Office Tension: Dentist Vs Hygienist

Dental office tension tends to come in two main varieties: dentist vs hygienist, and clinical vs administrative. Interestingly, “Dentist vs. Hygienist” tensions can be the most damaging. Good news is, it can also be more easily managed than with other team members.

So, where does this tension come from? Do any of these scenarios sound familiar:

1) The hygienist sees the patient first, does a great job finding all the problems, spends a lot of effort and time educating the patient on what the patient might need (co-diagnosis)….and then the dentist comes in and tells the patient everything is fine.

2) The dentist comes in while the hygienist is with a new patient, and sees the hygienist already cleaning. But on the x-rays there is calculus everywhere and obvious bone loss.

3) The dentist spends a lot of time discussing restorative work with the patient, answers all the questions, and leaves the room. Then the patient turns to the hygienist and asks, “do I need all this?”, and gets an answer that is anything but “absolutely!”

Hopefully none of these are familiar to you, but unfortunately, they are commonplace in a lot of offices. So why do scenarios like this happen?

Often it is just a lack of communication. The dentist thinks the hygienist should understand everything they do, and the hygienist is following the treatment planning they learned from their previous dentist.

So, dentists, let’s face facts. The joke we tell all the time is all too true. If you get 4 dentists in a room, you will get 5 treatment plans for the same patient. None of us work exactly the same way, so much of dentistry is a combination of art and experience. There is no absolute textbook on treatment planning because we all deal with humans who are all unique and in different stages of dental breakdown.

So why would we ever think that a hygienist should understand our unique thought process for treatment planning if we have not spent a good amount of time discussing it with them? If other dentists cannot agree, wouldn’t it be fair to say our hygienists don’t stand a chance without some calibration discussions?

And this lack of understanding of why we diagnose the way we do; might that also have something to do with why the hygienist does not instantly support our treatment recommendations when we leave the room?

And then when the hygienist does spend a lot of time pinpointing a patient’s dental concerns and the possible treatment needed, can’t we imagine the frustration that would happen if we come in and don’t at least support what they said? Does not mean we have to agree with the outcome, just support the reasoning for why the discussion happened.

“Mrs. Smith, Donna pointed out the concerns about your teeth of X. While it may not need treatment now, she is correct that this is a concern we want to monitor.”

Now hygienists, this does not mean the problem is all on the dentist side. Clear communication is a two-way street. Your job is to support the dentist to the patient, just like it is our job to support you. When a patient turns to you and asks if the treatment we just talked about is necessary, you need to be able to say instantly: YES!

If you cannot, then you need to put on a smile, do it anyway, and ask us about it later.

It all comes down to communication; respectful communication on both sides.

-Dentists needs to support what the hygienist told the patient

-Hygienists needs to support what the dentist told the patient

– It is the dentist’s job to explain their treatment philosophy as much as possible to the ENTIRE team.

– Hygienists, it is your job to ASK if you are unsure about why we are doing something.

Both sides need to get on the same page with treatment options, when to treat, when to discuss, etc. A great technique for getting and keeping on the same page, is to debrief recent cases with your hygienist reviewing the treatment plan, patient questions, and outcomes.

Remember, we are all here to take the best care of our patient, as a TEAM. And the best teams are the ones who communicate well and often.