Are you offering sealants to all of your patients? 
When it comes to reducing a patient's caries rate, sealants are one of the best lines of defense dental providers can offer. So why is it that many hygienists only suggest them for children, and only on first and second molars? 

Many adults are also prone to occlusal decay on all posterior teeth. Because many patients automatically decline preventive treatment if their insurance doesn't cover it, many hygienists wonder if we should waste precious minutes suggesting treatment that will be ignored. Let's face it, we already have a busy schedule and it seems like more practices are demanding us to work faster. How are we supposed to add sealants to our appointments when some of us are only getting 30 to 40 minutes to complete a prophy? 

I once felt like this, too, but recently I have taken an entirely new approach. I spend a majority of my appointments educating my patients on all areas that pertain to them. I make the same recommendations for my patients that I would make for my family. I have noticed that when I educate my patients and spend an extra minute making sure they understand my suggestions and treatment plans, they respond well to me, and every appointment that follows goes a little bit more smoothly. 

Whenever a hygienist says to me that she or he feels like a salesperson by suggesting treatment that may not be covered by insurance, I always laugh and tell them, that's where they are going wrong. We have to change our attitude. We are not in sales. We are in health care and our main goal is preventing oral diseases. 

It's all in the approach
If I have an adult in my chair and he or she is caries-prone, I spend a minute educating on how to prevent future caries by using sealants on non-filled teeth, and keeping up with regular fluoride treatments. If finances and insurance coverage are a concern, I simply say that the cost for a sealant and fluoride is similar to or less than the copay for a filling. If multiple sealants are needed, I may suggest doing one at time. This is helpful for the patient's finances, and great for us when time is not on our side. This is not a sales technique; it's educating my patient on preventive services that will provide a benefit and save him or her money in the long run. 

I have noticed that if I approach my patients with this attitude, I have a much better acceptance rate and I feel like an educator—not a salesperson. When I feel like my patients are leaving my chair with a little more knowledge than when they came in, I know I have done my job. 

Add value for them—and you
There will always be one or two patients who simply cannot afford preventive treatment that isn't covered. However, don't let those patients hold you back from providing exceptional care for everyone. If we are not offering services or products like sealants, fluoride treatments, prescription toothpastes, and chlorhexidine to our high-caries-risk patients, then we are doing them a disservice and not treating them with the standards of care set by the ADHA. 

If you—like me—work in a busy practice where they keep trying to shave minutes off of your appointments, don't let that hold you back, either. The reason your office manager is shrinking your appointments is because a prophy doesn't produce much. Adding sealants to your appointments will provide you with more production. 

Even though we are not in sales, I do think it's important for hygienists to be aware of our production. Without knowing our worth, how can we ask for a raise or seek a new position in today's competitive job market? Most patients will gladly pay for a sealant instead of a filling, and there really is no reason not to offer sealants to all patients at risk for caries. Adding sealants to our treatment plan is an easy way for us to increase our production, make ourselves more marketable, and better serve our patients who trust us with their oral health.