Readers' Forum

I read with concern the March 2002 article, "Pretty in Pink," by Martha Cort?s, DDS, regarding the use of lasers in cosmetic dentistry for the treatment of periodontal disease.

May 1st, 2002

AAP's response

Dear RDH:
I read with concern the March 2002 article, "Pretty in Pink," by Martha Cortés, DDS, regarding the use of lasers in cosmetic dentistry for the treatment of periodontal disease. The article cites the benefits of laser ENAP (excisional new attachment procedure), including bacterial decontamination and bone and ligament regeneration. However, the article fails to cite any evidence or scientific literature to substantiate these claims.

It is these types of unsubstantiated claims that led the American Academy of Periodontology (AAP) to issue a statement regarding the use of laser ENAP for periodontal treatment in 1999, available on our Web site (www.perio.org). At that time, the Food and Drug Administration (FDA) warned a dental laser manufacturer against marketing a laser for ENAP or indicating that the laser treatment would result in elimination or prevention of bacterial infections. The FDA cited a lack of supporting clinical data for these claims. As noted in our 1999 statement, the Academy is not aware of any randomized-blinded-controlled-longitudinal clinical trials, cohort or longitudinal studies, or case-controlled studies indicating that laser ENAP or laser curettage offers any advantageous clinical result not achieved by traditional periodontal therapy.

The dental hygienist is an indispensable professional in the partnership among patient, hygienist, dentist, and periodontist. With the care of their patients hanging in the balance, your readers should be given the best available evidence so they can make an informed and educated decision about dental lasers.

Kenneth W. Bueltmann, DDS,
President, American Academy of Periodontology

Will you still need me when I'm 81?

Dear RDH:
I've just been able to read the February 2002 issue and was drawn to the article about Marian Frazier and her very long career! With all due respect to Marian, if she always had the luxury of working part-time with only one patient per hour, it's no wonder she isn't burnt out!

Try interviewing some of us who have had to work five or six days a week with only 30 or 45 minutes per patient for 20 to 30 years - and raise a family - to see what can cause burnout! I have had such demands for most of my 35-year career and I am not burnt out! At age 59, I will likely have to work until I'm 81 (divorce will do that to your finances!) and I hope I can keep up with the demands of the dentists I've encountered over the years. Following a military career husband, I've worked in about 20 different offices in three different states, always 12 to 14 patients per day! Somehow, I still manage to connect with each patient and give them a quality experience. I know this because I am constantly complimented by my patients and have a loyal following; some have followed me through several job changes!

Maybe I'll be lucky enough to have an understanding boss like Marian's when I've very old, and I can continue to practice my beloved profession. If not, I'll need to win the lottery!

Anita Newbill, RDH
Valrico, Florida

Compassionate hunting? Doubt it

Dear RDH:
In your March 2002 issue, I applaud you for the tasteful story on hygienist Tracy Rowley. It was interesting and pleasant reading. Her appreciation and respect for nature made it a "feel good" story.

However, the Julia Egan story overshadows any warm and fuzzy feelings from Tracy's piece. I'm appalled that RDH magazine would glorify guns and the inhumane slaughtering of animals.

How can someone release 50 to 60 birds on a preserve, sic dogs on them, and then kill them? Some may label that hunting or a hobby; however, it's more rightfully called an execution.

Julia mentions that the wild birds behave differently than the farm-raised birds. Well, what hunters don't know (and probably don't care to know) is that the farm-raised birds probably have never seen daylight before, let alone fly freely as meant to be.

At first, Julia thought the deer guts and kill-cleanings were "disgusting." Now, she's accustomed to it. Wow! Anesthesia minus the xylocaine.

I've always felt good about being a hygienist. I feel hygiene is somewhat of a compassionate profession. I'd like to think that my hobbies and passions complement my career. Please continue with stories that promote good will to all.

Julie Kilker, RDH
Manhattan Beach, California

Kudos for hunting article

Dear RDH:
Kudos to your editorial board for the profile of Julia Egan. It is a testament to the "real world" nature of your magazine that you chose to feature a hygienist who enjoys hunting.

Upland game hunting is a sport that many Americans enjoy. Keep the good features coming.

John C. Hall, DDS
Traverse City, Michigan

Happy as can be with two-year degree

Dear RDH:
I am writing in response to a letter that appeared in the Reader's Forum from Karen Schacher, RDH, regarding the results of the salary and benefits survey. I usually keep my opinions to myself unless provoked, angered, or insulted. This letter left me feeling all of these plus some emotions even Dr. Neiburger failed to elicit!

In her letter, Ms. Schacher expresses her opinion about negative responses and the unhappiness of some of the hygienists that answered the survey. I, too, was unsettled to read the negative responses from some unhappy hygienists regarding their employers, team members, benefits, salary, etc. I also agree that if you are unhappy, change offices, change careers, change your attitude, and do whatever it takes. We are ultimately responsible for our own happiness.

What I take offense to is the assumption from Ms. Schacher that these unhappy hygienists are somewhat less educated and deserving of being "fully compensated" than she is. She makes it known that she is "more educated" than a lot of the hygienists responding. She states that "she sacrificed and received a great education" and that she has a whole two years of experience. All of this gives her the unconditional authority to insult a whole lot of more experienced and expertly educated hygienists when she states, "In my opinion, you should be compensated for what you do. I just hope those with associate degrees/preceptorship training are not expecting what more educated hygienists are receiving." And, she goes on to alienate us associate-degreed hygienists even more by saying that only those with bachelor's degrees who are unhappy should go find their deserved happiness elsewhere. Oh, please! How pretentious this "fellow hygienist" is with the garbage she is spewing by lumping associate-degreed hygienists in the same category as on-the-job-trained hygienists! There is a huge difference.

Nowhere in the survey does it make any mention of what the degrees are of the respondents. I'd like to enlighten Ms. Schacher with a few facts. First, I graduated in 1979 with an associate's degree from a small college that I chose based on its reputation for personalized instruction and excellence. In all, I took 31/2 years of full-time instruction to complete the program, and graduated with 125 credit hours (probably pretty close to how many credit hours she had). In her words, "What you put in is what you get out of it." What do you put in, Karen? Many of my associate-degreed colleagues and myself do a lot of volunteer work, community service, and community education. I am certified in nitrous oxide sedation and can administer local anesthesia. During the last several years, I averaged between 80 to 100 hours of continuing education per year, even though my state requires much less. I have advanced training in periodontal therapies and am licensed in the use of a soft tissue laser. I belong to the Academy of Laser Denistry and work very hard in spreading the word that degreed hygienists are a viable, professional, and fairly compensated member of the dental team.

In closing, I respect those RDHs with a BS after their name, and know they worked hard for this degree as I did. I would like Ms. Schacher to be brought down from her pedestal, and know that there are a great many educated, associate-degreed hygienists who make a difference in our profession. We are happy, satisfied, and well compensated. I cannot say that all BS degreed hygienists have this market cornered.

Patricia Zajac, RDH
Las Vegas, Nevada

Don't compare me with a preceptor

Dear RDH:
I am responding to Karen Schacher, RDH, who wrote a letter in the March 2002 issue. First, I am glad to hear you are very happy with your current job situation. I have been a dental hygienist for 22 years and also am very happy with my job. During the last decade, I feel many employers are recognizing hygienists more as valuable employees and are offering benefits, especially to part-time employees, that weren't available in the past.

A couple of statements in your letter, however, offended me as a dental hygienist. "... many hygienists today receive a compromised education and expect more than they are worth and/or willing to give ..." What exactly do you mean by a "compromised education?" Except for preceptorship (which is a totally different subject), all registered dental hygienists have had the same initial two-year training as you have had. We have all taken the required dental hygiene courses, graduated from an accredited college, taken the national boards, the regional boards, the clinical boards and received a license that says we can practice dental hygiene. We also take continuing education courses annually to keep our licenses current.

The other statement that bothered me was, "In my opinion, you should be compensated for what you do. I just hope those with associate degrees/preceptorship training are not expecting what more educated hygienists are receiving." How can you compare a hygienist with an associate degree to a preceptor and group them together as you did? Just because you have a bachelor's degree doesn't make you any more of, or a better, hygienist than one with an associate's degree. I think you need to go back to school and learn the difference between an associate degree's and preceptorship.

Pam Bergonzoni, RDH, AAS
Burlington, New Jersey

Associate's degree requires dedication

Dear RDH:
In response to Ms. Schacher's letter, shame on you! Certainly, our profession has enough worries without those hygienists who have earned a BS demeaning those hygienists who have earned an associate's degree. And how dare you lump those with an associate's degree with assistants who have "learned" through preceptorship. I can only assume that you don't thoroughly understand preceptorship, or what it takes to obtain an associate's degree. Please read the excellent guest commentary regarding preceptorship that appeared in the same issue as your letter.

Like many other hygienists, regardless of the initials behind their name, I chose my profession for a myriad of reasons. I chose an associate's degree for one reason: I live four hours away from the nearest university that offers a bachelor's in hygiene. But having an associate's degree doesn't make me less of a hygienist. It doesn't make me less dedicated to my patients or my profession. Prior to becoming a registered dental hygienist, I was unhappy with my job. That is why, at 30, I juggled three children, a spouse, and a part-time job. I attended a technical college near my home that had a strict hygiene program. My situation was not at all unusual in my class. In fact, many of my fellow students had much more to balance. Our dedication amazed me!

So, again, shame on you, Ms. Schacher. For someone so highly educated, it seems hard for you to relate to anyone other than those who are the same as you. No matter if there is a BS behind my name or not, I am proud of my education and my profession.

Pamela Lee, RDH
Merrill, Wisconsin

On the same playing field

Dear RDH:
I would like to respond to something I read in the March 2002 Reader's Forum. Karen Schacher, RDH, states, "In my opinion, you should be compensated for what you do. I just hope those with associate degrees/preceptorship training are not expecting what more educated hygienists are receiving." Wow! I hope I was not the only hygienist who was offended by that arrogant and uninformed statement.

Let me educate you, Karen. There is a huge difference between an associate's degree in hygiene and a preceptorship certificate (if there is even such a thing). After 10 years as a dental assistant, I decided to further my education so I could become a hygienist. I was accepted to a hygiene program in which I would graduate with an associate's degree in dental hygiene. Before I was accepted, I needed two years of prerequisites from a university. I think, Karen, if you were to check your courses from your college, they would be very similar, if not identical, to what I was required to take.

After graduating from my accredited hygiene school, I was then required to take the written exam and clinical exam. In Minnesota, which holds one of the highest standards for education of dental hygienists in the United States, students who have attended an accredited dental hygiene school either with a associate of applied science or bachelor's degree in dental hygiene are tested rigorously in a practical exam which not only includes a practical portion, but a written portion with case studies as well. We are tested side by side with no separation of who has a BS or an AAS. We are on a level playing field. I was held to the same standards as any other candidate for licensure taking the boards. I feel that my fellow AAS degree hygienists and I are just as "educated" as BS hygienists.

The preceptorship hygienist is trained on the job by a dentist and is only required to take a minimum of courses. They do not receive an AAS degree. So Karen, don't get confused by the fact that some hygienists with AAS degrees may have once been assistants; they are not trained on the job. They are held to the same high standards that all dental hygiene students in my state are held to.

In fact, I feel that my 10 years as an assistant has given me an advantage over my BS colleagues. I see the whole picture in the dental office. I can educate my patients on a wide variety of dental procedures - not only periodontal related issues. I also feel that being a former dental assistant makes me a better team player. I've been in the assistant's shoes, and I don't treat them like underlings. I've been a hygienist for seven years. I feel like a respected member of my dental team, and my employer pays me very well for the work I do.

So, Karen, if you think you're delivering higher quality hygiene care or deserve to be paid more than your AAS colleagues - think again. I think you're full of a lot of "BS!"

Kathleen Neumeister, RDH
St. Cloud, Minnesota

Makes it hard to be united

Dear RDH:
I was discouraged to read in your March 2002 issue a letter by Karen Schacher. She writes, "In my opinion you should be compensated for what you do. I just hope those with associate degrees/preceptorship training are not expecting what more educated hygienists are receiving." I am appalled you would publish something so degrading.

It is no wonder our profession has such a difficult time providing a united front. We have hygienists who believe they are performing more thorough treatment than the next person based on their level of a degree. This hygienist is saying that an associate's degree is on the same level as preceptorship. I would venture to guess that a majority of hygienists hold an associate's degree. I went to school for full time for four years just like my baccalaureate colleagues to receive my associate's degree. My class received an average of 91 on the national board exam and had the second highest score in the nation among all bachelor's and associate's programs. It seems to me we not only need to educate the public about our profession but each other also.

Allison Messmore, RDH
McKinney, Texas

Editor's note: There have been some exceptions, but, as a general rule, we try to publish any opinion offered by a reader.

Don't ignore supply and demand

Dear RDH:
The letter from Karen Schacher, RDH, in the March 2002 issue has provoked a response from this career hygienist (25+ years) with a "compromised" associate degree. I proudly attended St. Petersburg Junior College way back in the 1970s and received a high quality, uncompromised education. At the time, SPJC was ranked fourth in the nation, even above "superior" bachelor programs. Everyone in our class of 31 students passed the national board with flying colors, my own being a score of 90th percentile. Everyone also passed the Florida board, which has a reputation all of its own - amazing results for such undereducated, compromised students!

The experience I've had with compensation from employers had to do primarily with two factors:

• The degree of value the dentist placed on quality hygiene care
• Supply and demand

Most dentists are a close-knit group who will keep each other "informed" of the going rate of pay for hygienists, especially in times of high supply. The exceptional, high-paying dentists are few; their job turnover is low.

I suggest that, with a few years experience, Ms. Schacher will find in most, if not all areas of the country, some dentists are looking for any "live body" to "clean teeth." Others are seeking a qualified, professional, highly skilled, and caring hygienist. In either case, there is little regard for that person's college degree. Ms. Schacher will also learn in years to come that new graduates will be able to walk into a job at her same rate of pay, with or without a bachelor's degree.

Admittedly, there are branches of hygiene that require a bachelor's (such as teaching, program directorships, etc.), but let it be known there are vast numbers of AS degree hygienists who are providing a great service to both their patients and employers, and deserve no less compensation.

I will match my skills against any hygienist in the country regardless of their degree, having learned that the letters behind one's name offer no guarantee of superior service. And I will leave my arrogant attitude at home, for it has no place in a profession such as ours.

Proud to be an alumnus of SPJC, class of 1974,

Susan S. Noble, RDH, AS
Woodstock, Georgia

Please steer clear of labels

Dear RDH:
As licensed hygienists, we have to stop labeling each other and work together to educate the public on the best care possible by us, the professionals. Whether you have an associate's degree or a bachelor's, we both take and pass the same test for licensure. We have the degree; preceptorship trainees do not! Please don't place my education in that category. P.S. I am satisfied and very well compensated.

Nancy J. Kieler, RDH
Dickeyville, Wisconsin

Chills up my spine

Dear RDH:
The letter from Ms. Schacher literally sent chills up my spine with its air of arrogance, elitism, and a "prima donna" attitude that I thought our profession had put behind us. Ms. Schacher also shows her ignorance by equating preceptorship with the education most of us have received from a community college. What Ms. Schacher obviously doesn't know is that the community college education is held to the same strict and rigorous standards that any four-year BS degree-granting institution has to adhere to. I can't believe there are still hygienists who believe they are better just because they have a BS degree!

I hope with age and experience, Ms. Schacher will get in touch with some humility and realize that her attitude does nothing but create ill will and divisiveness within our profession.

Joanne Sweeny, RDH, BS
St. Louis, Missouri

A slap in the face

Dear RDH:
I am responding to the letter from Karen Schacher in the March 2002 issue. In her letter, she puts associate's degree hygienists in the same category as preceptorship-trained hygienists. I have been an RDH since 1998 and, previous to that, I was an RDA for 10 years. I am proud to have earned my associate's degree from the college I attended and feel that I am as clinically skilled and knowledgeable as any hygienist who graduated at the same time from a bachelor's degree program.

Personally, I am working towards a bachelor's degree part-time, but I feel this will not improve the quality of care that I deliver to my patients. This is a personal goal on my part. Ms. Schacher's letter was a slap in the face to myself and many other practicing hygienists.

Never put me in the same category as a preceptorship-trained hygienist! I worked hard to earn my degree and pass my boards. Also, I earn top dollar in the Twin Cities area and deserve every penny. My patients receive top quality care with professionalism and integrity; as a result, I bring in excellent production for my employer.

Finally, the majority of practicing hygienists, experienced and new grads, graduated from associate's degree programs; therefore, you have insulted many of your colleagues.

Fabi Regueros Small, RDH
St. Louis Park, Minnesota

Narrow-minded statements

Dear RDH:
I have been reading your publication for more years than I can remember. Several times I have read an article and thought I should respond, but didn't. This time, after reading Karen Schacher's letter, I knew I had to write!

I can't believe she thinks she is a more qualified hygienist because she has a bachelor's degree. How does she think those of us with an associate's degree would of been able to pass the national boards if we did not possess as much knowledge as she claims to have?

My employers are prominent periodontists who settle for nothing less than the best. After having worked for prestigious practices in New York City, I would gladly put my 20+ years against her barely two years.

I am in no way in favor of preceptorship, but am completely offended by her narrow-minded statements. Those of us with two-year degrees are registered hygienists as much as she is.

Cathy Eng, RDH
Wappinger Falls, New York

The real threat

Dear RDH:
I am writing in response to comments made by Karen Schacher, RDH. I would agree that only you can make your job situation better. However, I am extremely offended by her comments made about hygienists with associate degrees. How dare she lump these hygienists with those who only have preceptorship training? It is preceptorship training that threatens the future of all registered hygienists and will make the job market less competitive – not hygienists with associate degrees.

Becky John, RDH
Neillsville, Wisconsin

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