Hygiene Appointment & Recall Frequency

ONE SENTENCE SUMMARY

How to determine what the proper hygiene appointment frequency and recall frequency is for our patients.

BEST CASE SCENARIO IF WE ARE 100% CONFIDENT

Recommendations are prescribed by the doctor based on providing our patients with what’s in their best interest for optimal oral health.

WORST CASE SCENARIO IF SOME OF US ARE NOT

Family members have different procedures completed depending on the hygienist they see. There is no consistency in booking or billing and patients get upset because “they usually see X and never get billed Y”.

WHAT DOES 100% CONFIDENT MEAN?

ALL Doctors and hygienists are on the same page 100% of the time while: recommending, booking, communicating, and overcoming obstacles in a similar manner.

Appointment frequency & recall frequency may or may not be at the same interval.

Determining Patients Appointment & Recall Frequency

Who: 

The Doctor is to prescribe a recommended appointment and recall frequency for each patient based on their specific needs. As a general rule, it is recommended patients have their cleanings and exam on a 6-month basis.

When: 

The new patient exam is the ideal time to recommend the cleaning and recall frequency.

Note: this recommendation is subject to change at any time depending on changes to a patient's oral health.

Note: following NP exam and cleaning, the patient's next hygiene visit should be 6 month RC

How: 

“Sabrina, based on …(your risk level for cavities, extensive dental history, the areas we want to keep watch on the upper left…) I recommend you see Jessica for your cleaning and a check-up with me every 6 months while having cavity detecting x-rays updated yearly. It’s important we see you on a regular basis to continue monitoring for any changes. Often if we do find something it will be easier, quicker and cheaper for you to fix by catching it early.”

“Sabrina, I recommend you see Jessica for your cleanings and myself for a checkup every 6 months while having your cavity detecting x-rays updated on a yearly basis. You’re doing a great job with your home care, we want to make sure that if something is to change we catch it early.“

“Sabrina, based on the bone and gums that support your teeth I would recommend you see Jessica every 3 months for deep cleaning. The numbers you heard Jessica calling is the space between the top of your gums and the level of your bone. 1-3 are healthy areas that you can reach with your toothbrush and floss at home, while the 4 and 5 are areas no matter how well or how many times your brush and floss the pocket is just too deep for you to reach and clean on your own. These deep pockets collect bacteria which acts as a toxin to your bone. While we can’t regain bone support we want to stop it from progressing. I would recommend you see Jessica every 3 months with a check-up every other visit. In a years time we will take a new set of cavity detecting x-rays and re-evaluate.

Hygiene Patient Introduction

As we all know recommended frequencies are subject to change as per the Doctor. It is important when a Doctor presents for a recall exam the Hygienist provides them with their current prescription allowing an opportunity for the Doctor to make any changes.

How:

“Dr. Bennett, Sabrina is in today for her 6-month check-up and cleaning…”

“Dr. Bennett, Sabrina is in today for her 2nd 3-month perio cleaning and 6 months check-up…”

“Dr. Bennett, Stacey is in today for her 4th 3-month perio cleaning and re-evaluation…”

Updating Appointment/Recall Frequencies in Open Dental

This is very important to keep updated as the office as a whole uses this ready to determine if/when the patient is due next.

When a patient does not pre-book, Dental Intel used this as an alert to follow up based on the information set.

Watch how to access/change prophy/perio settings here:

Discussing Cost

The Hygienist is responsible to discuss the cost of the next cleaning with the patient based on the Doctors recommendations.

Attached you will find guidelines for appointment types:

https://docs.google.com/spreadsheets/d/14fiuLBur6phomiltYl9YuPnqy2woq3dMkXH9e2u0Q1A/edit#gid=0

Deviating from Doctor Recommendation

Things to consider:

1. If the patient is NOT scheduled for an exam but has a concern that needs to be checked have the doctor come in at no charge (please be sure to use the code but zero out for proper billing – or let the front desk know so they can help make the adjustment)

2. If the patient does NOT want to go ahead with recommended treatment and wants to reduce their units of scale/visit their appointment length should also be adjusted.

3. Don’t forget to communicate recommendations to set the next person up for success!

Overcoming Obstacles

Does my insurance cover it?

"I'm not sure. Most insurance companies do cover it or at least a portion, but I can't tell you for sure. Worst case scenario it costs you $____. It’s really in your best interest to continue with 6-month checkups and cleanings to help catch things early should they present. Early detection can save hundreds if not thousands down the road. Are you ok with that?

Can you check my insurance?

"I'll give you the code and you can either call your insurance company or go online and check. Let's set you up for 6 months, check your insurance in the meantime, and then we'll talk about it again next time when you have your plan details."

My insurance covers recall every 9 months, I’d rather do that.

“I can appreciate it if you would like to stay within your insurance limitations. An option we could look at is having you in every 4.5 months for your cleaning with your check-up at every second visit to stay within your recall limitations. Would that be ok? In the meantime check your scaling units and we’ll review it again next time you’re in.

No thanks I want to come every “X” for my checkups and cleanings

"No problem! Ultimately it’s your decision, we are here to provide you with our professional recommendations and guidance. In the future, we might bring it up again if we see a need and to check if anything's changed on your end. If you're not interested, all you have to do is say so and we're all good!"

*** We are not in the business of trying to convince people to do something they don't want or to care about something they don't. If they don't care, then neither do we. We made a recommendation. They can either take it or leave it. No big deal. Remember: No judgment, no lectures, and no hassles.