DSOPro Exclusive

Supporting and Educating Hygienists on Standards for Clinical Practice to Improve Patients’ Oral Health Outcomes

Smile Brands’ VP of Hygiene Support/Clinical Operations trains hygienists on standards for clinical practice to improve patients’ oral health outcomes.

DSOPro: Tell us about your background and what made you decide to become a hygienist.

As with many hygienists, I had some great experiences with dentistry in my early childhood years. My hygienist and dentist seemed to really love what they were doing. And I don’t know quite why, but perhaps I always had a fascination with smiles. Maybe it has something to do with my internal-core sense of enjoying positivity and seeing what’s possible. I knew I wanted to do something in healthcare, and dental hygiene became a real interest for me. So, I got an associate degree in dental hygiene.

I practiced clinically in both specialty and general practices, and I enjoyed the variety. I worked for a prosthodontist for about 16 years. I truly felt like we were saving lives with the work we did, and it was a very fulfilling career. I started on my bachelor’s degree when I developed a desire to go into dental hygiene education. I spent a little bit of my time in dental hygiene education while completing my bachelor’s degree in business.

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I’d always been involved with the dental hygienists’ association and served a term as president of the Wisconsin Dental Hygienists Association. I made many connections through that, which led me to a position working as an educator for a company in the field. In 2004, that led me to the first DSO I worked for, Midwest Dental, which was a growing DSO with fewer than 40 practices at the time. I fully enjoyed clinical practice, so when I was given the opportunity to work at the DSO, I thought, why would I leave something I love? But thankfully I did because it led to an even more exciting opportunity. I believe that if you’re not just a little bit afraid, you’re probably not challenging yourself enough. I went on board as the director of dental hygiene, then completed my master’s degree in organizational leadership and quality. It was a great way to combine my dental hygiene education fix with my passion for clinical practice.

Meanwhile, I continued to be involved with leadership in my profession, serving as president of the American Dental Hygienists’ Association in 2017. In December of 2020, Midwest Dental was acquired by Smile Brands, and since then I’ve been happy to be part of the clinical leadership team in the fourth largest DSO in the country.

DSOPro: As Vice President of Hygiene Support/Clinical Operations, what does your role encompass?

I am part of the clinical support team. I work closely with Dr. Robert Crim, our chief dental officer, and other clinical leaders. We, of course, partner very closely with our operational support team on the daily.

Smile Brands has 7,500 team members and nearly 700 offices. Currently, I’m focusing on building systems in areas that support our hygienists, whether it’s in the field doing training or talking about our standards for clinical dental hygiene practice. We address how we can take great care of patients and improve their oral health outcomes. I spend a lot of time on the education of our teams.

I’m also working on more specific initiatives with diode lasers. I’m often involved with orientation of our new providers. I speak a lot on the importance of the dental hygienist’s role in great patient care. I do a lot of training on periodontal therapy and treatment for our patients.

We really see our hygienists as providers, so having access to continuing education programming that supports our providers to practice at the top of their scope is also a focus.

I’m often also involved with other initiatives within the organization. That’s the clinical operations side of my responsibilities, whether it’s our clear aligner initiative, dental implants, or anything that sort of buckets into what great patient care looks like.

DSOPro: Do you have specialists in all your locations or just some of them? Or do you have locations that just offer specialties?

We have a mix. Some markets tend to have a bit more in the specialty space, others might have a bit less. I think that’s a really important part of how we provide comprehensive care to our patients. I always say the healthy patients don’t all come in on Tuesdays, and then the non-healthy patients are here on the other days. So, we want to provide an environment where our patients can get the care they need at any time. And within that space, also make sure our general practice providers, hygienists, and specialists continue to learn and grow in their area of expertise.

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DSOPro: How does your team liaison between the doctors and the hygienists?

We all work collaboratively throughout the organization. Sometimes you can have a topic that requires the expertise of another partner in the organization. For example, when we think about journeying through COVID, all partners were critical in making sure that our teams felt supported. We work together to train teams on all the things we need to. If it’s something in the clinical space, rarely does that not translate over into the operations space. We do a lot to support our teams in the areas of communication, case acceptance, conflict management, and other things that help lead patients to say yes.

Despite all the information that exists today I think we’re still finding our way. I’ve been in the profession for over 30 years, and I often say the ship is still turning too slow. We’ve known for some time now that infection in the mouth is not good for the body, and yet we’re still trying to turn that ship and educate the public so they recognize that teeth and oral health are important. We will continue to educate and learn and grow, not only within our organization but, I’m hopeful, within the profession as well.

DSOPro: Does working in an organization like this perhaps foster people in a different way than in smaller practices?

The irony is never lost on me of what we know we do in the DSO space vs what some may think happens. Many within the DSO space are so committed to continuing to educate about our environment and “foster” is such a great word. Think about new providers coming into an organization where they have mentoring opportunities, where they can get advanced training to learn and grow in many areas. There is a collegial, collaborative nature that just inherently exists when you’re part of an organization where we bring people together. That’s just part of the culture.

Culture is so important here at Smile Brands. Our mission statement is “Smiles.For.Everyone.” It seems so simple, but it’s very important because the “everyone” includes the employees, the patients, and the people we partner with. The cultural piece is not only part of what we do but who we are. We want to have an environment where all people feel seen and heard.

In our organization, we have another tenet called “Safe.Smile.Space,” which is lived throughout the organization. It means that we treat people with kindness, and we act in a certain way. We see our colleagues, even if they’re different from us, and we embrace each other with intention to have a great place to come to work every day. I talk about that even before I talk about the opportunity for professional growth and development, which is kind of secondary. Because if you can say, “I feel all those things in my work world,” then I just inherently think, “Well, what else is there? What’s next?” That’s when you can look at the opportunity to grow within an organization as a benefit that can be different in other environments.

With that being said, I would be remiss if I didn’t add that for me personally there’s always a mindfulness of how do we keep clinicians fulfilled in clinical practice as well? Because patients need care. Dental hygienists are highly educated, licensed professionals with many opportunities today, and we need to continue to take care of patients. If there are dental hygienists who have skillsets that allow them to go into another role, that’s good; however, it doesn’t mean it would be the right fit for every hygienist. When we look at the many different professional roles for a dental hygienist, I think there is opportunity for fulfillment in each one of them. They’re just different depending on who you are and what you’re looking for.

DSOPro: You do need to keep providers in those chairs. So, how do you support that, too?

It’s a little bit like when I was teaching and I’d look at my classroom of students and think, “Okay, if I said the same thing to all of them, how did they all hear it differently?” I think that’s a uniqueness in the profession. Depending on where you are in your journey, different things will be important. We try to create an environment where we have those things we know are most important to people.

First and foremost is having a place you want to go to, you feel good about, where you can make a difference with what you do. Because while salary is important, I’m sure many would agree that things like a safe work environment will always rise to the top in priorities. Salary becomes irrelevant if I’m not safe both in protocols and culture. Priorities can be a bit like a game of Jenga, they can be moving around in a career journey. That’s why you have to have an environment where all of the things exist.

We have community. For some people, community is big enough within their practice. For others, community is bigger, and they like to be involved in meetings or learning with colleagues. So, we try different things to keep people connected. There are many different ways to do that, but I think it’s just listening to people and finding out what’s important to them. I always say, “That’s a great idea, thanks for sharing your thoughts and being engaged.” However, if it’s not something we can have happen today, it’s important to communicate that we are growing as an organization, and as things change, as we continue learning and building systems, tomorrow might look different. That’s why I think it’s so important to hear from our teams and colleagues.

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DSOPro: How do you manage practices in 30 states? How do you deal with the differences from office to office, like socioeconomics?

The first thing I would say is if I wasn’t busy, I’d be bored! The good news is when you work on the support team, if our operation partners need help or support, they reach out. There are different ways to provide that support. I could be on a virtual call with a team one day and then conducting in-person training in another environment the next.

Technology helps us in many ways now, whether it’s a phone call with someone, or a live video interaction with a team, or an in-person meeting. Whether you’re in an office in California, Wisconsin, or New Hampshire, whether it’s rural or metro, this is the beauty of having systems. Systems exist internally within our organization, and standards exist in the profession. Dental hygienists in California and Wisconsin are taught with the same educational standards so there is a similar point of reference even when scope and practice vary by state.

When I’m working with a team, I have to ask myself, is this a state where the hygienist can do X? Or what is the supervision requirement for them to do that? It requires recognizing where the systems support the activity, and what the deviations are based on the geography, scope of practice, etc. But how we communicate with patients about the urgency of treatment for periodontal disease and the prevalence of oral disease across the whole United States, that transcends the organization.

DSOPro: What other types of activities does Smile Brands support as a company?

The level of our involvement depends on the initiative or the activity. We sponsor events and exhibit at industry meetings, we’re working in dental and hygiene schools, and recently we proudly partnered with Brown Girl RDH. Since 2011, our Smiles for Everyone Foundation delivered smiles globally in a number of countries. Those are some of the things we do to support the profession, oral health, and our future colleagues. We’re visible in a lot of different places.

DSOPro: What does the future look like?

I think if we’re standing still, that’s not good, because everything around us is moving. I would say that within the DSO space, I think we are also very mindful of what is happening within the industry. How are we responding, adapting, and aligning ourselves to continue to be the place that looks like the future of practice? I’m excited to be part of the DSO space and am feeling very confident that we are a big part of what the future of dental care and access to care for patients looks like.

I think access to care means patients can get to us when they need to, and with ease and equity. Often you can find those things within the DSO space. Maybe because we’re working non-traditional hours, perhaps being open on weekends or having early or evening hours. Being able to deliver care to people when and where they need it is important.

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DSOPro: Any final words?

Dental hygiene has been a great career for me. There is no greater joy than to support others and advance the profession and the organization. It’s a privilege to be in a leadership role like this. I truly believe that. My goal is always to leave the people I have the privilege to work with—my colleagues—with some inspiration that will create motivation for them to do something different and continue to be excited about what they do and the importance of their work.

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About Tammy Filipiak


A dental hygienist with over 30 years of experience within general and specialty practice, as well as educational and management settings, Tammy Filipiak has been in a DSO Clinical Leadership role for the last 20 years and is currently the Vice President of Hygiene Support/Clinical Operations for Smile Brands. She is a strategic partner within the organization to support execution of organizational initiatives in support of 600+ offices.

A member of the American Dental Hygienists' Association (ADHA) since 1986, she served as President in 2017-18 and as the Chair of the ADHA Institute for Oral Health in 2018-2019. She has been recognized for her leadership with numerous awards, including the J&J/ADHA Award for Dental Hygiene Excellence

She has served on a number of corporate advisory boards as a key opinion leader, on the Global Advisory and Advocacy Board for Proctor & Gamble, and on the advisory board for a dental hygiene education program in Wisconsin. She has written/presented numerous articles and continuing education courses throughout her career. In addition to her Associate Degree in Dental Hygiene, she has a Bachelor’s Degree in Business, and a Master’s Degree in Organizational Leadership and Quality.

Smile Brands

We are 7,500 dedicated team members at nearly 700 affiliated dental offices all focused on a single mission of delivering Smiles For Everyone!® Smiles for patients, providers, employees, and community partners. Everyone. Our entire culture is designed to promote WIN-WIN relationships by treating people with respect and pursuing business process excellence that makes it easier to provide great patient care.

At Smile Brands, we believe culture matters. We believe that happier teams lead to happier patients, and we’ve got the happiest team in the dental industry. Our organization has twice been recognized on Glassdoor’s Best Places to Work list. And we are proud to be the second highest ranked healthcare provider in the U.S.

Smile Brands provides comprehensive business support services through exclusive long-term agreements with affiliate dental groups. Our supported dentists spend more time caring for their patients and less time on the administrative, marketing, and the financial aspects of operating a dental practice. We were founded in 1998 by a management team that included co-founder and CEO Steve Bilt and CFO Brad Schmidt. Through acquisitions and the opening of new dental offices, Smile Brands has become a dominant player in the dental space with a rapidly growing number of affiliated practices across 30 states. The primary equity sponsor of Smile Brands is Gryphon Investors, a leading private equity investment firm focused on investing in physician-centric healthcare businesses.

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