How I spent my simple youth training to become a chimpanzee that scrubs teeth

April 1, 1996
Hygienists don`t need a formal education. After all, how tough can it be to scrub teeth? In fact, a chimpanzee can be trained to be a hygienist. Right?

Heidi Emmerling Jones, RDH, BS

Hygienists don`t need a formal education. After all, how tough can it be to scrub teeth? In fact, a chimpanzee can be trained to be a hygienist. Right?

Hardly! This brings to mind a conversation with a pre-nursing student during a physiology course. Through discussing our future plans, she learned of my status as a dental hygiene student. She was positively shocked. "You need physiology to clean teeth? I can`t believe it - that`s ridiculous! Do you plan to go on to assisting after you get a couple of years of hygiene under your belt?"

Maintaining my composure and gathering all the patience I could muster, I attempted to explain that, yes, hygienists are educated, licensed professionals. No, I added, my aspirations did not include being a dental assistant. I had, in fact, spent the last eight years as an assistant.

She still seemed confused. "Well, at least you`ll be able to slide through because you`re in a pretty simple field." At that point, I knew my work was cut out for me. Any attempt to enlighten her would be quite a chore.

Was a chimp really a role model?

Yet, I remember sharing her misconception. And my dad`s a dentist - I should`ve known better. I admired Jane, the hygienist in Dad`s office. She was intelligent, people respected her, and it was obvious she was an asset to Dad`s practice. I found her job fascinating.

Jane was the first person who ever told me a chimp could do her job. In my naive adolescence, I believed her. She made her job look so easy. In retrospect, I realize her comment was pure satire and intended more for my father`s ears.

Unless someone has actually experienced a professional program, it is nearly impossible to describe how much mettle is necessary. Many dental hygiene programs, such as those at Loma Linda University and University of Nebraska, are actually part of dental colleges. In some of the non-clinical courses, dental hygiene students sit right next to dental students.

The major hurdle to overcome was getting accepted into the program, or so I thought. Admission was based on overall GPA, science GPA, dental office experience, and several other minor criteria. I had it made: My overall GPA was 3.9 with a 4.0 for all the sciences; I received the maximum number of points for my assisting experience. And Dad`s a dentist. My talent was congenital. What more was there for me to know? Becoming a hygienist was a mere formality, and this program was going to be a cinch.

Ha! Boy, was I in for a rude awakening.

To begin with, the average GPA of the students accepted into my class was a 3.5 and most were also dental assistants. We were a serious and determined bunch. Once in the program, the courses were designed such that the instructors would award only two "A`s" per class.

This curve-grading technique imposed on high achievers created immense competition. It was a major blow to my ego when, after an enormous struggle to earn a 91 percent in my oral histology class, I received a "B."

Searching for warm bodies - anywhere!

Graduation requirements mandated that we successfully complete a minimum number of patient visits, radiographs, injections, root planing sessions, etc. In pursuit of better grades, we chased relentlessly after the points available by properly completing more and more procedures. Because of the competition, backstabbing was rampant. Students would actually steal each other`s patients by sneaking into the appointment book. If a student did not have a patient for a clinical session, she would receive an "F" for the day.

The only way to remedy the situation was to "drag in" a warm body. I would sometimes frantically scour the campus in search of a willing victim. When this didn`t pan out, the final resort was the bus stop across the street. Begging "Homeless Harry" or "Willie the Wino" to allow me to clean their teeth was, at the very least, embarrassing. The positive aspect to this was that I earned extra points for the more difficult patients, and these folks definitely met the criteria.

Yet, when we rendered care to these individuals, the instructors were often detrimental to our self-confidence. One particular clinical session stands out. I had a very difficult patient. He had to use the men`s room every twenty minutes, gagged, flinched, and couldn`t open his mouth very wide. I struggled for three hours trying to root plane his infected mouth. After exhausting my time allotment, the instructor reprimanded me in front of this patient. "These roots are still grainy. You`re obviously not interested in producing quality work. This is totally unacceptable!"

So much for my confidence. So much for congenital talent and sliding through a simple program.

Another distressing situation involved learning to administer local anesthesia. Did we practice on oranges or grapefruits? No. We practiced giving the shots to our pre-assigned fellow students. After one session, I left with a hematoma and paresthesia of the tongue that lasted for a year.

The academic testing methods were like nothing I had ever experienced. A devious tactic favored by one instructor involved the use of slides. During a lecture, she would use a slide to illustrate a specific microscopic tissue. An average student might expect to see the same slide during the exam and anticipate identifying the tissue on the slide. However, instead of asking us to identify the main subject of the slide (the tissue), the instructor asked us to identify some obscure microorganism, barely visible on the slide and never discussed in class.

This same instructor considered text footnotes to be fair exam material. I remember the subject of a particular question (a granuloma). I might have easily missed this, but my dad was browsing through the text the night before and had mentioned it to me as a matter of conversation. Thus, I had the distinct honor of being the only student who answered the question correctly - not a particularly effective way to be popular. But such breaks were quite necessary for maintaining my respectable GPA.

What did the grind really end up meaning?

Some may still wonder why I need all this instruction anyway. Aren`t hygienists simply overeducated malcontents? I remember Jane. Her job looked so easy because she had lots of talent and knowledge. To say that hygienists are overeducated is a definite fallacy. I utilize all of my education.

Some people are unaware that by virtue of having a license I am legally accountable for the services I provide. This means that if I fail to inform or treat a patient for gum disease and that patient subsequently loses teeth, I can be sued for negligence. This is where I use the talent I gained from those many intense hours (over 600) of clinical training.

In addition, my lessons in ethics, morality, philosophy, and jurisprudence aid me in exercising proper judgment. Likewise, as a professional, I am responsible for having a thorough understanding of a patient`s medical history before I begin any treatment. If not, I may actually severely compromise the patient`s health. This could occur if someone had a history of a heart murmur and was not informed that they needed to take antibiotics to prevent a life-threatening condition called bacterial endocarditis. So I rely on my knowledge of microbiology, anatomy, chemistry, pharmacology, and, of course, physiology.

At this point, I wonder if anyone`s still willing to sit for our chimp?

Learning how to reach out to someone

I work with a wide range of people - children to geriatric, mentally challenged to scholarly, indigent to very wealthy. To communicate on all these different levels, I apply the skills I developed through my speech, English, sociology, and psychology instruction.

The material from the other elective courses (history, economics, art, music, dance, etc.) gives me the ability to chat with people on a variety of topics unrelated to tartar and plaque.

In most states, including Nevada, dental hygienists are mandated to complete continuing education annually for licensure renewal. I am able to interpret scientific data, thereby keeping my knowledge current and accurate thanks to my epidemiology and biostatistics instruction.

My community dental health class prepared me to be an active member in my community and professional association. After ten years, I still keep in touch with the instructor and consider her a friend and mentor. In fact, she was partially responsible for motivating me to serve as president of the Nevada Dental Hygienists` Association.

Besides the paresthesia, the ordeal of my hygiene education had other more rewarding and lasting effects. It stressed to me the fact that nothing worthwhile comes easily. It strengthened my determination. And the most indelible impression is that I am not a technician. I am a professional.

Heidi Emmerling Jones, RDH, BS, is a consulting editor who practices dental hygiene in Sparks, Nevada.