Would you rather: 1) do your taxes, 2) use a restroom with broken locks, or 3) listen to a young child learn how to play the violin, rather than approach your employer for a raise? In the field of dental hygiene, many of us find it challenging to assert ourselves and discuss money. It makes the world go round and keeps the roof over our heads, but I’ve lost track of how many times I’ve heard a hygienist say they haven’t had a raise in 5…10…15+ years. The cost of living goes up every year, but what happens if our compensation remains unchanged?
I surveyed 180 dental hygienists from both Canada and the United States to find out how they are (or aren’t!) being compensated, and the results may surprise you, too. Before you bite my head off because “It’s a pandemic! This isn’t the moment,” you’re not wrong. Times are very tough, and your employers have been suffering as well with the staggering cost of PPE, new health and safety regulations, office closures and so much more. I’m writing this for you, for all of us, for the moment when we rise from the ashes of COVID-19 and regain some semblance of normalcy. I’ve combined my survey findings with techniques on how to approach a difficult topic with your employer that will provide you the highest chance of a positive return.
According to my findings, 65% of dental hygienists feel they are being compensated below market value – in a range anywhere from $1–10/hour below what they feel they should be earning (Fig. 1). As health practitioners, we aim to provide optimal care, maintain current certifications and continuing education, produce a considerable return for the office, and help our team work as seamlessly as possible. By accepting a wage that is below market, this indicates to our employer what we feel our monetary worth is. In turn, the wages offered will continue to decrease if employers are seeing hygienists accepting low pay. Even now, I’m seeing job postings for just $1–2 per hour more than what I made 10+ years ago as a new graduate!
Figure 1: Compensation in dental hygiene
Figure 2: Increase in hourly wage to years worked as a hygienist
Figure 3 illustrates the increase in hourly wage for hygienists who have been working for 6–15+ years. Of these hygienists, 33% reported that their hourly wage had only gone up $0–5/hour since they began practising. We can conclude that they are earning less money each year that they do not keep up with inflation.
Figure 3: Increase in hourly wage for Hygienists working for 6–15+ years
Let’s look at an example: the average yearly rate of inflation in Canada from 2010–2020 has been 1.80%. You start a job in 2010 being paid $35/hour. By 2015, with annual compounding, inflation is 9.3% higher than it was in 2010, so your wage should be at least 9.3% higher too, just to be earning the same value. To merely keep up with inflation, in 2015 you should be earning $38.26. At the very least, you should aim to obtain a raise that keeps up with the rising costs of living(1–3% per year). This does not consider the fact that you have amassed 5 more years of experience and perhaps additional certifications, skills or responsibilities. Furthermore, the dental fee guide goes up year after year; is your compensation doing the same?
Let’s put our money where our mouths are (see what I did there?) and discuss actual techniques for getting what (and how much) you want.
Know your worth
Thirty-one percent of the hygienists I surveyed are earning anywhere from $4–10 per hour below market. Prior to approaching your employer for a raise, do your research. Look into what you should be earning based on your experience, skills, qualifications, location and demand. Factor in additional responsibilities you’ve taken on, flexibility you provide for the office such as travelling to multiple locations or working longer to accommodate clients, and additional treatments you provide/sell such as whitening or laser therapy. Consider speaking to hygienists in other offices in the area to see what they are making, and check job postings to ensure you are in line with market demand and offers. In addition, 47% of hygienists said they have had a performance assessment in the past 3 years. A performance assessment is a good opportunity to gather information on the value you bring to the office.
Have a strategy
According to my findings, 71% of hygienists were too scared, nervous or embarrassed to ask for a raise, and hoped a raise would just be offered based on their performance. We’ve all heard the saying: if you don’t ask, the answer is always “no”. Have a plan of action for how you’ll approach the issue. Ideally, schedule a time to meet with your employer, and ask for a raise in person and in private. Do you get nervous in confrontation or in difficult discussions? If you must, consider putting the request for a raise in writing – this will have the added benefit of having a paper trail of the exact date you asked for the raise so that there is no miscommunication later on. It also allows your employer time to consider your request rather than just denying it in a knee-jerk reaction. If you have been working at the same office for less than a year, you may have a lower chance of receiving the raise; this increases exponentially if you’ve been at the office for 2 or more years. Research wages in your area, and factor in your experience, seniority, and additional responsibilities you’ve taken on. If despite all this, you are told “no”, you could ask what your employer’s expectations are which will enable you to receive the raise, and ask to revisit the topic in a set number of months.
Know your audience
Presumably, you’ve worked with your employer long enough to know what motivates him/her. Are they most focused on acquiring new patients? In that case, showing them referrals you’ve brought in, positive Google reviews or marketing incentives you’ve suggested or adopted might be a good route of approach. Are they most interested in patient retention? Here is where you may want to emphasize the relationships you’ve built with your patients, the positive feedback you’ve received and the loyalty you’ve established with patients who request you in particular. Perhaps most common of all is the office’s bottom line. At the end of the day, a dental office is a business and numbers will resonate. Keep track of your production/performance – have documentation to show exactly how much you produce for the office per hour/day/month/year. Follow up on patient acceptance of high value proposed treatment such as Invisalign, additional services you’ve sold or performed such as laser treatment/whitening/mouthguards, or anything else that brings revenue to the office. You may also want to consider your timing: COVID-19 may not be the best time to ask for a raise or if you know your employer has been struggling financially and is under pressure. Finally, come well prepared to reason and prove exactly why you deserve a raise.
Twenty-two percent of hygienists reported that when they asked for a raise, they were told it was not in the budget or they had maxed out. Walking away is the least preferred option but is sometimes necessary. At this point, it’s time to reassess the situation. Money isn’t everything, and there are other factors that may come into play in keeping you at the same office. In a positive spin, 56% of the hygienists I surveyed reported that they remained at the same office even without a raise because they love the patients, office, commute, schedule and team. Others remain at the same hourly wage but are offered a monthly bonus, benefits, or other perks that make it worthwhile for them to stay. Sometimes there are more factors to consider than just the bottom line. However, if you’ve looked at all the benefits and drawbacks and decided it’s time to move on, that may be the next natural step. It’s common knowledge that one of the best ways to get a significant raise is to move to another office.
Things to avoid
Getting emotional – Remain professional, calm, and collected. If the answer to the raise is “no”, revisit your initial plan of action to know how you will proceed from there. Do not threaten to leave the office. Do not bring up your own personal expenses or financial pressures, the reality is that your salary represents how you benefit your employer, and that is what he/she is most interested in.
Comparing yourself to others – If your argument is that Jenny has been at the office for 6 months less and you found out she’s earning more, this will likely not go over well. It is also possible that discussing salary with other employees is against your employer’s policy. Furthermore, this is not a strong approach. Highlight in detail the value you bring to the office and the reasons why you deserve a raise.
We would all love to work in unicorn offices that grant us raises with a wave of a wand (or curing light), but that is rarely the case. Obtaining a raise makes us feel more valued, respected and satisfied with our jobs, and less likely to look for a change in employment. Being well prepared, having a plan of action and knowing our employer are key strategies for getting what we want.
About the Author
Alina Fintineanu is a Registered Dental Hygienist with 10 years of experience in dentistry. She currently works in private orthodontic practice in Toronto. Alina has obtained a Certificate in Adult Education and is a Certified Training Practitioner. She is an educator on Invisalign and profoundly passionate about all things Orthodontics. When she is not reminding patients to wear their elastics, you can find her traveling, baking and petting dogs. Contact her at: firstname.lastname@example.org