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"Operatory Instrument Management Program Story" By Kathleen Bokrossy, RDH

I recently met a dental hygienist at a convention who showed great interest in the D-Sharp OIM program (Operatory Instrument Management) program.  She wanted to take the information back to her employer and see if she could ‘convince’ him to join.

The OIM Program is an instrument management program that supplies your operatory with new instruments every 4 months (if it is a full time op or an op that shares instruments between hygienists) or 6 months (if it is a part time op or an op that only has one hygienist).

 She understood all the benefits:

  • Puts systems in place; organizes your instruments; no handles to dispose of; makes sure that all the hygienists in your practice are using sharp instruments that are properly shaped…not sickle-ized curettes!
  • Ensures that you are providing the best care by using optimal instruments
  • Ergonomics (using dull instruments causes Repetitive Strain Injuries and will shorten your life span of your career
  • Saves money
  • Clients notice the difference when dull instruments are used.  They will complain and tell the receptionist that they don’t want that hygienist again…or they may leave the practice altogether!  Happy clients refer!  Angry clients will spread that news faster than if they were happy!

So a couple of weeks passed and I contacted the hygienist to see how she was doing and if she needed any information from me to give to the dentist.  She told me that her employer dismissed the program and that her and her husband had decided that her health is more important so she was going to get on the program and pay herself.  This was music to my ears.  I have been in the dental instrument business since I founded D-Sharp Dental back in 1998.  I am always looking at ways to help hygienists bring instruments into their practice without spending a fortune.  The more economical the instruments are, the more frequently you can replace them, the better it is for the hygienist and most importantly the client!  I have heard many hygienists complain too many times about their employers or their dentists not buying them instruments.  Or when they do the instruments are too far gone.  They complain how sore they are, how they can’t recognize the tips any longer, how they can’t get a sharp cutting edge, etc.  I know from personal experience that when dull instruments are used on you, it HURTS!!  When the experience is painful, clients will not come back to you.  Or they may come back less or … they may leave the practice altogether!  So I strongly believe in the hygienists taking ownership of their own instruments if they have to.  I spoke with one hygienist who said her employer has never bought instruments for her since she started working there.  I asked her how long that was.  She said 8 years!!  Why wait for your employer?   You can get on the program with one set even for $19.99 a month or if you have handles that can be re-tipped, you can always re-tip them for $11.98.   And trust me, you can’t tell the difference between re-tipped and new.  Well with our company anyhow.  I know of other re-tipping companies who use tips that are of lesser quality, and the tips are unrecognizable.  We re-tip your handles with the same tips that we use on our new instruments. They are of high quality, 440A North American stainless steel and are specially treated to keep a sharp cutting edge.  We need to stop blaming others for our discomfort or happiness and take responsibility for our own actions.  If you need to buy your own instruments, then I encourage you to do it.  Why wreck every day for you and the appointment for your client.  Get EMPOWERED!  Take control of your own destiny!  Your own future!  Get back to enjoying your day with new instruments that bite into the calculus versus an instrument that glides over.  Be gentle with your clients.  Sharp instruments mean you are going to use a lighter more controlled stroke, which means less discomfort for your clients during and after treatment and much better for your body!

This particular hygienist also said she was tired of waiting for permission.  She feels that as a dental hygienist she is always waiting for permission.  Permission from the dentist, permission from the client, permission from the insurance companies, etc.  She said this is something that she can take control of that will help her extend the life of her career and help her with overall daily comfort.  She felt so empowered.  She made me so proud that I just had to share this!


"Is Your Dental Hygiene Department ‘A Diamond in the Rough?" by Kathleen Bokrossy, RDH

Imagine a dental hygiene department that focuses on continuing to improve the “Dental Hygiene Experience” for every patient that walks in the door.  Imagine a program that consistently delivers a positive physical, intellectual and emotional experience for each and every patient.  Imagine an office where every patient knows that they have a team of experts that are delivering important health care and are honestly motivated and interested in their long term well-being.  Wow, now that’s an image worth chasing!    

A well run, well executed dental hygiene program can be a tremendous asset to any dental practice looking to grow and prosper in these changing times.  It provides the opportunity to interact with your patients on a regular basis.  Repeated positive exposure to your practice is the key to growing a strong and loyal patient base that can lead to a steady stream of new patient referrals and increased restorative revenue.   Making the “Dental Hygiene Experience” great, is an important piece to the success in any dental practice.  This article looks to outline the 3 aspects that make up the “Dental Hygiene Experience”.  After reading this article, evaluate your practice and see where you think there is opportunity to tweak, adjust, or completely overhaul how your dental hygiene department interacts with your patients. 

Based on my 25 plus years, I believe that improving the “Dental Hygiene Experience” from the patient’s perspective can be broken down into three primary aspects:


1. The Patient’s Intellectual Experience:  We can often forget how important it is to educate the patient on the importance of good oral hygiene.  As we know, good oral hygiene is both a preventative measure as well as an early warning opportunity for patients.  Through education and an engaged “Dental Hygiene Experience” the dental hygienist is able to reinforce to the patient the importance of home care and regular visits.  Too often the dental hygiene visit has become so routine and perhaps rushed, that the dental hygienist doesn’t use this great opportunity to educate and inform the patient on all the wonderful benefits of maintaining optimal oral health.  The patient’s intellectual experience is about reminding them why they are spending the time, effort and expense of going to the dentist and dental hygienist.  Done creatively, honestly and by getting a patient intellectually engaged in the importance of overall good oral hygiene will lead to increased visit frequency and excited referrals to their friends and family.  Getting your entire dental team excited and communicating the tangible benefits of regular dental hygiene visits will grow your practice year after year. 

2. The Patient’s Physical Experience:  Creating a positive physical experience is an essential part of any dental hygiene visit.  That fresh invigorated feeling vs the discomfort that can be part of any dental visit needs to be consciously developed and built into your work flow.  


An uncomfortable dental hygiene experience reduces repeat visits, offers no referral opportunity and at the end of the day truly hampers the practices opportunity for growth and productivity.  It’s critical to look at the “Dental Hygiene Experience” from this aspect as there are so many specific things we can do to reduce the discomfort and increase the positive and invigorated feeling that a patient can have following treatment. 

Examples of proactive steps that can be taken:

a. Measurement:  You can’t improve what you can’t measure so make sure your patients know that you take their comfort very seriously.  Get the feedback you need to know whether your patients find their experience more painful than it should be and be sure to react to the data you collect!

b. Training: Technique matters!  Education doesn’t stop at dental hygiene school.  It is important that dental hygienists continue to participate in hands-on training to take their skills to the next level.

c. Instrument selection:  Using the correct instrument for its intended use, reduces unnecessary pain and discomfort.   

d. Instrument maintenance:  This one is very common and has an immediate impact on the patient experience.  Poorly managed and maintained instruments chairside increases patient discomfort, dental hygiene fatigue and negatively impacts all aspects of the experience.

e. New Technologies and techniques:  There are new technologies that are being introduced all the time.  Being aware of these new methods to manage and reduce pain can help keep your patients in your chair instead of requesting to move to another one! 


3. The Patient’s Emotional Experience:  The path to strong restorative referrals, increased dental hygiene visit frequency and increased dental hygiene treatment comes directly from the trust that the dental team is able to develop with the patient.  The patient has to believe that you are only recommending procedures that are truly in their best interest.  Trust is an emotional feeling and must be satisfied on two levels. 


a. Trust Level 1 – Capability:  The patient must believe that your team is best suited to recognize and provide the procedure being recommended.   This comes from how well your dental team delivers on demonstrating your technical competence.  Through education and ongoing communication you are able to demonstrate your dental team’s strength and capability.

b. Trust Level 2 – Intent:  The patient must believe that their best interests are at the heart of any recommended procedure made by your team.  They need to know why you are recommending the procedure and that you truly believe it’s in their best interest to proceed.


Once you are able to build a culture that communicates strong specialized expertise (capability) combined with a heartfelt intent to deliver on important results to the patient, you will have a strong restorative referral machine that drives revenue into your dental office. 

There are specific and tangible things each office can be doing to move their ‘Dental Hygiene Experience’ in the right direction.    By intelligently integrating the patient’s physical, intellectual and emotional experience, you can turn your dental hygiene department into an exciting and invigorating aspect of your dental practice.  The dental hygiene visit is often a patients first exposure to you and your team, and as a result, that first impression is the opportunity to build a strong patient base that looks forward to their quarterly or bi-yearly visits and recommends your office every chance they get.  

So….is your dental hygiene department ‘a diamond in the rough’?   Even if your dental hygiene department runs like a well-oiled machine, I challenge you to revisit it from the patients perspective.  Look at all three aspects and continue to adjust and improve.  Continuous improvement after all is the key to long term fulfillment in life! 

I invite you to ‘Meet me in the Boardroom’ where we will be discussing The Dental Hygiene Breakthrough Blueprint.  I will share with you simple strategies that you can apply to your practice that will help you attract more patients, how you can wow them and get them referring.  Send me an email and I will send you all the details!  It will be fun!    


"How to Release the ‘Intrepeneur’ Within! Series continued." By Kathleen Bokrossy, RDH

126 resumes for one position.  How do you make yourself stand out in today’s competitive market?

I have recently spoken with five dental hygienists on separate occasions regarding how tough the job market is right now.

The first one is getting laid off because the dentist needs to do the hygiene appointments.

The second one is waiting at home for a job to come along since she has sent many resumes out.

The third one is filling in on a maternity leave and not sure what will happen when the time is over.

The fourth is moving out of the province with hope of coming back one day to practice in Ontario.

The fifth is working in a practice where she is not happy and feels like she isn’t making a difference, she is frustrated and would like to work in a new practice but fears there is nothing available for her.

We’ve all heard when a position is available the practice gets flooded with resumes.  I recently heard that one practice received 126 resumes for one position.  


What you can do to make a difference, secure your workplace and/or make yourself marketable so that your resume stands out and you get offered the position?


You want to do these three things to secure your workplace or make yourself marketable so that your resume stands out and you get offered the position.


1. Specialization

Have you ever thought about what you specialize in?  We all specialize in something, whether it be perio, ortho, laser therapy, ultrasonics, communication, etc.   What you know and the talents you possess may be hidden.  Use your knowledge and expertise to help others and start thinking about the things you specialize in. Share it with your colleagues and clients.  Highlight this in your cover letter and include your hands-on training certificates in your resume.  Wouldn’t it look great on your resume if you were skilled and trained in both piezo and Cavitron technology?  Or how about specializing in motivation and communication?  Make note of the hands-on training courses that you have taken to increase your skill and perhaps communication!


2. Innovation

Have you brought a program or put a system in place within your practice that has been beneficial? Be innovative within your practice.  What programs or solutions can you offer your practice that will bring positive results with both client care and productivity?  Programs like the Crest Oral B practice building program Oral Health Solutions or an instrument management program like the Operatory Instrument Management program, where you are providing gentle care to your clients, saving the practice money and putting systems in place. The more value you can bring to your practice, the greater the chance is of securing your position within that practice.  Once you have implemented programs, make note of this on your cover letter and resume.  Talk about the success you have experienced. 


3. Connection

Connecting with people is so important and sometimes we have to make a conscious effort in doing so.  You want to make sure you are a team player within your practice, that you don’t get involved with office politics and ever talk about someone behind their back.  Be positive with your communication.  When you speak with your clients, get to know them.  Take some personal notes so that you can follow up with them. Stay connected and show them how much you care.  

Doing these three things and making a conscious effort will help secure your position in a competitive market and make you a more marketable candidate for any dental hygiene position!  What are you going to do to make you stand-out?!


"How to Release the ‘Intrepeneur’ Within!" By Kathleen Bokrossy, RDH

It’s a common scenario.  You attend a continuing education course, a lecture or product demonstration at a conference.  The information shared is exciting, it offers the opportunity to truly change how the practice operates and/or the level of care the client will experience.  You can’t wait to share this practice-changing news with the team.  Unfortunately, when you explain what you think is the greatest idea ever; you are not greeted with the same enthusiasm.  With their arms crossed and their resolve to resist change solidly in place, the great idea dies a quick death.  Each objection they raise fills you with doubt about being able to follow through and implement the changes in order to reap the benefits.  You get drawn back into the daily routine and all the opportunity is quickly forgotten.  You and the practice slide back into the “rut” wondering why things aren’t improving and you’re not reaching your practice goals.  Well at least until the next course or lecture comes along when you repeat the entire cycle again.  How did Einstein define insanity?  “Repeating the same actions over and over and expecting things to change.”

If this isn’t a problem for you, then congratulations!  If you can introduce a new idea to your office, get the team excited and implement all the changes required, then you naturally exhibit the skills of an ‘intrepeneur’.  What is an ‘intrepeneur’?  One of the most valuable assets to any dental practice!  An intrepeneur doesn’t ‘own’ the practice but looks at how the practice runs and continues to introduce positive change, like it’s their own.  Whether change is through better client experience, which leads to greater client retention and attracts new clients into the practice, or efforts to reduce costs and increase revenue, an intrepeneur is an essential member of any dental team.  

The biggest difference between an entrepreneur and an intrepreneur is who needs to be “sold” on the game-changing idea.  Any change carries with it both risk and reward.  Where an entrepreneur in most cases risks their own time and money to move an idea forward, an intrepreneur risks the resources of their employer, in most cases, the dentist.  Presenting both the risks and the rewards in a manner that the team can understand is often the biggest barrier to change.  The good news?  Through some subtle changes in how you make your “pitch” to the team, you can dramatically increase your chance of success.  Follow these simple steps to ‘Release the Intrepeneur Within’ and drive positive change to your practice today!    

1.    Actions speak louder than words!  Focus on what matters. 

Show an active interest in the productivity of the practice.  Not all dentists will share their revenue numbers with you, and you don’t need to know everything, but you should have an idea of what revenue your operatory generates as well as your supply costs.  This change in focus made a huge difference for me.  When I started paying attention to what I was billing and the cost for each day, I began to understand where I was having a significant impact on overall profitability.  When I saw opportunities for improvement and pointed them out to the dentist, he/she saw that my focus was aligned with his/hers.    Showing your commitment to the practice consistently over time will build your credibility, so when you do bring forward ideas, the dentist will know your intentions and commitment is to implement positive change to the practice.

Warning: I believe positive client experience is THE most important aspect of any dental practice.  Be sure your efforts to manage costs and improve efficiency does not negatively impact how the client is  treated nor their overall perception.

2.    Do your Homework

Look for different ways that you can contribute to your team meetings by suggesting systems/processes that help increase productivity.  There are so many resources available today that offer great ideas that have been successfully implemented by other practices.  Resources such as; on-line education, continuing education courses or from the technical sales representatives that call on your office, there is no shortage of ideas that can be implemented. 

Warning:  The trick is to separate the good ideas from the great ones!  Introducing the flavor of the month will hurt instead of help your credibility.  It is important to do your homework to determine which ideas will deliver a measurable benefit instead of just being a distraction from what’s already working. 

3.    Prepare a Benefits summary that you can share with the team.   

If you would like to implement new technology, a product, a program or a system into your practice, you need to present your ‘case’ to the dentist AND the team.   By outlining the benefits as well as the risks into a single consistent summary, you can quickly address initial concerns and illustrate how the new idea will improve practice productivity.  It helps to engage the entire team when you get ‘buy in’ and there is an understanding of the total benefit available through the change.  Since different members of the team are affected in different ways, it is important that the total impact of the new idea is understood by all. 

It also demonstrates to the team that you are truly committed to the idea and will put forth the sustained effort necessary to see it through to the end.  

Prepare a document that you can share that has the following elements!

-       Current State

You need to understand and explain what the current situation is, related to the new idea, so that you can prepare a document that will show where you would like to be.  By identifying current inefficiencies or costs associated with the current method, it becomes possible to determine the net change of the idea you plan to implement.

-       Benefits of the new process

Create a list of the benefits that this new product, system or program can bring to your practice, and your clients.

-       Risks

Most people don’t like to talk about risk, but it is important to bring these risks forward and discuss them with the team.  Risks that aren’t exposed at the beginning appear to be bigger than they actually are and can sometimes highjack the idea during the implementation.

-       Proposed Costs

There are two types of costs that need to be identified.  The initial implementation cost as well as the ongoing operating cost.  Initial costs are the up-front costs and effort required to get the new process in place.  The operating costs reflect the specific time, effort and expense required to maintain the new process.

Summary:  Profitability and the Bottom Line

By comparing current costs to the proposed costs plus all the other benefits identified, it becomes possible to put together a single document that outlines the reasons (both fiscal and non-fiscal) to proceed.


For your reference, please find a few examples of how you can present your ‘case’:


1. Crest Oral B Program has a great program (www.healthypracticenow.ca) that is designed to help make the dental hygiene department more productive, it puts systems in place, recommendations for treatment, it empowers your clients and it involves the entire team.


On presenting this to your team:

a)     Show examples of a few current ‘recare’ clients:  How often they come in for treatment, the average revenue for each, what kind of treatment they receive, how long their appointments are and the self-care given to them.

b)     Show the same few ‘recare’ clients and apply the program to those clients and show the difference in the treatment received, the length of appointments, the frequency of the appointments, how the responsibility shifts to the clients, the team involvement

c)     Compare the revenue from the current situation to one of being on the program

d)     Show how the program works (visit the website and do the Practice Assessment together)

e)     Offer to bring in a sales rep if you need help to ‘close’ the deal, making sure that the dentist is present at the demo


2. Operatory Instrument Management Program (OIM Program) offered by D-Sharp, illustrates the potential savings associated with an instrument maintenance program versus what most offices do to maintain their instruments.  By plugging in your current situation, it is possible to use this format to evaluate whether moving to a managed program would deliver a significant benefit to your practice.  

a)     Show the current situation of your instruments:  How often your instruments get replaced, the cost of new instruments that you have purchased in the past, the organization of the instruments, purchasing of the instruments and the time spent, the sharpening situation, how much time it takes to sharpen, when do the instruments get sharpened, and if you can – the cost of the dental hygienist being paid for sharpening time.

b)     If you have a dental hygienist in your practice that you hear is “heavy handed”, note that.  Most times than not, it is the instruments in the hands of the dental hygienist rather than the dental hygienist him/herself.  Many clients try to switch dental hygienists or simply leave the practice.  Show the cost of losing a client (ex $10,000 over a lifetime of a client). 

c)     Show the benefits of being on the program for the client, the dental hygienist and the practice.

d)     Show the cost of the instruments per month by being on the program, and the time saved by not having to organize ordering, sifting through instruments to find the sharp ones, disposal of the instruments


3. An electronic periodontal probing method

a)     Show the current situation:  The time in the chair to probe, if an assistant is required and the cost associated with that.

b)     Show how this new technology will help you, the response of the client, the ease of use, the time saved.

c)     Compare the cost of the device to what it is currently costing you.

By being prepared, recognizing your current situation and knowing your facts, you will feel confident in presenting your case to your employer and your team.  By releasing the ‘intrepeneur within’, your practice will reap the rewards, your ‘job’ and professional satisfaction will soar, and you will become a valuable asset any office would be lucky to get.  

Warning:  If after consistently demonstrating your commitment to improve practice productivity, you do your homework and present well thought out strategies to improve the practice but you STILL can’t break in and help make a difference, you may not be in the practice that is best suited for you.  But that’s for a different article!!

Good luck!




"How prepared are YOU as a RDH to treat clients with exceptional needs?!" by Nadine Russell, RDH

I was discussing my “Clients with Exceptional Needs” presentation with some colleagues, when a fellow RDH had commented that her practice "just refers” all individuals with special needs for sedation.

Well, anyone who knows me or has attended any of my presentations KNOW that I am just a little passionate about this! So this makes me wonder…how prepared are YOU as a RDH to treat clients with exceptional needs?!

One of the very first topics I discuss in my presentations is that as Registered Dental Hygienists AND Regulated Health Professionals it is our OBLIGATION to know how to treat ALL clients…that includes those with exceptional needs.  It is the expectation of our College and of the public that as frontline oral health care providers that we have an understanding of and the ability to adapt our skills to serve this population. We are not auxiliaries; we cannot look to the dentist that employ us for guidance…it is our responsibility!!!

Here are some key points that I have highlighted in our Standards of Practice as outlined by the CDHO to support my statements:

“… dental hygienists have a social responsibility to promote access to, and delivery of, quality dental hygiene services”

“A dental hygienist demonstrates a commitment to professional responsibility by:

  • Using a client-centered approach that acts or advocates in the client’s best interest.
  • Contributing to actions that will support change and facilitate access to care; particularly in vulnerable populations.
  • Recognizing gaps in knowledge and taking the appropriate steps to acquire this knowledge.”   http://www.cdho.org/Standards+of+Practice.asp

All individuals are entitled the best possible care we can provide them…working with individuals with special needs is no different.  Some adaption to our “typical” routines can make this possible…that’s what client centered- care is. Assessing and recognizing the needs of our clients to be able to effectively provide them care.

The best way to better serve these clients is by arming yourself with knowledge!

As outlined in the CDHO Code of Ethics “PROFESSIONALISM- Is the commitment to use and advance professional knowledge and skills to serve the client and the public good.” http://www.cdho.org/Code+of+Ethics.asp

Being aware of our limitations and knowing when to refer is important, however; as professionals it is ESSENTIAL that we recognize when we lack the knowledge and then do something about it!


Yours In Health,


Nadine Russell, RDH