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The Reality of Dental Hygiene

Dental hygienists (RDH) are more than glorified "teeth cleaners”. This article aims to examine how dental hygienists are an invaluable member of the healthcare team.

One of the most popular questions to ask when you meet someone new is, “What do you do?” It is asked on first dates, in initial meetings, and as a conversation starter because it is supposedly a good way to get to know someone. As a species, humans often subscribe to the attachment theory regarding the meanings they associate with an individual profession. This theory explains that certain values and meanings are linked to different professions within society and intends to clarify the reasons people attach their perceptions of certain fields of work. Tell someone you are a doctor, and you get one response; tell someone you are a mechanic, and you get another. Yet, these responses, and the judgments they often accompany, are based on arbitrary and often untrue assumptions about the different professions. One often-misunderstood profession is that of the dental hygienist.


Some people perceive a dental hygienist simply as a glorified “teeth cleaner” who gets paid a decent salary for doing some “hands-on” work. The error in this misconception is that it over-simplifies the profound importance of the multiple roles of the dental hygienist. It assumes that the job is easy, lacks the requirement of skills, and does not require a comprehensive formal education. That is grossly untrue and an insult to the people who have studied and worked for years to become dental hygienists.


Beyond this oversimplification, lies the idea that dental hygienists are not a true part of the medical field. Again, this is simply false. The education, work lives, and daily stressors tied to the profession of dental hygiene have exceeded what is considered base level for a seated place in the healthcare profession.



The Education



One of the roots of the misunderstanding of the profession of dental hygiene is the level of education and training required to be a dental hygienist. Although most dental hygienists graduate with an associate’s degree, education does not mirror the curriculum of most associate degree programs 1B. Dental hygienists are required to take several college prerequisite classes, often prior to program entry, to a two or three-year dental hygiene program. Classes include topics such as pharmacology, anatomy and physiology, biology, microbiology, chemistry, medical terminology, along with english/writing, math, and public speaking, humanities, philosophy and psychology. As a result, many dental hygienists’ programs are equivalent to completing four or even five years of college.


After finishing these school requirements, a dental hygienist must then take an eight-hour written board exam, a five to six hour clinical board (varying upon geographic location), a clinical anaesthesia board, a written anaesthesia board, and a state exam for jurisprudence and ethics. Following the initial years of education and assessment, their education continues, as all healthcare jobs require constant, on-the-job learning and continuing education credits between licensure periods.



The Work



Experienced dental hygienist, Anastasia Turchetta, said that she does “a lot more than cleaning”. With over 28 years in the profession, she stated that “cleaning” does nothing to describe all that she does daily. For her, the job is less about cleaning and more about wellness, about health. Within a single appointment, dental hygienists are responsible for reviewing health histories, taking blood pressure and blood sugar readings, taking periodontal measurements, exposing x-rays, performing cancer screenings, managing harmful biofilm, developing a thorough dental hygiene diagnosis, assisting with the dental exam, answering patient questions, writing chart notes, and disinfecting rooms between patients, all on a tight time schedule.


One of the most important tasks a dental hygienist takes on is educating a patient to understand oral disease, their level of accountability, and how their habits affect this. Changing patient behaviors is both fun and exhausting, often leaving us to feel like the bad guys when we are teaching patients about their at-home care and lifestyle choices


Taking care of a patient's mouth is vital, as oral health is an important indicator of overall health. Having a healthy mouth is the first step to having a healthy body. This is because many bodily diseases are connected to mouth bacteria, and inflammation.2 Dental hygienists play a crucial role in general health, and are just as important as any other healthcare professional. Yet, why are they not treated as such?



The Stress



Similar to other health professions, dental hygiene practice is accompanied by a fair amount of stress. Many clinicians have a natural desire to comfort, nurture, and counsel their patients, but there is also pressure to stay within stringent time limits. This tension often results in mental stress because clinicians find it difficult to complete everything that is treatment planned during a preventive care visit. This, coupled with poor scheduling management and contentious relationships in the dental office setting, layer on additional stress. These factors are often attributed to a lack of or decreased quality of human relations personnel and business leadership within the various sizes of dental practice settings.


In addition to the mental stress of being a caretaker and employee, there are many physical demands placed on dental hygienists. Dental work requires very precise, yet static movements, and, in combination with the position at which they sit or stand to see into a patient's mouth, dental providers often suffer from back problems, shoulder pain and carpal tunnel syndrome deficiencies. 2


Dental hygienists are medical professionals, we are deserving of respect and appreciation, and the reality is that without these health care providers, the problems would be far greater than lacking someone to “clean the teeth”. The roles of the dental hygienist encompass all aspects of oral health, are integral to a patient’s total health, and the dental hygienist is also the individual who is in charge of a dental clinic’s risk management and asepsis standards.


Perhaps, if more people understand what dental hygiene, as a profession, is really about, then more people would make a knowledgeable decision to enter the profession. Articles that discuss the “ease” of obtaining a dental hygiene degree, describe that dental hygienists can leave the stress at work rather than being on call, and describe “the limited amount of education” to become a dental hygienist, have got to stop Educators and clinical practitioners report that students are entering this profession, then becoming frustrated or burned out because they had no idea what it actually took to obtain a dental hygiene license. Other professions see the dental hygienists lumped in with other career technical categories that are not in the realm of health care providers, and our jobs are mitigated. It is time dental hygienists stand up for our profession and start to shine a light on who we are and what we do for oral health all over the world!


Recently, the Standard Occupational Classification (SOC) for dental hygienists changed. The 2010 definition stated dental hygienists “Clean teeth and examine oral areas, head, and neck for signs of oral disease. May educate patients on oral hygiene, take and develop x rays, or apply fluoride or sealants” . The updated 2018 definition for dental hygiene occupational classification reads, “Administer oral hygiene care to patients. Assess patient oral hygiene problems or needs and maintain medical records. Advise patients on oral health maintenance and disease prevention. May provide advanced care such as providing fluoride treatment or administering topical anesthesia” .


The importance of this document, and subsequent change in language, lies in the fact that the national government is now acknowledging dental hygienists as providers of preventive dental treatment. The future is bright and now is the time to inform the public and spread the word regarding the benefits we can give to those who desire to receive them.


8 "Adha Annual Conference Research Posters - Journal of ...." http://jdh.adha.org/content/jdenthyg/91/2/62.full.pdf. Accessed 12 Feb. 2020.

9 "Standard Occupational Classification (SOC) - Bureau of Labor ...." https://www.bls.gov/soc/. Accessed 12 Feb. 2020.

10 "2018 Standard Occupational Classification System - Bureau of ...." https://www.bls.gov/soc/2018/major_groups.htm. Accessed 12 Feb. 2020.

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