How to Make Your Hygiene Exams as Effective as Possible!

Gary Takacs: Welcome to another episode of The Thriving Dentist Show. I'm Gary Takacs, the Thriving Dentist Show podcast founder and co-host. We have a great episode for you today, one that we have never covered in all of the Thriving Dentist Show episodes. The title for this episode is How to Make Your Hygiene Exams as Effective as Possible. I'm excited to share this information with you. But before we do that, two announcements to make. The first announcement is, you may know that Thriving Dentist regularly puts on virtual events. They could be webinars, they could be panel discussions. They could be simply conversations with guests that we think will bring useful information to our listeners. If you'd like to find out when the next Thriving Dentist event is, go to thrivingdentist.com/events. Again, that's thrivingdentist.com/events , and what you'll see is the next one on the calendar.

Gary Takacs: Take a look at that. If it's a topic that interests you, be sure and register. We do those events at no cost to you. We do that as a courtesy to our listeners. So register for those. If we're able to give CE on some topics, allow us to give CE, and others do not. But if we're allowed to give CE, it'll be hour to hour. So, for example, if we're doing a two hour webinar, and it's a topic that allows you to get CE, then we'll provide two hours of CE. And again, that's done at no cost. You do have to register, so be sure and register, and go to thrivingdentist.com/events . And I'd encourage you to bookmark that link, thrivingdentist.com/events , bookmark it and check it periodically and see what's coming up, see if it meets your interest and your availability, and come join us. The second announcement I have is we have a returning guest providing a top clinical tip. This is Dr. Darryl Burke, and he's got a great tip for you. His tip is titled, Why Ridge Preservation Should Drive Your Socket Grafting Decisions. Again, his topic is why ridge preservation should drive your socket grafting decisions. No further ado. Here's Dr. Darryl Burke.

Dr. Darryl Burke: Socket grafting is often thought of as a way to prevent soft tissue from collapsing into the extraction site, but the literature shows its primary benefit is preserving ridge dimensions, especially ridge width. After a tooth is removed, the alveolar ridge naturally remodels and resorbs, with the greatest loss occurring on the facial and buccal aspect. Studies consistently demonstrate that socket grafting does not completely prevent this resorption, but it significantly reduces the amount of horizontal bone loss compared to extraction alone. By maintaining space within the socket, limiting soft tissue invagination, grafting helps support bone formation during healing. However, the most important clinical outcome is the preservation of the ridge contour and ridge width, which simplify implant placement and reduce the need for additional grafting procedures. The takeaway is that socket grafting is primarily a ridge preservation procedure. Preventing soft tissue collapse is part of the process, but the ultimate goal is maintaining bone volume and architecture to improve restorative and implant outcomes. Thank you.

Naren Arulrajah: Hello, everyone. This is Naren, your co-host. Hope you are enjoying the summer. I am recording this from France, and we are having a heat stroke day, I guess, 107 degrees. So I'm having some fun cooking in the heat. Hope you're enjoying the summer as well. Gary, how are you doing? How is Phoenix today?

Gary Takacs: We're doing great, and 107 is just, we have a term for that. It's called normal.

Gary Takacs: At least in Scottsdale it is, but not in France. And as we know, maybe our listeners don't know this, but throughout the UK and Europe, very few places actually have air conditioning.

Naren Arulrajah: That is correct. Very true. Even if hotels don't have air conditioning, they're paying like hundreds of euros a day and still they don't have air conditioning.

Gary Takacs: Haven't needed it. Historically, they might, a warm day in France, a hot summer temperature would be in the low nineties Fahrenheit. And now it's extreme. So be careful. Heat exhaustion's real.

Naren Arulrajah: I heard, in France, this last Saturday, 40 people died because they jumped into rivers they shouldn't have jumped into. In other words, places they don't know enough about, and they just drown. It's crazy.

Gary Takacs: It's scary. Very scary. Well, I hope temperatures normalize and Europe gets back to a lovely summer, but right now it's a little toasty.

Naren Arulrajah: Yes. Gary, I wanna take a minute to also thank our guest, Dr. Burke. He's a returning guest. He has been very kind to help our community with wonderful clinical tips. And thank you, Dr. Burke. Both Gary and I share our appreciation towards you. So thank you for everything you do for the Thriving Dentist community.

Gary Takacs: He does a great job, Naren, of picking a topic that has wide interest and really delivering his information very concisely and accurately, and very, very well. So thank you, Dr. Burke. We appreciate you.

Naren Arulrajah: Today our topic is how to make your hygiene exams as effective as possible. Many of you have been listening to Gary for the last 10 plus years, and I have been co-hosting this with him for probably around seven years. And one of the things that Gary talks about is a hygiene driven practice. So many of you out there have hygiene driven practices, meaning hygiene is a central part of how you think about your practice, how you grow your practice. Two reasons. One, your hygienist is somebody your patients see twice a year if you do a good job in building a hygiene driven practice. And two, these patients have a relationship with your hygienist. And number three, a hygienist is the one who's able to prompt the patient, hey, by the way, if you don't take care of this, this is gonna become a bigger issue for you. So why don't I have the doctor come in and check this out? Oh, by the way, you talked about a beautiful smile, and I noticed something that maybe the doctor can help you with now. So it's a great way for the hygienist to make a difference for you. Gary, what are your thoughts before we jump into a perfect exam, the hygiene driven practice? I know you have talked about it before, but just wanted to get your latest thoughts.

Gary Takacs: Yeah, it's critically important. The exam is a touch point. It is the most frequent touch point you have with your patients. And it's really important to be intentional about it, and not just fly in and fly out. But be intentional about it. It's a way to connect with your patient. It's a way for the doctor to show the connection they have with their patient, greeting the patient by name, maybe asking about a family member. It's a great way for the doctor to demonstrate the connection that they have with their patients. So it's critically important. So we're gonna really get into this today about how to make it as effective as possible. I wanna recognize that the hygiene exams can be a challenge. They can be challenging because you likely have another patient in another room that you're treating restoratively and you had to take a break, and maybe you have two rooms with restorative patients, and you have to take a break and do hygiene exams. So I get it. I'm not pretending it's easy. It's a challenge. However, it can be done very effectively. And that's what we're gonna cover today.

Naren Arulrajah: Thank you, Gary. Appreciate it. So, one of the common complaints you've been hearing from practice owners lately is that production is fine. The team is busy, the schedule looks healthy, but case acceptance is not where it should be. And when I look at it with them, the answer usually comes back to a process nobody talks about much, the doctor exam during the hygiene appointment. We know they have a relationship with the hygienist, but the doctor exam is a key linchpin. An effective hygiene exam can make a massive difference in the practice. Why? Because it is directly tied to case acceptance. So today, I wanna spend this episode on tips that our listeners can use to make their hygiene exams as effective as possible. Gary, when most dentists hear doctor exam in hygiene, they think of this as an interruption. And quite frankly, many dentists think of the exam as a nuisance. Why do you think that the hygiene exam can be so much more?

Gary Takacs: Naren, I'm gonna reinforce this. Remember, from 1989 until 2020, I was an in-office consultant. I physically visited over 2,200 practices over that time period. And, you know, we'd hear doctor exam in hygiene. That was the heads up. And I would notice a look on the doctor's face. And the look on the doctor's face was, oh no, oh man. And so they go into it with that mindset, they're going into it like, this has just interrupted my day. And you can imagine that when you go into it with that mindset, it's hardly gonna be optimized. So start by flipping the switch on the mindset. And here's the reinforcement that I wanna give you. Naren, across our Thriving Dentist coaching client base, I looked at this data set that I'm gonna share with you, in the year 2025.

Gary Takacs: So last year, in the entire year across our entire coaching base, these are our practices all over the country. And for our offices that do a fair amount of what I call high value dentistry, the things doctors like to enjoy doing more of, like Invisalign, like placing and restoring implants, like cosmetic dentistry, 60% of those cases came out of hygiene. Came out of hygiene. Let me explain that. Meaning that the patient expressed, let's use cosmetic dentistry, the patient expressed an interest in having a gorgeous smile, and doctor talked to the patient about it, but it turned out that that wasn't the right time. Timing is something that's outside of your control on case acceptance. The case that I commonly think of is a female patient in her forties. She's interested in improving her smile, but she's got two kids in college.

Gary Takacs: So when she finds out the cost of the smile design, she's, oh, that's gonna have to wait. Right? We're tuition poor. But meanwhile, you keep her in hygiene, come in to do the hygiene exam, and at some point, she's gonna turn to you and say, doctor, I'm ready to do that smile. That's what I mean, 60% of those cases came out of the hygiene exam. The other 40%, Naren, came out of marketing, meaning new patients that were seeking out the practice to do those services. But notice the ratio. Notice the mix. 60% were internal, 40% were new patients seeking you out. Hey, that 40%, we're gonna talk about that later in this episode. That 40% is very important, but 60% is coming outta hygiene. So if you go into hygiene with a frown on your face, trying to get outta there as fast as possible, and not talk about any recommended treatment, or give them an update, you're really shooting yourself in the foot in terms of that 60% conversion.

Gary Takacs: So that's why I think it can be so much more. But it's also, you've heard me talk extensively about the value of a relationship driven practice, right? Naren, you could probably complete some of my sentences. It's important. Yes. And when you're intentional about this, and if I'm your patient and you're ready for that hygiene appointment, you're gonna come in. Gary, it's so good to see you. I saw you on my schedule. I was looking forward to seeing you today. How's Therese, how's her yoga studio going? And I have to ask you about your grandson, Canan. How's Canan doing? I've been thinking about it. How's Canan doing? What does that do, Naren? That deepens a connection. And how does a patient feel at that point?

Naren Arulrajah: They feel appreciated. They feel valued that you remembered them. And even though you don't have to see them, you took the time to come and say hello, and you are interested in them. I love Dale Carnegie's code, right? Be interested in people, they'll get interested in you.

Gary Takacs: Yeah. And what's everyone's favorite topic? Themselves. Themselves, yeah. Also from Dale Carnegie. And when you come in prepared and you're ready for that appointment, it can be done very efficiently, because hey, it has to be efficient. You can't spend 20 minutes in there. But you can be very efficient and you can be impactful with how you interact with the patient. So it can be so much more. And that's what we're gonna cover in a lot of depth today.

Naren Arulrajah: Thank you, Gary. Let's continue to explore this. So, can you walk us through what a great hygiene doctor exam actually looks like?

Gary Takacs: Absolutely. This is something that we spent a lot of time on with our coaching clients, and our clients report back that this has been a breakthrough for them. This has been something that they have completely changed from what they used to do before working with us, and what they're now doing now. And they said they would never go back to the way it used to be, it's making such a difference in their practice. And it is a team sport. The hygiene exam is not just the doctor. Your hygienist plays a very important role in that. Your hygienist should be prepared for you when you come in. So, most offices have intraoral cameras, and Naren, in most cases, those intraoral cameras are gathering dust because they're not sexy and exciting anymore. Naren, this was before you ever got involved in dentistry.

Gary Takacs: But in the early 1990s, intraoral cameras were whizbang technology. It was a wand, and you could put it in the mouth and take photos, and that was whizbang. What is it now? Nothing. Exactly. Taken for granted. Yeah, they take it for granted. And because of that, you've got the intraoral wand hanging on the wall, and you never use it. What I recommend the hygienist do is have photos up on the screen before you walk in. If there's an area of concern, let's say the hygienist is concerned about something on the upper right, because maybe in the treatment plan it has fillings on the upper right that need to be replaced, then she should put those photos up on the screen. And they're a prompt to you, doctor. That's what the unscheduled treatment is. In other words, that's a little secret reminder of what that treatment is, what remains to be completed. If there is no unscheduled treatment, then I recommend what the hygienist do is put up two photos. It only takes literally 10 seconds to take these photos. The back of the lower anterior teeth, take one photo before the hygiene appointment, and one photo after she's done her prophylaxis, because that gives you an opportunity to reinforce to the patient, because usually that first photo, before she started doing the prophylaxis, will show some plaque buildup. Naren, do you know why plaque builds up on the back of the lower teeth?

Naren Arulrajah: That's where it's hard to get to with the brush.

Gary Takacs: It's the salivary gland, it's right there. And the salivary gland tends to produce more plaque in people. So if you see those two photos up there, then that's a reminder. Let's say Gary's right on time. Hey, Gary, I noticed that you're right on time. You're six months from your last hygiene appointment. Way to go. Let me show you why that's so important. See this photo on the upper left. That's how the back of your teeth looked before Kelly did the hygiene appointment today. And this is how it looks now. Even though you do a great job of home care, that's why it's so important that we see you every six months. Now, what if the patient hasn't been there in two years? Now it gives us a chance to reinforce it. Gary, I'm glad I'm seeing you today, but I have noticed it's been a little while. Before you leave today, I wanna get back on a regular schedule.

Gary Takacs: Here's why. Look at the back of your lower teeth. This is what it looked like before she started the hygiene appointment. This is what it looks like now. And if we get you on a more regular schedule, we won't have that problem. So I want the hygienist to have some photos up there. But also I'd like a verbal pass off. What that means is something like this: doctor, I shared with Gary that you would take a look at the upper right. He has some fillings that remain to be completed as part of his treatment plan. Would you do me a favor and take a look at those? So now, doctor is totally focused, and has been prompted by the hygienist. It looks like a team that knows what they're doing, very carefully coordinated, and it sets you up for success.

Gary Takacs: So really that's the beginning of what a great hygiene doctor exam should look like. If there is significant treatment, what we'll call high value treatment, like that smile design, check in periodically. Maria, I know we've talked in the past about doing a smile design case so that you can have a beautiful, healthy smile. I thought I'd just check in with you today, how are you feeling about that? And just ask the question, just check in. Don't do it every time. You don't wanna beat 'em over the head with it, but check in with Maria. That also lets 'em know that you remember what you had talked about with them before. So those are part of what I think makes a great hygiene exam.

Naren Arulrajah: Thank you, Gary. Let's continue this conversation. My next question, Gary, is about how can the hygienist set the doctor up for success in the hygiene exam? So, is there something they can do before, during, or after that really makes this pop? And let me share my experience with my hygienist and my dentist. You know, when she first started, I have been a patient of hers, I guess for 10, 15 years now, a long, long time. She didn't get a lot of coaching or help on how to think about her practice. So now she does it much better than she used to. In the old days, I don't even remember if she had a strong hygiene program. Now, the same hygienist for years now, a great hygienist, and anytime she wants the doctor to do some work, she would set it up. So the doctor would just come in, it's like a layup, you know, in basketball, she lays it up and the doctor just closes it. Yeah. So, anyway, what are your thoughts, Gary?

Gary Takacs: Well, we talked a little bit about the visuals that should be up. We'll talk a little bit more about that, the photos, the intraoral camera photos, but also during her hygiene procedure, the hygienist, let's be careful, the hygienist cannot recommend specific treatment. They're not allowed to under the practice act, right? They can't do that. So I don't wanna violate that. We're not gonna cross over the line, but the hygienist can say, Gary, I'm concerned about something I see on the lower left. I'll ask doctor to take a look at it, maybe nothing at all, but I'll have doctor take a look at it when she comes in. So that's the role that the hygienist can play, staying within the guardrails of not recommending anything, but saying, I'm concerned about something. If the patient is in relationship with the hygienist, which let's assume for our listeners they are, when the hygienist says, I'm concerned, guess what?

Gary Takacs: The patient becomes concerned. So that verbal prompt is very helpful. So, I'm concerned about something I see here, maybe nothing at all, but I'll have doctor take a look at it. And then when doctor does come in, be sure to do the verbal pass off. Doctor, do me a favor and take a look at Maria's lower left. Saw an area of concern there. Could you do me a favor and take a look at that and give her a status report. So, very important to have the assist, if you will. I like the basketball analogy, do the assist. And the other way is to have the photos up. I hope that all of our listeners are dusting off those intraoral cameras and starting to use them, because even though it's not whizbang technology to us anymore, it's still whizbang technology to the patient.

Gary Takacs: And the fact that they're up on the screen, it's very particular to them, very easy to start doing. And just get in a habit of having photos up every time, every single time you walk into the room. Photos need to be up. If there's unscheduled treatment, there should be photos of the area of unscheduled treatment. And if there's nothing in the treatment plan that needs to be done, then take a picture of the back of the lower anteriors before the hygiene appointment, and that same photo after she's done the prophylaxis, and put those up. And that'll give you a chance to reinforce, compliment them for being right on time, or correct if it's been a while, 'cause there'll be a lot more plaque buildup before. Say, Gary, this is why we need to get back on a regular schedule. This is what it looked like right when you started today, and this is what it looks like. Notice how much better it looks. Yeah. So, that's how the doctor can really set the hygienist up. When I was in office coaching, Naren, I noticed many times the hygienist wasn't even in the room. She hit the light system that says, I need an exam, and then went to the lunchroom.

Gary Takacs: That's not an assist. Then doctor walks in cold. I hope that's not happening. That should not happen. So we gotta revisit what that system is. What is that system? And the things we've talked about would make a good starting point for how you wanna optimize that in your practice. It also makes it, if you have the setup, a shorter amount of time that you spend in there, because you can get right to the point, and you have to be efficient. And dental offices have an internal struggle between efficiency and connection. Efficiency and connection. Do you recognize that struggle?

Naren Arulrajah: Yes, Gary, yes. But I do think the—

Gary Takacs: We wanna be efficient. If you're so efficient that the patient feels processed, that's not good. Not good. It's not a relationship driven practice. And likewise, if we become absurd about connection, you can't spend 30 minutes in there doing a hygiene exam, you just can't. What happens to the patients in your chair or chairs? So you gotta balance it out. And the things we're talking about allow you to balance that out and strike a nice balance between efficiency and connection, because we're doing both.

Naren Arulrajah: Absolutely, get it. Yeah, I do think this is a place where you really don't want to be efficient. You want to be really focused on that experience for the patient. It's kind of like, I think anytime you're dealing with humans, it's kind of like performance, where the experience matters more than anything else, because that's all they see, that's all they remember, that's all that stays with them, asking about their family, spending that one or two minutes to chit chat.

Gary Takacs: It's the Maya Angelou quote, Naren. The celebrated poet Maya Angelou famously said, people will forget what you said, they'll forget what you did, but they'll never forget the way you made them feel. When you ask Gary about Therese, I walk away with a really strong feeling about connection to the doctor.

Naren Arulrajah: Also the natural handoff, the pictures, and the interaction between the hygienist, the patient, and of course the doctor, it should all flow naturally. So it's all pre-planned, pre-thought, and there's a method to the madness. But for the patient, it's like, wow. It's a great experience.

Gary Takacs: And you know what I would say, Naren, and this is something that I can't speak of with personal experience, but I can speak of with family experience. My wife is an amazing cook, absolutely amazing, world class. We have jokingly said that she needs to start a restaurant. She's that good. And occasionally she'll try new recipes, and I love being the beneficiary of those. But sometimes she'll forget an ingredient, a single ingredient. And she'll be critical of it. She'll say, oh man, it didn't quite come out right. And for those of our listeners that are chefs, you leave out one ingredient, right, it's not the same. Well, same thing here. Well, we leave out the intraoral photos, we leave out the greeting where we connect with the patient, where we bring up something we know, here's what's a hit every time.

Gary Takacs: If you haven't seen the patient in six months, you gotta be in a dental office every six months. And maybe the last time you were in, hey, do you have anything good coming up on your schedule? And you say, well, you know what, I'm gonna spend a little bit of time in Europe this summer, and the next time you come in, so next time is November. And maybe she does a teed-off to you. Oh, by the way, Dr. Naren has got a trip coming up to France in a couple weeks. And the doctor, oh my goodness, how cool is that? Where are you going? They're gonna have a little conversation around that. But then when they see you in November, if doctor says, hey, Naren, I was thinking about you, how was your trip to France, that was six months ago—

Naren Arulrajah: Right?

Gary Takacs: What happens psychologically right there?

Naren Arulrajah: Yeah, I think you, I will remember you, like, man, this doctor remembered, even though he is busy. And you might even think it means even more than anybody else remembering me, just because of how busy the doctor is.

Gary Takacs: Naren, you might be thinking, oh my gosh, I've completely forgotten about that trip to France. Since then, I've been to England, I've been to South America, I've been to South Africa. I forgot about that. But when the doctor says, hey, I was thinking about you, how was your trip to France, it lands, it really lands. Now let's get granular about this, Naren. AI is pretty cool. Would you agree?

Naren Arulrajah: I think AI is gonna change a lot of businesses in the next 10, 20 years.

Gary Takacs: Can I explain how it's gonna change it right here for our listeners?

Naren Arulrajah: For sure, I get it.

Gary Takacs: This is all AI. You haven't heard this. This is new. So every office has notes, personal notes. They're buried, buried, buried in the electronic chart, right behind five screens.

Naren Arulrajah: Right?

Gary Takacs: And it's not easy for the doctor to do the prep before the appointment.

Naren Arulrajah: Right?

Gary Takacs: Because they gotta pull up too many screens and they got five minutes to prepare for the day, and they can't do it. And so when I say be ready, you don't have to know your patients, you don't have to know all your patients at all times, but you need to know who you're seeing today. Here's how all of you can do that. In the old days, we used to have analog note cards, like five by eight note cards with personal notes, and you'd just review those note cards on the personal information about your patient. Well, that was in the eighties and nineties. Today, it's in your software, but it's not available to you. So use an AI agent, I like Claude, and describe to Claude: Claude, go into Open Dental patient notes and pull out the notes for every patient that's on my schedule today. Have them prepare that as a Google Doc.

Naren Arulrajah: Yeah, and just tell me the key things, two things I wanna talk about.

Gary Takacs: Oh, what you have to see is the note, just pull the notes, and you might have to show Claude where those are. And then pull it, and then have that on your desk when you walk in in the morning before the morning huddle and review the notes. Now, Naren, you're nerdier than I am, is that a good application of Claude?

Naren Arulrajah: I think it is. The only question is HIPAA and all that stuff. I'm not sure, because it's going to the cloud, and I don't know if that's an issue or not an issue. I don't wanna say it is, maybe it's not. I just need to make sure the i's are dotted and t's are crossed.

Gary Takacs: Well, all we're doing is we're pulling that outta your notes and making it accessible to you.

Naren Arulrajah: Right?

Gary Takacs: Making it accessible to you. I had a, how I came up with this, Naren, is that earlier this summer, I have a client that said, I really want to get those notes pulled out of my software on a sheet or two of paper every morning. And so one of, in fact, it was his hygienist's daughter, 17 years old, she's thinking about dentistry as a career. He hired the hygienist's daughter to pull those notes out and put 'em in a document every day. That's her job. That's her summer job. But you know what I mean, I don't wanna take jobs away from high schoolers. But Claude can do that in no time.

Naren Arulrajah: Yeah, in seconds.

Gary Takacs: In seconds. And then that's what the agents are set up to do. That's a great application, Claude. Now all of a sudden, you can have that on your desk. And if you're concerned about confidentiality or anything, shred 'em at the end of the day, shred those notes. And there you go. So that's a little bit of a modern twist on how you can fully prepare for the day. And doctors, you're not gonna like this suggestion, but come in 10 minutes before the start of your morning huddle. Naren, did you hear all the listeners just drop off because—yeah. Come in 10 minutes early before your morning huddle. I know, I know you don't like that, but just do it. Read your notes from Claude on the patients for hygiene and restorative patients. Now you're prepared for the day.

Naren Arulrajah: You could even, Gary, if you want to go a step further, you can create a tool inside Claude that will automatically, let's say, send it to your private device the night before, every day that you're working. So it goes, checks your calendar, knows you're working on these days, knows who you're gonna see. That's the power of AI, the game changer. The game is changing completely.

Gary Takacs: It's a game changer. Yeah. And that's a great application of a redundant process that technology can do way better than anybody. And if you wanna go the analog way, hire the son or daughter of one of your team members to do that as a summer job. If you want, go that way.

Naren Arulrajah: If you wanna go a step further, again, right after you see the patient, you could just say three things. Now there are technologies where you don't even need to type, you just talk to them, and it takes those three things you said and writes a personalized letter to the patient or to the doctor who referred the patient. There's so many things we can do in 2026 that you couldn't even imagine.

Gary Takacs: Oh, yeah.

Naren Arulrajah: Gary, let's jump to the next question. Question number four. We know that visuals are very important for patient awareness of conditions with their oral health. What are your thoughts about photos, specifically digital and intraoral photos, in the context of the hygiene exam?

Gary Takacs: Yeah, we should have the six digital Frank Spear photos for patient education on all of your patients.

Naren Arulrajah: Is that only for the first new patient exam, or is that for every hygiene exam?

Gary Takacs: They need to be retaken periodically because things change, but we wanna take them on all new patients moving forward. We wanna have a protocol for when do we retake those. They maybe need to be retaken every couple years because things do change in the mouth. But we should use those photos, a picture's worth a thousand words. We should use intraoral cameras, because now we can take those photos very quickly. We talked about the back of the lower anterior, but the hygienist, if we don't have photos, the patient can snap a photo of an area of concern. Now she can snap that photo, put it up on the screen, and verbally pass it off to you.

Naren Arulrajah: Right.

Gary Takacs: Doctor, I took a photo of Gary's upper right. Take a look at that if you would, and give Gary a status report on that. And it took her quite literally 15 seconds to snap that photo. So they are a must in the hygiene exam. A must have, not a nice to have, but a must have. And we talked about, I don't wanna beat a dead horse, but we talked about it earlier in this podcast episode. But absolutely, set it up so that those photos are up when you come in, and watch what happens to your practice. They'll see their teeth in a way you haven't seen before, they haven't seen before. Naren, I'm gonna switch gears and I'm gonna ask the fifth, the last question to you. So we'll switch roles here. This podcast episode is mostly a coaching conversation. How do we coach our listeners up to become more effective in the hygiene exam? So, hopefully this is landing and you're thinking about some ways you can turn it from a nuisance to maybe one of the more effective things you do to increase case acceptance. But now I wanna go to the marketing side. That's your world. What shows up online when hygiene exams are done really well, like we're talking about today? And why in the world is that even important?

Naren Arulrajah: Great question, Gary. I hate to say this, but a lot of people are not happy with their dentist for a lot of reasons. And also there are a lot of people who haven't been to a dentist in years and years and years. So you are looking at maybe 40% of the population who hasn't been to a dentist in at least two plus years. So that's a huge market. And one day they wake up and say, I need to go see a dentist, I cannot keep ignoring my teeth. If I do, I'm getting older, I'm gonna have all kinds of issues. Maybe they heard about dementia and the connection between that and gum disease, or who knows. But they read something, heard something, and obviously, health is in their consciousness.

Naren Arulrajah: So that could be one thing that triggers new patients to come find you. The second could be, they just are not happy with their patients - their dentist. So they're looking to change. And of course, they know what they want because they have been around the block and so forth, and they're in a new city, or, who knows, maybe they had a wonderful doctor and the doctor left, or maybe they used to be great, but not anymore, but whatever reason, they're looking to switch. So what these people are doing today is they're using Google close to 500 billion times a month. That's Google Maps, Google AI, and Google search, all combined, being used around 500 billion times a month. So when they're looking at Google, they're asking questions. It used to be simple questions, but now it's even conversational questions.

Naren Arulrajah: Like, who is, I moved to this city and I'm looking for a good dentist who is really known for hygiene, and also who has some experience in implants or whatever. So they're looking for something specific. And the question is, are you showing up or are you not? Do you wanna show up in AI Overview? You wanna show up, that's Google. Google still is 95% of the market. You wanna show up in regular search, you wanna show up in Google Maps, and you wanna show up on ChatGPT and Perplexity, even though they're less than two, three percent of Google's market share in terms of sheer volume. Who knows? So you wanna make sure you're everywhere. How much—

Gary Takacs: Is Claude? How much is Claude in your research?

Naren Arulrajah: Claude hasn't really played in the consumer space as much, Gary. They are focused on the enterprise side. So our whole thing is, we are going to help do the things that knowledge workers do, that, like you said, you gave the example of that high schooler who would print out notes for the doctors so that he has the notes ready before every day. So that kind of knowledge work, anything that somebody would log into a computer and do, Claude can do that for you. So the real competitors, the new AI search engines outside of Google, are ChatGPT and Perplexity, and Gemini. Gemini is a Google product. So Google has its own quote unquote direct competitor to ChatGPT, and then Perplexity and Gemini. So those are the companies that you should pay attention to, but still combined, they're less than two to three percent of Google's search volume.

Naren Arulrajah: I'm talking about the main Google engine. So anyway, you wanna show up on Google for anything to do with hygiene, anything to do with gum disease, anything to do with, I haven't been to a dentist and I need someone who can take care of my teeth. I mean, I'm talking like I would talk to an AI engine. Also, you wanna get reviews. And reviews are also important, because if I am one of those 40% who's looking for a new dentist because I haven't been to one in a long time, or I'm one of those people who's dissatisfied, I'm going to go and read the reviews as a second step. So I go to Google, I go to these AI search engines, I find you, and then I want to check you out. So the next thing I do is I go and look at your Google My Business profile. Of course, I'm looking very quickly at how many reviews you have.

Naren Arulrajah: And if you're not getting 10 or more reviews, the chance of you showing up is less. When I mean 10 or more every month, including the recent month, you may not show up near the top. And then the quality of those reviews, and there are two parts I'm looking for. One is qualitative terms, like they took care of me like family, they're thorough, they have the best technology. So those kind of qualitative terms, because maybe that's important to me. Second thing I'm looking for is that personalization: Dr. Smith, Jenny the hygienist, people are talking about human beings, and the same human beings keep showing up in these reviews. So I might spend a few minutes reading some of these reviews, and I think that just gives me the comfort. And of course, all these search engines, whether it's Google or the newer ones, they all understand that this is how humans are behaving, so they're also using that insight to decide whether you even show up or don't show up in their own search engine ranking. So these Google reviews, the quality and the quantity of those reviews, along with you dominating Google for anything to do with hygiene or new patient related queries, I think is important.

Gary Takacs: Well, and you get the voice of the patient. The patient uses their tone, their voice. When they say, I can't believe doctor remembered about my summer vacation. What does that say to a potential patient looking for a dentist? Oh, I wanna go where my dentist would remember that. And that's something that's very qualitative, and that's something that maybe the potential patient didn't even know they were looking for, but there it is, and it makes you the obvious choice. So it's really all about reviews. And I know, we have many mutual clients, clients that are Thriving Dentist coaching clients that are also Ekwa clients, and I see this, I see it time and time again, how they master reviews.

Gary Takacs: And as a result of mastering reviews, they end up on page one of an organic search, preferably at the top. They also end up in the map section, and they end up with a ton, and I'm literally talking about a ton. Just yesterday I was celebrating with a client because they just crossed over a thousand Google reviews, they just crossed over the thousand threshold. And they're saying, well, now I know why my marketing's working so well, because the Google reviews play a big role in that. Naren, I'd recommend for our listeners, if they haven't done it already, set up a Marketing Strategy Meeting with Ekwa. Go to ekwa.com/td  for Thriving Dentist, and learn about how you can really master marketing with organic search engine optimization.

Gary Takacs: And really set your practice on the right course when it comes to marketing. As we wrap up today, I'd also like to extend an invitation on the coaching side. We are accepting new clients here at Thriving Dentist. On the coaching side, we are accepting new clients. We don't always, sometimes we have a wait list. However, we've had a number of clients in the last couple months hit the finish line and successfully finish their Career by Design that we were a part of, and it's opened up some spots. Go to thrivingdentist.com/csm , stands for Coaching Strategy Meeting, that'd be a Zoom meeting with me, and we'll talk about your practice, talk about your goals, and talk about, try to determine if coaching might be a good fit.

Gary Takacs: And if that's the case, I would love the opportunity to meet you on Zoom. Naren, as we wrap up today, this has been a fun conversation. It's been something we haven't talked about in almost 800 episodes. Yeah. Hasn't the hygiene exam kind of been one of those forgotten things, right? And I hope, I'll go back full circle, I hope for our listeners that you flip the switch, and instead of thinking of your hygiene exam as an interruption or a nuisance, you think of it as an opportunity. And if that's all that you get, besides all the details we covered, if that's all that you get, I'm gonna suggest some good things happen. Well, Naren, on behalf of you and I, I wanna thank all of our listeners for the privilege of your time, and we look forward to connecting with you on the next Thriving Dentist Show.