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Exploring career alternatives

March 1, 2018
If you’re considering a job change (whether by choice or necessity), the world of dental hygiene career alternatives can seem overwhelming. But, in many cases, there are viable alternatives to working in an operatory. Whether by getting additional education or considering independent practice, there is much you can do to choose your own path.
The path is yours to choose if tired of traditional settings

By Jamie Collins, RDH, CDA

A degree in dental hygiene does not limit someone to working in a clinical operative setting—breaking free of the “op” is a viable option. For so many, a degree in dental hygiene means being in the clinical operative setting without many options, where for others the operatory is only the first step in a long-term plan. Still others explore dental hygiene career alternatives of necessity or in response to unplanned opportunities.

For many dental hygienists, the clinical setting has been the place to establish connections and serve the population. I have met some of my best friends and favorite patients this way over the years. I love the clinical aspect of our profession—not for the work, but for the human interactions and connections to families that I get to watch grow and prosper along the journey. I have been involved in patients’ lives enough that they have called to share life events, both joyous and heartbreaking, with me. This is what makes my career choice one that I have fallen in love with. But clinical practice may not be for everyone, and the beauty of our degree and knowledge base is that it does open some options to explore.

The aches and pains of the daily grind of contorting yourself to see the deep, dark areas of the oral cavity make clinical hygiene too painful for some, and they are driven from the operatory sooner than planned. Looking at alternative paths can be overwhelming when your body is not keeping up with the plan. The exit from the clinical operatory may be by choice, but either way it may require more than an associate degree. The majority of the over 300 dental hygiene education programs in the United States offer an associate’s degree that serves as the basic standard to take the boards for licensure and employment in a clinical setting, but to expand beyond that, you will likely need additional education.

If you are someone who, like me, seems to have multiple irons in the fire and enjoys the challenge of pushing your comfort zone, then maybe sales, consulting, or teaching are possibilities for you. The following are some career alternatives and what you can do to achieve them.

Nontraditional clinical options

There are options to keep practicing clinically, even if you are not in the traditional dental office setting. For example, the state of Washington employs hygienists to provide in-school sealant clinics, as well as basic functions (e.g., fluoride treatments) and referrals as necessary. Obviously, the hygienist only works when school is in session. Providing these preventive services reduces the need for emergency care and the incidence of childhood caries, especially for those who may not have access to care otherwise.

Follow your passion and plan your route—the journey is one to be written by you, no matter which road you take.

Addressing access-to-care issues among the elderly also offers nontraditional clinical opportunites for dental hygienists. As some of my elderly patients can no longer drive or care for themselves, they seem to disappear off the schedule. After visiting a retirement home, I realized how many of this aging population do not see a doctor or even a dentist on a regular schedule. The elderly are often the generation most in need, with the highest risk of oral conditions and complications such as xerostomia, root caries, and periodontitis. With so many being wheelchair bound and unable to travel much, let alone having a reliable form of transportation, the dental office is not a priority. A great hygienist in Oregon has established her own business and is now serving the elderly with mobile equipment, meaning she is earning her living while working for herself and providing the care needed by going to the patients. She has stepped outside of her comfort zone of working within a conventional dental office to become self-employed—and serving a need with passion. There are hygienists who are employed with Veterans Affairs who care for our veterans within the clinics and hospital settings as needed. The satisfaction of working in this type of environment and serving those who might otherwise find care difficult or impossible to obtain is what drives some hygienists to move from the traditional office setting.

A relatively new career path of a dental therapist is emerging in many states. States such as Maine, Vermont, and Minnesota have approved alternative practice for hygienists in one aspect or another. California and Colorado are at the forefront of creating legislation for midlevel practitioners; in other states, some legistlation has failed and or is still in development. Most importantly, this is a conversation that may help us expand the field of hygiene. For example, in Colorado and California, within certain regulations and licensure, a hygienist may own his or her own practice, unsupervised by a dentist. Being your own boss can allow for a flexible schedule and create your own potential. Your success is based on you and how you would choose to operate your business.


Teaching is a challenging and rewarding career path, often coming with preparation outside of the classroom setting. A bachelor’s or master’s degree is necessary in most dental hygiene programs to be qualified to teach. The education route offers you the ability to work outside of the home during the hours students are in session, and home when they are off. For many of us with children, this is an appealing option because it increases the odds we can be home while our own children are out of school for holidays and summer breaks. Teaching is not for the faint of heart; working with all types of personalities and finding the patience needed to teach the necessary skills can be challenging. I have taught students who are older than myself and from all walks of life, and finding the balance and learning styles for each student can be difficult, but it is also one of the most rewarding opportunities. RDHs who want to break into education may find it easiest to get their foot in the door as clinical instructors and eventually may be able to move into the didactic classroom setting. From teaching at the college level to public speaking and providing continuing education courses, all realms of education are possible.


Most sales positions require at least a bachelor’s degree. That being said, experience and knowledge can often play a large part in the hiring process. Dental sales provide a realm where your dental knowledge and networking skills can be put to good use, and provide a social environment since you may be visiting many offices each week. Many positions offer a baseline pay plus commission, which provides potential for high income if that is what drives you. Maybe working as a clinical trainer or educator for one of the many dental-based companies can provide a change or an outlet from the operatory, thus providing a little variation in the day.

Follow your passion and plan your route—the journey is one to be written by you, no matter which road you take.

Working as a clinical educator for a dental company can provide a flexible schedule, which can allow you to work around clinical practice. I have many friends who work in this aspect of dentistry and enjoy the flexibility it brings. Flexibility varies depending on the company and the position, but most clinical representatives enjoy travel and the ability to interact with many different people. Acting as a key opinion leader (KOL) offers a variety of involvement opportunities with many companies. Many companies, large and small, use KOLs working in the clinical office setting to provide input on the industry and products.

Writing and speaking

Some of us desire to teach and share with others. Most hygienists are social beings and enjoy the human aspect of the profession. Deep down, we are all teachers and caregivers, whether providing patient education or listening to others. If writing or speaking is what you desire, finding your niche is the key—if you are passionate about your topic, the likelihood of success increases. I choose to speak on topics that I live each day with the passion that drives me to improve. There is no specific degree required to speak. Knowledge is the key.

If you are like the majority of hygienists out there and have an associate’s degree, you can work a long, successful career in or out of the operatory. If you desire to continue your education, dental hygiene career alternatives can be overwhelming to sort through, but there is bound to be one that is right for you. A clinical schedule leaves little time to attend classes at a traditional campus, but online completion courses are abundant and varied. With everything from the online degree completion at any of the stateside schools to the international programs, such as O’Hehir University, you can continue your education and work toward opening doors.

My dad always stressed the importance of a good education when I was a teenager. He said it didn’t matter if I chose to use it, but there would always be the safety net of knowledge and a degree. Follow your passion and plan your route—the journey is one to be written by you, no matter which road you take. Whether you are headed on the path you planned as a new graduate, or your journey takes you down a different road through circumstance and opportunity, it is your story to write and impact others.

JAMIE COLLINS, RDH, CDA, resides in Idaho with her husband, Cory, and their four children. She currently works as a full-time hygienist as well as an educator at the College of Western Idaho. In addition, she acts as a content expert and contributor in multiple upcoming textbooks. She can be contacted at [email protected].