The mood out there

Jan. 1, 2011
Dental hygienists comment on the impact of the economy on their careers

Dental hygienists comment on the impact of the economy on their careers

Dental hygienists reported a variety of frustrations related to career growth and the economy during a survey hosted by the electronic newsletter, RDH eVillage, in August 2010.

The survey collected 1,824 responses, and results were posted in various 2010 issues of RDH eVillage. The statistics generated by the survey can be viewed by logging on to and searching for "2010 hygiene salaries."

The hygienists who participated in the survey noted a trend toward too many dental hygiene schools, a reduction in salaries and benefits, and a scarcity of available jobs.

Many of the comments below would probably be viewed as "negative" rather than "positive." Although some positive comments, such as "I work for a great doctor and with a great team," are included, more would probably have been published if the hygienist had added, for example, "The job market is great here too." The purpose of this article is to publish comments about dental hygienists' perceptions regarding their careers in the current economic climate.

The comments below represent just a fraction of the comments provided. All comments were read, though, and RDH and RDH eVillage remain grateful to the dental hygienists who participated in the survey.

Alabama I am considered well paid for this area of the state. The pending legislation in Alabama for expanded functions is not going to help the hygienists. It will serve to keep our wages low.

• Looking forward to expanded duties for auxiliaries in the state of Alabama. Really hoping they OK it and allow hygienists like myself who went through the certificate program but continue to upgrade themselves through self-education and continuing education to be grandfathered in.

Arizona I would definitely not recommend dental hygiene to anyone as a future career because of the glut of graduates in our relatively small market!

• I live in Flagstaff, where there is a dental hygiene school. Jobs are available, but mostly one or two days per office. Another very frustrating trend is that dentists at a lot of practices make the hygienist go home (no pay) if there is no patient for that hour (or two...or three...). We're treated like waitresses!

• In the Tucson area about 30 dental offices closed due to the economy; in Phoenix this number is about 100!

• There are several more community colleges turning out less qualified hygienists than when I graduated 31 years ago. The requirements are less stringent. It had been a great career up to the last 10 years, glad I am looking at retirement rather than starting this career.

• The lack of salary increases/raises provided is just the beginning of complications in the dental profession in my area. Not only did the number of available positions in all levels of the dental profession fall astronomically, but let's mention how many new dental and dental hygiene schools just opened throughout the state in the last two years. There is now a huge surplus of all dental professionals, a very high rate of unemployment, and dentists filing bankruptcy/closing down their practices permanently. The opportunities continue to decrease with no chances of improvement anywhere in sight.

Arkansas I am employed at two different practices. One practice is slow and the other practice is always booked. I love the career I chose and hope I never regret my decision.

• Within the last couple of years, my employer has had the hygienist start sharing in the write-offs from insurance companies. So, I did get a raise, but I don't make any more money due to having to take write-offs out of my salary.

California We have two dental hygiene schools in our area. One of them graduates a class of 30 every 18 months. Due to the high unemployment rate, many people in our area are losing their dental benefits.

• There is an abundance of associate degree programs that are graduating hygienists in central California. Many have graduating classes twice a year. I believe that factor plus we are needing to stay in the job market longer (many in their 50s and 60s!) are causing the difficult job market.

• As a dental hygiene program director, I have witnessed a decrease in the number of applicants to dental hygiene programs overall in the state. I also know our graduates are having difficulty finding plentiful employment opportunities in desirable locations.

• There are too many dental hygiene schools in my area, which is flooded with tons of new graduate dental hygienists – hundreds of applications for one job opening. It takes about six months or more to find work, and the new grad must be willing to take a 30% pay cut. The dental hygiene market is a mess. It is harder for older hygienist to find work.

• Though hired for a daily rate, I am finding that schedules can't be kept full and so we have to work partial days for less pay. Although very rural, the market is flooded in this area. I have not had a raise in three years, and, with the economy, I feel very threatened. Also, I am sad that hygiene is so narrow a field that other jobs are not available to us beside clinical unless one has a master's or bachelor's degree in hand. A job I once loved is becoming a job of survival and stress.

• Too many dental hygiene schools. Not enough jobs. Some schools are accepting applicants without requiring general education. Employers are noticing these students aren't the most marketable, but perhaps the cheapest employees.

• I teach in a dental hygiene program. We graduate between 10 and 14 students per year and have been in operation for 10 years. Our graduates are now, for the most part, having to leave the area and even the state to find dental hygiene positions.

• I feel there are many part-time opportunities for a day here or there. Full-time jobs with benefits are few and far between. We recently had a hygienist leave that had been at her job for 15 years. We had 50 applicants who applied for the position! For the first time, I also notice more employers wanting you to leave early or leave in the middle of the day if your patient does not show. They want you to eat the "loss" rather than have the loss of income themselves.

• I have worked in dentistry for over 30 years and my husband works in an industry that directly involves him with dentists. Our overall opinion is that most dentists seem to be very resentful about the salaries that they pay their dental hygienists. Because of my salary, my employer doesn't feel I deserve any benefits even though I've been with him for 25 years.

• I work in a college town in Northern California that has always done pretty well in keeping hygienists employed – until recently. Once the university was affected by the economy, it trickled down to the dental offices as people here are laid off and lose their dental insurance. We also have a surplus of hygienists now that there are more hygiene schools in California.

• As more and more private schools are graduating dental hygienists in the Los Angeles/San Diego areas, good positions for hygienists are becoming harder to find. Oversaturation is becoming a real problem. Dentists will start using this to their advantage so all hygienists need to make sure that their patients know their name and have a rapport with them as individuals and teach their patients what a professional prophylaxis should be and to expect no less than the best. When a dentist feels his hygienist is of great value to his practice, he will not replace her for a cheaper young graduate.

• The temporary services now require the dental hygienist to pay all, or part, of the fee when an office they placed you in hires you – a sign of the times with so many "hygiene (puppy) factories." Junior colleges and trade colleges are flooding the market with more hygienists than there are jobs. The tables have turned! This adds to the economic downturn to really give the employers the upper edge.

Colorado There are jobs available, but they require a lot of networking and work to find.

• Fees are being raised for the patients, but as employees we rarely see an increase in our salaries.

• There seems to be a trend in which offices prefer to pay a low hourly or daily rate accompanied by a commission.

• My doctor is afraid of what might happen in the economy. Our practice is thriving. He hasn't given raises for the last two years, because he is anticipating it.

• We had a hygiene program started in the area a few years back, and the market is now flooded. There were already several colleges within two to three hundred miles that offered hygiene programs.

• I have worked at one office for over six years and have not had a raise. My other office I have worked at for over two years with no raise. Yet unnecessary "toys" are bought in both offices. Both office doctors feel we should just be happy having a job.

• I had to leave my city of Pueblo to get a job in another city. I drive 100 miles round trip twice per week. We have a dental hygiene school in my city and have a surplus of hygienists here.

Connecticut Salaries are reasonable, but we need benefits! After 43 years as a hygienist, I will ride out my career, but I would not choose it again.

• It has been over a year and I have yet to find a part-time or full-time job within a 50 mile radius. The Internet sites all push dental hygiene as the best job out there and it has saturated the jobs all over. After 12 years at an office, I was let go due to the economy – what loyalty! But someone not needing benefits took my place. A full-time job with benefits is now nonexistent in this field.

• There are no full-time positions with benefits, and few good part-time positions. The surplus is essentially a result of dentists doing hygiene procedures more. I recently spoke with new graduate dentists who were complaining about all the prophies they had to do. They get hired in the hygiene positions in some offices because they can do the exams, prophies, and the restorative.

• They have recently opened three more dental hygiene programs, which is leading to a surplus of dental hygienists in the state, making job opportunities more difficult. General practices are feeling the pinch of the economy, which has had many hygienists looking to our practice for employment. I am glad I am in a full-time position (as I feel they are going to be difficult to come by as time goes on in Connecticut with these new programs recently opened).

• I lost my job recently because the dentist for whom I was employed sold his practice due to poor financial management. He was always in debt but kept spending. In the 20-plus years I worked there, he had at least three consultants and purchased all the new technology. His staff did not get raises for years. Dentists need to have practice management skills in their training, and if they do not, they should have an office manager to handle this for him/her.

Florida Economically, this area is in trouble. We have too many dentists for the amount of year-round population. We are a very affluent resort area with high prices. There are few jobs (at any income rate), many foreclosures, and little change in the near future.

• I am originally from New Jersey and moved to Florida several years ago, and I have to say finding a job here was so hard! It took me a year to find employment. Dentists here do not want to pay even a fair rate. When they say the pay in Florida sucks, they are not kidding! They really pay you in sunshine and orange juice!

• As a hygienist, you feel insecure that, because of the economy, your job can be replaced by either the dentist or the assistants. I see dentists who have their assistants do cleanings at half the salary of the hygienist, and the patients have no idea.

• I have been seeking employment for a year with no luck. Unemployment has run out and I'm almost homeless due to economic conditions. Dentistry in this area was sparse to begin with but has reached epidemic proportions. I am stuck because I have exhausted all my savings, etc. With no family at all, I don't know where to turn.

• I have not had a raise in four years. When the economy turned sour, I was working four days a week, had two weeks' paid vacation, paid holidays, $150 uniform allowance, and one-week paid sick pay. All gone. I lost whole days or half days if they weren't full. We were a fee-for-service practice and now we are on nine plans. Things have picked up a little, but I don't know if it is the economy or because of the plans. We are working harder and making less. I have subbed as a teacher, but there are no hygiene jobs as foreign dentists have taken any opportunities in our state. I am looking for other ways to keep in hygiene and still keep our family above water. I still love dental hygiene and always will. Hopefully, things will get better soon.

• I have been a practicing hygienist for 35 years and find it frustrating that the numbers of schools have increased in great numbers, but we can still only practice in a dental office. It is past time that the state boards wake up and let us serve the public in more accessible locations. I really do not see dentists breaking down the doors to practice in assisted living homes or nursing homes. No way do the dentists make house calls for people who have trouble getting to the office. I know if hygienists were allowed to go into those places, the public would be better served.

• I work in Gainesville, where there is a dental hygiene school at the junior college and a dental school at the University of Florida. It is extremely difficult for new hygienists to find a job as the area is saturated.

• I had to move 9 1/2 hours away from my home to be able to work as a dental hygienist. I also took a 50% pay cut just so that I could work. No jobs, poor pay, things are not looking so hot.

• We have a dental hygiene program at our community college, but our area has not experienced any growth in dentists in the 12 years I have lived here. There are no openings available for new grads. This puts the program at risk, because the job market doesn't exist here. They have an excellent facility and great instructors, but can't fill the seats with applicants due to the lack of qualified students for this area.

• Foreign dentists populate Florida's hygiene jobs because they can take the dental hygiene boards without any further education in the United States.

Georgia The market in my area is saturated. Along with this problem and the economy, my employer knows I am stuck. I have taken two pay cuts in the last year to "keep my job."

• Georgia has a large number of dental hygiene schools, so the market is flooded and there's not much money to be made unless you work in Atlanta.

• Our area is really being hit by the bad economy. Jobs in this field are scarce. Many patients are losing their jobs, thus their insurance. I fear I may be laid off in the future due to the economy.

Hawaii A new dental hygiene school has opened in the area. It is anticipated that hygienists will soon be flooding the job market. In addition, the dental association is about to introduce legislation to expand duties for dental assistants. It will not be long before there are no dental hygiene jobs and salaries drop.Idaho My employer has never been good about any kind of raise. He has always had a very healthy practice and continues to do so. Our numbers are always up compared to the previous year, yet he continues to use excuses on raises. Now, with the downshift in the economy, he also uses scare tactics to help him keep raises to "never."

• Due to the downturn of the economy and our business, we have laid off auxiliary personnel, vacation pay has been reduced in half, and no more "fun frills" like the staff going out to lunch for an employee's birthday. The chance of bonuses or raises is unlikely for some time. We also receive many résumés for dental hygiene positions, but no new hiring is planned.

• Since the opening of an associate degree dental hygiene college several years ago, there is a major saturation of dental hygienists. Jobs are hard to find and raises are unheard of!

Illinois It is very difficult to find a job in central Illinois, almost impossible to find full-time work. The local community college hygiene program is turning out hygienists who are unable to find jobs. I know several hygienists (new and with years of experience) that are driving an hour or more for work.

• There are way too many hygienists in this area. There is hardly any room to negotiate pay because there is always someone willing to work for less than deserved. Our hygiene schedule has stayed very full and steady; however, the doctors' schedule has started to slow down. It seems like the doctors treat you worse now that they know they can replace you at any time. I have only been a hygienist for 1 1/2 years but I assisted for many years before going to school and I see a big difference in the way the hygienists were treated then compared to now.

• I was laid off from my long-term dental hygiene job. After six months without a permanent dental office, I had to give up dental hygiene and take a steady job as a manager in the community clinic.

• I wouldn't say that it is extremely difficult to find a dental hygiene job in Chicago, but it is somewhat difficult. I see more hygienists piecing together a job with one day in this office and one day in that office. That's how it was when I first graduated in 1978. So things are going backwards somewhat. There are 13 dental hygiene schools in Illinois and I think they are just graduating too many hygienists. Consequently, salaries are going down.

• I have worked for the same practice for many, many years. I have great patients! A hygiene school in the area since around 1995 has flooded the area with hygienists, and it would be extremely difficult to find a job within 100 miles of here, including the nearby metropolitan area.

• There are 13 dental hygiene schools in the state of Illinois and only two dental schools. That means each new graduating dentist needs to employ 6 1/2 dental hygienists to give all new dental hygienists a job. There are hundreds of dental hygienists who cannot find a job within a year or two or graduating. We need more dental schools and less dental hygiene schools with associate's or bachelor's degrees. We need dental hygiene schools to offer more advanced dental hygiene training, like ADHP. Dentists are retiring in our state at a rapid rate and we have no one to take over their practices. Let's get moving on more education and allowing more skills for dental hygienists and change the dental practice act accordingly. There is such an underserved population in the state of Illinois. Counties in central and southern Illinois do not have a dentist, which leaves all of us hygienists out of a job or we must travel a great distance to be employed.

• The person who runs the temporary agency I work out of (when they have anything) tells me she has started to get permanent job openings, offering $5 to $10 an hour less than what was offered a year ago. Many assistants I know now are expanded function. In Illinois, expanded function assistants can do coronal polishing and apply sealants. The doctors are having them do coronal polishing and sealants on children, calling the polishing a "prophy" and billing both services the same way as when a hygienist used to do them. One is doing "prophies" on "children" up to 18 years of age! A hygienist I know whose practice cut her hours from 28 a week to 12 a week says the associate dentist in her office has taken over all the SRPs, since the crown and bridgework has dried up. Three guesses as to where the hygienist jobs have gone. And the first two guesses don't count.

• I have been trying to find another job for two years. I currently work only two days a week at my present office; they can't offer me more hours due to the economy. I have more than 20 years' experience in hygiene, but nobody seems to care. I later found out that, in all the jobs I interviewed for, they hired people just out of school who asked for only $25 an hour. I feel like a dinosaur in this profession. I am looking to leave dentistry as soon as possible!

Indiana There are two dental hygiene schools within a couple of miles of each other, which make it difficult for recent graduates to find employment in the area. Also, I feel older hygienists such as myself (age 49) are staying in the profession a lot longer, which also makes it difficult for recent graduates.

• I have taken a $5 an hour pay cut over the last three years, and have not been able to find regular employment since being laid off at that time. They started offering a dental hygiene program at a trade school in my area that I feel has caused our already saturated market to feel cheapened and even more difficult to find desirable employers. Dentists are letting go of the seasoned hygienists just to hire cheaper ones. I'm not sure this is a good trade-off.

Iowa Full-time positions are hard to come by, but there are many part-time and fill-in opportunities.

• Age discrimination is a very real downside of being a hygienist in a university town and in an area where a community college offers a two-year dental hygiene degree.

• Definite pressure from the oversaturation of new hygiene schools designed to fix the perceived shortage of hygienists. Salaries are sure to decline if my employer can hire a 20-year-old at a fraction of my wage.

Kansas In our state, we have scaling assistants and we are finding it very hard to get jobs. I am currently employed on Fridays. The other days I have to find fill-in work. The job was advertised on craigslist for 48 hours and 55 dental hygienists applied. I felt very lucky to get the job.

• Employers seem to be less generous with benefits. Health insurance changed to a high deductible insurance, and I will no longer receive pay for unused vacation days. Dentists say that I have maxed out the pay scale. At least I have a job!

• In Wichita, the recession hit the airplane industry hard. The unemployed are no longer receiving dental benefits, and this has had a direct effect on dentistry here. Our college in Wichita is producing dental hygienists every year and I know they are struggling to find work as is everyone.

• My hours are cut back, but don't expect to lose my job. Too many dental hygiene schools in the area. Also, scaling assistants hurt the market. They are used in the city, not the intent of the law.

Kentucky My hours have been cut from 24 to 20 at my main office. My dentist utilizes "dental consultants" that stress me out. They threaten to cut my hours more if I don't produce four times my hourly rate per hour. The dentist says if she can't net more per year, she will just do the cleanings herself; however, I don't see how she could do both.

• My students are having a harder time finding jobs than ever before.

Louisiana I was let go in June 2010 due to the economy, and have not found work since. I do look daily for employment. No luck. I live in New Orleans.

• My employer is participating in any available dental plan and our hygiene schedule is full with patients who do not have to pay much if anything toward their visit (many are seen at a reduced rate). The dentist's production is very low right now due to the type of patients we are attracting, who are insurance dependent and do not schedule dental work unless they are in pain.

Maryland Employer loyalty is hard to find, and benefits are hard to come by.

• No raise in three years, furloughed five days this year, and took pay cut.

Massachusetts Local dentists and their association contributed considerable funds to expand a local community college's hygiene program to pump more hygienists into the community. At the same time, the college decreased the acceptance standards. Many new graduates are either unemployed or underemployed. The salaries have also decreased and many dentists hire two part-time hygienists instead of one full-time employee.

• I had another job one day a week at another dental office, which I lost in May 2009 due to a reduction in staff (holes in the doctor's schedules). I haven't been able to find another job since. I work for a temp agency and fill in here and there for previous offices I used to work at. But those jobs are infrequent. I often talk to hygienists who are looking for more hours.

Michigan I have worked for one practice for six years. I have never received a raise. I started working a 40-hour week, and, because I would not take a $7 pay cut, my hours were slashed. I do recall when I can. When I am not there, recall is not done. My employer believes hygienists are overpaid, and feels that they will work for $20 an hour due to the economy. Unfortunately, new grads are accepting low pay due to the economy. I am presently in school full time working toward a master's degree in health administration and a teaching certificate.

• In our office, raises are an annual thing. This year was the first time raises were not given due to economic issues. I have been in the same office full time for 11 years.

• Dentists in this area continue to live a pretty high lifestyle (expensive cars, large homes, exotic vacations, boats, etc.) as office employees have to cut back at home to compensate for the poor economy.

• I would tell anyone who asks not to go into dental hygiene. No jobs. No benefits. Hard on your body. Can't transfer your license to another state. Too many hygienists and not enough jobs to go around.

• My hygiene production has increased this year, yet my employer has refused to provide me with a raise for three years, saying it is my job to provide the added income for him, since he has to pay off his dental school loans!

• I know of some offices that made their hygienists take a 10% pay cut.

• I'd like to work a couple of extra days now that my children are in school. It is nearly impossible to find even a sub job due to the supply/demand ratio. Many people have lost benefits and/or jobs in the state and it has trickled down across the board. Many newer graduates have told me that they've been unable to find employment (for two to three years and still looking) and are worried because subbing jobs aren't available because they have limited experience.

Minnesota Most private practices in the area hire several part-time hygienists rather than a full-time position so as to avoid providing any benefits. The last dentist with whom I worked took a day away from each of two hygienists and hired another hygienist so that he would have a bigger pool of hygienists to draw from to fill in when one of the "pool" called in sick. Each of the two hygienists lost a day of employment but the dentist let us know that he felt better knowing his business would not suffer.

• If business slows down, we have been told our hours will be cut.

• I know dental hygienists are getting hired for less money in my area. I know if I changed jobs, I wouldn't make what I am at this time.

Missouri There are absolutely no jobs in the St. Louis area. There are three schools in the area that crank out very poorly trained associate level hygienists. Salaries keep getting lower and lower because hygienists are so desperate for a job, any job, that they accept extremely low pay. Older hygienists complain about the hygienists accepting the lower pay and ruining the profession, but the new graduates have bills to pay too. The profession of hygiene has gone down the drain because of all the associate schools opening up. It is not a respectable profession.

• Another dental hygiene training "school" has opened locally. Over the past two years, I have noticed a significant $10 an hour decrease in salaries. I am gravely concerned about the quality of hygienists coming out of this new program. We already have two excellent colleges with a dental hygiene curriculum. In my many years in dental hygiene, over 30, I have never seen the job market so poor. The past eight months I have been looking for a permanent position with no luck so I continue to provide temping service. At a recent interview I was told by the dentist, "I feel so sorry for ladies with the years of experience you have because you haven't been paid this in five years." I corrected her that it's been 20 years since I worked for that. I don't see dental fees reducing, yet hygienists are expected to accept ever lowering wages.

Nevada For several years now, graduates from the two dental hygiene programs in Nevada have had much difficulty finding employment. The job market is horrible. Some grads have left the profession! I believe the education programs should reduce their enrollments, at least temporarily, but having been a program director and understanding education politics, I know this is not likely. It is very sad to see the salaries and jobs decline. It is so bad in California and Nevada that I refuse job opportunities to assist in developing new dental hygiene programs in those states. I have been a dental hygienist since 1980. I am glad I joined the profession when I did.New Hampshire I feel that dentists/office management are sacrificing quality of care by pushing hygienists to do quantity for less income. Dentists know they have hygienists in an awkward economy, and they strive for more office time in cleaning the office, and less effort on personal patient care. They are willing to pay less for a hygienist who is willing to do front desk work, clean offices, and assist the doctor, thus making it very difficult for a hygienist career. I hear this story all around. I feel the low economy has benefitted the dentist, now getting the hygienist to do all those low, dirty jobs that they use to employ other people for. I have heard many hygienists say that "they went to school to learn how to clean teeth, not toilets."

• I work in two different offices to get three days a week. I have been looking to pick up a fourth day for over a year. Full-time positions are unheard of, and I receive no benefits. When the offices are closed for vacations or holidays, I am unpaid. I pay for my own health insurance and continuing education because as a part-timer I am worth nothing. Trying to temp, but may get one day monthly somewhere for a greatly reduced hourly wage. I know many other hygienists in my position. Not only new graduates who cannot find any employment, but older, experienced hygienists who have had their jobs cut due to the economy. It is scary. We take what we can get, many of us supplementing with nondental jobs. They have even laid off clinical instructors at the state school. Whoever said hygiene was the next big career opportunity had no idea what they were talking about.

New Jersey If I could find a way to work for myself (moving to a state that allows independent hygiene practice or choose a another career), I would do it in a heartbeat. I give 100% of my effort for the practice where I work, but I do not get much on return. They blame the economy; I say it is poor management. The economy is just an excuse. The schedule is packed, and hygienists have to do so many duties within a 40-minute appointment time. Being in a small town, a $37 hourly rate is not bad, but I did not get a raise for three years.

• With my 27 years' experience in the field, it is my opinion that the only way to earn competitive salaries and benefits is for an RDH to periodically change practices. Hard work and loyalty are not rewarded in this profession. Benefit packages are almost nonexistent as a fair number of doctors hire only part-timers to avoid this.

• The practice I work in is making money. The doctor put himself before the rest of the staff, making us wait for a paycheck while he pays himself. He is using the economy to bully his staff!

New York Salaries in the New York metropolitan area depend on years of experience, location, and type of office you are working in. Some hygienists' salaries also depend on how many cases they can sell for the month.

• I have worked in the dental hygiene field for over 33 yrs. I have always felt that, even though our hourly rate is high, there are no benefits such as health insurance or 401K associated with this career. Now that I am nearing retirement time with hardly anything in my employer benefits package, I find I am having to work longer even though a major portion of my salary went into my own savings plan because of the hard economic times. I suffer from back problems from this career and it is extremely painful to work some days. I don't see myself stopping anytime soon. I also see several friends and family members who chose different careers now retired and living comfortably with their "pensions," which I never had. I may also add that these people have just high school education and do not have to complete CE courses every year, which are paid for by myself. I would never make this career choice again and have advised others thinking about this to think hard about their future!

• I feel some employers are taking advantage of the economic downturn and are not compensating their staff with raises even though their income has been steady. That's unfair. There are more duties required than years ago, more assessments required now, within the same amount of time. Many hygienists are getting burned out!

• By having a dental school and a hygiene school in our area, there are so many dental practices in our area where the dentists can pay such a low salary. If the hygienist seeks a higher salary, the doctor moves on to another hygienist.

• There are too many hygiene programs for the amount of hygienists needed today. It is a matter of supply and demand. We need fewer graduates and/or programs until there is a greater need for more hygienists. Until this is done, many hygienists will find it very difficult to secure employment.

North Carolina I was fired in September 2010 after 11 years with the practice. I'm very discouraged with current lack of openings due to surplus of younger hygienists working for low pay.

• Since I graduated dental hygiene school in 2003, I have lived in two different cities 2.5 hours apart. During the seven-year span, I've been called for an interview for only one full-time hygiene position within a 30 mile radius of my home. I am a single mom of a child with special needs, so staying close to family/home is important. I've been able to support my son by stringing together a couple of one day a week hygiene jobs, signing on with three dental temporary agencies, as well as taking on seasonal tutoring jobs, and substitute teaching. In North Carolina, there does not seem to be the availability of hygiene jobs that were "promised" when I began hygiene school. In my small town there seems to be a glut of dentists, and with the economy the way it is, only the ones who accept Medicaid seem to be relatively busy.

• There are too many dental hygiene schools in my area – six! The job market is flooded, and we have become less valued as employees.

• Don't bother trying to get a job in North Carolina. Get into another field. There are no jobs here.

North Dakota The lack of available positions in the area creates lack of movement and improvement for dental hygienists. Many dental hygienists are currently in positions in which they compromise their standard of care and ethical philosophies. Because they need the income, they stay and hope for the day when they can find work in an office that matches their work ideals.

• In the past 15 years the cost of a prophy has doubled, but my wage has only increased by a few dollars.

• The dental hygiene profession in North Dakota is saturated. There is one school and the graduating numbers have also dropped.

Ohio We have a surplus of new grads that have not found positions – too many schools, too large of classes, and the old girls are not retiring.

• I am thankful for my jobs in these terrible economic times. In Cincinnati, the market seems to be saturated. If it weren't for my awesome patients I would have been gone a long time ago! I will be glad when my dental days are done! I have worked for one dentist part-time for 11 years and never offered one day of holiday pay, vacation, sick pay, never says "thanks for all your years with us." Just leaves me with a bad taste in my mouth, but, because there is nothing else out there, I am stuck there.

• Our production is down right now, but I think it is my responsibility to do everything within my power to help improve that.

• In northeast Ohio, there are very few jobs with as many as 50 or more hygienists applying to each position. Community colleges continue to crank out 25 grads a year without an increase in positions. We have three hygiene programs in northeast Ohio alone, not to mention the five or so other hygiene programs in the state.

• Our area depends on the auto industry for most of the jobs. When insurance benefits were taken away from the retirees, we took a big hit. Retirees won't consider treatment not covered under insurance even for routine preventive procedures when "nothing hurts."

Oklahoma We haven't received a raise for over five years in my office. I just keep telling myself I should be grateful I have a job. I have thought about looking elsewhere, but I really enjoy my patients, and friends have told me that there are very few job opportunities around here. I have friends who have lost their jobs or who have had hours cut.

• Took a pay cut to have permanent two days a week. Used to temp but that slowed down so much that I had to seek permanent placement.

• Business has really slowed, to the point that our dentist recently took away all paid vacations for all employees.

Oregon Permanent employment opportunities in my local area are very sparse, even though the number of dental offices is plentiful.

• Too many hygienists on the market, and employers are getting cheaper about compensating for what hygienists do every day. My income has gone backwards. My employer has found ways to reduce my pay. Every change they make, my paycheck shrinks some. I am trying to complete my bachelor's degree for possible career changes.

• I could try to find a better paying hygiene position; however, jobs are tight, turnover is practically nonexistent. This is interesting because there will be a new dental hygiene school starting in 2011 in Salem. I do not think the economy will be of benefit for the new graduating hygienists, and there will be a growing number of hygienists for the shrinking job market in this area. I am changing to other employment opportunities, but will still be doing dental hygiene one day per week.

• Due to the surplus of hygienists, a raise is not in the near future. Some recent grads of hygiene schools have not been able to find employment in this area.

Pennsylvania I think dentistry was pushed to the limits by managed care. The recession may have pushed it further. Good luck to all new grads. Although we all know dental care is a medical necessity, food on the table and a roof over one's head are more important; dental care isn't as high a priority.

• In my one office, I received a dollar raise this year after five years. I have been employed there for 20 years. We feel our bosses know this, so they can treat us poorly and know that we will stay. Also, I feel that they don't care if we leave or not, as they can easily replace us. We have a dental hygiene school about one hour from us that graduates 20 or so hygienists every year. We are stuck.

• I've been wondering why I chose dental hygiene as a career lately. Been in the field for 24 years. Most employers I have had care only about the money they make and not the patients or their staff. I don't know what makes most dentists so greedy. I have been with my current employer for three years and haven't gotten a raise. The entire staff all see how the doctor is benefiting financially from his practice, but he is not willing to spread the wealth to his staff. I think my boss is using the weak economy as an excuse to not give out raises.

• I feel that dental hygiene is an excellent career choice and have never regretted going back to school and getting a different degree to change my career. No matter the complaints, we are still paid well in a job that offers some autonomy and job options.

• My raise that I received was the first raise I received in about three years. Salaries in the Allentown and surrounding Lehigh Valley areas remain lower than Philadelphia area due to a dental hygiene school close by and a huge surplus of hygienists.

• You are less likely to get a raise at the moment. The doctors blame the economy. I am also substituting as a subcontractor, so I get paid whatever I ask. But I try not to go too high, so that I get callbacks. It's a bit harder to find a job right now, due to most hygienists sticking with the job they have.

• There are too many dental hygiene schools in Pennsylvania, particularly the Southeast. It makes it difficult to find quality employment.

• I'm a recent graduate and I've worked in one office for almost a year. Since I work in an area with several hygiene schools, my wage is lower than a lot of hygienists elsewhere; I'm not in a position to move and I'm not sure when it'll be appropriate to ask for a raise.

Rhode Island I work at an exceptionally great practice. We have over a million dollar practice through years of superior service. There is no advertising done to acquire almost 100 new patients a month. It is all word of mouth. They have high standards for their employees and if you are not performing up to standard, then you are dismissed. I have been a hygienist there since I moved into this area over five years ago and I have never experienced such a well run practice. Overall, the practice does so well because all employees are well trained and respected by our employer. We are compensated well for our excellent patient care and the patients keep on referring to us because they love it!

• I'm one of the lucky hygienists in my area. I work in a good practice for a good dentist who treats us well. But, I hear from many of the newly graduated hygienists that good jobs are hard to find.

South Carolina The dental hygiene schools in South Carolina and North Carolina are accepting and graduating too many hygiene students for these two states. There are hygienists who graduated three years ago and cannot find permanent jobs. The class of May 2010 have only two students employed in permanent positions. Class of 2009 has over half of their class unemployed or can only find part-time positions. The economy is not all at fault for the dental hygiene positions not being available. These states need to allow more hygienists per dentist, dental hygiene practitioners should be allowed to check hygiene if dentists are not available or busy treating a patient. North Carolina should consider general supervision and begin to watch their business grow rapidly. Something needs to be done quickly or hygienists in this area will be worth 15 dollars an hour.

• The market for dental hygienists in my area is highly saturated. There are very few full-time dental hygiene jobs and very few offer benefit packages.

South Dakota Our graduates from May 2010 all have jobs, but many are part-time or subbing, so it is more difficult to find jobs than it used to be but I would not say it is extremely difficult. There is a surplus, but not a large surplus of dental hygienists in the area.

• While I work for a growing and busy practice, I know other hygienists in our area are concerned about job stability, as their schedules have been affected. It is also hard for the new, recently graduated hygienists to find jobs in our area.

Tennessee I work in a rural area in Tennessee. TennCare has really helped our business because so many factories have traveled across the sea, therefore the insurance benefits went with them.

• Due to the economy, hygienists are working longer than in the past. I also think there are too many dental hygiene schools. There are more hygienists looking for jobs. It's simply supply and demand.

Texas Small area with a dental hygiene program nearby that limits available positions. My salary for a year is $40,500 for a 40-hour work week, but I am thankful to have a job doing what I love to do!

• I worked in the St. Louis area from 2008-2009 and found the demand for hygienists was pretty low as the market there is oversaturated with hygienists. I worked three part-time jobs just to make full-time hours, and even then the pay was poor and benefits were hard to come by. Had I filled out this survey at that point in time, my answers would be very different. I moved back to Texas from Missouri in order to find good work and good pay once again! And now I am happy once again with my career as a dental hygienist.

• The hygiene department is just as productive as in the past, but, due to the drop in doctor production, hygiene revenue that was once shared with the hygienist is now used to pay other operating expenses. This is a bitter pill as I am working harder and longer while the dentists appear to be maintaining their same lifestyle. They work three days a week, have multiple homes, and take multiple vacations. They have a Cadillac health insurance plan that most employees cannot afford to participate in.

• Hourly rates have remained stable but hygienists in my area are slowly losing all their benefits.

Utah Before I was unemployed, I made $35 per hour with three weeks' paid vacation. Utah has way too many dental hygienists because of all the dental hygiene schools, so work is hard to find. My friend and I just moved to two different states and are frustrated trying to find a job. There are way too many hygienists and not enough jobs.

• I have not been in the market for a job for many years, so I am not one to judge that problem. I do know that there are a lot of new dental hygienists who have trouble finding jobs.

• I am currently taking two-week unpaid leave right now, due to the poor economy. The doctor is also closing down a few days for the next couple of weeks. Lately, there have been more hygiene patients scheduled than restorative. It looks scary.

Vermont In my opinion, there is never a surplus of dental hygienists because there is never a shortage of people needing oral health care; we just need to provide them with access.

• There is now such a surplus of newly minted hygienists that my employer feels he doesn't have to give well earned and deserved raises. He could always hire younger, less experienced hygienists and get away with paying a lower wage! There is no loyalty or respect for my profession – it's all about the profit for him!

Virginia We have so many dental hygiene schools in our area (southwest Virginia), it is really hard for any new or relocated hygienist to find jobs.

• There appears to be a decline in salaries. More employers prefer to pay hourly and pay for fewer hours. I have not received a raise in five years. I have recently received a temp offer for $30 to $35 an hour when I normally earn $45 an hour.

• Team Placement has been bringing dental hygienists here from other states and giving them jobs before placing local dental hygienists in the jobs. Most practices have not given raises for the last couple of years, saying that the economy is the reason, although the hygiene schedule is always full.

• There are three dental hygiene schools in this area – two bachelor's and one associate's programs. These schools are within 70 miles of one another. There was a study done about three years ago saying that dental hygiene was one of the top 10 fields of employment to consider. Unfortunately, the field has exploded and there are no available jobs in this area that are full-time, even fewer part-time. There are few to no ads in the paper for dental hygienists in the area. Hygienists are now forced to stay in the job they are in even if they want to leave that job and move to another practice. New and older hygienists are waiting more than a year to find employment in the area. When a dentist wants to hire a new hygienist, more than 60 resumes can pass over the doctor's desk. They are choosing the new hygienists over the seasoned hygienists so they can pay them less money. With the economy so low, a part-time extra job is impossible to find. Hours are reducing due to lack of patients coming into the office. If the economy does not change within the next year, I believe there will be a lot more hygienists out of work. We are trying to protect our profession as well. The DA11 position will be approved soon and then our livelihood will be in jeopardy as well. Why should a dentist keep a hygienist when the assistant can scale, regardless of those patients having periodontal disease. We are in very scary times.

• Economic shortfall has severely affected practices in limited socioeconomic areas. I was laid off in spring 2009 because, even though the practice was in a high earnings area, the practice was small and several corporations that employed most of the patients/families downsized or closed down. So being in a high earnings area does not guarantee job security, if major corporations that suffer from economic problems employ most of the clientele. I am now working three days a week in Richmond, but the area is more economically diverse. Things have slowed down even at this office, but it is near a university and there is a diverse populace surrounding the office, which helps a lot. I have not been able to find four days a week. Full-time jobs, once plentiful, are now hard to come by; most hygienists are hanging onto their full-time positions if they can.

Washington Although the practice is healthy in regard to the hygiene schedule being full and profitable, the restorative schedule has slowed considerably over the past 18 months. So the owner/dentist has taken to cutting hygienists' hours, doing some hygiene himself to fill his time and save on expenses of paying hygiene salary. He has always had a knee-jerk reaction to local economic climates that affect his schedule.

• I would like a raise, but will not leave the practice. I am treated with respect and have had some of the older patients for 27 years. Some things are worth more than money.

• Portland/Vancouver areas are flooded with dental hygienists. There are five dental hygiene programs! It is ridiculous that the schools are pumping out grads like little gingerbread men. I have been to interviews for an one day a week position, and was told they had 100 to 150 resumes for the position! I have started to expand my job search efforts farther from home and recently had an interview with a seemingly wonderful office, but I would have to commute 1 1/2 hours each way to take the position. I believe wages are going to start coming down too. One dental hygiene position I saw a few months ago was offering $28 per hour, which is quite low considering dental assistants can make that much, and EFDAs (which are new in Washington state) are demanding $30 to $40 per hour according to some online posts. I am just so frustrated with what is going on in dental hygiene right now!

• There is a newer dental hygiene school about 50 miles from here, and there are more hygienists than jobs. This has caused wages to be more stagnant, plus the economy has made the practice slower. But it is affecting the dentists' production more than the hygienists'. People who have insurance are still coming in for routine care, but don't seem to be spending as much on cosmetic dentistry and will do a lesser cost option if possible.

• With more dental hygiene schools opening, I foresee a trend for fewer jobs available in private practice, but tremendous opportunities for hygienists to practice in alternative practice settings, especially as legislation changes to allow hygienists to do what they are trained and licensed to do without the supervision of a dentist. I foresee more collaborative practice agreements, as we have in Washington state.

Wisconsin The dentist I work for on Mondays has been trying to hire only new grads so he can pay them less, and he pays them less than I started out in 2006 ($29 an hour). I think it's sad. He's blaming the economy, but he bought a panoramic machine and a laser in the last two months. He and his wife both bought new vehicles and put wood floors in their entire house. From what I hear, it seems like new grads are accepting less and less.

• I just graduated in May, but only a few of my classmates have yet to find a job. In fact, most of those that have a job are quite happy with their pay and hours. The situation was nowhere as bleak as many people painted it.

• Due to a surplus of dental hygienists in the area, dentists are able to keep salaries low and benefits few in the private setting. We have a technical college in the area that graduates 20 hygienists a year (many are nontraditional students) and there is simply not the turnover to support that many grads year after year. Dentists know this and take advantage of the situation.

• Salaries have remained steady and consistent, but benefits have been greatly reduced or eliminated.

• Dental hygiene is still rated as one of the top career choices in the country. Why? I understand that there are still underserved areas but this is mostly due to the choice of dentist's location to practice and the economic environment. For the most part, this career choice is very limiting and you really have to love your job in order to stick with it for an entire career!

• The trend is to get rid of the older, more experienced hygienists and hire new hygienists at $10 to $15 less per hour. There are too many hygienists out there!

The average hourly rates for the 22 states with the highest level of responses to the RDH eVillage survey: California ($48.08), Washington ($42.96), Virginia ($41), Colorado ($40.01), Arizona ($39.23), New Jersey ($39), Massachusetts ($38.53), Oregon ($36.37), Texas ($36.34), Illinois ($35.97), Georgia ($34.58), New York ($34.04), Indiana ($33.60), Minnesota ($32.91), North Carolina ($32.70), Missouri ($32), Ohio ($30.53), Florida ($30.42), Pennsylvania ($29.70), Wisconsin ($29.50), and Michigan ($29.38).

States with the highest percentage of dental hygienists who receive health insurance as an employee benefit: North Carolina (71%), Oregon (68%), Florida (58%), Massachusetts (58%), Washington (58%), Colorado (56%), Maryland (55%), Connecticut (53%), New Jersey (53%), and New York (53%).

States with the lowest percentage of dental hygienists who receive health insurance as an employee benefit: Louisiana (19%), Indiana (20%), Texas (31%), Illinois (33%), Michigan (34%), Tennessee (35%), Ohio (38%), Iowa (41%), Kansas (42%), and Missouri (42%).

The average hourly rate for metropolitan areas with 20 or more responses: San Francisco-Oakland-San Jose ($53.67), San Diego ($47.74), Washington, D.C. ($46.34), Seattle ($45.55), New York City ($40.53), Phoenix ($40.14), Denver ($39.42), Chicago ($37.46), Atlanta ($37.02), Dallas-Fort Worth ($36.12), Philadelphia ($34.84), St. Louis ($32.73), Detroit ($31.11). Los Angeles readers exclusively reported daily rates, where the average is $395 a day.

Percentage of hygienists who say "schedules are always full" in states with at least 25 responses: Massachusetts (36%), Oregon (36%), Tennessee (32%), Texas (32%), Maryland (29%), New Jersey (29%), New York (28%), Washington (27%), Missouri (26%), Wisconsin (25%), Indiana (23%), Pennsylvania (23%), Virginia (23%), Colorado (22%), Ohio (22%), California (20%), Illinois (20%), Minnesota (19%), Florida (17%), North Carolina (15%), Arizona (14%), Michigan (13%), Connecticut (12%), Georgia (10%).

Percentage of hygienists who say it is "extremely difficult" to find a dental hygiene position in states with at least 25 responses: Michigan (86%), Minnesota (81%), Ohio (80%), Wisconsin (76.5%), California (76%), Florida (76%), Illinois (75%), Arizona (72%), North Carolina (72%), Georgia (71%), Indiana (71%), Tennessee (67%), Missouri (66%), Connecticut (58%), Oregon (58%), Washington (50%), Virginia (49%), Massachusetts (46%), Colorado (43%), New Jersey (42%), Pennsylvania (39%), Maryland (36%), New York (35%), and Texas (29%).

Percentage of dental hygienists who say it is "highly likely" that they will leave the profession due to economic factors in dentistry: Connecticut (21%), Illinois (13%), Florida (9%), Virginia (9%), Ohio (8%), Pennsylvania (8%), Washington (8%), Maryland (7%), Michigan (7%), Oregon (7%), North Carolina (7%), California (6%), Missouri (6%), New Jersey (6%), New York (6%), Wisconsin (5%), Tennessee (4%), Texas (4%), Indiana (3%), Minnesota (3%), Georgia (2.5%), Arizona (2%), Colorado (2%), and Massachusetts (2%).

Percentage of dental hygienists who believe they do not receive pay raises at "fair" intervals: Virginia (77%), Ohio (75%), Florida (73%), New Jersey (71%), California (70%), Michigan (70%), Colorado (68%), Georgia (68%), Indiana (68%), Tennessee (67%), Massachusetts (66%), New York (66%), Illinois (64%), Missouri (64%), Pennsylvania (64%), Texas (64%), Washington (64%), Minnesota (63%), Connecticut (60%), Maryland (59%), North Carolina (59%), Arizona (57%), Oregon (52%), and Wisconsin (50%).

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