Top Dental Worker Questions Answered Part 1: Asking for New Instruments, Avoiding Overbilling, and Dodging Burnout

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At WORKFORCE, we’re massive advocates for dental hygienists and dental assistants. We spend most of our days helping them find high-quality practices to work in, handling some of their tax complexity, and ensuring they have amazing, wonderful long-term careers.

But we also have important discussions surrounding needs, wants, and issues. While there are many pain points we can solve by ourselves, there are also (unfortunately) some we cannot.

Over the past year, we’ve sat down with thousands of dental hygienists, dental assistants, and dental office staff. During this time, we’ve collected some of the most commonly asked questions and had many long conversations with dentists and office owners to find some answers.

In this multi-part series, we’re going to tackle these questions with in-depth research, answers given by dentists and hygienists we work with, and some good-ol’ fashion first-hand experience.

In part 1, we’ll discuss:

  • How to ask your boss for specific instruments or new instruments.
  • How to avoid overbilling.
  • Whether commission-based work or wage-based is better for hygienists.

Let’s jump in!

How do you ask your boss for specific instruments or new instruments when they are worn down?

Working with dull, worn-out instruments isn’t fun. In fact, it does a disservice to your patients, and it puts you at risk of musculoskeletal injuries — which impacts your long-term career. Unfortunately, some dental offices think waiting to replace dental equipment is more “ergonomic” and it saves them money in the long run. It doesn’t.

First and foremost, most hygienists are actively involved in purchasing decisions for dental instruments and equipment. In fact, recent surveys suggest that the majority of dental hygienists have a direct influence on the purchase of:

  • Ultrasonic scaling systems
  • Tips/inserts for scalers
  • Sealants
  • Prophy paste
  • Eyewear/loupes
  • Hand instruments
  • Facemasks
  • Disposable syringes
  • Hand cleaners
  • Flouride varnishes

Why? Well, dental hygienists work with these things daily, and these tools and equipment being up-to-date, polished, or filled are critical to your workflow.

So, now we get to the challenging part. Let’s start with the basics.

Who buys dental hygienist tools?

This is a pretty controversial topic. Some hygienist associations and dental authors recommend hygienists purchase their own equipment. Yet, some claim that this is the responsibility of the office.

From our conversations, most dental hygienists who own their own tools are happier. They have more control over their career, and they have more influence at the salary table. But that doesn’t mean you have to purchase your own tools. It’s just recommended. Many offices will provide them.

If you’re in a position where you need new equipment, and you feel that the dental office should provide it, you need to have a conversation. Here’s how you have it:

  1. Start by explaining the benefits for the dental office itself. Does the equipment improve your speed? Does it reduce hazards? Is it important for patient quality of care? All of these things directly impact profits. A new $1,500 ultrasonic scaling system may be a significant cost. But if it lets you take on an entire extra patient per day, that system pays for itself (fast!).
  2. Be prepared to discuss the reason for equipment degradation. Often, dental equipment comes with a manufacturer-estimated lifespan. But these lifespans are estimates. Busier practices, failure to regularly perform maintenance, and general wear-and-tear can reduce that lifespan. Often, dental offices will push back based on this estimated lifespan. So, be prepared to have this discussion.
  3. Be honest, yet firm. You need good equipment to do a good job. Replacing worn hand scalers with sharp new ones will pay for itself in less than a week. It’s a no-brainer. Make sure your office understands the importance of the issue. Discuss how important the equipment is, and how much extra stress it’s adding to your daily workflow.

If you are still struggling to get new equipment, consider shopping around for other workplaces. You’re in high demand right now. Almost all offices we talk to are more-than-willing to invest in new equipment. But, if you feel you aren’t being treated correctly and appreciated, find a new opportunity. As always, we can help with this.

How do you make sure to avoid overbilling?

Coding is a nightmare. It just is. Often, we find that dental hygienists are thrown into the piranha tank of coding, with very few actually having a well-rounded coding curriculum as part of their coursework.

From our discussions with hygienists, there’s a tangible sense of dread surrounding coding. The hyper-complex coding ecosystem collides with insurance complexity to create a living, breathing demon. You don’t want to overbill. It puts you and your dentist at risk. But, from our discussions with dentists, 99.99 percent of overbilling happens due to honest mistakes — not malice.

There are thousands of codes. And, whether you’re in the United States or Canada, there’s a significant amount of ambiguity and complexity surrounding coding and insurance coverage. So, how do you navigate the whirlwind?

You start by understanding code structures. For example, in the United States, there are a few codes that relate to inflammation. You use D1110 & D1120 when > 30 percent of teeth are impacted. You use D4346 for generalized inflammation (<30 percent of teeth), and you use D4342 or D4341 for periodontitis.

Often, the line between a D1110/D1120 and a D4346 seems tiny. There are plenty of workflow documents available online that can help you determine these seemingly-small differences. If you are confused by coding, there’s a near-perfect chance others are as well. So, you can find helpful resources, infographics, and guidelines on the internet. Just Google the code.

For most, you can slowly learn all the codes you work with regularly. Just ask your dentist for patience, reach out to other hygienists, and read some online guides. When you encounter rare codes, ask questions.

Don’t be afraid to look uneducated. You probably weren’t taught these coding systems in school — at least, not in-depth enough for day-to-day work. Trust us on this: dentists would much rather you ask them a question on coding than accidentally commit fraud. We’ve asked them. ALL of them seemed more than willing to have coding discussions with hygienists.

There’s no foolproof system to prevent overcharges. But if you ask questions, take the time to learn, and Google when in doubt, you’ll do fine.

How do you protect yourself from mental/physical burnout?

As a surprise to no one, dental hygienists and dental assistants suffer from jaw-dropping burnout rates. It’s the usual story: you help your patients, but you fail to help yourself. It starts early. Twenty-two percent of dental students are physically and mentally exhausted.

You can find plenty of tips to help you. We’ve seen dental organizations recommend yoga, eating correctly, working out, etc. But, at the end of the day, we say solve the core issue — don’t paper around it.

Why are you burnt out?

Are you working too many hours? Are you not making enough money? Is your equipment worn-out? Are patients or dentists treating you poorly? Do you feel like your job is overtaking your personal life?

These are all solvable issues. Remember this: you are in a career that’s in insanely high demand. Whether you know it or not, you have power. You just need to flex it. And you can. Trust us: we do this for a living. We spend our days helping dental hygienists create flexibility in their schedules, find meaningful work, and make the money they need to support themselves.

You can change jobs. You can ask your dentist to provide you with new equipment. And you can reduce your hours or create a more flexible schedule.

Need some help? Get in touch with us! This is what we live for. Think of us as your personal sports agent. You need something; we’re here to get it.

Looking to take control of your career?

WORKFORCE gives you the flexibility to take control of your life and your career. Ready to reduce burnout and live your best life? Sign up as a dental hygienist, dental assistant, or dental receptionist today!

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