An Easy Hygiene Exam Onboarding System

By Kristie Kapp, CEO, RDH

A clear training system for the new hygienist is imperative for efficient and effective hygiene exams.

There are three sections to the exam process:  the connection, the download, and the review. All three are essential to help patients understand their oral health needs.

Building a relationship is critical in building a loyal patient base. Aim for one to two minutes max.  Utilize a system for remembering a thing or two about the patient before you come in the op.  For instance, in your huddle meeting you or a team member might mention some current event about the patient.

Many doctors come into an op to perform an exam and don’t take full advantage of the help their team can give.  For instance, the doctor could say “Sarah, please tell me what you have found and what you and Mrs. Jones have talked about today.”  If the doctor forgets to ask, it should be agreed that the hygienist is allowed to Interrupt by saying, “Doc, I am so sorry to interrupt but can I just take a second and let you know what we have discussed?”

Information downloaded to the doctor includes:  review of the xrays, intra oral photos, gingiva health, oral cancer screening, caries risk assessment and anything the hygienist saw that might need treatment or that the patient wants treated.  If nothing was found, the hygienist could say “We took xrays and at first glance I didn’t see anything with the teeth, bone or nerves that I had a question about. But I told her we would wait and see what you think.  Gum tissue is healthy and we have no pocketing, inflammation or bleeding that would indicate infection.  Mrs. Jones is in a high caries risk assessment because … so I told her we recommend … Our caries detection scores are charted and I will walk you through each one that is above normal.  Doctor, I did have a few questions about a couple of teeth in the mouth I would like to walk through with you now.”

Next, as a hygienist, I would remind the doctor to place urgency to the treatment by saying, “Doctor, I shared with Mrs. Jones that you would be categorizing treatment into urgent, preventative and cosmetic categories so we could prioritize appointments.”

The doctor might say, “Thank you. I can see why you might suggest that but I would do xy and z instead of ab and c for this reason…”  As a hygienist I always presented worst case scenarios to the patient so that the doctor could always look like the more conservative one.

At this time, the doctor might say. “So far so good. My hygienist and I are going to talk in code for a second and we will be sure to let you know what it means when we are finished”.  At this time the two of you go tooth by tooth in the same order every patient every time.

SIT THE PATIENT UP, scoot your chair so that you are knee to knee and eye to eye with the patient. I can’t tell you how important this is! I once closed a case of scaling and root planning on a dentist’s sister in law that FOUR previous hygienists couldn’t close. And I’m convinced that it was because I stopped what I was doing, sat her up and looked her in the eye. She knew I was serious.

DOCTOR REVIEWS INFORMATION AGAIN.  “X-rays showed…, intra oral photos showed…,” followed by “If you have any questions about what we found, my hygienist can help answer them for you.  She’ll also connect you with our financial coordinator, Becky, who can help connect you with the best financial options.”

Training a new hygienist on these three points of the exam process will ensure a complete and thorough exam for every patient every time while also increasing case acceptance.


Kristie Kapp, CEO, RDH is passionate about quantifying dental team performance through a culture of trust. She understands not only the importance of KPI’s but HOW to help every team member improve them.  Founder of DIY Practice Management, Kristie’s online training platform includes 50+ training videos covering everything from defining practice identify and setting goals to advanced marketing techniques and the steps to run a profitable business. Kristie is approved to provide continuing education credits through the ADA’s CERP program. She enjoys meeting, speaking for, and coaching with dental professionals across the country.

View Kristie’s full bio