by Anne Nugent Guignon, RDH, MPH
My mom was born in 1926 and grew up with her grandparents living in a bedroom across the hall. Her brother's room doubled as my grandfather's office, where he wrote a daily newspaper column. Even though she was a young child, she distinctly remembers her mom and dad feeding people who showed up at their back door during the Great Depression. My mom also has vivid memories of my grandfather heading out the door to Union Station to catch a train in order to give another after-dinner speech at a convention two or three states away.
Eighty years ago this country was plunged into the worst economic challenge ever experienced in the life of this nation. For those of you who have grandparents, great grandparents, or a close friend who lived during that time, listen to their stories. If those folks aren't available, try to find old family photos, do a Google search of Dorthea Lange's black and white photos, or reread Steinbeck's "Grapes of Wrath."
The Great Depression taught people many things. Those tough times forced them to value the basics, work with what they had, and not take things for granted. It taught people to work together and share.
Enough of the history lesson. Despite today's hard times, what we are going through is not nearly as devastating as what happened during the Great Depression, when over 25% of all Americans were unemployed.1 Those that had jobs often worked 44 hours per week, with the average hourly wage hovering between $1.25 and $1.50 per hour.2 Today most of us still have jobs, and while your current position may not be in your dream office, you're still getting a paycheck.
In the late 1960s, community colleges all over the country established dental hygiene programs. The number of new graduates skyrocketed, and it soon became routine for a dental practice to employ one or more dental hygienists.3 Jobs were plentiful and most of us became comfortable with our ability to earn a living working a clinical schedule that dovetailed well with family obligations. We were in the driver's seat and could often call the shots with respect to the number of hours, days we worked, and amount of compensation we received.
A popular TV program in the '60s called "Father Knows Best" typified our role in the dental office in those days. The vast majority of dentist employers were men. Most referred to us as one of the girls. The pervasive culture at that time meant that real hygienists hand scaled. We spent our days cleaning teeth, using skinny hand instruments without gloves, masks, magnification, or effective desensitizers. Fluoride varnish, sealants, and digital radiographs hadn't been invented. Our days were spent removing calculus and stain and teaching people how to care for their teeth.
As a profession, we've come a long way over the last 40 years, and despite the times, we have much to be thankful for. The fundamental goals of the profession are the same and the profession continues to define educational standards.4,5 Despite the advances, dental hygiene is still a service profession. We provide preventive, diagnostic, and therapeutic oral health recommendations and services to those that we treat. Forty years ago most adults did not have posterior teeth and many did not have teeth at all. People now expect to keep their teeth for a lifetime. Dental hygienists have been a driving force behind improving oral health outcomes in this nation. The majority of our patients appreciate our skills and talents. Dental hygienists are now considered a critical part of the dental team.
The strides our profession has made in the legislative arena are astonishing. Efforts in state after state have resulted in positive changes in practice acts. Opportunities, which used to be the stuff of dreams, are now well-established realities. More and more hygienists are able to provide anesthesia, hospice care, and to work autonomously or under collaborative arrangements in remote facilities. The push toward self-regulation is now a reality in at least one state.
Today's forward-thinking dental companies recognize dental hygienists as key decision makers. They also realize that many of us are not relying on doctors to purchase every single piece of equipment.6 An increasing number of hygienists have their own ultrasonic scalers, hand instruments, polishing handpieces, clinician chairs, magnification, and illumination – purchases they have made with their own hard-earned dollars. With our growing ability to practice outside of the traditional dental practice, the list is getting even longer. As a profession our comfort zone is enlarging.
Today's dental hygienists are more than just tooth cleaners. We're well-respected, knowledge-based health-care providers who make a difference in the quality of people's lives.7 Despite today's economic challenges, the profession is still vital. We can learn to appreciate the basics and be grateful that we have the ability to earn a living while providing unique, quality services to patients.
Even though none of us like the price of gas today or relish the thought of waiting to get the latest upgrade on our cell phones, we're not standing in a bread line or living on the streets. From that perspective, scaling back to the basics and having a job to go to both look pretty good. Basic economic theory has proven over and over that the lean times will not last forever. When more prosperous times return, we're bound to look back and marvel at our ingenuity.
- Great Depression. http://en.wikipedia.org/wiki/Great_Depression. Accessed May 20, 2011.
- VanGiezen R, Schwenk AW. Compensation from before World War I through the Great Depression. www.bls.gov/opub/cwc/print/cm20030124ar03p1.htm. Accessed May 20. 2011.
- Johnson PM. International profiles of dental hygiene 1987 to 2006: a 21-nation comparative study. Int Dent J. 2009 Apr;59(2):63-77.
- Okwuje, Anderson E, Hanlon L. A survey of dental hygiene program directors: summary findings and conclusions. J Dent Educ., Jan. 1, 2010; 74(1): 79-87.
- Monson AL, Engeswick LM. ADHA's focus on advancing the profession: Minnesota's dental hygiene educators' response. J Dent Hyg. 2007 Spring;81(2):53. Epub 2007 Apr 1.
- Romanowski K. Market forces - The power and influence of dental hygienists. ADHA Access May-June 2005.
- DeAngelis S, Dean K, Pace C. Career choice and perceptions of dental hygiene students and applicants. J Dent Hyg. 2003 Spring; 77(2):97-104.
Anne Nugent Guignon, RDH, MPH, provides popular programs, including topics on biofilms, power driven scaling, ergonomics, hypersensitivity, and remineralization. Recipient of the 2004 Mentor of the Year Award and the 2009 ADHA Irene Newman Award, Anne has practiced clinical dental hygiene in Houston since 1971.
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