In 1984, I entered the dental hygiene profession as a clinician and couldn’t wait to begin my new career as a dental hygienist. There were many career opportunities available in our profession at the time, but not as many as there are today. As you know, the majority of dental hygienists begin their careers in private practice and work to develop their clinical and practical skills in treating patients with oral diseases.
The American Dental Hygienists’ Association (ADHA) established the six roles of dental hygiene as a policy of ADHA in 1986 and then as a second policy in 2001 to provide a variety of practice settings for dental hygienists to meet the prevention and therapeutic health care needs of the public. Here is a review of the roles and descriptions that were provided to dental hygienists:1
Administrator/manager - Utilizes data; communicates objectives; applies organizational skills; identifies and manages resources; and evaluates and modifies programs of health, education, or health care.
Change agent - Analyzes barriers to change; develops mechanisms to effect change; and implements processes and evaluates the success of programs that promote health for individuals, families, and communities.
Clinician - Assesses, plans, implements, and evaluates treatment for prevention, intervention, or control of oral disease while working independently or in collaboration with other professionals.
Consumer advocate - Influences legislators, health agencies, and other organizations to bring existing health problems and available resources together to resolve problems and improve access to care.
Educator/health promoter - Utilizes educational theory and methodology to analyze health needs; develops health promotion strategies; and delivers and evaluates the results in attaining or maintaining health.
Researcher - Applies the scientific method to select appropriate therapies, educational methods, or content; interprets and applies findings and solves problems.
The ADHA plans to review and may revise the six roles of dental hygiene in the future. Through the years, many areas of dental hygiene practice have expanded and developed. This article will review the career opportunities in several categories: private practice, education, public health, research, the corporate environment, and government. Please contact me by email to inform me of another area of practice.
Private practice - There are many different settings in which a dental hygienist can practice:
• General dentistry
• Cosmetic dentistry
• Dental insurance company
• Military base
• Pedodontics
• Periodontics
• Prosthodontics
• Orthodontics
• Oral & maxillofacial
• Veterinary
Additional training and educational experience may be necessary for practicing in a veterinary practice due to state practice regulations.
Education - The November 2004 issue of Access focused on education. The cover article, “The Educator Shortage,” provides interesting information in this area of practice. The article cites that there is a shortage of dental hygiene educators due to the closing of baccalaureate and master’s degree programs, the development of 76 additional associate degree programs across the country, and current faculty at or nearing retirement age.2 There are fewer programs available for dental hygienists who want to graduate with an advanced degree in education. If you are considering a career in education, now is the time to put your career plan together to pursue this type of position.
A dental hygienist can practice in dental assisting, dental hygiene, and dental school programs. There are many different positions in the educational area, depending on the university or college program and your education and qualifications:
• Dean
• Assistant dean for allied health programs
• Program director
• Dental/dental hygiene program advisor or chair
• Professor
• Associate professor
• Assistant professor
• Clinical instructor
• Adjunct faculty
• Visiting faculty
• Dental hygiene facilitator
•Graduate student teaching assistant
Other positions may be available. Ideally, you may require a minimum of a baccalaureate degree with potential advancement toward a master’s or doctorate, depending on the program in which you want to teach.
The approval of the Advanced Dental Hygiene Practitioner credential by the ADHA House of Delegates in June 2004, which addresses the unmet oral health needs of the public due to the access-to-care crisis in the United States, provides another important area of practice. The ADHA Council on Education is collaborating with the American Dental Education Association (ADEA), other dental organizations, and expert consultants to develop the curriculum for this credential. The next steps will be crucial for its approval by professional organizations, the impact it will have on state regulations, and which educational institutions will be chosen to offer the curriculum.
Public health - As defined by Webster’s Dictionary, public health is “the science and practice of protecting and improving the oral health of the community through identification of oral and dental health status of the public and need for treatment outcomes.”3 On May 25, 2000, Surgeon General David Satcher released “Oral Health in America: A Report of the Surgeon General.” This report identifies a “silent epidemic” of dental oral diseases in populations across the United States, and states that oral health must be improved in order to improve overall good health throughout life.4
As documented in the September/October 2004 issue of Access, “The scope of crisis in oral health care is evident in both documented research and anecdotal information.” There are more than 31 million people living in what the U.S. government calls “dental health professional shortage areas.” These are areas with less than one full-time dentist for a population of 4,000 to 5,000 people, according to a 2003 report by the Human Health Services Health Resources and Services Administration.5
According to the Surgeon General’s 2000 Report, the number of dentists per 100,000 U.S. residents has been declining since 1990, when it stood at 59.1 per 100,000. The number continues to fall, with an estimated 53.7 dentists per 100,000 people by 2020.4 There are many opportunities for dental hygienists in public health:
• Schools
• Head Start programs
• Community outreach dental clinics
• Hospitals and dental clinics (i.e., local, veteran)
• Progressive residential facilities (i.e., nursing homes, independent living, assisted living, and skilled nursing facilities)
• Long-term-care facilities
• Facilities for the developmentally disabled
• Residential and treatment facilities for the mentally disabled
• State and federal correctional facilities for juvenile offenders
• State and federal correctional facilities for adult offenders
• Dental professional and state organizations in administrative, clinical, and research positions (i.e., National Institutes of Dental and Craniofacial Health, the military, Centers for Disease Control and Prevention, State Department of Health, and State Department of Human Services)
• National Health Services Corps (NHSC), an organization that provides comprehensive, team-based health care to improve the health of the nation’s underserved populations
Research - A dental hygienist can practice in the research area in a dental hygiene or dental school program, public health, or a corporate setting. Dental hygienists can write grant proposals, develop research methodology, or conduct research surveys as well as clinical study programs. In clinical studies, a dental hygienist can write protocols; recruit patients; become a clinical investigator assessing gingivitis, bleeding upon probing, plaque, attachment level measurements, suppuration, and tooth mobility; write research reports; present research findings at professional meetings; or write articles, abstracts, or scientific papers for dental professional publications. A minimum of a baccalaureate degree in dental hygiene is required.
Corporation - This can be a very exciting work area for a dental hygienist, depending on the company and department in which one is employed. Hygienists can work in an oral care company, pharmaceutical company, dental insurance company, corporate placement agency, or consulting firm. Some career opportunities for dental hygienists in an oral care or pharmaceutical company include:
• Sales - As a sales representative, district manager, or regional director who details over-the-counter and/or pharmaceutical products to professionals and manages sales representatives.
• Education - As a corporate educator or a sales training educator who trains the sales representatives, district managers, and regional directors, and works with dental hygiene and dental school programs across the country.
• Consumer marketing - As a marketing person who oversees the day-to-day operations of one or more products in a specific product area (oral care, cough/cold, hand lotions, soaps).
• Professional marketing - Works with the sales and marketing departments on oral care or medical care products and targets their messages to dental and medical professionals.
• Market research - Works with marketing to conduct market research studies and focus groups to determine research outcomes from target audiences (dental professionals, medical professionals, consumers).
• Product development - Develops new products or line extension products in research and development.
• Research - Conducts exploratory research in-house to determine product efficacy.
• Regulatory affairs - Works with the FDA and global organizations to comply with regulations for product launches, line extensions, or existing products.
• Clinical affairs - Works in conducting and completing clinical research studies on specified product lines to support claims and clinical efficacy.
• Consumer affairs - Addresses consumer inquiries over the phone, addresses product issues, and provides professional advice.
• Professional relations - Works with U.S. groups and global affiliates in product launches and new introductions, educates dental and dental hygiene school programs about product information, and develops relationships with professional organizations.
• Media advertising/relations - Works with advertising agencies to develop press releases, professional relation campaigns, product launches, new product claims, and advertising initiatives with consumers and professionals.
I worked in the Warner-Lambert Company (now Pfizer, Inc.) for 12 years in dental research, sales training, sales, and professional marketing. It was a wonderful learning experience for me to be in four different areas of the company. I appreciate the value of those positions and working with the professional community. There are more dental hygienists pursuing positions in corporate America today than in 1984.
Government - This is a wonderful area for making positive changes in our profession. You may already be working in your state dental hygiene organization as a legislative chair, working with legislators to pass bills expanding practice regulations, or fighting against preceptorship bills. You may also be serving on a State Dental Board, State Dental Hygiene Committee, or as a lobbyist. You may be interested in working in public office as a state legislator. Currently, one dental hygienist holds a legislative position in government and other dental hygienists work in governmental positions.
Dental hygienists may also consider working in independent practice, abroad as a dental hygienist or serving in the roles of inventor, board examiner, professional speaker, writer, editor, consultant, entrepreneur, owner of a retail or online store, and dental or dental hygiene practice broker. The possibilities are endless, and more opportunities can be created to fill the needs that arise for dental hygienists in innovative clinical, practical, and management positions.
Good luck pursuing the many career paths dental hygiene can offer you.
1.) Name, address, and telephone number and/or email address
2.) Briefly describe your:
a.) specialty practice
b.) independent practice, or
c.) dental hygiene position outside of private or clinical practice
3.) Indicate the number of years in your current position.
Christine Hovliaras-Delozier, RDH, MBA is president of Professional Savvy, LLC, which is based in Flanders, N.J. Chris is an oral care consultant who works with various companies in clinical trials, product development, professional marketing/relations programs and materials, professional sales, and continuing education symposiums. She has written articles for several dental hygiene publications. Chris works with professional organizations in presenting continuing education courses and other projects. Chris works with dental hygienists and student dental hygienists in writing cover letters, resumes, curriculum vitaes, and career plan counseling. Please visit Chris’ Web site (professionalsavvychd.com) beginning in April. She can be reached at [email protected].
References1 Six Roles of Dental Hygiene. ADHA Policies - Education: Accreditation 17-91/13-86 and Continuing Education: Professional Development 9-01.
2 Majeski, J. The Educator Shortage. Access 2004; 9(18):16-22.
3 Webster’s Dictionary online, 2005.
4 Oral Health in America: Report of the Surgeon General. www.surgeongeneral.gov/library/oralhealth.
5 Ring, T. The Advanced Dental Hygiene Practitioner. Access 2004; 8(18):14-20.
