A Winning Season

Throughout the pandemic, the dental workplace held a unique position, as its teams were already knowledgeable and practiced in infection control procedures. However, mandated levels and lack of understanding about transmission kept many patients away from their routine and preventive care. Because of this treatment backlog, the industry is now anticipating a rebound in dental services, as vaccinated patients begin to make appointments.

This is good news for dental hygiene career opportunities. Another employment factor is the significant increase in Dental Service Organizations (DSOs). The scope of dental hygiene practice varies greatly among these organizations and different geographic areas. However, with the potential changes in oral healthcare delivery, this may be a unique time to explore hygiene career goals and workplace options, and how these may align with shifting career and personal interests.

"When you're in dental hygiene school, they explain all the different career options you have as a dental hygienist," says Angela M. Fuller, RDH, BA. "I thought, I'm going to try all of them." Fuller, who is currently employed by a Federally Qualified Health Center (FQHC) in Missouri, arrived there after a varied career. Earlier, she worked in a high-end private practice that performed full-mouth rehabilitations, where she had the opportunity to continue her education with course work in advanced periodontal instrumentation and neuromuscular dentistry.  She has served as a key opinion leader and in product development and research. On relocating to Missouri, she shifted from the private practice environment to an organization model at the FQHC.

One notable difference is the range of benefits. "Insurance, 401K, educational benefits - these are all important for a lifelong career," Fuller says. "I really appreciate the stability in working in a managed, DSO-type, public health setting." Another advantage that drew her to this setting was that it qualified for loan repayment options through the National Health Service Corps Loan Repayment Program.

Several states have an expanded scope of practice for public health hygienists, some offering more tasks that the public health hygienist can legally perform under varying levels of supervision with additional certifications than a private practice hygienist can do. Fuller explains: "After 6 years here in Missouri, I decided to jumpstart my education again by taking a restorative class. When I have a cancellation or a no-show, I can do fillings for the doctors and help keep the schedule moving."

Fuller notes that one of the key differences between her experience in private practice versus public health is the relationship with her patients: "In private practice, I had a little more flexibility in how I cared for my patients," she says. "It was a more personal experience among the team, dentist, and patient, with longer durations of consistent treatment. Here, the patients and the dental staff are more transient. I am very passionate about what I do here, because of my patients and their extreme needs for a dental advocate. You form bonds with them, just like in private practice, and maybe even stronger because they need you. For example, when you're teaching a 60-year-old patient to brush her teeth, because no one showed her before. That's when I know that I'm not just cleaning teeth, I'm helping to change lives."

Natalie Angelini, RDH, began her career in private practice and currently works for Dental Care Alliance (DCA). "I've found that the difference, in private practice, is that you may feel a patient needs certain treatment, but the dentists who own the practice don't agree," she says. "They have the final decision. At DCA, there are protocols in place to align hygienists and doctors, which promotes a team decision on the treatment of our patients."

She advises hygienists considering employment options to consider what they want. "If you prefer to stay busy and have a full schedule, a DSO might be preferable," she explains. "The organizations work to keep the schedule full, so you are less likely to lose pay for a lower patient volume. For example, we have management systems that most private practices don't have access to, which keep the office workflow running efficiently."

In addition, she explains, the DSO offers opportunities to further her career. "I am not only chairside, but I am also one of the Hygiene Coaches for Pennsylvania," she explains. "The organization provides support to team members and continuing education on the newest trends in hygiene care. They also partner with the vendors to introduce the latest research instrumental to patient care."

Adandra Torres-Martin, RDH, a Sub Regional Mentor and Laser Team Facilitator at Heartland Dental, also focuses on the strong hygienist relationships. "Collaboration between hygienists is highly valued within the organization," Torres-Martin says. "There are hygiene mentors who provide resources and provide support-emotionally, technically, and clinically. You have a whole team of experienced hygienists throughout the supported practices whom you can turn to for advice and recommendations on a product or a new tool."

Prior to Heartland, Torres-Martin had worked in various private practices, including one large multi-provider office. "That practice was progressive with a strong periodontal program," she says. "The doctors had high standards of care. They trusted and valued hygienists. However, when I relocated, I first worked for a smaller practice that did not have that same opportunity for collaboration. That's when I moved to the DSO and discovered incredible support. I appreciate the way Heartland Dental values hygienists as providers, and the opportunities I have to educate and advocate for my patients."

If a hygienist is interested in moving out of the operatory, some workplaces provide more opportunities, such as management roles and community (or foreign) volunteer service. Morgan Gerth, RDH, who works at Aspen Dental, considers these options a valuable career move, along with the autonomy the organization offers. "On top of the benefits and compensation, I've appreciated being able to accomplish some of my goals outside of the operatory," she says. "For example, I've been able to travel with Aspen. I was also involved with developing a voice-activated charting software. That was an amazing experience, and not something I planned, but it happened through this organization."

Having access to the most current protocols and products to offer patients is another key feature of the workplace. "I always feel as if I have everything I need to help a patient," Gerth says. "The hygienists have autonomy over the tools they use, and the time required to provide comprehensive care."

Gerth set goals for herself when she graduated hygiene school, and she's been able to accomplish many of them in this working environment. "I have an amazing work family, I am appreciated and rewarded financially for my hard work all while being home every night and having time to enjoy my family. If I need additional time for things, I have plenty of PTO." As an example, on top of an hourly wage, hygienists are paid an additional compensation for extraordinary patient care. "This type of compensation package has allowed me to save for retirement and live above average while doing so. At Aspen, we are encouraged to do what is in the best interest of the patient. By working for this organization, it has allowed me to accomplish all of the things I wanted out of life for myself and be happy in my career while doing it."

Identifying the professional setting that aligns with your goals is not a straightforward decision, but as the dental industry heads into an expected period of growth, it might be time to explore new opportunities. Some benefits are quantifiable: compensation, hours, insurance, education, vacation, retirement, and more. Others involve intangible, cultural aspects of a workplace: flexibility, autonomy, promotion, workload, access to equipment, and of course, the ethics and personalities of the people that you see daily. Both private practice and dental service organizations are providing many interesting options, and now might be the time to give them another look.