I speak in opposition to the expanded duties, i.e.  for dental assistants scaling teeth in my native state of Virginia.

I was a dental assistant in the early 1960s in Henry County and left the state to attend Wayne Community College,  Goldsboro, NC as a member of their first class of dental hygiene.  My plan was to return  to  VA and work with my dentist emloyer as his dental hygienist.  I did carry out these plans and am most grateful for my opportunity to attend a community college where I earned an Associate Degree in Dental Hygiene.  I had actually earned my CDA through a correspondence course from UNC Chapel Hill;  however, I was savy enough to understand the need for  formal education if I wished to fulfill my goals of rendering quality care directly to patients. Yes, there  was a shortage of dental hygienists in Virginia in the early 1960s and prior years.

Old  Dominion University and Medical College of Virginia implemented dental hygiene programs in the mid-sixties graduating  four year degreed dental hygienists and have done so since.  Then came the Community Colleges in various regions of the state,  North, Central and Southwest ,and maybe more areas that I am not aware of, providing additional  dental hygienists with  Associate Degrees in Dental Hygiene.  These graduates possess  outstanding skills and education  to work as dental hygienists providing an abundance of caregivers from accredited porgrams for the entire Commonwealth.

With more avaliable dental hygienists, too many dentists begain to develop greed and looked for ways to pay less to dental hygienists by offering only part time positions without benefits, making it difficult for some dental hygienists to survive financially. They may have had to select another form of employment. In another scenario, numerous dentists would make the patient load so heavy that the clinical dental hygienist would have only 30 to 45 minutes to render a prophylaxis to an adult patient, do x-rays and patient education. If all the calculus could not be removed in that visit, then one was expected to get it  off the next time around regardless of the time frame at which the patient returned, maybe six months, twelve months or more.  One cannot survive these conditions  without burnout and possibly have had to resort to another career.  Many of these dentists did not expect full mouth perio chartings nor did they encourge the level of quality care that is taught in dental hygiene programs and that dental hygienists yearn to deliver.

Having lived in four states and obtaining licensure in VA,  NC, DE,  and MI, I have worked in numerous dental practices as a substitute prior to settling into a permanent position.  Some of my experiences have been good; however, some were apalling.  I have been expected  to work  with broken insturments,  outdated equipment, limited supplies, and packed schedules with inferior pay which can turn dental hygienists away from a dental practice. Then the dentists cry....... shortage.

In the archives of Richmond, Virginia one could find a document that I was required to sign during the process of my Virginia State Board Examination.  This was a statement of  commitment to render the highest quality  care to the patients that I cared for while working as a Registered Dental Hygienist.  For me, signing this statement was sacred similar to a marriage vow .  I take my profession seriously, it is my passion. I wonder, are dental hygiene state board candidates still required to sign such a commitment statement?

If  any Virginia dentist  has problems employing a dental hygienist, they may want/need to reassess the working enviorment provided and the level of income/benefits offered. Focus on quality vs quanity could be a major asset in employing a dental hygienist.

My personal experience in Virginia was outstanding prior to my moving out of state in 1977.  I worked on 50% commission and had whatever equipment/supplies that I asked for. I was limited on the number of patients that I saw each day because I was expected to deliver the highest quality care. Quanity was not the focus. While my experience was great, I did hear  other dental hygienists speak of undesirable work arrangements as more dental hygienists entered the work force in VA.

I am not burned out and I am still working after 41+ years of clinical dental hygiene.  Yes, I have one hour per patient and spend a lot of time on patient education.

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