2016 Annual State of Dental Hygiene survey: Part I

With any profession, there are awesome aspects to the job but also downfalls and points of concern. So what are hygienists thinking about the dental hygiene profession?

To find out and as a way to evaluate the state of the dental hygiene profession, Modern Hygienist conducted its first Annual State of Dental Hygiene survey.

This non-scientific, anonymous survey covered topics from the basics of hours worked per week and pay structure to factors that contribute to on-the-job stress, burn out and how often hygienists are allowed to replace their instruments. In this three-part series, we explore the survey results.

You can read the second and third parts of the survey results by clicking here and here.

Demographics of the respondents

The demographics of the 3,279 respondents broke down into these groups:

Gender

Female: 99.7%

Male: 0.3%

Age

35 or under: 42.2%

36-51: 38%

52-70: 19.5%

71+: 0.3%

Marital status

Married: 69.6%

Single: 15.2%

Divorced: 7.7%

Living with partner/significant other: 6.8%

Widowed: 0.6%

Education level

Associate’s degree: 64.3%

Bachelor’s degree: 27.3%

Master’s degree: 1.7%

Doctoral degree: 0.2%

6.5 percent responded that they hold a degree outside of dental hygiene. Some of those degrees include: nursing, accounting, architecture, animal science, psychology, business, geography, economics, anthropology, nutrition, biology, sociology, early childhood education, chemistry, physical therapy, social work, fine arts, civil engineering, elementary education, health management, marketing, foreign trained dentist or two Associate degrees (general studies and dental hygiene). A few answered this question that they are preceptorship-trained hygienists with a certificate in Alabama.

Years practicing dental hygiene

0-5 years: 34.2%

6-10 years: 18.1%

11-15 years: 13.2%

16-20 years: 9.8%

21 or more years: 24.6%

Primary position

Practicing dental hygienist: 84.6%

Hold license but not currently practice: 1.8%

Public health: 1.2%

Educator or faculty member: 1.1%

Unemployed:  1%

Dental company/government/consulting: >1% each

Other: 2.4%

Some of the “Other” responses included: both practicing hygienist and educator, combination of practicing hygienist and assistant or office manager, work in nursing homes (expanded practice),  dental practice or mobile dental practice owner, or has a dental hygiene license but are working as a nurse.

Job status

Permanent employee: 94.8%

Temp: 4.2%

On leave, planning to return: 1%  

Schedule and wages

Type of position

Full-time: 61.9%

Part-time: 35%

Other: 3.1%

Some of the “Other responses” included: working at two to four different offices part time that together equal full time; working one day as a hygienist and three to four days in the front office; or working two days as a hygienist and two days as a dental assistant.

How many hours hygienists work per week

Less that 10 hours/week: 4.4%

10-20 hours/week: 11.1%

20-30 hours/week: 40.5%

30-40 hours/week: 26.9%

More than 40 hours: 17.1%

Hygienists were then asked if they were content with the number of hours worked. 17.8 percent stated ideally, they would like to work fewer hours. 54.1 percent responded that they are working just about the number of hours they want to. 28.1 percent stated that ideally, they would like to work more hours.

Pay structure

Hourly wage: 81%

Salary: 12.7%

Other: 6.2%

“Other” pay structures stated include: straight commission ranging from 30 to 50 percent; $15/hour +18% commission; $25/hour + 15% commission; flat rate of $250/day; daily rate + 10-30% commission; bonus programs; daily rate + 30% after goal is met; hourly but if a patient no shows or cancels pay drops to $12/hour; and salary + bonus.

I was saddened to see that some hygienists stated they were paid on commission based on collections instead of on production. It is my belief and an industry standard that commission is based on production. Hygienists do the work and have no control over what is collected or office contracts with insurance companies. Another “other” response that I felt bad to see was hygienists being paid as an independent contractor with a 1099. If your state requires you to work under any sort of supervision of a dentist, you are not an independent contractor. Temp or permanent, hygienists are an employee if under supervision. Both of these situations are taking advantage of these dental hygienists.

Hourly wage

Wages vary state to state and even county to county due to the cost of living. This must be taken into account when reading results on hourly wage range. Here’s what hygienists stated their wage is:

Under $20/hour: 1.5%

$20-$25/hour: 6.4%

$26-$30/hour: 20.6%

$31-$35/hour: 29.9%

$36-$40/hour: 23.1%

$41-$45/hour: 12.2%

$46-$50/hour: 4.6%

Over $50/hour: 1.7%

On a side note, to find out appropriate wage ranges for your state and county, the best place to look is your state’s employment department occupational wage range breakdown. Salary.com and other “salary surveys” aren’t always exactly accurate and are too averaged or generalized. It’s always best to go to the appropriate source for this information.

Annual gross income for 2015

Respondents were asked what their annual gross income was for 2015. Again, we must take into account geographical location and hours worked when reading these results.

Less than $25,000: 5.5%

$25,001-$30,000: 3.7%

$30,001-$35,000: 4.5%

$35,001-$40,000: 8.7%

$40,001-$50,000: 17.3

Over $50,000: 56.1%

Don’t know: 4.2%

Motivation

Why did you choose dental hygiene as your career (Hygienists were asked to check all that apply.)

Income potential: 77.9%

Desire to work with and care for patients: 77%

Desire to help people: 72.6%

Potential for flexible hours: 70.5%

Well-respected occupation: 38.8%

Love the concept of preventive health: 33.9%

Influence by a friend or relative in dentistry: 33.1%

Always wanted to be a dental hygienist: 26.3%

Love working with my hands: 26.3%

Fall-back position (Example: I really wanted to be a nurse): 6.3%

Not applicable: .4%

Other: 5%

There were myriad “other” responses. Some of these included: better working hours than a nurse; started in dentistry as an assistant first; hygiene was an in-demand field when I went to school; easier than manual labor; enjoy meeting new people; fascinated with biology/microbiology and the science behind preventive health; flexibility to have a family; had a great dentist growing up so interest in dental hygiene started in childhood; positive dental childhood experiences; love teeth; love cleaning things; no working holidays or weekends; office hours not hospital hours; wanted to be a dentist and worked with an unethical RDH as an assistant; and wanted patients to have better care so I went back to school to do achieve it.

What was the primary reason for choosing dental hygiene as a career?

Desire to work with and care for patients: 23.1%

Income potential: 18.2%

Desire to help people: 13.6%

Potential for flexible hours: 13.2%

Always wanted to be a dental hygienist: 13%

Influence by a friend or relative in dentistry: 6.9%

Love the concept of preventive health: 3.4%

Well-respected occupation: 2.2%

Love working with my hands: 2%

Fall-back position (Example I really wanted to be a nurse): 1.7%

Not applicable: .3%

Other: 2.2%

The “other” responses were many as the same as the previous question. Some different answers included: closest thing to becoming a dentist; life got in the way of becoming a dentist; length of school to income potential ratio is excellent; able to be financially independent; allowed me to be a parent with flexible hours; and I saw dental discomfort family members had gone through so I wanted to prevent it in other people. The most moving reason for becoming a dental hygienist was: “My grandfather died of oral cancer-if I could prevent just one more person from going through it, it would be worth it.”

On the job

How often are you able to replace your instruments?

Not being able to replace instruments as needed is a huge problem. It’s not only an issue in regards to providing excellent patient care; but working with dull, worn-out instruments can take a toll on your body and the longevity of your career. A dentist/employer that won’t provide the instruments the hygienists needs is not only doing a disservice to the patients but they are literally shortening your career. You end up working harder, not smarter, which is inefficient and time is money in dentistry. Many factors go into to play regarding when instruments need to be replaced, such as the number of set-ups, how many hygienists are using them, quality of the instruments, difficulty and amount of patients seen, etc. Instruments simply don’t last forever. The average stainless steel instrument can last anywhere from six to 18 months. If the doctor needed a new carver or bur, I’m sure they would order it – it’s a business expense and they need it. The same goes for hygiene instruments. Further, hygienists should bring in on average one third of the office’s total revenue. Not to mention that an estimated 50-80 percent of the doctor’s treatment (restorative) is generated through hygiene exams. Hygienists must be allowed to do their job properly with the proper instruments and equipment because they do produce for the office and add to the bottom line.

Re-tipping is dangerous for both the clinician and the patient. Tips are forcefully removed from handles which lends itself to micro-fractures, this is an infection control nightmare. Re-tipping also unbalances an instrument and the angulation of the blade is not the same as the original instrument. Unbalanced and changed angulation is hard on the clinician ergonomically. Often time’s re-tipped instruments are not of the same quality as the original instrument and can break in a patient’s mouth. I cannot count the amount of times I have received frantic messages from hygienists who just had a re-tipped instrument or instrument that is being used past its prime break in a patient’s mouth. How do you even explain that to a patient?! Well, my doctor was trying to save a buck, so we use subpar instruments, that’s why you just swallowed, or even worse - aspirated, an instrument tip. I doubt that would go over well. I also don’t think any patient would appreciate knowing they are being treated with sub-par instruments as re-tipped instruments must be clearly marked that they are re-tipped. Hygiene instruments are medical devices and shouldn’t be forcefully taken apart and put back together, period.

It saddens and angers me to no end that only 44 percent of hygienists who responded to this question are allowed to replace their instruments as needed. And further, a whopping 25.7 percent are only allowed to replace every couple years. The “never allowed to replace” option should be zero percent, not 8.3 percent! And of course, re-tipping should be zero percent too.

Does your dentist back-up your treatment recommendations?

How much time are you allowed for an adult prophy?

“Other” responses included: Not pedo: 10 minutes, 15 minutes, 20 minutes; some with assistants, some without. Swinging the other way, other responses stated they are given as much time as they need based on patient need.

If you have worked under an assisted hygiene model, did you like it?

This article is just the first in a three-part series outlining all of the hygienists' responses.

Click here and here to see parts two and three, which detail feelings on job satisfaction and stress and burnout.