The Doctor’s View:
There are a variety of viewpoints on this issue which affects dentists and hygienists frequently. I need more details before I can provide my opinion. What are you being asked to do by your dentist during the prophy? Are you enrolling each patient and conducting co-discovery, or are you merely cleaning their teeth?
It would be unfair to compare hygiene prophy times. It’s like comparing apples and oranges. Everything depends on the hygienist's responsibilities.
As a hygienist, I agree with the dentist that your time should be limited if all you are doing during a prophy is cleaning teeth.
You will need additional time if you are performing co-discovery, which entails examining the patient's radiographs, probing to evaluate gingival health, looking for any suspicious lesions, and checking for decay while also evaluating the patient's oral health. Because hygienists are typically unable to provide a final diagnosis for these illnesses, we refer to this as co-discovery. Then, you would require more time if you were to deliver these results and enroll the individuals in treatment. Naturally, the dentist will check everything the hygienist finds, but the more involved the hygienist is with the patient's health and education, the more time is required.
As a dentist, I believe that my hygienist deserves more time for a prophy session the more value they add to the patient.
The Hygienist’s View:
This problem affects so many hygienists! The amount of time allocated for procedures differs from office to office, but how much time is really necessary? We realize that asking for 90 minute prophy times for every patient is unrealistic. What am I currently unable to perform in the time that is available to me should be your first thought. By first asking yourself this question, you can gain some understanding of what you are actually seeking in the time that you have available. You may not necessarily require more time for the prophy, but rather more time to offer a higher caliber of care.
Increasing the standard of care is the best approach to boost output. Many doctors disagree with adding more time to a prophy because, in their opinion, adding an extra 10 minutes to your scaling time would be ineffective. Instead of going to your doctor and requesting "more prophy time," request extra time for sealants, fluoride treatments, talking about additional treatment choices (including the treatment they may provide), or enrolling patients in periodontal therapy. These office productivity-boosting care strategies also give you the brief window of time you might need.
Expectations are the key to everything. If all you are doing with an adult recall patient is scaling, we believe between 30-40 minutes is the right amount of time. A better amount of time would be 50–60 minutes if you were offering value, such as co–discovery, patient education, or therapy enrollment. Typically, you would allow an extra 20 to 30 minutes for establishing a rapport with a new patient, recording their progress, and finishing their films.
Every doctor and hygienist has a unique work schedule, and the times listed above are only suggestions. The doctor-hygiene partnership should, in the end, be a collaborative effort with honest communication about your roles and responsibilities. Expectations must be discussed with your doctor before discussing prophy time.
Kristin Goodfellow RDH
Kristin is Chief Clinical Officer of OraCare, a practicing Registered Dental Hygienist