Sloppy dress code: How should hygienist address office's work attire?

March 16, 2016
Dianne Watterson answers question from dental hygienist about sloppy dress code.

How should hygienist address office's work attire?


Dear Dianne,

I've been a dental hygienist for 10 years and have worked in only two offices. I've been in my current office for one year. This office does not have any written dress code. One of our business assistants comes to work dressed like a hooker and the other like a homeless person. The chairside assistants and I wear matching scrubs, but they are showing the normal signs of age from being washed so often. The doctor wears a white jacket, but most of his jackets are much too worn.

I'd like to approach the doctor about buying some new scrubs, but I think it is even more important that our business office people tighten up. I don't think I'm being overly critical. The previous office where I worked had written guidelines, and everybody looked professional.

I feel that the way we look reflects on the practice. Do you have any suggestions on how I can approach this matter with the doctor?

Carrie, RDH

Dear Carrie,

When offices do not have any written guidelines pertaining to appropriate attire, employees feel free to wear whatever they wish. Sometimes, their choices are entirely inappropriate.

I consulted once in an office where one of the business assistants was inappropriately dressed. She wore a skin-tight sweater with a deep cut V neckline, exposing about five inches of cleavage. Her shoes were Uggs, and she wore large, gaudy earrings and heavy eye makeup. I actually felt sorry for this young woman, because evidently nobody had taught her what constituted a professional look. The senior doctor in the practice said to me, "Dianne, I think there is entirely too much boob at the front desk. What do you think?" I laughed at his choice of words and said I agreed. Then he said, "Well, what are you going to do about it?" I replied that WE would address this by developing some written guidelines in the office policy manual pertaining to appropriate attire and appearance for all staff members. My perception was that he felt inadequate or maybe intimidated to address the problem directly.

You are exactly right in stating that the way staff members are dressed reflects on the practice. In fact, patients form perceptions of dental (and medical) practices based on two things: (1) tangible things they can see including employee appearance, and (2) how you make them feel. (People remember more about how we make them feel than what we say.) Doctors who allow their staff members to come to work inappropriately dressed do not realize how that reflects on them. Patients might assume that when people look sloppy, the work is sloppy too. Right or wrong, nonverbal communication sends some powerful signals, and people make assumptions based upon appearance. If those assumptions are negative, it will be more difficult to gain the patient's trust.

There have been numerous studies examining patient perceptions of health-care workers' attire. In the June 2003 issue of The Archives of Internal Medicine in an article by Lawrence J. Brandt, MD, titled "On the Value of an Old Dress Code in the New Millennium," Dr. Brandt writes: "Attire of the health-care provider is important to patients across all lines of population and geography studied to date; young or old, child or parent, Eastern or Western, Northern or Southern. Among professional apparel, the name tag and the white coat are most preferred by patients." In study after study cited in the article, a more formal look projects professional competence and inspires trust among patients, whereas a casual look, wearing sandals, clogs, scrub suits, or blue jeans is disapproved by most patients.

More recently, Medscape published a study titled, "Healthcare Personnel Attire in Non-operating-room Settings" ( In this large systematic review, patients expressed preferences for certain types of attire, with most surveys indicating a preference for formal attire, including a preference for a white coat.

It is fair to say that patients notice far more about us than we consider. They notice our clothes, our hair, our shoes, even how we walk. They notice if the doctor has a hairy neck or nasal hairs, faded or ripped scrubs, and provocative or sloppy clothing on staff members. They notice when the patient restroom or reception room is old or in need of updating. They notice when the carpet is stained and the furniture is worn out.

They also notice when everyone looks sharp and professional and when the reception room and patient restroom is clean and modern. These attributes engender competence and a general positive feeling about the practice.

I do not know if your office has a formal office policy manual. If it does, it should not be difficult to include a section on employee attire (see example in sidebar).

Since business assistant attire is problematic in your office, I recommend that the doctor provide a stipend for their attire as well as for the clinical scrubs. I like to see business assistants in a business jacket and white blouse or shell. The guidelines will need to be clearly articulated.

If you have a good working relationship with the doctor, find a time when you can speak with him privately. You should voice your concerns about lack of professionalism in attire. If the doctor sees that your motives are for the good of the practice, he should feel grateful. You can even show him this article.

All the best,RDH


Every business owner has the right to establish standards of attire and behavior for employees. Here is a sample:

Proper attire. Patients often equate the quality of the dentistry we provide by our appearance. There is a "casual" look that is appropriate for outside the professional office, and there is a professional look that is desired for time spent in the office. In keeping with the image of professionalism that we wish to project to our patients, we set forth these guidelines:

Provocative is not professional! Blouses and tops should be conservative and professional with no visible cleavage exposed.

It is the policy of the practice that body art (tattoos) should not be visible to our patients.

Jewelry is permitted as long as it is conservative. Clinical staff members are restricted by the nature of their work, such as refraining from wearing rings that might tear gloves and breach infection control measures. Business assistants are permitted to wear jewelry as long as it is tasteful and appropriate. Body jewelry/piercing, other than the ear lobe (such as eyebrows, lips, nostrils, tongue, etc.) is NOT permitted.

Fingernails should be kept at a length that does not interfere with the staff member's work. Bold colors and gaudy designs are not recommended.

Clinical personnel. Uniforms consisting of lab jackets and/or scrub shirts are provided by the office. OSHA requires that long sleeves be worn. Scrub pants or other type pants are to be provided by the staff member. Closed toe shoes are also required. Uniforms will be laundered in the office.

Nonclinical personnel. Employees not working in the clinical areas are expected to wear dressy-casual professional clothing. Blue jeans and sneakers are not permitted if patients are scheduled in the office.

DIANNE GLASSCOE WATTERSON, RDH, BS, MBA, is an awards winning speaker, author, and consultant. She has published hundreds of articles, numerous textbook chapters, an instructional video on instrument sharpening, and two books. For information about upcoming speaking engagements or products, visit her website at Dianne may be contacted at (336) 472-3515 or by email [email protected].