Dental Hygienists Want to be Treated With Respect

March 23, 2021
Lynne H. Slim, RDH, MS

Taking a look at the reasons why dental hygienists are feeling the pressures of job without any of the recognition.

Rodney Dangerfield, a bug-eyed comedian who passed about 15 years ago, used a lot of self-deprecating humor about a “lack of respect.” Known as the prince of one-liners, his theme of not getting respect was the centerpiece of his standup routines.

A lack of respect for dental hygienists can affect quality of care. Not feeling valued by employers (not necessarily patients) is a common theme that’s being repeated over and over online by hygienists who are venting in support groups. When dentist-employers don’t treat hygienists with the same respect as themselves, morale suffers and hygienists perform poorly. In addition it stifles teamwork and undermines individual performance1. In fact, the old definition of “teamwork” that has been a mantra for success in dentistry over the last few decades, no longer works as well as it once did. The importance of teamwork and the influence of a team in the success of any organization is well-known, but it requires a full commitment on the part of all players. For whatever reason the dental hygienist is being left out of the success formula. I think there are many reasons for this.

It’s About Respect

I am a dental hygienist and I’m proud to be one. When I first began my career during the pre-Jurassic period (1970s when people had real teeth), I always held my head high and found that my dentist-employers wanted me to succeed. Back then, the cottage industry with its independent dentist-practitioners in small private practices, hired one dental hygienist to serve the patients’ preventive needs. In today’s world of large group practices and DSOs, multiple hygienists work in a hygiene department to increase patient care and production by adding hygiene-related services. 

As Roger Levin and many other practice management consultants continue to say, “Besides the Doctor, the hygiene department is the largest production center in the practice.”2 With this in mind and considering a hygienist’s status as a healthcare provider in a dental practice, I would think that every effort would be made to keep the hygienist happily employed. The most common job complaints I hear online by hygienists are:

  • lack of benefits
  • lack of assistance by a dental assistant
  • unreasonable patient schedule without adequate time to complete procedures
  • delegation of front office procedures to hygienist
  • outdated equipment
  • not feeling valued
  • no pay increases or advancement opportunities

Coronavirus disease 2019 (COVID-19) has changed dentistry in many unexpected ways. Dental practice recovery will probably continue for years to come. Strategies will continue to help get to a higher volume of patients; however, maximizing hourly production, especially in dental hygiene, has its drawbacks if the dental hygienist is expected to produce more without help and if the above job complaints aren’t taken into consideration. Relationships between providers and patients matter and a high turnover of dental hygienists is unwise if you want to get back to some degree of normalcy. 

I review and learn from nursing research frequently. Recently, I studied several research reports on the challenge of respect as it relates to a healthy nursing environment and want to share some of what I’ve learned.

A positive workplace environment increases the level of overall job satisfaction along with staff maintenance and retention. If your office manager isn’t keeping your dental hygienists happy, that person needs to be reminded, retrained or replaced.3 Lack of respect influences the quality of a nurse’s working life which also influences the tendency to quit an organization.3 Without respect, nurses would not consider their career to be ideal.

Obstacles to Overcome

If dental practice owners want a large pool of hygienists to select from, treating hygienists with respect will enhance their reputation as a good practice to be employed at. Here are some of the obstacles to overcome if you want your hygiene department to soar: (and I make the assumption that nurses and hygienists want to be treated the same way because some of the studies were done using nurses as subjects.)

  1. Stop ignoring our opinions. In making dental practice decisions, involve us and get our feedback. Don’t try to address problems in our department without consulting with us. 
  2. Give us regular feedback. Feedback shouldn’t just be negative. Instead, make sure you acknowledge us for our positive contributions including what the patients are saying in reviews online.
  3. Pay close attention to our problems and needs. Show that you care about our problems. For example, if we do not have the time to schedule the patient’s next appointment from our operatories, delegate it to the front desk. If an assistant is assigned to us and chooses not to assist us, make sure that particular problem is resolved to our satisfaction so we can deliver best care.
  4. Help us maintain a strong public image. Don’t lump us together with auxiliaries whose roles are much different from ours. On the provider signage, include our names as providers, too. Help patients and members of the community understand that dental hygienists are college educated and licensed healthcare providers who have their own area of dental expertise. 
  5. Encourage managerial support. Office managers play a crucial role in creating a respectful work environment. Without the support of office management, a respectful work environment is hindered.
  6. Give more overall support when you can. Dental hygienists are frequently anxious about increased workload, lack of merit pay or bonuses, performance evaluation and an overall lack of moral support when patients criticize them for no reason.
  7. Improve organizational climate. In large group practices, hygienists are frequently concerned about ineffective communication, lack of collaboration, work pressure and overall tension among team members. Mark Hartley, former Editor of RDH magazine, regularly surveyed job satisfaction of dental hygienists in private dental practices. In 2015, he mentioned that more than half of dental hygienists felt stressed by their jobs on a daily or weekly basis and 67% believed a supervisor or their workload was the cause of that stress.4
  8. Foster more trust. COVID-19, and the increase in remote work, has contributed to a work atmosphere with less trust which makes employees feel more disconnected.5 Managers and practice owners who show dental hygienists more support and appreciation can foster more trust and job satisfaction. 

Dental hygienists are often referred to erroneously as “Prima Donnas”, probably because traditionally most dental hygienists were female and perhaps because they made a salary similar to an RN. I’ve never been called a Prima Donna (to my face), but nothing could be further from the truth for most of the hygienists I have known. Most dental hygienists want to spend their time as providers, and we are happiest when delivering patient care to the best of our ability. Everyone in the dental practice should be honored and respected consistently.

References

1. Setting the Stage: Why Health Care Needs a Culture of Respect. Harvard Medical School. August 31, 2018. Accessed March 2021. https://postgraduateeducation.hms.harvard.edu/trends-medicine/setting-stage-why-health-care-needs-culture-respect
2. High-Profit Hygiene. Dental Economics. April 1, 2005. Accessed March 2021. https://www.dentaleconomics.com/practice/overhead-and-profitability/article/16394969/highprofit-hygiene
3. Challenges of Respect as Promoting Healthy Work Environment in Nursing: A Qualitative Study. National Center for Biotechnology Information. December 31, 2019. Accessed March 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6967129/
4. Career Satisfaction Survey: Coping With Stress. Dentistry IQ. April 8, 2015. Accessed March 2021. https://www.dentistryiq.com/dental-hygiene/salaries/article/16350568/career-satisfaction-survey-coping-with-stress
5. Why Remote Work Has Eroded Trust Among Colleagues. BBC. March 18, 2021. Accessed March 2021. https://www.bbc.com/worklife/article/20210315-why-remote-work-has-eroded-trust-among-colleagues