In my previous article I delineated many advantages or benefits of becoming a dental hygienist. But in order to really make a good and wise decision the other side of the coin must be considered. What are some of the disadvantages or challenges associated with the dental hygiene profession?
Some of the disadvantages, or challenges, of being a dental hygienist are the high propensity toward musculoskeletal disorders, exposure to blood, saliva and other bodily fluids and odors, difficulty in transferring professional license to another state, a lack of employer benefits, fast-paced work schedule, pressure to sell dental services, length and cost of schooling, difficult patients, occasional monotony, and uncomfortable ethical dilemmas.
Some of the items in the list may be deal-breakers for you and that’s OK. But if you are not completely dissuaded by these disadvantages I can offer some solutions to overcome the challenges and make a success out of your career choice.
1. Musculoskeletal disorders
What are musculoskeletal disorders (MSDs)? MSDs are the wear and tear of the muscles, joints, tendons, nerves, and even blood vessels due to repetitive, cumulative trauma over a period of time. They manifest as pain and/or numbness in hands, arms, feet or legs.
A dental hygienists job in clinical work consists of repetitive motions of the hands and arms. For example when activating the scaling instrument across teeth or moving the polisher handpiece from tooth to tooth. Poor ergonomics are also a major contributor to MSDs.
A study of dental hygienists revealed that 93% of respondents reported having some kind of MSD pain within the preceding 12 months and a majority indicated the presence of pain within the wrist or hands, neck, and upper back (Nye, Partido, DeWitt, Kearney, 2021)
I myself was affected by MSDs early on in my dental hygiene career. I would wake up with numbness in my fingers and my shoulder mobility was reduced. And I was only 23 at the time! I knew then I had to do something to reverse the condition before it became permanent.
Solution: Have a self-care routine! This includes regular exercise, stretches between patients, proper ergonomics and adequate rest. With a good foundation you can practice dental hygiene pain-free for a long time.
2. Bodily fluids or bad odors
Saliva, blood, pus, left over food bits, and sometimes even rotting food residue can be found in the human oral cavity. Not to mention “perio breath” which is the unique aroma of a person infected with gum disease. It can get so bad that their very presence fills the room with the smell. *shudders from a memory*
There is also the real risk of contracting a disease from the patients you treat; hepatitis B,C, HIV and other blood-borne illnesses. In fact, any person you treat may have a disease that they are not yet aware of! The most common transmissions are through sharps injuries or needle stick injuries, which occur accidentally.
Solution: Follow standard safety precautions with all patients, that is, treat all patients as if they were infected with something. Also, keep your scaling hand tools sharp. You are more likely to prick yourself with a dull tool than a sharp one. And use single-hand recapping techniques with needles. *Tip: smear a little scented lotion inside your face mask to help with body and mouth odors.
3. License transfer difficulties
The United States of America are not so united when it comes to transferring your dental hygiene license from one state to another. Unfortunately, you will have to go through the application process every time you move to a new state.
Some states easily allow you to acquire your license simply by proving you have a license in another state. Others will want you to submit additional proof of the number of hours you have practiced as a dental hygienist. Still others will want you to re-take a hands-on clinical test to prove you can take tartar off teeth.
I recently went through the process of acquiring my license in California. I had to take a two month California-approved course on local anesthesia, nitrous oxide, and soft-tissue curettage before I could apply for my license. This course can only be taken in California which meant me traveling to complete the course.
The variety in licensing requirements could stem from the fact that different states allow (or don’t allow) dental hygienists to do different duties in a dental office.
Solution: There is no immediate solution to this challenge because it is legislative. To solve this challenge laws would have to be changed.
4. Employer benefits can be hard to come by
Employer benefits can be hard to come by as a dental hygienist because finding a dental office that works 40 hours per week can be hard to come by. Although, it is nice to not have to work a full work week, for some people, benefits are a must. This is not to say that you cannot find a dental office that offers benefits for their part-time workers but it may not be easy.
Solution: If benefits are very important for you, you may have to search for that office. Or, you may be able to create that opportunity by asking the office to get you a benefits package on your interview.
5. Fast-paced schedule
When you compare everything you are taught in school to the time frame you are offered in a traditional dental practice it will blow your mind. The time available to the dental hygienist in a busy dental office is very reduced.
Many offices will schedule 1 hour per patient, others will schedule 45 minutes, while still others will operate on an accelerated hygiene schedule where you only have 20 minutes with the patient (it’s possible with the help of a dental hygiene assistant).
Some of my first offices I temped at didn’t even have a lunch break and I would need to find a sliver of time between my patients to gulp down my smoothie. Those were some tough days. But! we would get out an hour earlier which helped miss rush hour.
Solution: A fast-paced schedule may or may not be something desirable for you. Talk to the person in charge of creating your schedule and determine what time frame you wish to work in. Set expectations at the very beginning of a work relationship.
6. Pressure to sell
Dental hygienists are not salespeople but they do work within a business model. No patients. No work. No income. Some office managers can begin to put pressure on their hygienists to sell more fluoride or more pending dental work each time a patient comes in for their hygiene appointment. This pressure can make some people uncomfortable or stress out.
Solution: You can either work to develop your salesmanship skills with an arrangement of a corresponding compensation or change to an office that has less of a sales drive for their hygienists. Some offices will have a dedicated treatment plan manager that focuses on selling the recommended treatment to the patients.
7. Length and Cost of Schooling
The initial investment of time and money into becoming a dental hygienist can be off-putting for some. If beginning from zero college credits it can take up to 4 years to become a dental hygienist. The reality is there are other careers that have a shorter training span like dental assistants or even fire-fighters.
Family obligations may also demand more of your time.
Some may have to take on a school loan to complete the course. It can cost up to $30,000 for the dental hygiene program itself not to mention the cost of the prerequisites and the cost of living expenses while you are going through school.
It is very difficult to work and complete a dental hygiene program because the curriculum is so intense. And there is no night-school for dental hygiene (which would be awesome by the way!)
Solution: If you don’t have the time you may need to choose a different career or arrange your personal matters in order to have the time. You may be able to take your prerequisites online or in the evenings. Talk to a college counselor about financial help and apply for scholarships to pay for your schooling.
8. Difficult patients
The dental hygiene profession is a people-centered career. Caring about people is key to becoming a successful dental hygienist.
As with anything people-related you will encounter those difficult patients. They come in a variety of flavors: bossy patients that want to tell you how to do your job; creepy patients that want to get handsy with you; special-needs patients; and the ever-present contentious “Karens”.
At my first long-term dental hygiene position I worked with many special needs patients. Some were high functioning while others were not. When I would ask them to open they wouldn’t and I would need to fight with their “lips of steel” to get my tools to where they needed to be. It was a tough job but the experience was like no other.
Solution: DEVELOP PEOPLE SKILLS! Read books, take classes, talk to a mentor, apply the skills. Communication skills are also very important with people. If you really want to overcome this challenge, invest in these two invaluable skills. You won’t regret it.
9. Monotony
There is a certain type of monotony that can set in when working in private practice, especially if it is a well established practice with few or no new patients. It goes something like this:
Set up a room. Take x-rays. Clean teeth. Dentist does the dental exam. Clean bill of health. Break down and clean the room. Write notes. Next patient.
Sometimes it feels like the life is being sucked out of you and you just can’t wait for the day to end. Yes, dental hygiene can get boring because you get good at the basics.
Solution: Get excited about dental hygiene again! Attend a continuing education course. Learn about new products for patients and talk to your dentist or office manager about implementing what you’ve learned. Try dabbling in public health. You can get some really gnarly cases come across your chair that are a lot of fun to treat.
“EXCELLENCE IS TO DO A COMMON THING IN AN UNCOMMON WAY”
-BOOKER T. WASHINGTON (AFRICAN-AMERICAN AUTHOR)
10. Ethical Dilemmas
Ethical dilemmas can be uncomfortable and troublesome because it is difficult to make a proper decision that takes into consideration many moral laws.
Ethics are defined by Merriam-Webster as “the discipline of dealing with what is good and bad and with moral duty and obligation”. In other words, making the morally correct decision in a morally gray area where the answer is not black and white.
As a dental hygienist you will find that ethical dilemmas abound in a dental office. Especially when it comes to the behavior of others such as the dentist.
Lets say a dentist has entered his golden years and doesn’t have the fine motor skills he once had. His patients trust him and are happy he is still practicing. Although you can see from the x-rays that his dental work from years ago used to be very good his recent work has been severely lacking.
What would you do? Would you report him to the Health Department? Would you talk to him? What would you say? Would he fire you? What would you tell the patients?
Solution: Ethical dilemmas can be best dealt with when you calibrate your moral compass. Read or listen to books that cover a variety of examples and experiences and learn from others. Consult with another experienced dental hygienist when faced with an ethical dilemma. Strengthen your resolve to live up to your values.
The Hard Truth
Despite these challenges dental hygiene can still be an excellent career choice. With proper training and a strong desire to improve your craft you can make a success of a wonderful career choice.
