If you are searching for the best ways to support and retain your dental hygienists and help them grow within your practice, you’ve come to the right blog! Registered dental hygienist and corporate consultant, Amber Auger, shares her thoughts about what hygienists want dentists to know.
Registered dental hygienists (RDHs) are the backbone of the dental field. With a focus on preventative care, early detection and screening, and patient education, hygienists undertake a significant task.
Dental hygienists are vital not just for patients but also for dentists. Apart from often being the first to identify early warning signs of dental issues through X-rays and oral examinations, RDHs have the integral role of supporting dentists. From managing dental records to assisting during dental procedures, hygienists help free up dentists’ time to focus on more complex treatments.
RDHs also aid in the growth of dental practices by building rapport with patients and gaining their trust. It’s no secret that dental visits can be stressful for many patients. Skilled RDHs do more than just clean, scale, and polish teeth; they also spend time addressing patients’ concerns, explaining treatment plans, and providing reassurance.
Some hygienists even go so far as to participate in community outreach programs to raise awareness about the importance of oral hygiene. Needless to say, dentists rely heavily on their dental hygienists. In light of this, it is the dentist’s responsibility to help their hygienists feel valued and supported.
Unfortunately, many dental hygienists feel overwhelmed and burnt out in the post-COVID climate. In fact, one in twelve hygienists were reported to have left the workforce since the start of COVID. There are simply not enough hygienists to meet the demands of patients requiring treatment, so employed RDHs are now finding themselves being overworked.
When RDHs feel overworked and undervalued, they are likely to seek employment somewhere else where they will be better supported. This is why it’s now particularly important for dentists and practice owners to address the needs of their dental hygienists.
Are you unsure of what those needs are? Amber Auger, MPH, RDH, gives a glimpse from a dental hygienist’s perspective on what it takes to feel supported. When hygienists feel supported, they are more motivated to provide exceptional care and to remain with your practice.
Amber Auger, MPH, RDH is an accomplished dental professional and preventative dental therapy advocate. With 12 years of experience as a practicing RDH and 17 years of clinical, consulting, and corporate coaching under her belt, she is well-equipped to be an international speaker, podcast host, dental marketing strategist, published author for several industry-leading publications, and the recipient of the 2019 Sunstar/RDH Award of Distinction. Amber is also the founder of Thrive in the OP® and the Functional RDH®.
This is the first blog post of a 6-part series where Amber will share helpful insights from a distinct viewpoint on how dentists can enhance their business success.
Insights from a Seasoned RDH
Q: As an RDH, what are some of the main things you value or prioritize in your career?
The number one thing that I prioritize in my career is respect. It’s essential for me to work in a collaborative environment where I feel respected and have autonomy. I never want to feel like I’m walking on eggshells. Unfortunately, there have been several instances in my clinical career where I was hired based on my strengths, but I quickly realized that I would not be allowed to actually use those strengths when working in the practice. It’s as if they hired me because I’m a circle, but it turns out they wanted me to be a square. Hygienists tend to be passionate about educating and treating their patients, so when they are given respect and autonomy, they are free to exercise their natural gifts.
I also appreciate when dentists invest in mentoring and training their hygienists. In today’s environment where there is so much transition of team members within a practice, dentists don’t always have the time to coach hygienists and help them assimilate into the practice culture. Some dentists might not know how to equip and empower their RDHs, which leads to complacency within the workplace. Oftentimes, practice owners will hire me as a consultant and vent their frustrations with one of their hygienists. But when I ask them if they have talked to the hygienist in question, the answer is always no. In general, there is a lack of leadership training and open communication.
Q: In your experience, what are some of the common misconceptions about the wants and needs of RDHs?
A common misconception is that dental hygienists are equipped to handle every situation when it comes to treating patients right out of hygiene school. That’s just not true. There is only so much time to learn the curriculum in school, but science is ever-changing. Schools do a really good job of isolating the information that is critical and fundamental to proper care, but there’s so much more in dentistry.
For instance, one thing I love learning about is identifying the root causes of oral diseases, which is not usually taught in schools. I recently was treating a patient when I noticed that her soft palate was yellow and her hard palate was white. Both of these areas should actually be light pink, so I knew there was something peculiar about her case. Nothing stood out to me in her medical history, but after I noticed increased bleeding, I told this patient that I wanted her to be tested for anemia. I also mentioned that she potentially could have some sort of sleep disturbance based on the size of her tongue and the white color of her palate. When I mentioned those two potential issues, she disclosed that she did have anemia as well as a family history of sleep apnea.
When I am able to look past superficial issues and try to get to the root cause of the observed symptoms, patients are more likely to trust me. When they trust me, I am able to recommend treatment that would prevent further issues down the line. But these are things that I was not taught in school. I’ve learned so much by participating in continuing education programs and investing in the growth of my career.
Q: Are there any tools or technologies that can promote communication and collaboration between RDHs and dentists?
In my opinion, artificial intelligence (AI) can help hygienists and dentists stay on the same page when it comes to treatment. One amazing AI tool that I love to use is Pearl’s AI. Patients usually like to see concrete evidence of disease. Technology like Pearl’s Second Opinion® disease detection capabilities allows patients to visualize bone loss, or whatever else the issue might be, in a concrete way. I compare it to blood tests that we all take at our primary care physician’s office. AI helps us see firsthand those “biomarkers” that indicate potential dental problems.
The great thing about AI is that it has the ability to calibrate everybody on the team. When considering treatment plans, one dentist might have an “older school” mentality toward treatment while another dentist on the team might take a more conservative approach. But Pearl ensures that everyone is seeing the same exact data, which is taken into consideration with treatment planning.
Pearl’s AI also has a dashboard that benefits your team’s morning huddle. The software audits your patients in the hygiene department, indicating patients that might be periodontally involved. Ultimately, it can help you with time management and making sure that you’re following up with patients on treatments they might need.
Q: As someone who coaches and mentors RDHs throughout their careers, what would you say RDHs want dentists to know?
Dentists often feel like finding an RDH who is eager to learn, educates with excitement, and is a stakeholder in the practice, is an impossible task. On the other hand, RDHs often feel that it is impossible to find a dentist who values their insight, respects them, and allows them to have autonomy in building a soft tissue management and preventive care program. Over the years working as an RDH and consultant, I’ve realized that the foundation of an effective partnership between the RDH and DDS is collaboration, communication, and calibration!
Q: How would you recommend an RDH confidently approach her boss to share her needs?
When approaching your boss, the best thing is to start out explaining how your request is ultimately going to impact the patient experience. For example, if you want to ask your boss for new instruments because the ones you are using are getting dull, consider mentioning that dull instruments are going to be uncomfortable for the patient. You’ll also want to bring up the fact that instruments without enough of a working end will also inhibit you from being time efficient and will put unnecessary strain on your body. If you’re not using the correct ergonomics, you’re more likely to experience issues like carpal tunnel syndrome.
If I am approaching my boss for something I might need, I like to start out with a relevant question. For instance, instead of asking, “Doc, what do you think about purchasing new instruments?”, I might lead with, “Hey doc, I’m wondering what our instrument budget is for the year because our instruments are very dull. I’m concerned that the scaling and root planning may not be as comfortable for the patient.”
Q: What are some of the key factors that contribute to job satisfaction for dental hygienists?
One key component of job satisfaction is community support. If you’re in school, your community might be a study club. If you work in a dental practice as a dentist, hygienist, dental assistant, or even office manager and have a bad day, do you have people to reach out to? Dental professionals deal with so many different personalities not only on their teams but also within their patient populations.
If we’re being honest, most patients don’t love coming to see us, and that can take a big toll on our mental health. So I think the most important thing for any member of a clinical team is to have the support of people who understand the stresses of what you are dealing with and who you can bounce ideas off of.
Scheduling time for fun activities, focusing on maintaining a healthy diet, and staying active are so important for reducing the risk of burnout. Working nine to twelve hours a day is very hard on your body, so you need to make sure you are fueling your body for success and not just mindlessly reaching for whatever is on the lunch table in your dental office. You should also look for types of physical activities that you don’t dread doing. That could be running, kayaking, or biking. It doesn’t really matter as long as you get your body moving to make sure you strengthen the muscles that will help sustain you without injury when you’re chairside.
Q: How have the expectations of RDHs changed over the years? Has COVID had an effect on those expectations?
The changes to expectations for RDHs over the years have been astronomical. Depending on the practice, some hygienists are expected to fill every single minute of every single day. If you have a one-hour cancellation, instead of being able to sharpen your instruments, you might be tasked with filling your schedule and following up with patients.
In the post-COVID environment, dental hygienists are getting paid more now than ever before. There’s a higher demand for hygienists and also a higher expectation of duties they perform outside the scope of their traditional clinical role. I’ve found that more and more hygienists are taking on somewhat of a hybrid role. As an example, I’ve seen many hygienists who have wrapped marketing into their clinical roles. I’ve also seen other hygienists help one or two days a week at the business team level. Between increasing costs of dental instruments and hygienist staffing shortages, RDHs are expected to take on extra roles and responsibilities.
Most dental professionals have been in survival mode since COVID. Many hygienists don’t even have an opening in their schedule until three to six months out, which has never happened before in the history of dentistry. We’re seeing this major shift because many clinicians, especially dental hygienists, have left the field during COVID. So, we’re seeing patients with greater disease progression because many people were not able to be seen during COVID, and the wait times are much longer now.
Q: Are hygiene schools able to keep up with the changing demands for dental hygienists?
The typical hygiene curriculum taught in schools usually only covers the basics, but students are not going to learn about marketing or how to be a business team member. I find that most RDHs are trained on the job to do those things, which is an interesting dynamic because they are getting trained by someone who hasn’t been formally trained either. That’s where we run into issues like legacy errors, where they might be doing something wrong, but that’s just the way the office has always done things.
Also, basic education for hygienists does not usually include lessons on how to stay healthy and prevent injury while working. Many people don’t realize the lasting effects that working chairside can have on the body. Carpal tunnel syndrome is a common disorder I see with hygienists. I’ve also seen RDHs with chronic pain in their neck and shoulders from hunching over their patients all day. Ergonomics is absolutely essential, but the topic is usually only covered over a one-hour PowerPoint lecture in hygiene and dental school. In reality, students should be tested on proper ergonomics because if they experience pain, it can cause adverse effects ranging from increased stress levels to chronic fatigue.
The caliber of education does depend on the school that hygienists attend, however. Students at Cape Cod Community College in Massachusetts, for instance, actually receive training in guided biofilm therapy, which is an advanced training that I only received last November. It’s really an amazing technology! From a clinical standpoint, those students are going into the field at the top level, but not every practice is ready to implement that technology.
So to answer your question of whether or not schools are handling the load of what the market is demanding from hygienists, the answer is no. The other issue is not enough hygienists are graduating to compensate for the number of hygienists that have left the industry.
Q: How important is work-life balance for RDHs, and what are some strategies that can help achieve it?
A healthy work-life balance is critical, particularly in the present time where more medications are being prescribed than ever before for issues such as depression and ADHD. It makes treatment care for patients much more complex, so a good work-life balance is a critical component of reducing stress and staying fulfilled in your career.
Q: Would you share some insights or advice for dentists and practice owners on how they can better meet the needs of RDHs?
The greatest necessity, in my opinion, is open communication. Dentists might look into giving their hygienists personality assessments or “love language” tests to figure out what each hygienist needs in order to feel supported in their growth within the practice. Practice owners should also be aware of their hygienists’ career goals and consider ways to foster those goals, which would be mutually beneficial.
One of the biggest stressors for hygienists is when they are unclear on the practice’s philosophy or on why a doctor recommends a certain treatment. If practice owners are able to support their hygienists as human beings and not just employees during the onboarding process, the hygienists are more likely to become a stakeholder and become invested in the success of the practice. That’s what every practice owner wants. Honestly, it’s what every hygienist wants – a place where they feel heard, valued, and respected. The patient experience will almost always be better if the hygienists feel happy and fulfilled in their careers.
