Key highlights

• How Red Rising mirrors many of the challenges facing dental hygienists today.
• Why insurance became the group's biggest real-world parallel to the novel.
• Lessons on leadership, advocacy, and creating change without waiting for permission.
• A discussion of Virginia legislation and why educating policymakers matters.
• Why every hygienist has opportunities to "level up" regardless of where they practice.

Episode description

Sometimes the most meaningful conversations about dental hygiene begin somewhere completely unexpected.

In this special book club episode recorded at RDH Under One Roof, Jessica Atkinson, Dave Torres, and Ashley Kear discuss Red Rising by Pierce Brown and explore the surprising parallels between the novel and today's dental hygiene profession. What begins as a conversation about science fiction quickly becomes a discussion about leadership, advocacy, insurance, legislation, professional identity, and the courage to challenge systems that no longer serve patients or clinicians.

Throughout the episode, the hosts reflect on what it means to grow beyond the operatory, communicate the value of dental hygiene, support one another, and create meaningful change one conversation at a time. Whether you've already read Red Rising or you're simply looking for fresh perspective on the profession, this episode offers thoughtful insights into leadership, resilience, and finding your voice.

A Tale of Two Hygienists Podcast – Episode 549

Red Rising, dental hygiene, and the courage to challenge the system

Ashley Kear:
Welcome back, listeners, to another episode of A Tale of Two Hygienists. I'm so excited because today we're going to do our best to keep this conversation rooted in dentistry, but we're also going to talk about a book we've all been reading.

Dave Torres:
Do you remember back in January when we interviewed our bestie, Ashley Kear, and talked about Red Rising?

Well, we finally did it—we started a book club, which is honestly one of my favorite things. I already have a little book club with two of my former students. We read a book, write notes to each other in the margins, then rotate the books around. Apparently I'm not the only one who enjoys this, because Ashley was immediately on board.

No regrets, either. Dental hygienists are nuanced people. Of course we like reading books.

I picked up Red Rising because everyone kept telling me I needed to read it. Once I started, I kept thinking, There are so many parallels to my life as a dental hygienist.

I texted Ashley and said, "This is crazy."

Jessica Atkinson:
And I told you, "Just wait."

Dave Torres:
Ashley had already finished several books in the series before I even started.

Jessica Atkinson:
There are six books now, I think, with one more still coming. I'm somewhere around book four or five at this point. I honestly can't remember because I just keep reading.

Dave Torres:
She knew exactly what was coming while I was still discovering all these connections.

So welcome back, Ashley.

Ashley Kear:
Hello!

Dave Torres:
We're recording this live from the exhibit hall at RDH Under One Roof, and today we're talking about Red Rising by Pierce Brown.

Before we dive in, fair warning: there are spoilers throughout this episode. If you've been meaning to read the book spoiler-free, pause here, read it first, and then come back.

Ashley Kear:
Although honestly, even if you hear all the spoilers, it's still worth reading. I'm not usually a science fiction reader—we talked about that last time—but I was completely hooked.

Dave Torres:
It's so good.

Leadership. Advocacy. Resilience. Professional identity.

Those themes are woven throughout the story, and they kept making me think about dental hygiene.

Jessica Atkinson:
It really is that good.

Ashley Kear:
As you're reading it, challenge yourself to think about dentistry at the same time.

Jessica Atkinson:
I honestly don't think that's difficult. We kept reading scenes and immediately saying, "That's happening right now."

Seeing dentistry through Darrow's eyes [04:30]

Dave Torres:
Early in the story, we're introduced to Darrow, who's a Red—the lowest class in this society.

Everything revolves around earning the laurel by mining helium-3. The winning clan receives better food and small luxuries during Laureltide.

Jessica Atkinson:
The whole culture borrows heavily from Greek and Roman mythology. Laureltide is almost like Yuletide. Winning means you get little luxuries—sugar, whiskey, things like that.

Ashley Kear:
The Reds all live underground on Mars. They've been told they're sacrificing everything so future generations can eventually live on the surface.

They truly believe they're doing meaningful work by risking their lives in the mines.

Winning the laurel simply means life gets a little better.

Dave Torres:
A chance to enjoy something nice.

Jessica Atkinson:
If you haven't read the books, it's important to know that these people have absolutely no idea what's happening above ground.

They don't know there's another world.

Dave Torres:
That immediately made me think about RDH Under One Roof.

We've spent all weekend talking with hygienists from different states, and I realized a lot of us live inside our own little bubbles.

Jessica Atkinson:
Sometimes literally.

Maybe your operatory feels like it's underground.

Especially if you don't have windows.

Dave Torres:
My hygiene school didn't have windows.

I absolutely felt like I was underground, head down, grinding every day.

Covered in PPE.

Jessica Atkinson:
I even had specific scrubs I was required to wear.

Dave Torres:
Those little details made me think about how easy it is to believe your current environment is all there is.

Outside your operatory—or outside hygiene school—there's an entirely different world you haven't discovered yet.

Not knowing you're being limited [07:15]

Dave Torres:
Then Eo shows Darrow the hidden garden.

Spoiler alert—she dies.

Honestly, I knew almost immediately that she wasn't going to survive because she represented too much hope.

Ashley Kear:
She's really the catalyst for everything that follows.

Dave Torres:
Exactly.

The Reds work incredibly hard for this reward, only to discover they never actually had a chance to win it.

Another clan was always going to receive the laurel.

What's interesting is that the privileged group isn't necessarily creating the system.

They're simply living inside it.

Jessica Atkinson:
And they don't know anything beyond it either.

They believe this is the highest level anyone can achieve.

They don't even realize another reality exists.

Most importantly—they don't know they're oppressed.

Dave Torres:
That reminded me of conversations I have with hygienists all the time.

Sometimes they don't realize what's possible until they attend a conference like this.

They meet someone from another state and suddenly discover there are hygienists who own practices or work under completely different practice acts.

Then they go home wondering why things look so different where they live.

Ashley Kear:
Sometimes growth starts with changing your mindset.

Maybe it's a classmate who tells you, "You could do more."

Maybe someone else sees potential in you before you see it yourself.

Pain often becomes the beginning of change [09:30]

Dave Torres:
One of the biggest motivators in my own life has been pain.

That's exactly what happens to Darrow.

His grief pushes him toward something entirely different.

Someone recognizes potential in him and offers another path.

He risks everything because he feels like he has nothing left to lose.

I think a lot of hygienists reach moments like that professionally.

Maybe you're burned out, maybe you're frustrated, maybe you're thinking, Why not try something different?

The question that kept running through my mind while reading was this:

What system should all of us be challenging together?

For me, the answer kept coming back to dental insurance.

When the real problem is the system, not each other [10:30]

Jessica Atkinson:
One thing that really stood out to me is how the different colors are constantly being pitted against one another.

I couldn't help thinking about dentistry.

Sometimes it feels like assistants are fighting hygienists, hygienists are fighting dentists, and everyone is focused on each other instead of the bigger issue.

Because we can step back and look at the whole picture, we can see that everyone is spending so much energy fighting among themselves that they're missing the real problem.

Even among the Golds, some recognize there are problems, but many don't. They don't understand how difficult life is for the people below them because they aren't living it every day.

Dave Torres:
Then Darrow becomes a Gold.

Suddenly he has a completely different perspective, but something interesting happens. He enters another system, and that same hierarchy exists there, too.

It reminded me that no matter where you go, people are still people. Different titles don't eliminate human nature.

Ashley Kear:
That made me think about dental insurance.

The reimbursement might be completely different from one state to another, even when we're using the exact same code.

Sometimes you're practicing in an environment where you feel limited because patients only want what insurance covers.

Then something changes.

You start saying, "Let's talk about what you actually need, not just what insurance will pay for."

That's a different mindset.

Maybe then you attend a conference like this and realize there are other opportunities.

Maybe you could teach.

Maybe you could speak.

Maybe you could earn another degree.

You start leveling up professionally, but then you realize there are still bigger problems that haven't been solved.

When I first became a hygienist more than ten years ago, I honestly thought clinical hygiene was the only path.

Now we have platforms where we can educate, inspire one another, and create change together.

None of us can do that alone.

Dave Torres:
Exactly.

We need each other.

Why insurance became the biggest parallel [14:00]

Jessica Atkinson:
I also understand the hygienists who think stepping outside what's familiar is scary.

That's exactly how change feels.

When Darrow enters this new world, he realizes that even though everything looks different, many of the same problems still exist because the system has operated that way for so long.

Making change is difficult because people don't recognize something is a problem until they finally see it differently.

Insurance is such a massive system.

When you look at how much money insurance executives make, it's easy to think of them as the Golds in the story.

They're making decisions about patient care without ever sitting chairside with the people affected by those decisions.

How can someone deny scaling and root planing because it doesn't meet some internal standard?

Who created those standards?

One company approves treatment while another denies it.

The problem is much bigger than any one clinician can solve.

Eventually, all the colors have to work together.

That's one of the themes that continues throughout the series.

Dave Torres:
Because they have to.

Jessica Atkinson:
Exactly.

Right now there's so much conflict—assistants versus hygienists, hygienists versus dentists, legislation, insurance companies.

Meanwhile, the larger issue remains.

Yes, money drives so many decisions, but we still have a voice.

The more people hear these conversations, the more likely they are to become inspired and start working together.

That's one of the reasons I love Darrow's story so much.

He's realizing that change has to happen.

Small changes create bigger ripples [16:00]

Dave Torres:
The thing I appreciate most is that Darrow doesn't suddenly become a perfect leader.

He makes mistakes.

He doesn't always want the responsibility.

Things don't unfold the way he expects.

But he learns to create change one step at a time.

That's what I think about professionally.

I can't transform the entire system tomorrow.

What I can do is change how I practice today.

Maybe I spend more time discussing nutrition.

Maybe I explain to patients that dental insurance isn't treatment planning.

Maybe I present another option for care.

Those are changes I can make immediately.

Ashley Kear:
Or maybe it's investing in something you believe will improve patient care.

Maybe you purchase a piece of equipment before your office is ready because you believe it will eventually become the standard.

Sometimes leadership starts with one person making one decision.

Jessica Atkinson:
Small changes create ripples.

You also can't do this by yourself.

Darrow succeeds because he has people around him helping him grow.

He had mentors.

He had people teaching him how to communicate in a completely different world.

That made me think about patient communication.

We understand clinical language, but our patients don't.

Sometimes we have to completely change how we explain things if we want people to understand.

Dave Torres:
That gave me chills.

Do our patients really understand what dental hygienists do?

Do they know our education?

Do they know our scope?

Or have we unintentionally reduced ourselves to simply being tooth cleaners?

It's worth asking how we communicate—not just disease processes—but our professional identity.

Helping patients become advocates, too [19:00]

Ashley Kear:
Imagine what could happen if patients became advocates alongside us.

What if patients started writing legislators because of the care they received from their hygienists?

"My hygienist found my oral cancer."

"My hygienist changed my health."

How powerful would that be?

Jessica Atkinson:
I actually have these conversations with my patients.

I practice in the Washington, DC, area, and many of my patients are physicians, engineers, attorneys, and highly educated professionals.

When the opportunity comes up, I explain what's happening in Virginia.

I tell them that hygienists complete extensive education and training.

Then I explain that, in Virginia, dental assistants can be trained entirely on the job.

I'm not criticizing assistants.

I've worked with incredible assistants who learned on the job.

But competency should never depend solely on who happened to train you.

There needs to be a consistent standard.

Otherwise someone could simply decide you've completed enough scaling and call you qualified.

That should concern everyone.

When trusting the system isn't enough [21:00]

Dave Torres:
Later we're introduced to Mustang, and there's a moment that really stayed with me.

Things are getting dangerous. People are dying.

Mustang still believes there have to be limits. She trusts the system enough to think someone will step in before things go too far.

Darrow sees it differently.

He says there are no limits.

That really made me stop and think.

How often do we tell ourselves that legislators or regulatory bodies would never allow something that puts patients at risk?

You want to believe those safeguards exist.

Then something happens that makes you question that assumption.

For me, that connected directly to what has happened in Virginia. It's a reminder that sometimes people place their trust in systems that don't always protect them the way they expect.

The Virginia legislation conversation [22:15]

Jessica Atkinson:
I don't necessarily think legislators understand what they're voting on.

One of the legislators involved has family ties to dentistry, and from everything I've seen, I think they were told there would be competency requirements and safeguards in place.

Then, when everything was finalized, the Virginia Department of Health Professions determined there wouldn't be those regulations.

I know legislators believed protections would exist because I reached out to mine repeatedly.

I called.

I emailed.

I tagged them on social media.

Eventually I received a response, but then another hygienist told me she had received the exact same response.

Recently one of those offices reached back out and asked to meet.

That's great.

I'll bring the information.

I'll bring the evidence.

Then I'll ask a simple question:

Would you feel comfortable having someone who learned entirely on the job providing this type of care?

Dave Torres:
So you're taking Mount Olympus.

Jessica Atkinson:
I wouldn't go quite that far.

The difference is that I don't believe most legislators are trying to create bad policy.

I think they simply don't understand the realities of clinical practice.

That's where we come in.

Dave Torres:
Exactly.

The people making these decisions often don't have firsthand experience.

It's our responsibility as professionals to explain what's actually at stake.

Regardless of how everything unfolded, we ended up with an outcome that surprised a lot of hygienists.

Jessica Atkinson:
I honestly think much of it comes down to miscommunication.

I don't believe anyone set out with bad intentions.

Unfortunately, the end result still isn't good.

We understand the long-term consequences because we practice every day.

That's another parallel with Red Rising.

People think they're improving the system, while those living inside it continue to struggle.

Sometimes all you've done is replace one problem with another.

Leadership begins before you feel ready [26:45]

Dave Torres:
Listening to you reminds me of Darrow.

He never planned on becoming a leader.

He simply recognized that he had a responsibility.

I don't think you ever expected to become one of the voices speaking about this issue.

Jessica Atkinson:
Not at all.

But I already had a platform.

It would have felt wrong not to use it.

I'm certainly not an expert in legislation.

I don't know everything.

But I know what I'm seeing.

That's why we need other people involved, too.

Darrow had the Howlers.

He had people around him who supported the mission.

I'm not trying to become the spokesperson for Virginia.

I just want to be one voice among many.

Hopefully that creates enough momentum for change.

Dave Torres:
You had already earned people's trust.

That's why people listened.

The best leaders usually aren't the ones chasing leadership.

They're the people who recognize they have a responsibility to speak when something matters.

That's one of the biggest themes throughout Red Rising.

Darrow realizes he has influence, and he chooses to use it.

One conversation can start a ripple [

Ashley Kear:
Sometimes that responsibility comes from caring deeply about your profession.

Sometimes it comes from caring about one patient, one coworker, or one friend.

Sometimes you simply become frustrated enough that you decide things shouldn't stay the way they are.

The people in power don't always understand because they're dealing with completely different problems.

Jessica Atkinson:
Exactly.

They're fighting their own battles, too.

We can only do what we can do.

Maybe all we accomplish is helping one person think differently.

But people have to understand these decisions affect real patients and real health outcomes.

You don't know what you don't know.

From where we sit, we can see how these decisions might affect patient care years down the road.

That's another lesson from the book.

People can genuinely believe they're doing the right thing while the larger system slowly begins to fail.

---

Where can you make a difference today?

Dave Torres:
One thing I loved about Darrow is that he continually asks himself who he is.

I think that's a great question for hygienists.

Am I just someone who scales teeth?

Or am I something more?

Level up wherever you are.

Never lose hope.

At its core, Red Rising is a story about believing things can improve.

I think that's true in dental hygiene, too.

You can become a stronger clinician.

You can improve your patient education.

You can add new therapies.

You can strengthen your risk assessments.

You can improve your operatory.

You can improve your practice.

You can improve your profession.

There are opportunities at every level.

I don't want anyone listening to think they have to walk into a CEO's office tomorrow or take on the governor.

Instead, ask yourself:

Where am I today?

What change can I make today?

How can I rise?

Ashley Kear:
Exactly.

Dave Torres:
RDH Rising.

Ashley Kear:
You can even start greeting people differently.

"How are you today?"

"I'm prime."

Dave Torres:
I'm prime.

Bloodydamn prime.

(Laughter.)

Jessica Atkinson:
We've been in the trenches.

Dave Torres:
We've been in the Red tunnels.

---

Looking ahead to the next book

Dave Torres:
If you enjoyed this little book club episode, let us know what we should read next.

Send us your recommendations.

Ashley will probably finish every book before Jessica and I even get started, but we'll catch up eventually.

I've honestly been looking forward to recording this conversation all week.

Ashley Kear:
You've been texting me nonstop asking where I was in the book.

Dave Torres:
I needed to know whether you'd reached all the parts that made me emotional.

Jessica Atkinson:
If you've been trying to get back into reading and enjoyed books like The Hunger Games, I'd definitely recommend giving Red Rising a chance.

I don't know that I'd call it dystopian.

It's really more science fiction.

But it's a fantastic story.

Dave Torres:
It's a great read.

And if nothing else, it just might inspire you to make one meaningful change in your own career.

Thanks for listening, everyone.

Ashley Kear:
Thank you, guys.