Having a great career in dental hygiene means advocating for yourself and knowing what the best fit for your skillset is.
As we enter the new year, I’m troubled by what I read online about dental hygienists leaving their careers and choosing other paths. Even when it means returning to college, I read about dental hygienists who are so frustrated with their jobs that they dream of throwing their curettes up in the air and bolting out the office door, never to return!
One of my close friends was so exasperated with her clinical position that she would find herself going next door to the bar for a margarita almost every night after work. She was frustrated because she was working in an assembly line dental practice which meant she had no time to herself and could not treat her patients in an ethical manner. Somehow, management ended up giving her 2 columns of patients to treat instead of 1 and she found herself shortchanging her patients.
The COVID-19 pandemic has allowed many dental hygiene clinicians to re-examine their careers. Since some hygienists have left dental hygiene or have chosen to stay home instead, clinical dental hygiene positions have become plentiful. This allows many practicing hygienists to leave positions they aren’t satisfied with, and with more jobs to choose from, hygienists can carve out a position that meets their professional and personal needs.
Dental hygienists are in a unique position in a profession unlike any other. When the profession was born in the early 1900s, hygienists were trained as “women assistants.”1 Graduates of the Connecticut dental hygiene program at the time worked in public schools. When I graduated from Fones School of Dental Hygiene in the 1970s with an Associates in Applied Science degree in Dental Hygiene, I entered clinical dental hygiene full-time in New Jersey. My first clinical position was a nightmare because my dentist-employer was very controlling, and my daily schedule was almost empty. I would mope around the office and decided I deserved better so I began interviewing at different practices. I ended up working in a delightful general dental practice located in Closter, NJ. I was only 20 years old at the time and I loved my job and the entire dental team. Believe it or not, I worked with an ultrasonic back then and even though it was a clunky, old Cavitron box with 1 insert, I used it on almost every patient and never had a single patient complain. I was scheduled to see adult patients every 45 minutes, but the day was very relaxed. I had minimal assistance, but clinical dental hygiene was easier and mostly consisted of scaling and rubber cup polishing. We took radiographs and developed films in a film processor with rollers and occasionally, all the films on the rollers would get stuck! I once took an 18-film series of radiographs on an elderly gentleman and every single film was ruined in that processor. At the tender age of 20, I had to look him in the eye and explain that I needed to re-take all of his films.
Back in the 1970s and in recent years, dental support organizations (DSOs) evolved but when I started practicing dental hygiene, dentistry was a cottage industry. I was paid well, and it was a daily, not hourly wage with a few benefits like vacation and sick pay. Dentistry wasn’t making money from the hygiene department but from crown and bridge which was all the rage at the time. Jobs were plentiful and I was happy as a lark in my employment.
So much has changed in dental practices today and in those states where hygienists are still ‘supervised’, there was period of time where many dental hygienists were not appreciated and valued for their contribution. Instead, dental hygienists were treated as a means to a monetary end, and I blame, in part, a practice management trend that created this conundrum. The introduction in practice management of dental hygiene as a profit center began 20-30 years ago when it was recognized that additional sources of profit from the hygiene operatory could be “passive income” with minimal additional chairside time.2
It was thought that hygienists could become salespeople in addition to oral health-care professionals. Soft tissue management programs sprang up in the 1980s as periodontal diseases were increasingly receiving non-surgical treatment. Hygienists enjoyed providing non-surgical periodontal therapy and periodontal maintenance procedures including the administration of local anesthesia in most of the United States. The dental hygiene department of a general dental practice that was once described in the past as a “loss leader” was replaced in the early 2000s as a potential profit center. Non-surgical periodontal therapy procedures and adjunctive sustained release local antimicrobials, professional oral irrigation, and diode laser therapy were added to scaling and root planing (SRP) regiments to further increase productivity in the dental hygiene department.
Burnout in dental hygiene does not seem to be related to additional job duties or salary requirements. Instead, it festers when hygienists feel stressed, unappreciated, and when working a haphazard schedule with inadequate assistance. About 8 percent of dental hygienists left the workforce since the onset of the COVID-19 pandemic.
How to Have a Great Career in Clinical Dental Hygiene
If you are a “supervised” dental hygienist working as an employee in a dental practice, these career nuggets are for you. These nuggets come from a seasoned clinician (me) who sometimes learned the hard way. I failed miserably in some clinical positions but I’ve learned some valuable lessons over the last 4 decades.