Dental hygiene is an expanding field. The mean pay for dental hygienists in 2018 was $74,820, reports the Bureau of Labor Statistics, which expects 11% job growth for the profession through 2028. Jan LeBeau, vice president of hygiene support for the west coast at Aspen Dental Management Inc (ADMI), attributes this growth to a number of factors.
For example, there has been a greater focus on disease prevention and preventive healthcare over the past 20 years, LeBeau said. There also has been a growing awareness of the relationship between oral health and overall health driven both by medicine and dentistry among patients and practitioners alike.
“Periodontal disease is the second most common infection in man, second only to dental caries. Additionally, we know that periodontal disease is considered to be a contributing factor to many long-term chronic diseases such as cardiovascular disease, stroke, diabetes, Alzheimer’s disease, and many, many other diseases of a chronic, inflammatory nature,” LeBeau said.
“The common link is inflammation. Studies have shown that managing a patient’s periodontal infection or chronic inflammation will have a positive effect on the patient’s overall health. The dental hygienist plays an integral role in managing this chronic inflammatory disease through patient education and disease prevention,” said LeBeau.
Aspen Dental hygienists are aware of this connection between oral and systemic health. The company’s mentoring team works with clinicians and hygienists alike to help them recognize how managing their patients’ oral health, particularly when it comes to periodontitis and inflammation, can have a positive impact on their patients’ overall health.
“I think patients are responding well to these efforts. There’s so much in the news today relative to preventive healthcare services and the oral-systemic link,” LeBeau said. “The general public actually is coming in and not only accepting this type of comprehensive care they’re seeing within the dental practice, but, by and large, they’re expecting it.”
Technology plays a key role in addressing these concerns and improving care. Recently, Aspen Dental adopted Align Technology’s iTero intraoral scanning systems, which LeBeau said helps dentists and hygienists perform “health scans” and do a better job of educating patients about what’s going on in their own mouths and about how it affects their overall health.
Better patient education leads to better case acceptance, LeBeau said, as Aspen Dental looks at other technologies such as lasers to help its clinical staff manage periodontal disease in the hygiene chair.
“Currently, 39 states have laws allowing hygienists various levels of direct access to patients to initiate treatment based on their assessment of the patient’s need,” said LeBeau. “A hygienist working offsite from a dental office can assess the patient’s needs and then virtually connect and collaborate with a dentist for a restorative diagnosis and treatment plan.”
Teledentistry also enables general dentists to connect with specialists in other towns or even states to collaborate on patient care. However, LeBeau cautioned that nothing can replace an in-person comprehensive examination by a general dentist or specialist, though the model may offer greater access to care to those patients in remote areas or who face other barriers.
“I think we’re seeing a lot of potential with teledentistry relative to access to care,” said LeBeau. “It’s unfortunately a band-aid approach, I think, because nothing is going to replace that patient in a brick and mortar dental office with a comprehensive exam performed by a dentist or specialist.”
Many states believe they can provide better access to care by increasing dental hygienists’ scopes of practice with expanded roles, such as dental therapy. These professionals are allowed to perform more procedures, with or without supervision, than dental hygienists do, but they aren’t approved for all of the treatments that licensed dentists can provide.
“Dentistry is really following the medical model,” LeBeau said. “Medicine has successfully integrated the midlevel provider with the use of nurse practitioners and physicians assistants. And I think this has created greater access to care while keeping costs lower, and dentistry is looking at the dental therapist as a potential workforce model to do the same.”
Though dental therapy has been used in more than 52 countries for many years, LeBeau noted, it is still being debated in the United States. The greatest concern, she said, is the perceived lack of quality care. As dental therapy becomes more widely accepted, she said, those perceptions will change, just as perceptions towards nurse practitioners and physicians’ assistants changed.
“I think access to care is probably one of my greatest concerns for the population as a whole. We know that less than 50% of the adult population in this country actually see routine dental care,” LeBeau said. “I think there’s still a lot of work to be done with the dental hygiene profession. I think there’s a lot more that the profession can be doing.”
Dental hygiene students need to prepare for this shifting landscape as well. LeBeau said that they need to focus on oral health and its role in overall health. Also, these students should be ready to communicate with the patient’s healthcare team and be proactive in educating other healthcare providers as well as patients about the link between oral and overall health.
“Dental hygiene is so much more than chairside care and delivery. The dental hygienist is both an educator and an advocate for oral health. And by advocating for oral health, dental hygienists can have a positive effect on our nation’s overall health,” LeBeau said.
“Hygiene students need to be prepared for the future, and I think it really comes down to putting the mouth back in the body and being focused on the patient’s overall health and being a key member of the patient’s healthcare team, not just their dental team or their dental hygienist,” LeBeau said.
Indeed, dental hygienists have career opportunities far beyond cleanings and x-rays. LeBeau said positions are available as clinicians, researchers, educators, administrators, advocates, and mentors. The greatest growth opportunities, she added, are within the dental service organization (DSO) model, especially as hygienists seek a future after the chair.
“Aspen Dental employs and supports just under a thousand hygienists. Although the majority of these hygienists are chairside clinicians, we also have hygienists in clinical leadership positions and positions working with the operations teams. And I think hygienists are looking for and want career paths beyond chairside hygiene as they progress and grow in the profession,” she said.
In fact, LeBeau said that Aspen Dental’s robust mentoring program helps younger hygienists just coming into the field develop their clinical skills as well as their coaching abilities, leadership potential, and operational acumen, preparing them for other roles in the organization. And Aspen Dental has lots of new employees who need to learn these ropes.
In 2019, Aspen Dental opened a new dental practice every four days and now has 780 offices, with more expected ahead. Also in 2019, the company hired, developed, and mentored just under 500 dental hygienists in its new and existing offices, all creating greater access to oral healthcare. As vice president of hygiene, LeBeau will guide those employees.
“My goal is to scream it from the mountaintop, to help people understand that coming into an organization or DSO like Aspen Dental, there’s so much opportunity for clinical development, allowing you to deliver real high quality of care for patients,” LeBeau said.
“It’s going to be my role to ensure that hygienists are aware of this great opportunity and then to help lead my team to again work with these hygienists and develop them in their clinical skills and their professional career,” she said.
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