Hygiene: Longevity in Practice – How Long Can You Go?

by Harriet Rosenbaum, Dip. DH

I remember attending my first professional dental hygiene conference way back in the early 1980s. I was fresh and new and ready to explore the world of dental hygiene. I was introduced to a hygienist — I don’t remember her name or where she was from. The only memory I have of that introduction is that she had worked for 25 years as a hygienist ands was still working. She was an icon, someone I should emulate. I wondered if I had it in me to do that too…

Fast forward 20 years to a dental hygiene meeting where a few of us dinosaurs of dental hygiene are discussing our past, present and future. We all agreed. It was never documented anywhere but it was assumed that the ‘survival rate’ of a practicing dental hygienist was approximately five years. Having said that, the range of years of employment among us was from five to 29 years.

Are we starting to stay in practice for longer periods? Are we re-entering practice after a few years of leave? Are we more satisfied with our profession and places of employment? Have legislative changes and licensure had an effect on our staying power?

As I began to investigate these questions I gained some insight into dental hygiene information. Neither Statistics Canada nor Employment Canada have much in the way of statistics on the practice of dental hygiene. For that matter, licensing bodies only have numbers of licensed hygienists and the Association only has numbers of licensed hygienists. I’m pleased to hear that we have some 13,000 dental hygienists across the country but to glean any information on practice retention we have to examine some survey results.

A 1970 survey on employment expectancy reported that, “Most dental hygienists in North America are women. Women frequently use a career to bridge the interval between formal education and marriage. Their employment is frequently interrupted, if not abandoned, on account of family obligations. Consequently, life expectancy tables cannot be used to calculate the work expectancy of a dental hygienist.” An added note said, “that as the percentage of working married women increased more and more women combined employment and family responsibilities.”

We have to keep in mind that during the last 30 years social values have changed and women who were once expected to stay home with their babies were starting or continuing on with their careers. This can be attributed to economic factors and social factors as well. The cost of running a household in the 1990s and 2000s demands acombined salary of two people rather than one like in the 1950s and 1960s.

One other comment of the 1970 study is that the profession was relatively young. Universities and Colleges were starting undergraduate programs some five to seven years previous.

Moving on, we have a 1987 study of workforce patterns and trends of dental hygienists, as well as registration, licensure and employment. The length of time a hygienist remained employed was given as more than five years with 30% of respondents citing 10 or more years of practice. A 1990 survey suggests the following reasons for leaving practice: family responsibilities, infectious disease risk, lack of decision-making opportunities, limited variety in practice settings and boredom.

On the bright side, the factors mentioned influencing re-entry into practice were; reduction of family responsibilities, broader variety of practice settings, increased salary, employment benefits, flexible hours, increased decision-making ability, increased collaboration with other professionals and increased input into policy setting. These factors correlate to changes in legislation and licensing authorities.

Though this may not hold true in all provinces right now, 92% of dental hygienists in Canada are self-regulated, and employment opportunities and practice settings are widening accordingly.

I would like to distinguish between the number of years practiced and number of years in one individual practice. The numbers from the United States indicate that turnover in the US in practice is about three years. One of the issues I hear hygienists discuss about “practice power” is office satisfaction. Sometimes, variety is the key.

One hygienist I spoke to who graduated in the class of ’65 (I tried not to sound impressed when she told me that) is working a shorter work week. Others are combining two jobs with variety appearing in the form of practice, education and public health settings. Beating the “burn-out” phase of the profession may include managing your day as you see fit. That means having some input into how much time you book your patients. That in turn means a flexible employer. Issues such as increased decision-making, policy-making, increased benefits and salaries are key in the development of long-term work relationships.

Getting involved in professional organizations can offer an individual a rewarding experience while giving a different vantage point of the profession. Hygienists I know who have been working for 20 years or more love the offices they work in. They have found a supportive and nurturing work environment. That means positive co-worker relationships, client relationships, hours, professional development, and whatever other needs the dental hygienist requires are being met.

Take the time to enjoy each client and truly listen to what each one has to say. Every client has a story. As practitioners, we need to speak less and listen more. If we take the time to understand our clients’ needs and where they are coming from, we can help them within the context of their lives. They will respond to treatment better and we will feel rewarded.

It is what we make of each day for our clients and ourselves that adds up to many days (hence many years) of satisfaction.

As Oliver Wendall Holmes concluded, “What lies behind us and what lies before us are tiny matters compared to what lies within us.”

Harriet Rosenbaum has worked in private practice for 20 years. She is in her third term as president of the Manitoba Dental Hygienists Association.