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Musings of an older hygienist

May 1, 2023
Kirsten Brancheau, BA, RDH, shares her insights into the advantages and disadvantages of being an older hygienist.

My coworker Patty and I sat down at the lunchroom table, both of us letting out huge sighs. It had been a rough morning. As we usually do, we swapped stories of our unusual experiences. Coincidentally, we both had seen patients who described to us their extremely graphic bathroom difficulties. I also told her about the patient who, when asked for any medical updates, replied, “Yes, I have toenail fungus,” and then kicked off her shoe and brought her foot up to my face.

Patty, a 50-something-year-old dental assistant with many years of experience, questioned whether patients were always so forthcoming with such personal details. She said she couldn’t remember patients being so uninhibited back in the ’80s when she started working. With the exception of a few “characters,” she remembered most patients coming in, exchanging a few pleasantries, and then sitting back and opening their mouths to get their work done, and that was that.

Also by Kirsten Brancheau:

Hygienists have the power! Or do we?

These old hands

I thought about what she said. I’ve been a dental hygienist for 45 years. Had patients really changed all that much? I’m not sure if that’s true, but I suggested a different possibility. Perhaps patients are simply more comfortable sharing information with us, now that we are older. This got me thinking about the advantages and disadvantages of being an older hygienist.

Are there any advantages?

For a while, I couldn’t see any advantages of being an older hygienist. The pay, compared with that of new graduates, isn’t much better. Frequently, dentists encourage new graduates to apply for hygiene positions. I always wonder if that’s because they don’t want to pay older hygienists what we deserve.

There is definitely an age bias in dentistry. I have witnessed this firsthand. When I was in my 50s, my 30-something employer at the time needed another part-time hygienist. He gave me a stack of résumés to look over. One hygienist stood out above all the rest. I showed the dentist her résumé, and he looked at her age (40s) and said, “I don’t want another old hygienist.”

Another dentist (also in his 30s) told me that studies prove that patients prefer younger dental auxiliaries. I have never seen those studies, and I have a hard time believing they exist. But is what he said true? Do patients really prefer younger hygienists?

“The stare”

I have not found that to be true in my experience. In fact, I’d say I’ve found the opposite to be true. Although I am now an older hygienist, I was once a younger hygienist. I have worked in many dental offices over the years, often with another hygienist in the practice. When I was the young hygienist, I frequently got “the stare” when I saw an established patient for the first time. I can’t count the number of times I went into the reception area to bring in a patient, only to hear, “You’re not Judy!” This was said in an accusatory tone and not with a smile, despite the fact that I had put on my most cheerful and welcoming face to greet them.

When I started in my current position 11 years ago, I worked with another hygienist who was a little older than me, but she had been there for more than 30 years. I never got “the stare” when I brought a patient in for the first time. They accepted me without hesitation. It was then that I realized that it wasn’t because they preferred the established hygienist so much as they preferred an older hygienist.

The other hygienist in my practice retired, and we hired a wonderful young hygienist, in her 20s. She is now the recipient of “the stare,” and hears “You’re not Kirsten.” I feel sorry for her because I know how that feels, and I’ve told her many times not to take it personally. I told her that I went through the same treatment as a young hygienist. And then I offered her some cheerful news: “Someday you’ll be old too, and then patients will love you!”

Yes! There are advantages

Of course, most patients are perfectly willing to see either one of us, but I have found that quite a few older patients prefer to see me. I think they simply feel more comfortable with an older hygienist. Maybe they think I can relate better to their health issues, or maybe they think I share their bathroom woes. (I don’t!)

Being the older hygienist is good for a laugh sometimes. When I make phone calls to schedule overdue patients, the patient sometimes requests to see “the older hygienist.” I say, “Oh, you mean me.” Apparently, patients don’t expect the hygienist to be making these calls. They usually stumble over what to say next, probably thinking they’ve insulted me, but I think it’s funny.

Another advantage of being an older hygienist is that I have learned over the years how to deal with difficult patients. I have refined my approach to dental-phobic patients, extremely sensitive patients, nervous children, prejudiced and racist patients, overly chatty patients, the do-not-recline-me patients, and the inevitable “dirty old man.” It has taken me years to find the best ways to deal with these patients, but I think I’ve got it down pretty well now. (For those who want to know my approach to the “dirty old man,” it is simply stony silence and my own version of “the stare” when inappropriate remarks are made. More often than not, the offender starts squirming a bit and then starts talking about his teeth.)

Then came ... a pandemic

In 2020, when COVID-19 turned the world upside down, I worried about the health risk of being an older hygienist. When my office closed down in mid-March, I was out of work for four months. That is the longest stretch of unemployment I’ve had since I graduated hygiene school. I admit that I really enjoyed being home during that time.

But something strange happened that June. Suddenly, I was bombarded with employment offers. Dentists whom I’ve worked with when they were associates begged me to work for them. A temp agency asked me to help them out and increased their pay rate. Dentists I’d never even heard of were calling and emailing. Pre-COVID-19, there were too many hygienists in my area. Post-COVID-19, hygienists are in short supply. Apparently many hygienists decided not to return to work. Suddenly, this old hygienist looked good again! For the most part, salaries are still higher than prepandemic, and many hygienists received long overdue raises when we returned to work.

I hadn't planned on retiring in March 2020 when my office closed down for a few months due to the pandemic, but I seriously considered it during those months at home My age and occupation put me at high risk for COVID. Financially, I didn’t need to work. Why put myself at risk when I was so close to retirement? I was scared to go back. I didn’t want to work without an ultrasonic scaler. I didn’t want to wear all that extra PPE. I didn’t want to put my health at risk. I enjoy being at home and have plenty of projects to keep me busy for the rest of my life. Retirement simply seemed the logical choice.

But it didn’t happen. I’m not sure why. I think it was just some stubborn idea that it would be me who would dictate when I retired, not some evil virus. So I did something I never thought I’d do. I bought a pair of Crocs. I wanted shoes that I could throw in the washer at the end of the day. Then I donned the scrubs, the disposable gown, the hair covering, the face shield, the loupes, the N95, and the gloves, and I went back to work. It takes more than some stupid virus to keep this old hygienist down.

Editor's note: Originally posted in 2020 and updated regularly