Teeing Up a Hygiene Temp for Success

Rachel Wall, CEO of Inspired Hygiene, shares tips for guest hygienists’ success, elevating patient care and team experience.


About Rachel Wall

Rachel Wall is the founder of Inspired Hygiene, where she and her team provide coaching, workshops, and other products to help dentists in their pursuit of hygiene department profits. Rachel also serves the dental community as a consultant and speaker. In addition to private coaching Rachel draws from her 20-plus years of experience as a hygienist and practice administrator to deliver focused clinical articles and speaking programs. Rachel has written for, and been featured in, numerous industry journals including Dentistry Today, Progressive Dentist, RDH, and Hygienetown. She recently received the 2012 Dental Excellence Award from DrBicuspid.com for “Most Effective Dental Hygienist Educator”.

About Alex Nottingham JD MBA

Alex is the CEO and Founder of All-Star Dental Academy®. He is a former Tony Robbins top coach and consultant, having worked with companies upwards of $100 million. His passion is to help others create personal wealth and make a positive impact on the people around them. Alex received his Juris Doctor (JD) and Master of Business Administration (MBA) from Florida International University.

Episode Transcript

Transcript performed by A.I. Please excuse the typos.


This is Dental All-Stars, where we bring you the best in dentistry on marketing, management, and training. Here’s your host, Alex Nottingham. Our topic is T-Up the Temp, how to set your guest hygienist up for success. Our guest is Rachel Wall. Rachel is the CEO and founder of Inspired Hygiene, a coaching firm focused on elevating hygiene services, systems, and profits. She is an award-winning educator.


author of the book Return on Hygiene, and has spent the last 30 years serving the industry as a clinical hygienist and hygiene productive coach. Please welcome Rachel. Hey Alex. Great to have you back, it’s been a couple years. It has been a couple years, I’m happy to be here. Teeing up the temp. So we’re talking about hygiene temps, temp agencies? Yeah. Cool.


Excellent. And that’s certainly something. And the term, yeah, certainly something that’s happening in the industry a lot. And the term that I did not coin, but I love it, is guest hygienist. Guest hygienist. Okay. Okay. Yeah. And hiring has been a big deal. I may have told you before, we have a hiring service. We help hire for an office. We help hire hygiene, assisting, the whole gamut. And temp is an option, definitely an option.


So tell me about this, maybe the prevalence of temp hygiene situations and, and yeah, educate me. This is your world. I, this is your world, Rachel. Yeah. So this, you know, this arena has always been around. Um, I’ve been a hygienist for over 30 years and, you know, I’ve done my share of being a guest hygienist, whether it’s long-term guest or, you know, in and out for a day or two.


And it’s definitely, I would say in the last couple of years, Alex, become even more prevalent. One of the things that we saw, you know, after the pandemic was that, you know, we heard the statistic that 15% of hygienists left the industry. Well, about half of those came back is what the statistics are showing now. But the other thing that has resulted in, you know, fewer hours available for patient care is that a lot of hygienists cut back on their time in the office.


So they may not have left the professional together. A lot of hygienists that may have a home practice are actually, they cut back their days. Maybe they were at four days and now they’re at three days. Maybe they were at two days, now they’re at a day and a half or something like that. And what some of them are doing is picking up temp hygiene shifts. A lot of that is because of the level that they can be compensated at with those. And everybody has different feelings about that.


But we’re seeing that and I think it’s something that our industry is going to see continue to be an, I would say, employment model with hygiene because it creates a lot of flexibility for the employee, for the hygienist, and then also allows the practices to bring in hygienists to help serve their patient needs. And


Just from my experience in the past and currently what’s happening is, you know, there are some challenges that come along with that. There are definitely some pros to it, but there are some things that I think practices really can do to really elevate the experience that their patients have when they have a guest hygienist, the experience that the practice and the team has, and also make it a good experience for that hygienist because who knows, they may want to, you know, have you as their regular…


Friday gig or maybe they’re looking for a home practice and because they’ve had a good experience with you, you know, they might think about, think about working with you. Often I have offices that will say, well, I don’t want to train temps or guests. I don’t want to put that investment in, in those temporary positions or people that are part time. And what I think you’re insinuating is to improve the patient experience. We do want to make those investments, right?


Absolutely. And I don’t feel like it has to be a, I mean, we’re talking maybe an hour. So it doesn’t have to be, you know, a half a day intensive training. It could be. And if it’s somebody honestly, that’s going to be there, let’s say they’re doing a maternity leave, then I would absolutely have them come in if they’re willing to shadow for, you know, half a day and do some training so they are really comfortable, you know, the first couple days. But even with somebody that’s going to be with you for a day or two,


It’s worth taking that time to prepare. And so the other thing that we’re looking at, and I was just talking with a colleague this week, actually about this experience, is she’s in marketing for dental. So she has the context, right, of the dental world and kind of what we’re looking for. She went into her dental office, had a bad experience with a guest hygienist. You know, she said, hey, she just seemed like she didn’t care. She was just kind of going through the motions.


And she said, because I have a good relationship with the practice manager and I’ve been a patient there, of course I’m gonna stay, but did not, it was not a good experience. So then what happens? Patients, patients without context that don’t understand what’s happening in our industry, you know, often might think, well, gosh, every time I come in here, this dentist has a different hygienist. So she must not be very good to work for. Or, you know, every time I come in here, it’s different. There’s no continuity between,


my experience from one visit to the next, even if it’s a, and that can happen, Alex, actually with multiple hygienists, even if they are, you know, full-time employees within the practice. So, so we think about it from a marketing standpoint too, like how might that affect your reviews? So is it worth investing in that hygienist for everybody to have a good experience and for, you know, it to trickle down to, you know, um,


building that patient’s experience in your practice so that you’re getting a good review, or at least you’re not getting a bad review. So true, and then I think about, you’re right, even, first of all, dentists don’t train as much as they should in general, and then they segment the offices into admin and then in clinical, and then sometimes hygiene is his own weird beast that is pushed off. And so you have to have, everybody’s gotta be on the same page.


no matter what position you are, no matter how often you are there, if you’re going to temp or guest or part time, you’re part of the show and you have to embody that. Yep. So totally makes sense. So you so dentists have to have that perspective going in. What? Yeah. And it’s not going to be perfect. I mean, let’s be honest, you know, it’s not it’s not that that hygienist with one hour can step in and, and, you know, look exact, you know, look and say everything exactly like the rest of the team.


But I think that that effort is well spent and it certainly can elevate the experience for everybody with just a little bit of time investment and some preparation. So if I’m bringing in a temp, what, and it’s a short certainly testing this out or it’s a short stay, how can I at least get my values and that there’s some sort of cohesiveness with the office?


Yeah, so a few different things and I will say this too, you know, we’re putting together a guest hygiene guide and would be happy to share that with any of your listeners. We can talk about that near the end if you want to. Yes. But I share this with my team members, our coaches, and one in particular has had a lot of experience being a guest hygienist. And one thing that she said was, you know, one thing I’ve noticed is if I go into a practice and they have a list, so they have a checklist for the guest hygienist.


She said, actually, it’s not a great experience because they think the list is going to kind of tell me everything that I need to know and they’re gonna be very hands off and I feel like I’m on an island here. And that’s not the intent. The intent is to have some information for the hygienist so that they’re not going in blind, but also to give them that warm welcoming experience so that they have somebody that they can go to. So the first thing I would say to do, Alex, is identify who in the practice is going to be.


let’s call it the concierge for that hygienist that day. Who is going to be their main point of contact either before, during, and after, you know, that experience that if they’re looking in the doors for something and they can’t find it, they don’t feel like they’re interrupting that person or they don’t feel like they’re, you know, being a bother by asking for things multiple times throughout the day. That person gives them a smile. They’re like, absolutely, let me show you where that is. So that’s the first thing is,


is kind of setting the intention that they’re going to have a point of contact and that we’re going to really give this guest hygienist an experience that they’ve not had before so that our patients can have continuity of care and they can have a great experience. I would say the next thing is really identifying how can we communicate to that hygienist what our standards of care are and if that’s not something that you’ve done for your practice yet I would encourage you to do that. We have a document that we are happy to share as well.


that will kind of give you a starting point as a worksheet of how to do that. But essentially what it is is, these are our standards for when we typically take radiographs, right? And of course it’s different based on patient’s risk and things like that, but it’s good to have some guidelines. This is how frequently we do a complete periodontal assessment. And then this is how we do it. Do we have voice charting? Is there somebody that’s gonna help you do the charting, that data ensure that that information gets in?


And then also, if there’s anything really specific that you do at every visit for your patients, like, you know, do they get the warm towel experience? You know, something like that, like letting them know that so that they can be on on the same page, you know, with the rest of the team. And then having the operatory prepared for them so that when the hygienists come in, that there’s at least, you know, enough cassettes there to get through the morning.


that you show them where the ultrasonic tips are, that they’re all ready to go. You have equipment that is in good working order and everything’s not worn out. And then prepare that for them. Give them a little guidance on where everything is located. And then also what’s really amazing is if there’s any way that you can get that hygienist, even the day before if you know in advance, a list of the patients that are coming in and you can take the names off, right, for HIPAA, but just what are the…


what’s the expected schedule and which patients are expected to need radiographs, which are expected to need a comprehensive perio evaluation, so that they know a little bit about their day when they’re going into that. So if you can just prepare those things for them and communicate that with them, it just makes for a much smoother experience for everybody. That’s so detailed and fantastic. We will have


those documents will put in the show notes for everyone to be able to access the resources. Appreciate that. OK, so we were talking about, I mean, this is really onboarding, essentially. And this is like a mini onboarding. Yeah, like an express onboarding. Yeah, mini onboarding. We’ve got to get you going with respect to that. And you kind of alluded to it, but tell me the benefits. How will doing this mini onboarding and integrating the hygienist, the temp


benefit the patients, the team, the practice, give me some benefits behind this. Yeah, so think about continuity of care for the patient. Whether that is reviewing their treatment plan and reviewing what has been treatment planned for the next procedure and showing the patient the photos, whether that is completing an oral cancer exam because that’s the standard of care in the practice, all of those things help the patients feel


Like even though this might be a different person that I’ve not met before, I’m getting the same level quality of care. And by the way, clinically, if you have, you’re an attorney, I’m not an attorney, Alex, so you might be able to speak to this. But think about if, during a thorough oral cancer exam is something that your hygienist do with every patient and now you have a guest hygienist and they’re not aware of that, maybe they don’t get a chance to do that and then something appears.


and it’s not detected until later, when the patient comes back six months later, what are the risk ramifications for that for your practice? So continuity of care is really important for patients. And then also continuity of treatment planning not only helps the patient, but it also helps the practice. So think about your other team members that are there supporting this guest hygienist. Maybe you’ve got a bonus system in place for your practice and they want every day to be productive.


So it’s in their best interest to help this hygienist be productive for that day and to keep what’s on the schedule, you know, on the schedule. And then again, for that hygienist, it’s just nice to be able to go in and say, okay, like these folks have it together and I feel comfortable and that I am being respected in this role and I’m here to serve these patients and serve this practice. And I’m part of the team today.


And you know, this is somewhere that I’d like to come back to. Or maybe somebody asks in the future, hey, do you know a dentist in this particular town? And they say, you know what, actually, I worked for a day and, you know, Dr. Nottingham’s practice and it was amazing. You ought to go check it out. So you just don’t ever know when that preparation will come back. Hmm. Makes a lot of sense. Makes a lot of sense. And hygiene, just in general, this is a big topic. Talked about how difficult it is to, this is probably the


toughest position to hire for now is hygienist. And we have to consider multiple options. So actually tell me a little bit, since we’re on this topic, what are some ways that we can handle a practice, can fulfill this role? We don’t have a hygienist, we’re having a hard time. So hiring is one, and maybe you have some hiring tips and temps is another, what are options? What do we do? We’re in panic mode, we need a hygienist. What do we do, Rachel?


So I would say absolutely, Alex, there are lots of different options. And I feel like this is something that hygienists in particular should be very aware of, is that dentists practice owners, they’re business owners. They will find a way to solve this dilemma one way or another, and they’re willing to be innovative and creative. So I think as hygienists, I’m saying this with a lot of love,


We can’t think that we’re the only game in town. And, you know, we have very unique skills and I might, you know, I wanna just give a shout out to all those hygienists that are out there that are continually upping their game and that are learning new things, that are continually providing new services, that are, you know, stepping into that role as healthcare provider and talking to their patients about their overall health and how their, you know, oral wellness affects that. So I don’t wanna diminish


the value of the hygienist in any way. I’m a hygienist, right? We work with hygienists. All of our team is hygienist. So I don’t wanna diminish that in any way. I just think we need to look at reality and know that dental business owners are going to find a way. And so here’s what we’re seeing. Yes, traditional hiring, Alex, you guys probably give advice on this. If you have a hiring service is…


It is now, you’re not only marketing to your patients, you’re marketing to potential team members, regardless of the position. And so I always give advice that include in your ads as much as you can with regards to images of your team working well together. If you’ve got videos on your website that really illustrate the doctor’s commitment to the practice and the team, and maybe have some…


some videos of the team actually talking about how great it is to work in your practice. All of those things are really powerful to include in your ads and also on your social media because you never know who’s following you. They might have a niece that lives in another town and is looking for a hygiene job in your town. I think the temp agencies for lack of a better term or staffing agencies are also a great option. I think you just wanna be really cautious


the firm that you’re going to work with and be sure that the hygienists are being engaged in a proper way with regards to employment laws in your state. So make sure that they are being employed properly in that regard. And you know, there are quite a few that have really great, almost like an uber style, you know, platform.


where you can see the hygienists that are available and they can see the jobs and the shifts that are available. And sometimes you’ll find a great hire, right, by working with a temp. So you just don’t ever know who you’re gonna meet. The other thing that we’re seeing in some states too, Alex, is changes in the Dental Practice Act to help offset some of this workplace shortage. Like, I mean, I believe in advanced or expanded function dental assistance. And that is going to be coming to more and more states, I believe.


where assistants do have some scaling abilities. And I know a lot of the hygienists were like, oh my God, that’s the worst thing ever. But what if an expanded function dental assistant could see children to free up the hygienist to do more periodontal therapy, to do some of the higher level procedures so that they really become that periodontal therapist, that prevention therapist, and they can really step, the hygienist can step fully into their scope of practice.


You know, we’re seeing dentists hiring dental dentist associates, uh, to do hygiene or working with an assistant, right? To do the polish and the dentist is doing the scaling. So there are a lot of ways that practices are alleviating, you know, this strain of a shortage of hygienists, because the bottom line is the, the businesses need to keep going and patients need care. Yeah. I think that in a lot of the research about hiring and Robyn Reis, our director of hiring has.


done the research on this and the Bent Erickson consultant, she’s brilliant, is that it’s not just money that people choose. It’s not their number one reason for coming. And certainly if hygiene, and not if it is a high topic or high commodity at the moment, I think that a lot of dentists think that all hygienists are mercenaries. And it’s like, are you going to pay me the most? And that’s the only thing. And the reality is you’ve got to compete on multiple levels. You got to pay people well enough.


But you also have to, you can’t be lazy anymore. And just to say, okay, I’m just a run a business. You have to be training. You got to be doing events. You got to be doing things that make a difference in their lives because they’re choosing. And this is just in general from COVID, how things have changed that people are saying, I want to have purpose in my life. I would like to, I’m going to be spending a lot of time in the office. It better mean something to me. So what are we doing to make their lives


have purpose and fun. And so we certainly have to fix any toxic cultures and improve it. And then on the upside, finding ways to inject something of value for people’s self-worth, if that makes sense. Yep, and I would agree. One thing that I look at a lot every year is the dental post salary survey. And so they released that early this year.


And same thing out of the, I think there were six or 7,000 hygienists that, uh, participated in the survey was the top two, you know, reasons for job change were, you know, pay or finding a better culture. So I absolutely a hundred percent agree with that. And like you said, a lot of hygienists will stay in a practice, even when they know they can go make a little bit more somewhere else, if they feel really bonded to the team and they feel supported.


and cared for by the owner. It’s, it’s huge. Give me a per and I think, yeah. And I think the same is true for hygienists too. And you said, you know, you can’t, you can’t be lazy running a business anymore. Um, you really have to be intentional in how we’re doing things. I think that’s true for us as leaders, um, in any business. Uh, and also for hygienists too.


You know, I feel like there’s going to be a divide. There already is a divide, but I feel like it’s going to get wider in the next few years between the hygienists that are determined to stay in that scale and polish lane and those that are willing to expand their role and expand even just how they’re communicating with patients about the importance of what they do. And lastly, I’m a doctor. Again, I have, I need a hygienist or I have one. I’m not happy or I’m looking.


but I feel that this is not the best time and I feel like I’m almost stuck with the situation. Yes. How can you, any advice you can give a doctor regarding their perspective? So I would say, you know, make sure that you’ve had the appropriate conversations with that hygienist, you know, and make sure that you’ve put yourself in the position of, you know, here’s where.


Here’s what I’m seeing, here’s my desire for this role in our practice, like this is a really critical piece of our practice and we’re going in this direction and we would love for you to come with us. How can I help? So make sure you’re listening and then if there are things that they say, you know what, I’d love to do that but I don’t have XYZ equipment, how can we make that happen? So I think it’s a two way street, right? Always.


is as a practice owner looking at what can you do to support the growth of this hygienist. If you feel like you have tapped out, you know, you’ve had all the conversations that you need to have, or if you’re dealing with an individual that is really stirring up a lot of problems in the practice, then you’re honestly better to release them. Even if you have to utilize guest hygienist for a while, you know, as well as I do,


how that type of attitude in a practice can really pull the rest of the team down. And if that is released, it’s like everybody can breathe again and they’re like, okay, all right, let’s do this. We know we’re going to have to pitch in together. We know it’s going to be tricky, but we can do this now. I know that’s easier said than done for me because I’m not running a dental practice. So you do have to just kind of look at it and be strategic. But I would say start with having heart to heart conversations with your hygienist.


If you feel like you’ve done that, there are hygienists out there. There are solutions out there. So I don’t think anybody should ever feel trapped. But I think a lot of business owners are feeling that way. All right, Rachel, tell me about those links. So we have one called the inspired hygiene.com slash guest hygienist guide one word that’s going to be a resource for our listeners. Yes.


Yep. And then the other one I would share is inspired hygiene.com slash standard of care. So that is the worksheet that I mentioned. Yeah. And happy to share both of them. And then inspired hygiene.com to learn more about you and your coaching services. Rachel is amazing. And your company is amazing. I got it. I got to visit it in the beginning. Now it’s probably a huge empire, but it’s okay. It’s wonderful.


Yeah, yeah, back. That was back in the day. You guys came to Charlotte. That was fun to get to spend time with you and Heather. Yeah, and we’re always happy to do what we call a complimentary hygiene opportunity assessment. You know, we spend an hour with you, you send us some data, and we can really look at the hygiene department at a top line level, right and just see where there may be opportunity and how we can help support. Well, thank you, Rachel so much for joining us. Remember everyone to follow us on Apple podcast, Spotify and YouTube.


Get the episodes as they are released, share with your friends, and until next time, go out there and be an All-Star.


We hope you enjoyed this episode of Dental All-Stars. Visit us online at AllStarDentalAcademy.com.

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