2016 Annual State of Dental Hygiene survey: Part II

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 part two of this three-part series, we continue to explore the survey results.

The first and third portions of the survey can be found by clicking here and here. 

Job satisfaction

Job satisfaction in current position

Respondents were asked to rate their satisfaction with attributes of work in their current position.

1=very satisfied, 2=somewhat satisfied, 3=indifferent, 4=somewhat dissatisfied, 5= very dissatisfied

Relationships with patients got the highest rating with almost 70 percent of hygienists very satisfied and 26 percent somewhat satisfied. Following closely behind was relationships with co-workers. Falling right in the middle of satisfaction rate was pay structure. 42 percent responded that they were somewhat satisfied. Not surprising was the category of benefits received falling last in rate of satisfaction.

It boggles my mind that as healthcare providers, many hygienists aren’t offered medical benefits let alone vacation time, sick pay or maternity leave. Many employers claim that means the employee isn’t full-time, they don’t qualify for benefits. However, it is up to the employer to determine what full-time is and further it is completely in their power to offer benefits no matter how many hours an employee works. One reason for this is that the job market is saturated in many areas and hygienists simply need a job to put food on the table, so they take what they can get. But what would happen if we all, collectively, put our foot down and demanded benefits? Certainly something to ponder.

Feelings about being a dental hygienist

Survey participants were asked which statement describes their feelings about being a dental hygienist.

Love it: 50.4%

It’s okay-I have no desire to change fields: 24.9%

It’s okay-I wish I chose a different field: 17.8%

Indifferent: 4.9%

Unhappy/wish I’d chosen a different career: 1.9%

These leads me to wonder why the almost 50 percent of hygienists don’t love being a dental hygienist. Are they not happy with the actual work of hygiene? Have they not found an office that meets their standard of care? Or that they don’t like where dentistry is heading as a whole? Beyond wondering why, we must think about how someone can re-invigorate their career. Changing offices, attending dental hygiene conferences, getting involved with the ADHA to help be a part of advancing the field and change laws, volunteering, or even taking a completely new direction in your career path are all options.

There are many paths a dental hygienist can take; going from private practice to public health, becoming an educator, research, or even working with a dental company. Simply put, if you don’t love what you do, do something about it. Being a dental hygienist doesn’t only mean you must work in private practice. There are many career paths, you just need to be brave enough to take a new path. To hygienists that don’t love what they are doing I encourage you to look for opportunities, if you can’t find any, make your own.  

If you won $10 million in the lottery, what would you do?

Satisfaction with the profession

Would you recommend dental hygiene as a good profession to pursue?

Why or why wouldn’t you recommend dental hygiene as a good profession to pursue?

The most common answer for why current dental hygienists wouldn’t recommend dental hygiene as a good profession to pursue is the saturation in the job market. This not only makes it hard to find a job, it makes it hard to find a good job. The saturation also drives down wages, raises and offered benefits. Many hygienists have noticed shrinking wages with an increased pressure to produce, instead of delivering quality patient care, lends them to not recommending hygiene as a career.

Along the same lines, many commented that the inability to find a job in which the employer pays a decent and fair wage makes it hard for new graduates to pay student loan debt, so for that reason they wouldn’t recommend hygiene. Others noted that the inconsistent hours, wages and benefits would lead them to recommend a career in nursing or as a physician’s assistant instead. Some respondents felt that dental hygiene is a thankless career and hygienists are devalued and underappreciated by both dentists and patients. Further, they feel that organized dentistry is hostile toward hygienists and the advancements of scope of practice of hygienists. The expanding duties of dental assistants in some states, like the ability to scale or perform restorative work with less training than a hygienist, lends some to not recommend hygiene as a career. Others felt that dental hygiene is a limited career path, is too physically demanding, and has the potential for burn-out. Lastly some hygienists would not recommend dental hygiene as a career because hygienists cannot practice independently of doctors and dentistry has become an industry, not healthcare.

The most common answer of why current hygienists would recommend dental hygiene as a career is the family-friendly and flexible work hours. Many respondents commented that the ability to make an impact in the health of patients, working with patients and the relations made, makes the job rewarding. Opposite of why some would not recommend dental hygiene as a career, some hygienists feel they make a decent wage, are financially secure, are well-respected, and there are many career paths a hygienist can take. Some would make the recommendation because there is personal satisfaction in being a licensed professional. Lastly, a few hygienists commented that there is job security because a computer or machine cannot replace a dental hygienist.

Some hygienists had mixed emotions about recommending dental hygiene as a career. Many responses stated that years ago they would have recommended it, but not now. Along the same lines, some said that hygiene is a great career but not a lot of opportunity, especially for new graduates. Some said that if someone has a personal plan for retirement and health benefits, then yes, they would recommend it. Many said that if you could know for sure that you can get into a great office where patient care is the priority, hygiene is great. However, if you get into an office that is corporately run or the business model is solely based on production, then no. Many stated that dental hygiene simply isn’t for everyone; if you are just looking for a job, it’s not for you – you need to have a passion for dentistry. Some hygienists said that if your body can hold up, they’d recommend it. Lastly, many respondents were indifferent. They said they would give both the pros and cons to a potential hygiene student and let them weigh them for themselves.  

What do you think will be the biggest problem for the next generation of dental hygienists?

Respondents were asked to check all answer options that apply

The most commented “Other” response on the biggest problem for the next generation of dental hygienists was the lack of benefits. The expanded duties of dental assistants (scaling assistants) came in a close second. Hygienists also saw dental insurance dictating treatment as a big problem. Many mentioned decreasing pay for dental hygienists as an issue for the next generation of hygienists. There were several comments about decreased appointment times with a greater expectation to produce and tasks to complete; the ethics of dentists: over-treating to make money, corruption, production-driven and having to “selling dentistry” as a problem that is growing. The prevalence of dental consultants pushing the practice of being production-driven was mentioned as a problem for future clinicians. Lack of respect from dentists and co-workers even though dental hygienists are licensed, educated professionals was something mentioned a lot. Employers/dentists not abiding by labor laws was a worsening problem that respondents noted. A small few were critical that corporate dentistry was an option in the survey, as some don’t see it as a negative or an issue in dentistry whatsoever.

Are you happy with where the dental hygiene field and dentistry as a whole is heading?

Feelings about the current office you work for

Respondents were asked to choose a statement that best describes their feelings at their current office.

Some of the “Other” responses included: work at two offices – one I love and one I hate; happy but need benefits so I will leave if I find an office that offers benefits; I temp – some really good offices and some really bad offices; I am not happy with the stress level but don’t know if I’ll find another office any better than the one I’m currently at; I’m concerned that my potential is not being fulfilled at this office due to the mindset of my employer; I teach and I love it; unhappy – counting down the days until retirement; I love my patients and co-workers but the boss’s wife has made things miserable; love the patients hate the office drama; love the people I work with but haven’t had a raise in 11 years; love the dentist but my co-workers are not team players; most of my co-workers are great but my boss is a narcissist; and the stress is horrible – the new boss and new office manager make it impossible to do a good job. Many “other” responses were to the effect of: I am miserable and looking for a new career; unhappy so looking for a non-clinical position; unhappy so going back to school; and unemployed.

Only one fifth of respondents are very happy at their current office and about 50 percent mostly happy. While those two responses make up about 70 percent, it saddens me that the other 30 percent are indifferent, unhappy and even miserable. Every office has its quirks no matter what profession it is, there’s no escaping that. Like mentioned before due to the saturation of hygienists it isn’t always that easy to switch offices, but it’s still bothersome that some hygienists not only choose to stay where they are but choose to not even look for other options. If you have higher standards for an office than where you are at, please for the sake of yourself and the patients you treat, continue to look for a new office! I promise great offices are out there, it just may take some effort to find them!

Most rewarding thing about your current job

Hygienists were asked what the most rewarding thing about their job is. By far the most common answers were helping patients, seeing improvements in patients’ health, the relationship with patients, working with patients, educating patients and seeing patients have ah-ha moments, patient satisfaction and appreciation. Speaking of appreciation, employer appreciation and respect was mentioned quite often too. Other responses about the most rewarding part of hygienists’ current job were: flexibility of hours, working in a team environment with great co-workers, helping patients overcome their fear of dental treatment, trust earned by patients, making a difference in patients’ lives and health, and earning a salary doing what I love.

Biggest frustration in your current job

On the flip-side, hygienists were asked what their biggest frustration in their current job is. There were common themes in the answers given, from the doctor/employer to the office manager to co-workers being the most mentioned.

Frustrations stemming from hygienists’ doctor/employer included: not being provided with the supplies and equipment needed to give the best patient care; doctors with poor time management skills, poor business sense, control issues, lack of communication, and micromanaging; working with a doctor who over-treats, has poor chair-side manners, and whose quality of work is lacking. Many felt their doctor does not appreciate and/or respect them, or the work they do, and won’t back up periodontal treatment recommendations. Sadly, many hygienists felt their doctor cares more about money than patient care. Others wrote that their doctor keeps expecting more and more from them, however they aren’t given adequate time or help to accomplish these requests. Many felt they weren’t given enough time with patients in general due to the doctor’s greed; many respondents said they had 30-45 minutes with a patient with no help.

Yet another frustration came from doctors breaking labor laws and forcing hygienists to clock out if a patient cancels or no-shows. Many feel production goals from the doctor are unrealistic and cause frustration and stress because instead of practicing dentistry they feel they are “selling dentistry.” A very common theme was hygienists who are underpaid, given no benefits (insurance, sick time, vacation time), and haven’t had a raise in several years, if ever. Some hygienists were promised a certain amount of hours and these promises were broken.

Frustration of hygienists stems from the office manager and front desk too. Office managers trying to dictate treatment and micromanaging (without dental education); not scheduling effectively and over-booking the hygienist; and expecting hygiene to see significantly late patients while still wanting all treatment completed in one visit while staying on time. A big frustration for hygienists is when the office manager is the doctor’s wife; for some this isn’t a good office dynamic.

Co-workers were next on the list of frustrations. Responses included: one co-worker that changes the whole dynamic of the office and not for the better; lazy co-workers; co-workers with no accountability; co-workers not working as a team or willing to help others in the office.

Another common theme that led to frustration for respondents of the survey were patients. Patients who think they are lying about periodontal disease and the need for periodontal treatment just to “make money;” challenging patients who are difficult to please; and patients that are rude no matter how much you kill them with kindness. Non-compliant patients and patients who won’t value or take responsibility for their own health was a frustration for many. Patients who constantly show up late and don’t respect appointment times round off frustrations from patients.

Other common themes that cause frustration for hygienists is body pain; whether it be hand, shoulder, neck, back or hip. Insurance is a big frustration: insurance dictating treatment and dealing with insurance in general. Frustration comes from consultants who have come in and changed the office dynamic to be only concerned with production and money. And lastly, corporate dentistry; with people with no dental experience or training calling the shots.

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

Click here and here to see parts one and three, which detail responses on demographics, salary and job satisfaction.