me to attend their "Contemporary Aesthetic Diagnosis and Treatment" course at Baylor University to see for myself what dentistry was now capable of offering. I witnessed the most complex and beautiful dentistry I had ever seen, performed by the participants - dentists, just like you. The specifics of each case was diverse and complex. Each case was applicable for patients in our own practice, but the treatment plans and materials used were entirely different. I had never seen anything like it before. It gave me a whole new insight and such a renewed passion for dentistry, that I felt reborn. Value that goes beyond the basics.

After experiencing this I knew I would never be the same again. In fact, it moved me personally to such a higher level of consciousness, that I left the position that had brought me fame, fortune, and $100,000 a year. I was working for a very fine dentist, but I could no longer market and sell his dentistry again. It was adequate and it worked. But it wasn't the minimally invasive adhesive aesthetic dentistry that I knew I now wanted.

I began a quest to find a dentist like the ones I witnessed at Baylor. I found that most dentists were unwilling to invest in themselves. Few had spent the time and money required to acquire this new technology. When I had to decline a position with Dr. Rosenthal's office (my husband and family were against the move to New York), prospects were dimming. Larry recommended Dr. Diane Wright, a clinical instructor for Dr. Dickerson's anterior courses and Dr. Ron Jackson's posterior courses at the Las Vegas Institute.

I have been working for Dr. Wright for about two years as a full time hygienist and I have never been happier or more passionate about what I do for a living. I have learned so much from her. Offering my patients this technology and seeing its result in their smiles is inspiring, motivating, and makes me feel better about myself. I can't imagine working for anyone else.

With my new understanding of aesthetic dentistry, I have become more confident and competent to really look at and discuss smile designs with patients. Now I see every patient as a "canvas." As my enthusiasm and passion for aesthetic dentistry increases, so does patient acceptance.

Dr. Rosenthal once told me "The eyes cannot see what the mind does not know, but once your mind knows, your eyes cannot help but see it every time." I now see what my aesthetic dentist sees. I pre-diagnose treatment plans with accuracy because I understand the complete restorative aesthetic concept.

This is of paramount value as an Aesthetic Hygienist. My education, marketing and sales skills are vital to the success of the aesthetic dentist for whom I now work.

Aesthetic dentistry is extremely technique sensitive and timing is critical. There is certainly no room for error. For an aesthetic practice to be successful, the doctor must maintain total concentration. The doctor will need dedicated time to perform this difficult and complex work, unhindered by other activity at the office. There are times she simply cannot get up and check my recare patients. It is then my responsibility to educate, motivate and market to our recare patients.

It is now my job to increase and improve the patients dental IQ about restorative dentistry and aesthetic dentistry. I show our patients how adhesive dentistry isn't restricted to cosmetic applications as their insurance has led them to believe.

An Aesthetic Hygienist must become an effective salesperson. I know that selling is not easy for most people. In fact, "SELL" is often considered a negative, four-letter word, especially in dentistry. When you think about it, however, our lives are filled with sales. We sell safety to our children, business concepts to the staff, ideas and strategies to our boss; life is all about selling.

In my 22 years of experience as a hygienist, "SELL" has become a very positive four-letter word, akin to "love" and "care." I care enough about my patients to help "sell" them what they need and might want for their happiness. Patients have so many true needs and desires when it comes to basic dentistry and aesthetics, that pushing unnecessary or unwanted services isn't even a consideration.

I believe we owe it to our patients to educate them about what they need for their dental health and to encourage them with the outstanding results they can achieve through aesthetic dentistry. Some patients even suffer severe psychological distress due to the appearance of their teeth. Nearly all would benefit from the big boost in self-esteem that comes with a brighter and healthier smile.

Doctors, are you ready to maximize all of that new equipment? Are you itching to make the money invested in consultants and continuing education really payoff? Encourage the transformation of your hygienists into aesthetic hygienists. Give them knowledge of the possibilities and the procedures of aesthetic restoration, freedom to develop relationships with patients, and the responsibility to sell your work.

Since the selling is usually the part that comes least naturally, I am preparing some scripts for your staff to use in patient consultations. Sometime the best way to market your work is to emulate the success of others. My success is a result of my passion for the wonderful work my doctor performs and my experience with helping to build our practice into a profitable aesthetics fee-for-service solo practice in a small town called Brandon, Florida.

The scripts will be published in the next issue of Building The Power Practice and will give your staff a head start to bringing in that steady flow of challenging and profitable cases.

Until then, I want to thank all the dentists and hygienists out there who are responding to these ideas. Together, we will find new ways to work, help our patients, build our businesses and achieve our own professional goals. A journey of a thousand miles begins with a single step...Take it!