From license plates to checkbooks, I tell everyone I encounter: I scale

I love reading personalized license plates. It tells me a great deal about the person behind the wheel. What does the driver do for a living, for example? As hygienists, we are proud of our profession, and we love to tell the world. We show our pride and solidarity in a number of ways, including license plates: 2THBIZ, 2THFARY, BRUSHEM, FLOSSEM, SPARKLE, GR8 RDH, ORLJNTR.

Heidi Emmerling Jones, RDH, BS

I love reading personalized license plates. It tells me a great deal about the person behind the wheel. What does the driver do for a living, for example? As hygienists, we are proud of our profession, and we love to tell the world. We show our pride and solidarity in a number of ways, including license plates: 2THBIZ, 2THFARY, BRUSHEM, FLOSSEM, SPARKLE, GR8 RDH, ORLJNTR.

Oral janitor? That last one makes me bristle. I certainly hope this is an attempt at irony. Unfortunately, I think people assume my colleague literally sees this as her role. After all, most hygienists can relate to the scenario of having the cantankerous patient tell us, "Just do your job and clean my teeth, honey. I don`t need any lectures."

Having someone say this to me puts me right on my hygiene high-horse. Over the years, I have tried to restrain my knee-jerk indignation at such demands - but the demands still get to me. Isn`t it bad enough we have to fight the public`s perception of us as tooth scrubbers without perpetuating that image ourselves? Is that how we see ourselves? As dentition dusters? Not I. Not most hygienists I know.

"Just do your job." What does that mean? According to a former employer, my main job was to make him happy. Ha! According to a comment by Dr. Burton Press in the July 1995 RDH, it is a hygienist`s job "to make people love her." I adamantly disagree. The article, which quoted dentists` perspectives on the dental hygiene field, also had dentists focused on the hygienist`s role as a product peddler and a profit center. I disagree more.

According to a more objective source, the dictionary, hygiene is "a science, the establishment and maintenance of health." There is no mention of patient-pandering, dentist-doting, or molar-mopping anywhere.

Certainly, a clean mouth is a healthy mouth. We achieve this by using curettes, sickles, ultrasonic scalers, and prophy angles. Removing the deposits can facilitate the patient`s own efforts at home. By accessing areas where the patient is unable to access, we are reducing the amounts of periodontal disease-producing bacteria. But for the mouth to continue being healthy, we all know that the patient must maintain it by following through with appropriate home care procedures.

As the preventive professionals in the dental office, it is only appropriate that hygienists, the ones responsible for the establishment and maintenance of health, be the ones to educate our patients. Some dental professionals promote the concept of using assistants to dental hygienists to perform this function. Once again, I disagree.

The assessment of dental health and related patient education are probably more important than grabbing the metaphorical broom and dustpan to sweep out a sulcus. Patients` awareness of their periodontal condition (which includes an awareness of what must be done to improve or maintain that condition) is truly what makes the difference in their oral health. Therein lies our major role.

Proudly saying, `I scale`

So what about my own license plate? Because of my local anesthesia license, I could have chosen I INJECT (sadistic alternatives include I JAB, I POKE, I STICK) but that could be easily misinterpreted to mean an illegal activity of which I do not partake. If I were more risqué, I might have dared to use I STROKE. Call me a prude. I could have chosen GAS EM due to my license to administer nitrous oxide analgesia, but that might conjure up an equally perverted image. Instead, my license plate reads I SCALE.

Yet, I`ve just gone on a tirade emphasizing that hygienists are not oral janitors.

Allow me to justify my choice. Anyone can be considered an oral janitor. In fact, everyone should be their own oral janitors. My six-year-old son is an oral janitor. However, scaling teeth is a privilege reserved only for those who are specifically licensed to do so - dentists and hygienists.

According to ADHA figures, dental hygienists devote at least three times as many classroom and clinical hours (over 1,000) learning preventive and therapeutic (non-surgical) periodontal treatments than dentists. Most dentists spend a small fraction of their time, if any, scaling teeth. Therefore, declaring to the world that "I scale" is virtually synonymous with saying, "I am a dental hygienist and proud of it."

Despite dentists spending far less time learning and performing traditional dental hygiene procedures, some dentists push for preceptorship, which involves a dentist training an assistant to be a hygienist. In a guest editorial by Dr. Charles Barotz, published in the September 1995 issue of the Journal of the Colorado Dental Association, the author writes, "I would like to see preceptor hygiene licensing in the future ... after working with a preceptor dentist ... the assistant could be licensed to do clinical dental hygiene."

Perhaps a preceptor hygienist`s license plate would read MPOSTOR or GYP. Or perhaps it would read ORLJNTR.

And Dr. Barotz did not stop with preceptorship. "In the interim," he writes, "I would recommend that dental offices bypass hygienists by using recent dental school graduates to fill their hygiene needs ... The patients perceive increased quality when a doctor, rather than a hygienist handles their cleanings and preliminary aspects of periodontal treatment." Dr. Barotz refers to the new dental graduates as "junior" dentists. I wonder how proudly dental school graduates would wear that title. I wonder if he or she would drive around town with plates that read JR DDS. JR RDH might be much more appropriate keeping in mind truth-in-advertising.

In light of the challenges facing the profession, hygienists should see this as an individual challenge to let the public know who we are. Why are we much more than oral janitors? Why shouldn`t preceptor hygienists or junior dentists perform your job? Tell them.

I am proud of my profession. I boast of my education and credentials. I have "RDH" printed on my checks. My licenses, diplomas, and tokens of professional achievement cover my operatory wall for all to see. My operatory is much larger than my vehicle`s license plates. Since license plates limit me to seven letters, I`ll be succinct. I`ll simply say, "I scale."

Heidi Emmerling Jones, RDH, BS, is a freelance writer and practices dental hygiene in Sparks, Nevada.

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