Best states to be a dental hygienist

We checked the classifieds at the Des Moines Register on this fine early winter day, and found zero help wanted ads for dental hygienists. Sorry. Check back next week. The word must be out that Iowa is the best place in the United States to be a dental hygienist.

Do we have a point with this “best places” ranking? Yes, and it’s this: If you’re happy where you are, hang out the state flag and sing a rousing chorus of the state song. You’re home. We respect that, regardless of where your home state is listed below.

But with the job market getting tougher, families thinking about relocation choices, nasty-looking criminals banging on the door, and dental hygiene schools opening up on every corner, you might wonder if a change of scenery would be helpful.

We, uh, didn’t check for the proximity of beaches or ultra-cool nightclubs in this ranking. This is all about making a living as a dental hygienist, as comfortably as possible, and we think there might a nuclear family somewhere on your priority list too. If you want to know what states are the most fun, there are other rankings for that.

Here’s what we did. We evaluated the “ease in rendering preventive care,” the “ease in making a living,” and the “ease in enjoying life.” In that order, we weighted them. Dental hygienists are a passionate bunch about their career choice. We figure if the job is right, the living is easy.

We should explain how we came up with the rankings. But this is the boring part. Feel free to skip down to the rankings. We would, if we didn’t have to write the following explanation.

  • Ease in rendering preventive care — This is not referring to operatory equipment or commitment of employers (although that would be a dandy survey in the future). This is about the mindset of the state in general about health care, as well as some specific dental considerations. We figure if everyone is gung-ho about health care, then the likelihood increases that there will be more compliant patients. Of course, some dental hygienists view the opposite as being their mission. They want to head for a state where teeth are missing, breaths stink, and patients keep asking for the “cleaning lady” at the front desk. Set those folks straight, if that’s your goal. Otherwise, the things we evaluated in regard to a state’s emphasis on health care included:

 

  1. The number of times residents visited a dental clinic for any reason in the past year
  2. Adults who have had any permanent teeth extracted
  3. Community water fluoridation
  4. Percentage of population without health insurance
  5. StateMaster.com’s health index, based on 21 criteria
  6. Students with below basic eighth grade science proficiency. Residents who understand some scientific principles can better follow your explanations of disease.
  7. Children living in poverty
  8. Percentage of children who have undergone both medical and dental preventive visits in the past year.

 

  • Ease in making a living — The salary is part of it (but only as a tie-breaker, in some cases). The government thinks dental hygiene is a great career choice for the future. The profession will grow by leaps and bounds in the coming years. There are certainly underserved areas that would benefit from more hygienists. But we also believe employers like an influx of too many hygienists because it keeps salary levels down. This factor can’t be ignored, particularly in states with high unemployment rates where even a second career can be difficult to start. We also think things such as mortgage rates and taxes can influence how much you enjoy that salary. The factors evaluated for this category included:
  1. Ratio of dental hygiene schools to overall population
  2. Cost of living rankings
  3. One-year increase in the unemployment rate for the year ending in September 2009
  4. Monthly mortgage costs. Yes, not everyone owns a home, but we believe home ownership is still part of the American dream
  5. Tax burdens

 

  • Ease in enjoying life — Some states are like the proverbial fine wine; students keep graduating from colleges within the borders and don’t want to leave. The living is just so good. Even though this category accounted for just 25% of the final score, we fully recognize that hygienists want to have fun too. We looked at a couple of consumer rankings of states, including Woman’s Day’s “Can Money Buy Happiness?” ranking of the states. The ranking in Woman’s Day’s September 2009 issue explored the “level of satisfaction” with all aspects of life. Finally, crime was weighed in, as well as the peer-pressure factors of physical activity and education (if the neighbors stay active and encourage kids to do well in school, then living just got easier for you). The factors evaluated in this category included:

 

  1. StateMaster.com’s “best places to live” ranking, which rated 44 “livability” factors.
  2. Incidents of violent crime
  3. High school graduation rates
  4. Physical activity levels on a monthly basis
  5. The aforementioned Woman’s Day ranking

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Job benefits for dental hygienists: Part 2

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We start off with Iowa.

1. Iowa
The lowest ranking in any of the preventive care categories was 12th in the percentage of children with both a medical and dental preventive care visit in the past year. That’s healthy! Other than that, Iowa is 16th in cost of living, and 27th in taxes. It’s not bad, yet it’s not outstanding. The average income is $50,210. So weigh one against the other. We found one Internet forum where someone was thinking about relocating to Iowa and asked for some insight on what it’s like to live there. One response, which is also applicable to all of the states in the top five, was: “The winters can be brutally cold, especially if you're not accustomed to the temperatures. The coldest actual temperature I've seen since living here has been 31 degrees below zero. The wind chill was close to 80 below. When it's that cold, you feel it to your soul.” That kind of pitch will make anyone excited about relocating.

2. South Dakota
South Dakota has the third lowest increase in unemployment, the fourth lowest tax burden, the ninth lowest cost of living, and is 11th lowest in mortgage payments. There are a couple of burps in the preventive care category, such as being 34th in children living in poverty. Overall, though, the state is focused on health care, and the cost of living is very reasonable on the high plains.

3. New Hampshire
Iowa, Minnesota, and New Hampshire scored the highest in the preventive care category. What bumped New Hampshire out of the top slot? The Boston suburbs are 40th in cost of living and 44th in mortgage payments. Can the average income of $59,600 of families with a single breadwinner compensate? Maybe; maybe not.

4 North Dakota
Hey, the state is first in patients who have an understanding of eighth grade science. You may not even have to spell P-E-R-I-O-D-O-N-T-A-L for them. North Dakota, though, is 48th in percentage of children with both a medical and dental preventive care visit last year. But you gotta like the state’s No. 1 ranking in the lowest unemployment rate increase and the fewest violent crimes. Is there a relationship between the two? Where’s a sociologist when you need one?

5. Connecticut
Forget California and its reputation as a trendsetter in dental hygiene! Forget Illinois and its role as the center of the universe for organized dentistry! Head back to where it all started, where Dr. Al Fones thought what we needed for oral health care was an individual known as the dental hygienist. The state is first in adults visiting the dentist, and third with the percentage of children with medical and dental preventive visits. Dr. Fones would be proud. The rub? Connecticut is 46th in monthly mortgage payments. Ouch!

6. Vermont
In this parade of stellar New England and upper Midwest states, we encounter Vermont. A very solid score in preventive health care. Check. A great place to live as a citizen. Check. Whoa! Forty-second in cost of living, 39th in taxes, and 32nd in mortgage payments. Erase those check marks?

7. Virginia
Virginia is above average in every aspect in “ease in rendering preventive care.” The weakest links were a ranking of 21st in both lowest percentage of population without health insurance, and percentage of children with both a medical and dental preventive care in the last year. Pretty impressive. But the nation’s capital is still on the northern border, ensuring that Virginians are 37th in mortgage payments, meaning a healthy chunk of the $66,000 plus change in salary covers the rent.

8. Nebraska
It’s all about living in the plains, the “ease in enjoying life” category. If that’s the deciding factor, Nebraska is the fifth best state to be a hygienist, not eighth. On top of it, the Cornhuskers have witnessed the second lowest increase in unemployment over the last year, trailing only North Dakota. However, the state is just so-so in percentage of adult visits to the dentist (25th) and percentage of children with both a medical and dental preventive care visit (33rd). Surprisingly, the tax burden (37th overall) takes $107.71 out of every $1,000 those hygienists making $47,000 earn.

9. Minnesota
We have already mentioned (see New Hampshire) that Minnesota is high on preventive care (second in loss of natural teeth and 10th in adults visiting a dental office). Still think it’s too cold? Buy a better coat ... and grab an extra checkbook too. The state’s tax burden is 44th in the country, cost of living is 34th, and mortgage payments are 35th. The Twin Cities are on the expensive side for an average income of $58,910. A greater concern, though, is that Minnesota ranks 38th in the ratio of dental hygiene schools to overall population. However, one of those schools is the pilot program for the next generation of dental hygienists — a sign of exciting times to come.

10. Wisconsin
Do they race each other on the St. Croix, and the Badgers lose just by a hair to neighboring Minnesota? Wisconsin’s only negative ranking in preventive care is that the state is 34th in percentage of children with medical and dental preventive care visits. Wisconsin, though, is 46th with its tax burden and 33rd in the job market pinch over the last year. But the economic struggles that pull against the average salary of $52,120 must be worth the trouble. Wisconsin boasts the nation’s top high school graduation rate and third lowest number of violent crimes.

11. Kansas
So Kansas is bumped out of the “top 10 best states for a dental hygienist to live in” by 0.9072 of a point to Wisconsin? Is it fair to hold Kansans accountable for sharing a border with Oklahoma (see No. 33)? What a difference an invisible line in the wheat fields makes! Kansas scored 19 points better than Oklahoma in “ease in rendering preventive care.” Although Kansas, like Oklahoma, enjoys a low cost of living ranking (10th overall), the Sunflower state was merely average in most of the other career and lifestyle factors.

12. Colorado
It would make sense to say we’re crazy for placing the first truly “independent” state for dental hygienists below Kansas and Wisconsin. Add this to the reasons for certifying us as crazy: Colorado has the eighth lowest ratio of dental hygiene schools to the overall population, the sixth lowest tax burden, and Woman’s Day thinks Colorado is the fourth “happiest” place to live. But take this as our plea for sanity: Colorado is 30th in percentage of children with both a medical and dental preventive care visit, 32nd in adult visits in the dentist, and 36th in percentage of population without health care. It’s not awful, but those kinds of obstacles will allow Wisconsin and Kansas to slide by you any ol’ day.

13. Idaho
Let’s start with the negatives, since everything else is pretty good in the Gem of the Mountains. Idaho ranks 30th with its one-year increase in the unemployment rate, and the state also ranks dead last in the percentage of children with both a medical and dental preventive care visit. But Idaho ranks 11th through 20th in nine out of the 18 categories we considered. Like we said, Idaho is a gem.

14. Maryland
Woman’s Day claims Maryland is the sixth “happiest” place to live. The percentage of children living in poverty is the fifth best in the country. The state ranks seventh in the ratio of dental hygiene schools to overall population, and the average income is $74,780. However, Maryland is also 46th in cost of living rankings and 41st in mortgage payments. Gotta hustle to pay those bills.

15. Utah
Well, we discovered Utah is ranked 50th in the percentage of population receiving fluoridated water. Afterwards, we receiving an e-mail from the Beehive state asking, “What water? That’s a salt lake over yonder in the desert!” Now that we have that joke out of the way, let’s point out that Utah is first in retention of natural teeth, second with fewest children living in poverty, and at the very top of Woman’s Day’s “happiness” rankings. Don’t get too excited, though; Utah is above average in tax burdens (38th), mortgage payments (30th), and the ratio of dental hygiene schools to overall population (37th).

16. Montana
Utah and Montana are not neighbors; Idaho gets in the way. But it does seem like our scoring system finds regional similarities, particularly in lifestyles. Only 0.35 of a point separate Utah and Montana in that category. But Montana fares 11 points better in the “ease in making a living” category. The treasures of Montana include a 10th lowest one-year increase in unemployment, 13th lowest tax burden, and 17th lowest median mortgage payments.

17. Maine
Maine is the fifth lowest in percentage of population without health insurance and 10th in percentage of children with a medical and dental preventive care visit in the past year. Despite a solid emphasis on preventive care, Maine is 49th with its tax burden and 38th in cost of living. Even Woman’s Day just gave it a mediocre salute with a ranking of 29th.

18. Washington
Washington is one of those politically correct states in the world of dental hygiene, always considered to be very progressive and eager to try new concepts. To make it even sweeter, the average income for a dental hygienist is $73,600. But Colorado and Minnesota are ranked higher because the best ranking the state receives in the “ease in making a living” category is 19th for its tax burden. It’s tougher than you think to stretch that $73,000 to cover the expenses. It’s enough to make you sleepless in Washington.

19. Delaware
Someone warned us the other day not to call Delaware “little.” We’re not going to do that. Oops, we just did. Here’s what’s gigantic about being a dental hygienist in Delaware: fourth highest percentage of adult visits to the dentist and 10th fewest children living in poverty. That cute little state, however, is too close to the District of Columbia and Philadelphia, and the First State is 30th in cost of living, 33rd in median mortgage payments, and 36th with its tax burden. At least we liked the little state better than Woman’s Day (36th).

20. Pennsylvania
Pennsylvania has the seventh lowest percentage of population without health insurance and is eighth in percentage of children with both a medical and dental preventive care visit. If you’re an outsider, do what we do: Blame the negatives on the Steelers and the Eagles. The Keystone State is 31st in cost of living and 44th in violent crimes. However, we liked the fact that Pennsylvania is 12th with is ratio of dental hygiene schools to overall population.

21. Hawaii
See Kansas at No. 11 above. How do the islands not make the Top 20? Only 0.09 of a point separate the islands from Pennsylvania in our scoring system. Sip a Blue Hawaiian on the beach, or stand in line at a Starbucks in Philadelphia? Having a hard time with that decision? Well, Hawaii does score better in the “ease in rendering preventive care” category, including a ranking of second in lowest percentage of population without health insurance. But, man, those Hawaiian luaus are expensive to absorb. The state is 50th in cost of living, 48th in median mortgage payments, and 47th in tax burden.

22. Wyoming
Woman’s Day liked those cowboys, giving Wyoming a third-place ranking in its search for happiness. The state also has the seventh fewest children living in poverty and has the third lowest percentage of violent crimes. But it’s above average in getting patients in the door: 36th in adult visits to the dentist and 35th in percentage of children with both medical and dental preventive visits.

23. Ohio
Buckeye hygienists earn about $57,000 a year, and the state is 15th in cost of living. Ohio is eighth in percentage of population with health insurance, so business traffic is good. What’s not to like? A ranking of 40th with both its tax burden and violent crimes.

24. Missouri
Show me the low rankings in percentage of adult visits to the dentist (46th), loss of natural teeth (40th), and percentage of children with medical/dental preventive visits (40th). OK, we will. Show me the high rankings in cost of living (8th), tax burden (12th), and median mortgage payments (13th). OK, we will. It all adds up to the middle of the pack.

25. Michigan
We’re officially at the halfway point. Michigan is 21st in cost of living, 25th in ratio of dental hygiene schools to overall population, 26th in tax burden, 27th in median monthly mortgage payments, and 28th in percentage of children living in poverty. Welcome to the middle. And, yes, we watch the same news broadcasts you do: Michigan just experienced the 50th largest one-year increase in the unemployment rate. Or was it decade?

26. Indiana
Indiana is above average in percentage of population with health insurance (14th), cost of living (12th), and median mortgage payments (16th). But the Hoosiers are 44th in children living in poverty, loss of natural teeth (38th), and adult visits to the dentist (34th). Overall, though, the state’s score in the “ease in making a living” category is fourth best among the remaining states below, which means the average annual income of $62,210 goes a little further in the bank account.

27. New Jersey and Rhode Island
We have arrived at the only tie in this ranking. Since the wife is a New Jersey native and the daughter-in-law’s family hails from Rhode Island, we decided to be kind. New Jersey has the seventh best percentage of adult visits to the dentist, as well as the ninth best percentage of children with both a medical and dental preventive visit in the past year. The Garden State also has the 11th fewest children living in poverty. We’ll blame the rankings of 48th in cost of living and 50th in mortgages on New York City. Rhode Island boasts similar statistics in the preventive care category: first in percentage of children with medical/dental preventive care and third in adult visits to the dentist. It’s also 41st in cost of living and 43rd in mortgages, and the state had the 45th highest one-year increase in unemployment. We’ll blame all of that on Boston, OK? Now we can show our face at the next family reunion.

29. Oregon
You know how every state has dumb laws on its books? We heard that you can’t eat ice cream on Sundays in Oregon. Ready to skip on down to No. 30? Illinois, of course, is reputed to be North America’s largest producer of ostrich meat, and we’re betting you can order up a steak of it any ol’ day of the week. Since we just slipped down PETA’s list of friendly publishers, we’ll go back to Oregon. The state has the 13th lowest percentage of children living in poverty, but is 47th in the percentage of children with both medical and dental preventive care visits. Don’t have enough time to take the kids to the doctor? Oregon, though, scores well in the “ease in enjoying life” category, and Woman’s Day gave it a ranking of 18th, which, of course, is better than ours.

30. Illinois
The trouble with the center of the universe for organized dentistry (the ADHA and ADA are based here, as well other smaller associations) is that no one seems to be particularly proud of that fact. The state’s residents are merely average in seeking out preventive care. Illinois is 37th in the one-year increase in the unemployment rate, and we’re reasonably certain that Chicago makes a sizable contribution to the state’s ranking of 46th in violent crimes. But it is known as the Prairie State. Like many of the neighbors to the west and south, cost of living isn’t bad (22nd overall), and Illinois hygienists boast an annual average income of $64,970.

31. Georgia
Is it just us, or do things seem quiet down South since we mentioned Virginia at No. 7? Georgia is 30th in percentage of loss of natural teeth, 38th in percentage of population without health insurance, and 39th in children living in poverty. If you’re a “Yankee,” go ahead and snicker. You’ll probably hear this song again as we start ranking other southern states. But, hey, Atlanta keeps humming along, and hygienists earn an average of $60,990 a year. Georgia is sixth in cost of living, and the tax bite is not too severe (17th overall).

32. Alaska
We butchered Alaska in the “ease in making a living” category. The state is expensive (47th in cost of living, and 42nd in median monthly mortgage payments). The preventive care scorecard looked like this: seventh in lowest percentage in loss of natural teeth, and third fewest children living in poverty matched up with rankings of 34th or worse in four out of five of the other categories. Despite its size and rugged environment, Alaska is 11th in the violent crimes category.

33. Oklahoma
The Sooners have an excellent dental school. They have a well-structured dental hygiene system that even trains students in rural areas via satellite centers. What is it that Oklahoma residents don’t get? The state is 50th in adult visits to the dentist. Ah, yes, the state is also 42nd in percentage of population without insurance. Who says insurance doesn’t matter? Is there a bright side? Yes, it’s No. 1 in cost of living expenses (as well as fourth in monthly mortgage payments).

34. Tennessee
Two things about the Volunteer State: 1) It probably needs some volunteers to spread the gospel of dentistry. The state ranks 48th in percentage in loss of natural teeth, 40th in children living in poverty, and 38th in percentage of adult visits to the dentist. 2) Tennessee is first with its lowest tax burden, and second in cost of living. So the average income of $54,030 counts for something. Be forewarned, though; Tennessee ranked 33rd in the one-year jump in the unemployment rate.

35. Arkansas
Let’s count the ways Arkansas is ranked 42nd or worse in the preventive care category: 1) 47th in percentage in loss of natural teeth; 2) 45th in percentage of adult visits to the dentist; 3) 42nd in percentage of population without health insurance; and 4) 42nd in percentage of children with both a medical/dental preventive visit. It reminds us of the comedic insult, “What do you get when you have 32 Arkansas residents in the same room?” “A full set of teeth.” So why isn’t Arkansas at the bottom? Well, if you’re up for the challenge of treating Arkansas residents, the state is second in median mortgage payments, fifth in cost of living, and seventh in the one-year increase in the unemployment rate.

36. Massachusetts
In a complete contrast to Arkansas, Massachusetts is second in both percentage of adult visits to the dentist, and children with a medical/dental preventive visit in the last year. The state also has the 10th lowest percentage of population without health insurance. Ask any college student who falls madly in love with Beantown about what the problem is. Massachusetts is also 43rd in cost of living and 47th in median monthly mortgage payments. It just seems that it would be daunting to a dental hygiene student that the bills have to be paid with an average income of $62,920. StateMaster.com and Woman’s Day obviously disagree with us, giving the state a ranking of seventh and eighth, respectively, as a great place to live.

37. Kentucky
Did you know that Kentucky was No. 1 in the highest percentage of population receiving fluoridated water? We didn’t either. Unfortunately, the state is also ranked 48th for the number of children living in poverty, and 43rd for percentage of adult visits to the dentist. The Bluegrass state is also third in cost of living and sixth in mortgage payments. Remember how we talked about our disagreement with Woman’s Day and StateMaster.com rankings with Massachusetts? They ranked Kentucky 49th and 41st, respectively, as a “best place to live.” Maybe we’re too fixated on the “ease in making a living” category. But we just think the impact of living expenses is relevant to dental hygiene salaries, particularly when the average income in Kentucky is $44,280.

38. North Carolina
North Carolina’s worst ranking was 41st in violent crimes. Its best ranking was 16th in its tax burden. That means there’s a whole lot of middle of the road rankings that don’t suggest any particular benefits to practicing dental hygiene there, unless you happen to be a college basketball fan. In addition to that taxation thing, North Carolina also scored above average in fluoridated community water (18th), median monthly mortgage payments (21st), percentage of children with both a medical/dental preventive visit (23rd), and cost of living (24th).

39. Texas
As we get ready to list the 10 worst states to practice dental hygiene, we might as well ask something off-the-wall to clear the cobwebs out of our minds. Texas is 48th in violent crimes. What exactly is the state’s famous death penalty deterring? The Lone Star state is fourth in cost of living, has the ninth best ratio of dental hygiene schools to overall population, and has the ninth lowest tax burden (the average dental hygiene income is $65,370). The challenge is in preventive care: 50th in percentage of population without health insurance, 47th in adult visits to the dentist, 43rd in children living in poverty, and 39th in percentage of children with both a medical/dental preventive care visit in the last year.

40. South Carolina
At the beginning of this article, we mentioned that we also computed a state’s proficiency in eighth grade science. We argued that patients with a better understanding of general scientific principles can better understand all that “yadda yadda” that dental hygienists mumble during the patient education portion of an appointment. South Carolina has the 48th worst high school graduation rate, and is ranked 31st in eighth grade science proficiently. We’ll talk real slow here, so you can follow us. South Carolina is 15th in percentage of children with both a medical/dental preventive visit. Two thumbs up! The Palmetto state has the 10th lowest tax burden. Two thumbs up! The rest of the rankings were a mixed bag of mediocre to not-so-good.

41. Arizona
All righty. You probably looked at the top 10 states, and you’re probably curious about the bottom 10. The 10th worst state to practice dental hygiene is ... Arizona? Arizona had the worst score in the “ease in rendering preventive care” category than anyone in the top 40 except Oklahoma. Well, let’s just move the Sooners down here and move Arizona up to No. 33. Not so fast. Oklahoma is an inexpensive place to earn $60,000 to $70,000; Arizona is not. Plus, it’s bothersome that Arizona ranks 50th for the number of children living in poverty. However, we would be remiss to not point out that the Woman’s Day “happiness” ranking has Arizona at No. 10. Living in the desert would be your choice.

42. New York
Since anyone who has paid a hotel bill in New York City knows this is coming, let’s just get it out of the way. One hundred and thirty dollars and seventy-nine cents out of every $1,000 you earn goes to taxes. Yes, that is the heaviest burden in the country. New York is also 44th in cost of living and 45th in median mortgage payments. On the plus side, the state is seventh in percentage of children with a medical/dental preventive visit and 12th in the number of adult visits to the dentist. How does New York then rank 44th in the loss of natural teeth? Does the 47th ranking in violent crimes have anything to do with it?

43. California
California’s a mess. We sometimes wonder if the headaches from the natural disasters that seem to occur every other week are a respite from all of the other headaches (such as cash flow, even though dental hygiene salaries are always among the highest). But hey! This is the land of RDHAPs! This is the land of self-regulation! No way is California at the bottom of the list! Plus, despite the groans you hear from the natives, the state is fourth in the ratio of dental hygiene schools to overall population. So there’s room yet for fresh talent.

44. West Virginia
The Mountain state does have a No. 1 ranking in one category. It is at the very top in lowest median monthly mortgage payments. There is a comedic insult that West Virginians learn to eventually tolerate. “How do you know the toothbrush was invented in West Virginia?” “If it was invented anywhere else, it would have been called a teethbrush.” The state ranks 50th in loss of natural teeth and 48th in adult visits to the dentist. However, West Virginia is a respectable 14th in percentage of children with both a medical/dental preventive visit in the past year. Often, when we discussed a challenge in preventive care in other states above, we focused on the inexpensive lifestyle in those states. West Virginia, though, is only 17th in cost of living and the tax burden ranks 43rd. In addition, the one-year bump in the unemployment rate was the 46th highest.

45. Louisiana
We’re inclined to say that we wish both Louisiana and Mississippi well in the ongoing efforts to recover from Katrina. Louisiana did not have an above average score in any of the “ease in rendering preventive care” criteria. In regard to earning a living, Louisiana had the fifth lowest increase in the unemployment rate last year, and the state is also seventh lowest with its median monthly mortgage payments. We also ranked Louisiana fourth best for its ratio of dental hygiene schools to overall population. So here’s hoping the opportunities continue to emerge for the dental hygiene profession in Louisiana.

46. New Mexico
New Mexico is 49th both in percentage of population without health insurance and children living in poverty. Those factors do affect the state’s overall score in the “ease in rendering preventive care” category. In the other two lifestyle categories, New Mexico is ranked ninth in lowest median monthly mortgage payments. Otherwise, the state ranked below average in all of the criteria considered. However, as is the case with Arizona at No. 41, the Woman’s Day “happiness” rankings give the Land of Enchantment a much better overall ranking than we do (17th).

47. Florida
What’s that large peninsula that’s just to the southeast of Alabama? Oh yeah, Florida. Everybody worries about preceptorship in Florida. Everybody worries about foreign-trained dentists working as hygienists. Everybody worries about the proliferation of dental hygiene schools in the urban areas (although overall, we ranked Florida at 13th for the ratio of dental hygiene schools to population). The state is just so-so in cost of living and mortgage payments, but the one-year bump in the unemployment rate was 43rd worst in the country. The “ease in rendering preventive care” scores were all below average too.

48. Alabama
Preceptorship, preceptorship, preceptorship. Even if you want to argue that dentists can train students better than dental hygiene school professors can, don’t insult our intelligence by saying the state’s ADHP program doesn’t affect the country’s rock-bottom average annual income of $32,800. It doesn’t wash. The cost of living isn’t that good either (14th), so don’t throw that argument at us. Alabama, however, is 19th in fluoridated community water and just 29th in health insurance (translating to a rating of 31st for children receiving medical and dental preventive care). So Alabama is not at the bottom, even though admittedly we wanted to put it there due to preceptorship.

49. Mississippi
We haven’t been there since Katrina wiped out the coastal casinos. Did something else happen? The consumer-oriented polls have the state ranked 48th and 50th. It’s also 49th in percentage of adults visiting the dental office, 49th in loss of natural teeth, and 46th in children who live in poverty. But if you accept the challenge, mortgage rates are low (third in the country).

50. Nevada
The only thing messier than California is Nevada. The state had the 49th largest increase in the unemployment rate last year. It’s also 44th in percentage of population without health insurance. See, when the rest of us save a buck by not vacationing in Las Vegas, somebody has to pay for that thriftiness. Generally speaking, though, the state’s salaries are comparable to California. You’re getting paid big bucks to get those adults (44th worst in the country) and children (49th in the country) to come pay you a visit.

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