You Are Not a Tooth Scraper

Maggie Augustyn, DDS March 29, 20226 Mins read9.2k Views

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Dentists Lead by Taking Care of Those In Their Charge

As the conversation initiated in my first article ¹ on this matter ensues regarding an open discussion of the ill balance between the contemporary RDH and the dentist, I’d like to invite all readers to participate in bringing about the change necessary to rebuild the strained relationship this has become. However, it is important to do this in a constructive way.

Venting to one another is important; releasing the pressure valve is necessary, but I’d also like to invite you to speak with one another, within whatever community you’re a part of, RDH to RDH, DDS to DDS, RDH to DDS, and back around to DDS and RDH.

Branch out, if possible, and keep an open mind, to listen, to generously listen, to what the other side has to present.

You’ve got our attention

Walking undisturbed within the confines of my own journey as a dentist and practice owner, I was recently introduced to the following comment: “I just don‘t feel anybody with a two-year associate‘s degree is medically qualified to correct your health. They‘re trained to clean teeth. They take a sharp little instrument and scrape your teeth. That‘s what they do. That‘s all they do.”

That quote was taken directly from an article written in October of 2019 By Giles Bruce ².

Perhaps, I was living under a rock, or maybe I was too busy paying attention to the road ahead of me. Still, this information had not come onto my radar.

Why? Because, most likely, it didn’t affect me personally. It had nothing to do with the way I was practicing dentistry, and it was stated during a time when, within my own office, I had been practicing without a hygienist. In the difficult post-covid circumstance, I was unable to replace our long-term hygienist, who had left dentistry altogether due to unrelated circumstances. I missed that conversation and the controversy that came with it.

But as I have recently continued to dig further into the overall experience of a contemporary hygienist in a dental culture that may not have caught up to appreciation earned by that two year degree, I came across article after article liking our co-provider to limited regard. I erupted in aggravation reading the headline “7 reasons to respect a hygienist” by Lisa Newburger, LISW-S, published pre-pandemic in 2018. Newburger did an excellent job with her specifications, but it saddens me that she needed to present the reader with seven reasons.

Why on earth do we need SEVEN reasons? Don’t we just need one? They are healers who take care of our patients. And, isn’t one enough?

In furthering this consideration, a quick google search shows articles with the following words: “hygienist” and “respect” published in:

2005 – “The Triangle of Respect” ³

2013 – “Earing R-E-S-P-E-CT” ⁴

2018 – “7 reasons to respect a hygienist” ⁵

2019 – “A constant battle for career respect” ⁶

2021 – “Dental Hygienists want to be treated with respect” ⁷

Do we see a trend building here? It’s no surprise that, and in my research, the lack of respect toward our co-therapist (a term I heard from former ADA President Dr. Maxine Feinberg) continues to be drawn into the light. It is something that they are intensely affected by, and it is one of the primary reasons for leaving the field.

And yet, the disdain continues to layer on social media. More often than I’d like to mention, I have been told that a supervisor or dentist has told hygienists that a monkey can do their job. Below you will see two conversations on Facebook showing the commonly found use of monkey relating to an RDH. To further this point, in mid-March 2022, I presented to hygienists in the Northern Suburbs of Chicago. As the subject arose, a third of the room murmured in agreement of having heard that comparison themselves.

It’s possible that it takes more than you know

We may all be guilty in the ways we have undermined what it takes to become a dental hygienist and what it takes to remain the periodontal fighting machines that s/he is.

Though, in most universities and colleges around the country, anything above a C will guarantee a degree, admittance into a hygiene program is so difficult that only A’s and B’s are required on a college transcript. The prerequisites aren’t easy to get through, and the program requires a background knowledge of psychology, sociology, microbiology, anatomy, physiology, and biochemistry; some even require pathology, nutrition and pharmacology. Many programs require three years worth of college education.

The race to get into school is very competitive. Looking at the graph below, there are generally 300% more applicants than there are spots in the programs.

The average acceptance rate over a ten-year period for dental hygiene school hovers at 27%.

In contrast, the acceptance into dental school, depending on how the data is interpreted, is at 10-50% (the data, in this case, is difficult to interpret because many pre-dental students submit their application to several different universities creating such a highly examined applications’ number).

The two-year hygiene program is grueling and exhausting at times; it requires dedication, focus, and most of all, passion for remaining within the profession. Five years of education not only allows its new graduates to scrape teeth with sharp instruments, but its compilation also produces a fellow provider. In the right environment, the role of an RDH isn’t just to probe and scale. With research that continues to pile on the effects of inflammation on the body, often including the mouth.

Hygienists are practicing medicine!!

They evaluate patients, educate them, treat disease, and heal human beings. So, let’s start treating them as such.

Where does that leave us? What lesson is here?

My thought is that revisiting the opening statement itself or dwelling on it would not be constructive to the discussion and process of un-wedging the discord between the dentist and hygienist. I speak instead from the place of a practice owner. Our role is to assemble a team who will promote and protect the overall health of our patients. A team who will present with the same passion and vigor that we exhibit. A team who will find and have similar reasons to ours for getting into the profession.

And that team includes a co-provider who is much more than just a hand scraping a tooth. As long as we dishonor the RDH, having spent decades comparing their job to something a monkey can do, as long as we undermine their education, experience, and expertise, their dedication, and commitment to our patients and to this profession, we will continue to lose them to fields and places where they will feel personally and professional rewarded and appreciated.

Let’s change the narrative. If you are a dentist or practice owner, pull your hygienist aside and let her/him know that their talents lie beyond scaling root surfaces. Let your hygienist know that we consider ourselves, with them, as one part of the profession focusing on healing our patients.

If we were to band together and stand up for one another, look out for one another, and support and speak out for one another, the landscape would change. Perhaps the idea of hierarchy in dentistry has been outgrown. Perhaps our webpages ought to no longer just feature the lone standing dentist as head of its herd.

Perhaps we ought to reconsider why patients visit our practice and whether it has as much to do with those within our team as those with a DDS degree. Unless we are speaking about legally qualifying the duties of a hygienist per our licensure and state laws, do we really need to divide and belittle the roles we play in patient care?

Hygienists ought not to feel unsupported by the very entity that they themselves support on a daily basis. They are and ought to feel as the anchors of the profession. In “Leaders Eat Last,” Simon Sinek vigorously pronounced the idea that the role of a leader is “to take care of those in their charge.” And as those leaders have, we failed them.

Can’t we consider each other a part of a larger system, a bigger process that ultimately stands to benefit the health of a patient, and deep down within ourselves, a process that will advance our self-professed need to serve and help people?

I receive and consider all communication from readers. I receive input on all points of view, some of which vehemently disagree with my findings while others welcome my option. Let me say: any and all comments are welcome, as long as they are presented in a courteous and constructive manner. They can be directed to me in the comments section below, social media (https://www.facebook.com/maggie.augustyn) or via my email at drmaggie@myhappytooth.com.

I further want to specify that though many times, in Mindful Moments, I may ask more questions than I can answer, this conversation on the RDH crisis will be ongoing. I plan on writing several column entries from different perspectives and our different realities of this matter.

More about Mindful Moments (the column) here: https://www.dentistrytoday.com/mindful-moments-dentistry-today/