State of mind

Do doctors understand what dental hygienists do? A survey finds out

Do doctors understand what dental hygienists do? A survey finds out

by Lory Laughter, RDH, BS

A couple of months ago, I was given the opportunity to speak to the graduating dental hygienists from Idaho State University – an honor taken very seriously. My written remarks focused on the reality of professional life outside the academic setting. Promptings of being independent, responsible, and part of a changing profession filled over two pages of notes. When I stood up that night, the reality came to me that this class of outstanding career- and community-minded individuals did not need or want to hear those words. My memory is a bit sketchy on my exact remarks, but my thoughts were on their present – not the future.

At that moment in time, this group was the best they had ever been as students, clinicians, and public health educators. They were at the top of their game in technical and research skills. There was nothing to gain by telling them so much would change between graduation and passing clinical boards. Science is not stagnant and technology improves by the hour, not the day. What sets apart the great from the average in dental hygiene is the ability to continue learning, accepting change, implementing positive professional advancement, and never settling for less than our best. There is no doubt that every student in the class left with those skills. Their reality would change soon enough.

The reality of dentistry today is the changing roles of providers and where dental hygiene will fit into the new picture. Less education and more care-giving responsibilities have, unfortunately, become the norm. Scaling assistants and mid-level providers without a college degree are no longer a threat – they are treating patients today. In the conversation and grumbling surrounding the changing landscape of dentistry, a comment heard often is, "Dentists have no idea what dental hygienists do." I decided to put that statement to the test.

An online survey asked identical questions of dentists and dental hygienists. Each group was given a different link, but the survey was the same. Too keep it as simple as possible, the questions asked what role or jobs the hygienist filled in the office and then what roles the participant thought the dental hygienist should fill. Surprisingly, the dentists and dental hygienists answers to the first part were statistically the same. Dentists do know what the dental hygienist does in the office and for the patients.

The big difference was in the second half of the survey.

Only 27% of the dentists responded in the positive to hygienists co-diagnosing, while over 90% of dental hygienists desire co-diagnosis as an allowable duty. Interestingly, 75% of dentists in the survey want their hygienist to recommend needed treatment: a task I see as nearly impossible without co-diagnosis. In the same confusing manner, several dental hygienists used the comment section to state they did not like "selling dentistry." Other than the difference of words, recommending, co-diagnosing and selling are all after the same goal – needed treatment for the patient's oral health.

More than two-thirds of the dentists commented on the value of their hygiene team. Four dentists even remarked the hygienists in their practice were exactly what the practice, employer, and patients desired. Most dentists valued continuing education for the dental hygiene team (93%).

A response I found exciting and positive for career growth was the five practices listing the dental hygienist as the practice manager or staff leader. Our value is being recognized beyond scaling, polishing, and educating! Leadership is valued not only in our academic educational experience, but in the real world as well.

One of the largest discrepancies occurred in the question of how much time the dental hygienist spends outside the office preparing for their role; 59% of dentists believe we spend one hour or less a week off the clock to prepare for work. Yet 60% of hygienists believe they spend three to five hours of unpaid time benefiting the practice every week. Either the dentist does not understand how many hours are spent reading, studying, and taking courses to stay on top of our game, or hygienists overestimate time spent in those settings. I believe almost every dental professional spends time online researching techniques, products and news without realizing it is education and indeed very valuable to treating patients.

Sad to me was the result that only half of the dentists and dental hygienists responding checked volunteering as something of value for enhancing the practice. The question did not ask about dental related volunteering, but rather giving of our time and talent in general. Giving back to the communities that not only need us, but support our careers as well is essential to being a professional. It's not charity, it is repayment.

According to my results, the truth is that dentists do know what the RDH does for the practice. They recognize our value and, for the most part, appreciate our knowledge and skills. The difference of opinion comes mostly from wording and not actual duties. Dental hygienists educate; we do not sell. Co-diagnosis is needed to provide complete patient care and calling it "recommending treatment" does not change the function.

Here is the reality: Dental professionals know their roles. The challenge is changing the status quo to best serve the overall health of the community. We can complain and point fingers all we want, but in the end we will dictate our own fate. We can strive to change our settings, education and roles to grow the profession and deliver quality health care or we can complain our way to becoming obsolete. One is power and the latter is submission.

Lory Laughter, RDH, BS, practices clinically in Napa, Calif. She is owner of Dental IQ, a business responsible for the Annual Napa Dental Experience. Lory combines her love for travel with speaking nationally on a variety of topics.

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