Why This Should Concern Every Dentist and Hygienist
Hygienist pay has risen 20% since 2020. That sounds great—until you realize that hygiene collectible production (not projected, not on paper, but truly collectible) must also rise by 20% just to keep pace.
If reimbursements and fees haven’t increased by that much—and let’s be honest, they haven’t—then hygiene risks becoming a loss leader rather than a profit center.
And if hygiene isn’t profitable, opportunities for growth—for both dentists and hygienists—quickly dry up.
“If a cleaning ends in bleeding, that’s not maintenance—it’s a warning and an opportunity.”
Why “Doing More of the Same” Won’t Work
The solution isn’t cramming more prophies into the schedule. It’s rethinking the entire hygiene equation. Enter salivary testing.
Not because it makes you money directly—it usually doesn’t. In my own practice, it was break-even at best. But it builds something even more valuable: trust.
Trust is the secret sauce that leads to case acceptance, and case acceptance is what actually grows revenue.
Periodontal Care: The Real Growth Driver
The old rule of thumb? 25% of hygiene revenue should come from periodontal therapy.
In today’s enlightened practices, that percentage is much higher.
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- A D1110 becomes a D4910.
- Twice-a-year visits become quarterly.
- Bloody 60-minute prophies shrink into efficient 30–45 minute maintenance appointments.
And bloody prophies themselves? Let’s call them what they are: a red flag.
💡 TLP TIP:
If you brushed your hair and saw blood, you’d run to a doctor.
If a prophy ends in bleeding, it’s not a “routine cleaning.”
It’s a warning sign that demands treatment.
The Barriers: Fear and Perspective
Why do too many practices avoid recommending periodontal therapy?
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- Fear of No. Nobody likes rejection.
- Not wanting to be the “bad guy.”
Both are solvable.
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- For fear of no: persuasion is a skill, not a personality trait. Dale Carnegie’s timeless principles and Dr. Robert Cialdini’s 7 Principles of Influence provide a roadmap.
- For “bad guy syndrome”: it’s all about perspective. What’s worse—recommending treatment that could prevent a stroke, or staying silent while inflammation rages?
Objection Buster:
“I Don’t Have Time.”
This one’s common. Hygienists often feel their schedule is already jammed—how can they possibly add testing, education, and more periodontal care?
Here’s the reframe:
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- Shorter appointments in the long run. Once patients transition from bloody prophies to maintenance, visits become cleaner, quicker, and more efficient.
- Better prepared patients. Salivary testing and diagnostics make conversations easier—patients already “see the evidence,” so less time is wasted on persuasion.
- Return on time invested. A few extra minutes now prevents countless hours of re-care, retreatment, and patient frustration later.
In other words: you don’t have time not to do this.
“The hygienist or dentist who avoids hard conversations isn’t protecting time—they’re guaranteeing more problems later.”
When Fear and Perspective Are Solved, “All Boats Rise”
Here’s the bigger picture: when hygienists and dentists master these two barriers—overcoming fear of no and reframing the “bad guy” role—acceptance doesn’t just improve for perio and salivary testing.
It improves across the board:
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- Cosmetic dentistry
- Implant therapy
- Occlusal therapy
- Sleep and airway treatments
Why? Because patients who experience clarity, confidence, and trust in hygiene are far more likely to say “yes” to other services. Hygiene becomes the gateway to comprehensive care.
That’s the true rising tide effect: solve the hygiene equation, and the entire practice grows with it.
The Takeaway
Salivary diagnostics won’t make your hygiene department profitable on their own. But they will:
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- Build trust in your recommendations
- Increase case acceptance
- Shift hygiene from a liability into a growth engine
- Open the door for all other services to thrive
- When combined with a physician communication system, it encourages referrals
Combine that with modern periodontal protocols, and hygiene becomes the heartbeat of a thriving practice.
Special Offer for OralDNA adopters.
Want to overcome “fear of no” and master the art of ethical persuasion?
The Liberated Practice has a limited number of Dr. Robert Cialdini’s Ethical Influence Certification courses—available to Oral DNA subscribers with a $500 discount.
This is an investment in confidence, clarity, and case acceptance.
Michael built a prestigious group practice in Manhattan where he focused on comprehensive, whole-body care. As he treated so many physicians, his colleagues dubbed him “The Doctor’s Dentist.”
He is a Fellow of the AGD, International Academy of Dental-Facial Esthetics, The New York Academy of Dentistry, the American College of Dentists, and a charter Fellow of the American Academy for Oral Systemic Health.
Michael teaches practice management at Temple University and speaks nationally and internationally on a variety of subjects. He and Practice Perfect Systems are the official practice management consultants to the Spencer Study Club, their Business Elite Groups.
Michael has authored 3 books, including “What the Tooth Fairy didn’t Tell You”, “Beyond Ahh: A Guide For Physician’s” and “From Here To Where; a guide for dental practice success”. He’s recently had been the chief editor of a book on Sleep Dentistry written by 24 of North America’s finest dental sleep practitioners.
Michael is on the board of 3 charitable organizations that help provide care for the indigent and people with special needs around the world.
His mission: help people who help people help more people.
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