Aug. 25, 2009
In 2002, Missouri community college began its first class in the dental hygiene program. A year later, the job market for dental hygienists suddenly became saturated, and the author has found jobs to be scarce ever since.

By Karen Donaldson, CDA, RDH, BS

I love dental hygiene! Back in 1986 when I made the decision to quit my dental assisting job and return to school to pursue a degree in dental hygiene, I felt excited and positive about the decision.

Right after I had finished the dental assisting program, I had discussed dental school with a UMKC representative. That was 1983 and there was a shortage of dentists, a familiar story that I wonder about now. The school was offering a shortened entry requirement of undergraduate college. It sounded great. Go to college for two or three years then off to dental school. I had no college (only the CDA certification program under my belt), but I was a straight-A student. I felt I could make it. Instead, life got in the way and that idea went to the back burner when my husband lost his job.

So when the new job he took was in a city with a dental hygiene program I got excited again. That profession meant more money, more respect in the dental office, and more of a career challenge that I needed. After two years of working as a CDA in the new city, I finally had the opportunity I had been working towards, acceptance into the pre-requisite level of the dental hygiene program at University of Southern Indiana.

That university served a large area in both Indiana and Kentucky but there were still plenty of jobs to be had. It was a great program and I graduated with honors and finished my Bachelor of Science with a full scholarship and worked part time.

Before my dental career, I had been in retail sales and had made myself a promise that I would never work for a boss I didn’t like. That empowered me to move around in my job selection. About every five years I would make a change, either moving to a better job, a different city, or because the office family dynamics had become sour. That was a frequent problem I encountered. Some of my colleagues were at the same office they began in right out of school even though they had also suffered bad times of office dynamics. I just couldn’t tolerate the stress that brought into my life.

I had even moved to Missouri and was in a city where the closest dental hygiene program was 70 miles away. It wasn’t until I had worked in three or four offices in this city in stints that lasted 2-5 years that I discovered there were many offices that did not employ a dental hygienist, they were performing dental hygiene procedures illegally according to the state law.

In 2002, the community college there began their first class in the dental hygiene program; a year later, the job market suddenly became saturated in Springfield, MO, where I lived.

I was working part time in an office where I had discovered that the doctor was allowing the assistant to see hygiene patients on my days off. I thought about how to correct this problem. I loved the job, and I thought the dentist and myself were in a great working relationship. But, I was wrong.

After giving the assistant a copy of the state dental law proclaiming it illegal for an assistant to scale teeth she showed it to the doctor. When he called me to his office to discuss the document, I explained to him that I wanted more days to work and she was seeing the patients I could see and it was after all, illegal.

A month later I found a part time job in another office and added that to my work schedule. One morning in the second office I discovered a friend of the other hygienist was interviewing for my job in the other office! I called the doctor on his cell phone as he was driving to the ADA meeting in New Orleans and asked him when he was planning to tell me I was fired? He acted as if the phone was cutting out and hung up on me. I was furious! I immediately went to the office and got all my personal belongings and mailed the key to the office address.

The second job was temporary so I needed to find a job as soon as possible. The only office I knew I could get hired was one I had put at the bottom of my list since I had moved to Springfield in 1993. They employed eight hygienists and doctors and had over fifty employees all together. It was not the quality of office environment I tried to seek out, but a job was a job and I needed one.

After two years and lots of office dynamics turmoil, I left the big office and was without a job. But now my personal life was also in turmoil and perhaps a vacation from work would help. My husband had serious health problems and staying home was a good idea.

About six months later, I suddenly needed to get out of the marriage and needed a job. I called everyone I knew in the dental community and went door-to-door delivering my resume. There were no jobs in or around Springfield. I had to begin searching a larger parameter. Finally I found a job in a small town 100 miles away. That meant moving.

This office was a great preventive-dentistry focused office. But there was one problem; the dentist was OCD about everything! I lasted six months and moved again to another job in Arkansas this time. I had to get a new license and settle in again. I really was anxious about the move but felt it was my only choice. During the interview, the doctor warned me that one of his assistants had “run off” the last hygienist and I should work to build a good relationship with her.

Almost a year later I was struggling to survive in a world run by that assistant. She had power over everything in the office, including the doctor! When our relationship came to a blowout in a meeting I had requested I was told that I would have to leave because if he fired the assistant she would take all the patients she had brought him with her. My reference to blackmail did not receive a response.

Now what? I had already moved twice in 18 months. When I called my daughter in St. Louis about the dilemma she suggested I put everything in storage and move in with her family and look for a job in St. Louis. Apparently there were lots of job listings in the newspaper. So I moved most of my belongings to storage and the rest to St. Louis to take up residence in the basement family room.

In the 14 months I lived in the St. Louis area I can’t even tell you how many jobs I applied for that I never heard a response but the ones that did interview me sometimes had more than twenty applicants.

I even attended a meeting by the dental society about opening a new campus of one of the programs in St. Louis, “because there was a shortage.” I told them if there was a shortage why did I not have a job? They had no answer but suggested I register with the dental society office so I did, it cost me $5 and I never got a call from that listing for a job. Most of the jobs listed in the paper were for one or two days a week. Some that said that were exactly that, a job for one or two days period!

I took every part time job I could find. I had to undercut the services to get the job so my hourly was lower than I had worked for a while. And when I finally found a job it was in a large multiple practice again, the type of office I had promised myself not to ever work in again. The salary was lower than my starting salary right out of school in 1989. I felt like a slave but was glad to have a job and kept telling myself just that. But after six months when the schedule had more openings than any office wants to see I was told that there were too many hygienists for the office and too many openings in the hygiene schedule so since I was the last hired, I was out!

I started the job search again only to find that some offices were focusing on my age a lot. I could never prove it, but age discrimination had raised its ugly head in my professional life. Finally I started applying for jobs anywhere in the state of Missouri or Arkansas where I was licensed. I could not get a job!

Finally a dentist near Springfield called me with a part time position for one week. The same day a listing appeared on the Springfield Association’s website for a maternity leave in an office there. I drove down and interviewed at both offices and got both jobs. I was counting on this giving me the opportunity to get back in the network and hopefully find a job that would last.

But after making a double move, one from my daughters’ home and one from the storage unit and working for three months while constantly looking for a job; the only jobs I could find were temporary and in a denture clinic doing debridements and some scale and root plane cases one day a week. This job was 70 miles from where I lived.

I even did a three-day working interview in NW Arkansas, which would mean another move! It was an office that practiced accelerated hygiene, I could keep up since I had done this in one of the temporary jobs I had but I didn’t get the job. I noticed all the staff was much younger than me, as were most of the offices I had worked in as a temporary.

I came to an abrupt realization. I was too old to be hired. The offices that would hire me were the type of office I had vowed not to work in when I graduated. Meanwhile my colleagues that had stayed at the same office all these years still had a job and would until they decided to retire. Even some of those offices wouldn’t hire me when they left. “We are focusing on a new approach,” was one of the excuses I got. Or “we chose someone that better fits our dynamics.”

I began to think that I was getting a bad reference from one of my former bosses.

Perhaps the fact that I had “temporary” jobs for the last three years was the problem. I had my resume evaluated by experts; I called former employers and discussed my references. Most had never even had a call from any offices.
I made changes on the resume and included another page listing every temporary job instead of just saying, “worked as temporary clinical dental hygienist in various offices.” None of this worked.

Finally I moved again to the town where I was working one day a week for the denture clinic. The very next day after I moved I got a call about a teaching position I had applied for months before. I had to laugh. I had moved five times
chasing dental hygiene jobs and now this job would mean another move. At first I said no thanks but when they called again a few days later I thought this must be the real thing and scheduled an interview. I got the job and after only being in that location for two months I planned another move.

This job was with a new distance-learning dental hygiene program. How ironic was that, taking a job teaching new hygienists, the same ones that were taking the jobs away from me. “If you can’t beat ‘em, join ‘em” they always say, so I did. But a few months into the program I had experienced no training, a director’s ouster, and a co-worker that was working behind the scenes to undermine everything I tried to do. I decided in September that I would leave at the end of my 12-month contract that had started in June.

I was again looking for a job but would have to fight for one against all the newly graduated and licensed dental hygienists. Surely there was a doctor out there that appreciated the value of a highly trained hygienist over a “young and cute” new graduate? I even applied for other teaching positions, even though they were not my favorite idea since I had such bad luck with the last one. I had an 8-hour interview for one teaching position and felt like we were on the same page philosophically and they promised training! But I lost out to a colleague that had a master’s degree.

Finally a dentist colleague called with the news that she was opening her own practice later this year. She offered me a part time position but the salary was below the normal rate until the patient numbers built up. So here I am helping to plan a new office from the ground up without pay, but once it opens I will have a salary.

Why am I telling this lengthy tale you might ask?

Recently, Mark Hartley mentioned the overpopulated state of dental hygienists and dental hygiene schools in his blog. I am here to tell you it is real. Those statistics of 67% of respondents feel there were fewer employment opportunities in their state; 80% that responded to the ADHA survey stated they feel there are too many hygienists living in the area. Of the 14% of RDHs that are currently not working as a dental hygienist, 62% of them said they could not find a dental hygiene job.

Most jobs are now only one or two days a week instead of full-time. This eliminates any benefits, if you are lucky to even get them with a full-time position.

While dentists cry out that there is a shortage of dental hygienists nation wide, especially in rural areas, they really are trying to legalize dental assistants scaling teeth. When the local and state components of ADHA fight this attempt, the answer the state dental boards give us is to open more schools, especially distance-learning schools in the areas where they say there are no hygienists available for the jobs.

Funny, the small town where I taught in one of those distance-learning programs only needed about five hygienists in a 40-mile radius. We graduated ten. So now the hygienists in that area need to beware, the market will be flooded and the salary-range will go down. Just as it did in several of the cities I have worked in, St. Louis, MO; Springfield, MO; Evansville, IN; just to mention a few.

So if you are thinking about changing jobs because you are unhappy with the social dynamics of your office or the lack of legal dentistry being practiced, think again my friend. You need to keep that job even though it may not live up to the standards you were taught years ago, there will be a new, young, cute dental hygienist that was not taught those same standards in one of these newer campuses waiting to take your job and you will be left…chasing dental hygiene.

If you have time, take a moment to fill out the RDH eVillage salary survey.

Karen Donaldson, CDA, RDH, BS, has worked as a dental hygienist since 1989 when she graduated from the University of Southern Indiana as a non-traditional student. She graduated Magna cum laude in 1990 with a Bachelor’s Degree in Health Sciences with a Geriatrics and Social Services emphasis. She also holds certification from DANB as a Certified Dental Assistant and has had Expanded Functions training. She has moved eight times in four years chasing dental hygiene jobs, a profession she loves. In 2001, she wrote an article for RDH magazine, which can be viewed here.