The inevitability of change: Is dental hygiene education today's version of snake oil salesmen?

July 1, 2017
Dorothy Garlough, RDH, argues that dental hygiene education may be misleading dental hygienists about their careers.

By Dorothy Garlough, RDH, MPA

Snake oil salesmen of the 1800s had a bad reputation. Although modern science shares some of the benefits of snake oil,1 snake oil salesmen are more commonly seen as charlatans. These salesmen made less than transparent claims regarding the effectiveness of their products (medicament, ointment, or tinctures). They would then quickly leave town before the townspeople discovered the worthlessness of the claims and products.2

I can’t help but wonder if some of our private hygiene schools employ similar tactics regarding the changing nature of the hygiene profession. I recently met two young hygienists who feel like they have been sold a line by the private hygiene school they attended. When they applied for the program, they were told that hygienists are in huge demand, there is a plethora of jobs awaiting them, and they would command great salaries.

Both of these bright young women walked away from our honorable profession, disillusioned because they couldn’t find even regular part-time employment in this area. Both have taken other modest paying jobs with the goal of paying off their hefty school loans. One is thinking about taking on more loans to obtain training in what she hopes will be a more marketable field.

The system failed these two young women. Were the private schools so hungry to meet their student quota that they didn’t paint a clear picture, or was their attitude one of “buyers beware”? Who is accountable for the misconception or miscommunication to these two women, or have times simply changed?

Graduating at a time when students wore caps, I entered the workforce when the dental hygiene profession was far from saturated. Clinical positions were easy to find, and because there were fewer schools with a limited number of openings, there was also a limited number of hygienists. Supply was low and demand was high, which affects the marketability of any profession. The hygienists of my era had earnings that corresponded with this reality.

That was then. A different picture is presented today for many hygienists, such as the two women mentioned here. With more hygienists in the market, there is a greater supply and less demand for our services. This creates an atmosphere where some doctors hire hygienists for less money. Associates who buy practices from retiring dentists often let the more experienced hygienist go. They can hire a less experienced hygienist (who needs to pay off school loans) for less money. Whether we agree with it or not won’t influence the market. It is the reality and the nature of business, and our profession is not exempt.

Socrates said that the secret to change is to focus energy not on fighting the old, but on building the new. Yet we often resist change, and the more disruptive the idea, the more pushback we give. We are too often closed off to trying new things. We are driven by a perception of loss and we have an emotional response. We’re not necessarily afraid of the new, but we’re more concerned about the consequences of loss.

Experts agree that there are two main reasons people do not willingly adopt change: the fear of loss of our livelihood, and the fear of loss of our identity.3

There is nothing new about the unwillingness to embrace new ideas, processes, or innovations. Humanity has always feared change. Even those people considered the backbone of our country opposed adopting mechanistic changes of their profession. For example, farmers did not welcome tractors because their livelihoods and identity were at risk.

At the turn of the 20th century, tractors made their debut and were met with an uproar of disapproval from the farming community. Farmers passionately argued that tractors would never replace horses and that tractors were inferior. Early tractors were clumsy, broke down often, and they quickly depreciated. Unlike horses, they could not replace themselves by reproduction. There was more resistance because farmers felt that tractors would compromise their independence. They would have to rely on outside sources for gasoline, parts, and repairs.

The whole identity of the farmer was at risk. Farmers were connected to horses and this was who they were. They claimed that people were not interested in seeing machines work the field, and that the public and the farmers wanted the pastoral look of horses working the land. 3

Tractors eventually won out because machines had the ability to improve production. As technology developed, so did the tractor, whereas the horse had reached its limit of improvement. Tractors were more diverse, and since they could harrow, cultivate, and plow, great expanses of land made them much more efficient than horses. Tractors made farmers’ lives easier and more profitable. Although I agree the pastoral look of horses working the land in the Mennonite Community near my home is quite pleasing to the eye, it is inefficient compared to a John Deere tractor.

Hygienists today fear both the loss of livelihood and the loss of identity. The changing landscape of our profession is disruptive to some, and frightening to others. We need to recognize that time never stands still, and change is in perpetual motion. We can’t stop time and either we adapt to the new or we get left behind.

If we understand that change is a process, we might be more prepared for the future. Instead of fighting to retain the old model, we can focus our energies on embracing the new. There are still plenty of opportunities in our profession, if we recognize that the landscape is changing. Those who are willing to plow out of the old turf and into the new will discover new possibilities, and early adopters will lead the way for others.

There will be a seminar at RDH Under One Roof in Chicago that will inform and inspire you. Sponsored by Colgate, “Open the Door to Your Career Opportunities” will focus on the career paths of four hygiene leaders who have embraced change in four different ways: Phyllis Martina - corporate; Christine Emmert - public health; JoAnn Gurenlian - education; and me, Dorothy Garlough - entrepreneurship. This final event of the conference will introduce you to the possibilities of career prospects and motivate you to look at the panorama that is being created within dental hygiene today.

There will be no snake oil salesmen tactics and no hidden agenda. The workshop’s goal is to inspire and offer solid advice for hygienists to look ahead, visualize what can be, and become early adopters. By embracing the new, we can navigate the changes and discover career opportunities that will help us grow in ways that many may not yet be able to see. Innovation supports that if we can perceive it, we can create it. The result is a bright future for our profession and ourselves. RDH


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Dorothy Garlough, RDH, MPA, is an innovation architect, facilitating strategy sessions and forums to orchestrate change within dentistry. As an international speaker and writer, Dorothy trains others to broaden their skill-set to include creativity, collaborative innovation, and forward thinking. She recognizes that engagement is the outcome when the mechanisms are put in place to drive new innovations. Connect with her at [email protected] or visit