I originally wanted to go to school for broadcast journalism. I did an internship at CNN and some other things. However, things were changing, so I decided to become a hygienist. 

I worked in a dental office again while in hygiene school, where I started noticing things that needed fixing. For instance, they had charts and a peg board—that’s how far back I go! 

My dorm at Georgia State University was across the street from Georgia Tech. So, I knocked on the door at a fraternity house where I heard lots of computer engineers belonged and said, “Hey, I have this idea. I know dentistry, and I need somebody who knows computers and can install them.” That started me on consulting and putting computer systems in dental practices.

It was kind of the first practice management system out there back then. My first system used the old floppy disc. After we got the computer systems running, I started teaching dental offices how to file claims electronically. We also created this niche of putting phone and communication systems into the offices.

Soon, I began seeing a different side of dentistry that I could impact. I started giving presentations and doing CE programs with my local ADHA. I had the opportunity to do some speaking gigs for the Atlanta Dental Hygiene Association. Different dental companies sponsored me to speak for them. During that time, I met Janet Hagerman, who was already in the DSO community. She is an international speaker, author, and consultant based in Georgia. She said, “Hey, I think you’d be great in this role.”

I loved being a hygienist, but then I had my son, and I needed insurance and other things the private sector didn’t offer. So, I began working with the different DSOs in my area and started to see how they did business. Once again, I saw a need for change. I contacted Janet Hagerman, who had a position available with a DSO, Coast Dental. I came on as a corporate hygiene administrator.

DSOPro: Tell us about your experience there. 

I had outstanding leadership there and continued to grow. I even stepped down from the role to the office manager level because I wanted to learn more about operations from a different perspective. I learned so much in that position that set me up for success. I’d always understood the clinical side and dove into the business side. We did a lot of mergers and acquisitions, and I helped with that and did a lot of training.

Eventually, my operational skills grew to the point where I was promoted to regional vice president for Coast Dental. I worked with district managers and got to groom a team. I’m so proud of that journey and what we were able to do there.

When I left Coast, I went to an oral surgery company, which was so cool and unique for a hygienist. I have to say thank you to Northwest Oral Maxillofacial Surgery in Atlanta. They had seven locations when they brought me on. We also handled trauma cases at the hospitals in the area. There’s a real need for oral surgery, and I learned the depths of that and experienced running a different type of business and marketing. I created a call center and the systems and processes that allowed us to grow and improve patient experience and profits. That experience is what led me to where I am today.
 

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DSOPro: Tell us about the transition to Sage Dental.

Tom Marler found me. He was our CEO at Coast Dental for a period. He had been gone from there for many years before he reached out to me at Northwest Oral Surgery. I remember saying I wasn’t interested, but he said, “Just come down and see what we have and what you could do here. We need a good leader for hygiene. I think you’ll love it.”

So, I met with him. He is such a dynamic person. He’s not a man of many words, but what he does say is of extreme value. Tom knows what drives me is making a difference and impacting whatever I’m doing. His mission spoke to me, so I agreed to join the team in October 2018.

Honestly, and indeed, it’s been the best thing I’ve ever done for my career. Sage didn’t have a lot of structure set up for hygiene. It was underserved. There was a lot of turnover and burnout. Tom gave me the autonomy to build something unique here. I’m very proud of the program we have at Sage.

DSOPro: What kinds of things did you change or put into practice? 

Since joining this team, we’ve implemented many changes and improvements. One of the main things is treating hygienists as providers because they are. And they’re pertinent to our business. We created that culture and worked on the doctor-hygiene partnership and improving their communication.

We put a peer program in place, so our hygienists have support from the beginning. They shadow and train before they see patients independently. We added another layer, which is our regional hygiene team. They work individually with hygienists in each office, which I do, too. I always say you must have street credibility. I love to go into the office, see patients, and work with the teams one on one.

We also allow hygienists more time with patients. We provide at least an hour per patient; the providers determine how much time they need from there. I’ve found that hygienists use the time to build better relationships, which helps with building trust and a long-term relationship with patients.

Regarding the implementation of technology, we’ve done a lot. We’ve added intraoral scanners, Perio Trays, advanced technologies for early detection of oral cancer, and teledentistry. We are using better products for our patients. We also created My Sage University, a continuing education program for all our team members, and a hygiene support hub for the hygiene team.

There is room for growth on many levels, not just in hygiene or peer training. A hygienist recently brought a product to me to consider incorporating into our practices. So, I have her putting together all the materials we would need to assess it. If team members want to do something, I encourage them to do so and create the environment for it.

If there is a product we want to utilize organization-wide, usually the regional trainers try it out first. We do a test pilot, see what their thoughts are, have some conversations, and collaborate on the product verbiage. When we launch something, we create a hot sheet with all the information on that product and what our peers have said about it. I use a lot of scripts to get people up and running with particular products, so they learn and get comfortable with them. Then, we do our final review and launch it to the company. Our best ideas come from the field.

DSOPro: Tell us about Sage Dental.

We have more than 100 locations, which I’m so proud of. We’ve grown tremendously since I got here. When I started, I think we had 54. We have about 2,000 employees, and 186 of them are hygienists.

Currently, we have locations in Georgia and Florida, but we’re looking for more growth opportunities.

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DSOPro: Do you think DSOs offer hygienists unique career opportunities?

Absolutely. DSOs offer hygienists a wide range of career opportunities. They can do clinical or customer service; they’re educators, and they know business. I’m a proponent that a hygienist can do any job in dentistry.

Many of my hygienists have gone on to dental school and come back to work for us. I encourage that, and it honestly happens a lot. About six hygienists left Sage in the last 18 months and are currently in dental school. I recently had the chance to catch up with them at a dental residency program. One of our hygienists, who enrolled in dental school about 6 months ago, was doing it remote from Albany, Georgia. It was so cool when she said, “I’m coming back!” and I said, “I will have a spot for you when you do!” 

So, hygienists are unique because they can choose to do anything. Our schooling entails more than just cleaning teeth. I am really an advocate for hygienists being in leadership positions. They can grow in the DSO community on so many different levels. 

DSOs also provide an excellent place for hygienists and doctors to work clinically. They can walk in and do their job, while we, as a support organization, handle all the back-office management tasks. They get to have that work-life balance, more so than in any other setting.

DSOPro: Any additional thoughts on how hygienists’ impact and contribute to DSOs?

Dental hygienists are the backbone of every office. They’re the drivers and who people come in for. When people say, “I’m going to the dentist,” most often, they’re going to get their periodontal care, aka cleaning. Hygienists have a relationship with the patients, whereas the doctors often just pop in and out because they manage more rooms and are doing restoratives.

I think it’s unfortunate that in some areas, there’s a significant shift in the community where a lot of hygienists have left clinical. I hate to see that because they are so integral to every practice. I think DSOs set themselves apart, and I do this here at Sage, by creating a space where they feel heard, respected, and valued. 

That’s one of the areas I think that DSOs have really worked hard on. Over the last couple of years, I’ve seen lots of great things done in the DSO community to elevate hygienists in their business models. In the private sector, I think a lot of hygienists have felt like they were underappreciated. At DSOs, we see the value they bring and work to build our business around them to keep them successful and happy. I think that’s important in today’s world because burnout is real. 

This is not 100% Covid trickle-down effects. In 2016, the US News & World Report projected there would be an 8% shortage of hygienists in 2022. Then Covid hit, and the ADHA and the ADA reported that another 8% left. So that gave us about a 16% shortage across the country.

But the interesting thing I read about that 8% who left during Covid is it really wasn’t because they were super scared. Maybe at first. But I think many of them were in situations where they didn’t have the PPE they needed or were being asked to shorten their appointments because they had more patients to see. 

There was a wide variety of things going on, and I think being scared was the least of it. One thing hygienists do well is infection control. We’re very well versed in that. When Covid came, I thought, “We survived the AIDS pandemic.” To think when I started working in dentistry, some people didn’t wear gloves. It’s changed so much. I was like, “Oh, we got this” because we already had those barriers in place, we are familiar with aerosols and things like that. 

The hygienists I’ve talked with say they didn’t feel respected and valued in the field. I’ve taken that to heart and created a space here at Sage where they do feel valued and appreciated. It’s my job to create a space for them to be successful. My job is to take care of them, because when I do, they take care of our patients.

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DSOPro: What advice or tips would you like to give to hygienists who want to follow in your footsteps?

First, try out as many different areas as you can, like periodontics, pediatrics, and all the different specialties to find your niche. It’s important to do something that you really love. Find that passion for hygiene. 

I encourage you to work for a DSO. Try them so you can see what it’s like. And continue to learn. I think that has been my greatest strength, that I continue learning about different products and ways of delivering care. 

I think the best thing I ever did was to take that job as an office manager, slow things down, and really learn about claims, the back office, the revenue cycle, etc. All those pieces were essential to learn about the DSO side of things that are different from a private practice.

Be brave and take risks. I always say that in today’s world, it’s no longer a ladder that we climb—it’s a jungle gym. Sometimes you must be willing to take a leap onto the jungle gym to find your niche or where you really fit in. I’ve done that a couple of times and have been blessed to have worked in some great places with great people who inspired me to be better and do better. Join organizations like Women in DSOs and ADHA.

And more than anything, care about others. Because truly, when you care about others and you put people before yourself, that is when you get the greatest rewards back in life.