Be Transparent about Expectations with Team Members

By Amy Kinnamon, RDH, EFDA, BAS

As dental professionals, we cannot escape expectations, even though many a literary figure has warned against it. Our patients rely on our knowledge and expertise and expect us to provide excellent treatment. Without expectations, there is a potential for a breakdown in communication, treatment acceptance, outcomes and, ultimately, the health of our patients. 

As patients have expectations of the dentist, so do the dentist’s team members of the dentist, and vice versa. For example, a dentist employing a hygienist or a team of hygienists has unavoidable expectations; the dental hygienist is a licensed member of the team and as such is expected to be competent to perform the delegable duties under his or her respective state dental board. Conversely, the hygienist or team of hygienists has expectations of his or her employer; they expect the dentist to be competent in performing the duties that he or she has been licensed to perform as well. Unfortunately, competency under licensure is not enough to have a successful team relationship.

Expectations are the cornerstone of the practice philosophy. Effectively managing those expectations in a dental practice is equally important as clearly verbalizing those expectations that may seem superfluous. Mismanagement of expectations can lead to an unhealthy relationship that can negatively affect not only the dentist/dental hygienist relationship, but also the entire team dynamic. 

Expect Your Dental Hygienist to Align with Your Clinical Philosophy
Every expectation in the dental practice begins with a clinical philosophy. Having a team in place whose members’ clinical philosophy aligns with yours is crucial to the success of the practice.

During the job interview process, too many times, the focus is on hours, salary and clinical skill. What the hiring dentist may not realize is that this is the time to get an in-depth view of a dental hygienist’s ideal practice environment and his or her own philosophy about patient care. A quick-to-hire, slow-to-fire approach may leave the dentist with a hygienist who is averse to the expectations that the dentist has in place to achieve optimum treatment, or the dental hygienist may have a completely different view of what acceptable treatment may be. 

When clinical philosophies are aligned, the dental hygienist will anticipate your diagnosis and recommendations for a seamless conversation among the patient, dentist and him or herself. The patient will hear and see the same message presented from both professionals. This will solidify the patient’s trust with the dental team and increase case acceptance. In return, the dental hygienist will expect the dentist to support his or her clinical findings and recommendations.

Expect Standardization of Care
Dental hygienists come from a multitude of backgrounds and may have varying bases in research, education, knowledge and experience. For example, some perform a cancer screening at every recare appointment, while others do this yearly or not at all; some only use an ultrasonic scaler, while others selectively polish. Employing more than one hygienist in a practice requires a standardization of care. 

Patients should receive the exact same preventive treatment in the exact same way in accordance with the most up-to-date protocols that suit the practice. Patients notice when treatment varies. The evaluation and maintenance appointment that is guided by clear protocols (expectations) provides a calibrated experience and establishes treatment standards that are met for every patient every time.

In exchange, the hygienist will expect up-to-date equipment and consideration when exploring the addition of technology to benefit the dental practice. Standardizing care across the hygiene department can eliminate confusion about processes and elevate the patient experience. 

Expect Participation in Lifelong Learning
Dentistry is changing, and advanced knowledge is necessary to competently treat patients. Successfully addressing oral-systemic considerations requires knowledge of not only dental health, but whole-body health as well. In order for dentists to differentiate the practice, highly educated dental hygienists are needed.

I am not suggesting advanced degrees; rather, the expectation of constant learning to increase critical-thinking skills and optimize patient education and preventive treatment. Hygienists who are vested in their education provide competent case presentation with the verbal skills to accurately educate the patient and increase acceptance. Openness to change is an added benefit of relying on research in today’s constantly changing health care environment. In accordance with expecting the dental hygienist to evolve his or her education, the dental hygienist will expect an investment in that education that may not necessarily be monetary. Looking for ways to encourage dental hygienists to increase their knowledge base is a win for the practice.

Managing expectations is an undervalued leadership skill. In order to manage expectations, there have to be concrete expectations in place. Do not presume that your team knows what is expected beyond clinical competency. Have the expectations of your practice been clearly verbalized?

Amy Kinnamon, RDH, EFDA, BAS, has 21 years of experience in the dental industry, including clinical practice, research, clinical education, marketing, writing and speaking. To comment on this article, email