Job market outlook for sunny San Diego

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30 year vet in Edmonton, Alberta

52 months ago

Suzanne in Terre Haute, Indiana said: Hi exp,
You are so right! It is doubtful that the OM/dr would tell the current hygienist how many resumes they are getting on a daily or weekly basis. I don't believe they (the majority) just throw them in the trash. They keep them confidential and any hygienist out there who doesn't believe it is just plain naive! All dds are constantly looking for ways to run their practice more cost effective. I've talked candidly with many and the first place they look is staff salaries. #1 is the hygienist. It's called profitability. They need more of it, we get cut. One way or another be it time, work in more pt's for the same pay = more production to pay out ratio. Better yet, cut the hourly pay and still work in more pt's. Profitability just jumped up. More people in the profession wouldn't recommend it as a career path than would. That speaks for itself. It isn't just us!

Suzanne, Well articulated....our office, which is not and has not been advertising for a Dental Hygienist for over five years, has now received over 150 resumes in the last 4 months. The dentists are happy with all the RDHs they have and are not interested in any of these resumes....but I know if someone quits in our practice that they'll probably hire someone for $10 less per hour straight away. The other way this is impacting us is that no one can get any extra hours for shifts....cause we have too many hygienists who want them. The saturation is evident, whether people want to know it or not. It is just the new reality of Dental Hygiene after the insurgence of all these 'dental hygiene schools which have opened up all over Canada and the US'.

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exp in Exeter, New Hampshire

52 months ago

30 year vet in Edmonton, Alberta said: Suzanne, Well articulated....our office, which is not and has not been advertising for a Dental Hygienist for over five years, has now received over 150 resumes in the last 4 months. The dentists are happy with all the RDHs they have and are not interested in any of these resumes....but I know if someone quits in our practice that they'll probably hire someone for $10 less per hour straight away. The other way this is impacting us is that no one can get any extra hours for shifts....cause we have too many hygienists who want them. The saturation is evident, whether people want to know it or not. It is just the new reality of Dental Hygiene after the insurgence of all these 'dental hygiene schools which have opened up all over Canada and the US'.

Hi Suzanne and 30yr VET, Well stated by both of you! Some don't get what we are repeatedly saying about the market. It they want a job in a field when they have completed the intense training...THIS is not it! We do not come on here to keep work for ourselves...MANY of us are in a tough situation as the new grad's are, and could further be if there are change overs at offices, let go for the Dr.'s other staff, money reasons, etc...Please try to understand others if not me, that have even more experience (25+ yrs), THEY TOO are saying the field is SATURATED. If you want to pursue this in 5 or so years, keep abreast of the work sit. on this site...with all the tech that we are exposed to, many IMO go online to the govt. pgs, schools, news /world reports....THEY DO NOT TELL YOU THE TRUTH, THEY TELL YOU WHAT YOU WANT TO HEAR....NOT REALITY. I am not trying to bash dreams, only let you know if you REALLY only want to be an RDH, you will find a long road in 2010 and beyond. You may not find roses, reg. work/days/paycheck that you can COUNT ON, to pay back loans, parents, etc.? If you do find work , it will take a lot of sweat and other jobs to obtain decent pay...

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JackiePa in San Diego, California

52 months ago

future/curent RDH's! Here is an awesome page from the ADHA website showing several other options in Dental Hygiene other than just private practice! I actually saw Shelby Kahl (from Colorado) speak last year on opening her own holistic practice, she was so inspiring. These few tidbits on other options is really motivational and encouraging, showing that you do NOT need to be at the mercy of under pay/ unfair Docs/ "over saturation"! (If that's your main concern!)

Look into your other options as a dental hygienist! You are worth so much more! Enjoy!!

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JackiePa in San Diego, California

52 months ago

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smile in Calgary, Alberta

52 months ago

JackiePa in San Diego, California said: I'm 26 years old, practicing for a year. Sure, I am a new grad and super excited about the profession... and maybe things will change. But I've been succumbed in the dental field since I was young, having my mom as a hygienist. I know RDH's who have been practicing for 25+ years, who are still just as hyped on their career, and that is what I'm looking forward to.

I have absolutely no idea what the average rent is in San Diego, but I'm sure you can google it. Of course, it will change the further you live from the ocean. I did not say ANYWHERE that California was cheap... in fact, you probably know even all the way up in Canada, that CA is the most expensive state to live in. $1,375, for a 2 bedroom, walk to the beach and train, shops, located right in the heart of a beach town. I have no opinion on the rent at all because I'm born and raised in this city, I've always known it was expensive to live. The rent amount doesn't hinder me from doing anything, not when you're making $6,000 a month. (by myself). HOWEVER, Since the cost of living is higher... so is pay! It's all relative.... I feel lucky to have an amazing job, living in one of the most top vacation destinations on earth, and surviving comfortably! (while still being able to save). But wasn't this a job post about the DH market??

Doesn't cost of living have alot to do with job market? A person has to be able to afford to live where they work. You seem to be a smart enough & have all the experience in the world to understand this. Maybe I was thinking of relocating there & looking for some information.

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exp in Exeter, New Hampshire

52 months ago

JackiePa in San Diego, California said: future/curent RDH's! Here is an awesome page from the ADHA website showing several other options in Dental Hygiene other than just private practice! I actually saw Shelby Kahl (from Colorado) speak last year on opening her own holistic practice, she was so inspiring. These few tidbits on other options is really motivational and encouraging, showing that you do NOT need to be at the mercy of under pay/ unfair Docs/ "over saturation"! (If that's your main concern!)

Look into your other options as a dental hygienist! You are worth so much more! Enjoy!!

But how many when they graduate go into "other areas" beyond PP? I bet MOST WANT TO GO INTO "PP", because they want to start making a living, and or pay back loans...if those of you who do want to pursue further ed in DH and don't plan on being in PP...the oversaturation would probably go down a little (not much IMO, only slightly). I still think you, Jackie, should pursue Vet DH, maybe that would open up a couple of spots for others who do plan on being in PP. Just my thoughts. I KNOW you said you would probably stay in PP and maybe pursue the other, but I bet you won't leave PP totally, thus the above continues.

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JackiePa in San Diego, California

52 months ago

exp in Exeter, New Hampshire said: But how many when they graduate go into "other areas" beyond PP? I bet MOST WANT TO GO INTO "PP", because they want to start making a living, and or pay back loans...if those of you who do want to pursue further ed in DH and don't plan on being in PP...the oversaturation would probably go down a little (not much IMO, only slightly). I still think you, Jackie, should pursue Vet DH, maybe that would open up a couple of spots for others who do plan on being in PP. Just my thoughts. I KNOW you said you would probably stay in PP and maybe pursue the other, but I bet you won't leave PP totally, thus the above continues.

MANY students are not even interested in private practice right when they graduate. We had different RDH's with so many second titles that came in and spoke to our class.... which shows why only HALF of my class is in PP right now. What makes you think that PP is the only place to make money and pay back loans/survive?? Management positions or even working on the insurance side of hygiene pays great. And from what a lot of you keep saying... "wages are being cut in half/ hours are being lost/ over saturation..." ETC... well then maybe some of you "VETS" should look at something outside of PP yourselves???

Alberta, maybe you didn't read my correctly. You can afford to live here with you work here because the pay is higher. Just a quick example... my friends in Colorado are making about 280/day in PP. I am making 375/day.

I would love to stay and chat but I'm off to work:)

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smile in Calgary, Alberta

52 months ago

JackiePa in San Diego, California said: MANY students are not even interested in private practice right when they graduate. We had different RDH's with so many second titles that came in and spoke to our class.... which shows why only HALF of my class is in PP right now. What makes you think that PP is the only place to make money and pay back loans/survive?? Management positions or even working on the insurance side of hygiene pays great. And from what a lot of you keep saying... "wages are being cut in half/ hours are being lost/ over saturation..." ETC... well then maybe some of you "VETS" should look at something outside of PP yourselves???

Alberta, maybe you didn't read my correctly. You can afford to live here with you work here because the pay is higher. Just a quick example... my friends in Colorado are making about 280/day in PP. I am making 375/day.

I would love to stay and chat but I'm off to work:)

In Canada, the ins part of hygiene DOES NOT!!! pay well. My sister-in-law does that. BTW, I make much more than $375/day.

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JackiePa in San Diego, California

52 months ago

Then BRAVO Alberta!! You also, are surviving on your dental hygiene income! Many on here don't think it's possible.. Congrats:)

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FlossBoss in Oceanside, California

51 months ago

JackiePa in San Diego, California said: RDD's....... go the to ADHA website.... adha.org and actually LOOK UP how many dental hygiene schools are CLOSING yearly! I graduated from the University of Colorado, and was the last graduating class after 30 years. There are MORE programs closing than opening!!! SO, the over-saturation, as some of you keep pointing out, is NOT the issue! It's the economy! It's as bad as any other job is bad. So please look up these school and see how many are shutting down every single year because they are not able to be funded...... and that's a whole different issue.

Jackie,

Most of the programs that are closing are bachelor degree programs. The new ones opening up in California now aren't even in junior colleges anymore. Some are even 16 month programs in "career colleges". Pretty sad, huh?

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FlossBoss in Oceanside, California

51 months ago

I have been a hygienist for over 40 years. I relocated to San Diego after practicing in the San Francisco bay area for 32 years. I took a big hit in income to move to San Diego. I still don't make what I did in northern California.
It took me quite a while to find my new dental "home". I temped for a while and realized that the quality of dentistry was lower here than what I was used to. Unlike Jackie from Encinitas, I found a lot of unethical dentists here in San Diego. Some want the hygienists to do rp/stc on every 4 mm pocket, some allow the DAs to "clean" children and teenagers' teeth (even when there wasn't a DDS in the office!)and some expect you to "sell" products for them.
BUT I do believe that if one is persistent, the right office will open up and one can find a good dentist to work for. In this economy you need to prove to the dentist first that you are valuable to him and then you can ask for what you deserve for in compensation. After working full time (4 days per week) in Carlsbad for two months on probation, I negotiated 2 weeks paid vacation, 6 personal/sick days, paid CEUs,and 1/2 health insurance paid for by my employer. I have been with him for 8 years now and now also have another retirement plan to add to the two that I already have from previous employers in the bay area.
Even though I am a "senior" hygienist, my 4 day a week employer (and also my 1 day a week employer) value my services greatly. The office in Carlsbad is a paperless office with digital x-rays and charts and I make my own appointments. My Friday office is always asking me if I want more days there. That office has cut 3 hygienists already due to the recession. The ones they let go were the ones who didn't regularly perio chart, didn't take x-rays, never took intraoral photos and often let patients go years without exams. I have found that if you do your best for your patients, you will eventually be compensated well if you find a great employer! I STILL love dental hygiene!

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JackiePa in San Diego, California

51 months ago

FlossBoss, you are such an inspiration, it was wonderful to read your post. We are also neighbors! I live in Encinitas. I have temped for a few DDS's in Oceanside and Carlsbad. You will naturally make more money in the bay area because the cost of living is even more expensive than southern CA. My family is all up there, and I used to temp in the city and in Walnut Creek, and was doing very well. Thank you for your comment! I believe when you can show a dentist what you're worth, and how much you love your profession/care for the patients... he/she will notice that and reward you in return. The production that hygienists bring in is HUGE. But patients only return if they can connect with YOU specifically and believe that their services are needed. There are a ton of awful docs that over diagnose and use dentistry as a sales point. BUT there are several that do not, and you and I have both found that office. I wish you all the best! Will you be attending the ADHA convention in June in Vegas? Best of Luck neighbor!

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FlossBoss in Oceanside, California

51 months ago

JackiePa in San Diego, California said: FlossBoss, you are such an inspiration, it was wonderful to read your post. We are also neighbors! I live in Encinitas. I have temped for a few DDS's in Oceanside and Carlsbad. Thank you for your comment! Will you be attending the ADHA convention in June in Vegas? Best of Luck neighbor!

Jackie, I will be at the CDA convention in Anaheim next month. My boss pays for his WHOLE staff to stay for 3 nights! We all eat together and bond at Disneyland and the CE courses.
I am very lucky indeed. I usually have more than enough units for relicensure that he pays for so will probably not go to Las Vegas.
Coincidentally, I worked in Castro Valley for most of my professional life. I know Walnut Creek well! I still have a house in Danville that I rent out now.
It is not easy finding a great boss but I have always been lucky in that respect. I worked for exactly one week for one woman dentist in Oceanside before I realized how unethical she was. The first and only time I ever worked with a woman dentist. I was really hoping that she would be a good one. What a disappointment that was!

And sadly it is sometimes the hygienists who are not doing everything the way that they should. That hurts all of us. That could be part of the problem with the dentists who do not value hygienists. Patients can tell when the hygienist really cares about them and wants the best for them. My Friday office has a younger dentist who thinks I am "an exception" and thinks most hygienists are primadonnas. This office has let 3 hygienists of all ages go in the last 6 months. I am still holding on to my one day there...but the dentists like the way I work and are always asking me if I want more days...the money I make there goes into my retirement savings.
It was good hearing from you so quickly.

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Suzanne in Terre Haute, Indiana

51 months ago

FlossBoss in Oceanside, California said: Jackie,

Most of the programs that are closing are bachelor degree programs. The new ones opening up in California now aren't even in junior colleges anymore. Some are even 16 month programs in "career colleges". Pretty sad, huh?

There cannot be jobs for all the candidates graduating no matter what type of college because the number of dds graduating is so much lower proportionately. Corporations are buying up practices thereby reducing the workforce also. It is NOT "just" the economy.

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smile in Calgary, Alberta

51 months ago

FlossBoss in Oceanside, California said: Jackie,

Most of the programs that are closing are bachelor degree programs. The new ones opening up in California now aren't even in junior colleges anymore. Some are even 16 month programs in "career colleges". Pretty sad, huh?

What is the intake in a degree program there as compared to a "career college"? Some of the "colleges" in Ont have 3 intakes/year. As many posters here keep stating, these schools graduate 1000 DHs provincially/year. I went to a public college that graduated 26 DH/year-1 school, 1 province. If the schools that produce less DHs are being replaced by schools that produce more DHs, won't this saturate the field more?

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30 year vet in Edmonton, Alberta

51 months ago

smile in Calgary, Alberta said: What is the intake in a degree program there as compared to a "career college"? Some of the "colleges" in Ont have 3 intakes/year. As many posters here keep stating, these schools graduate 1000 DHs provincially/year. I went to a public college that graduated 26 DH/year-1 school, 1 province. If the schools that produce less DHs are being replaced by schools that produce more DHs, won't this saturate the field more?

Sadly.....I have heard that even graduates from programs that offer the degree to 'finish up with' are trying to figure out what they should do....some are just wanting to get into the workforce as soon as possible to line up a job and do the degree at a later time. This is really alot of pressure on them because while they probably WANT the degree, they also see all this influx of Ontario grads into their province taking up the few jobs left. With the saturation of the job market across the country, what is a grad supposed to do.....?? GET A JOB or finish their degree?? Are there any recent U of A grads willing to talk about this issue...? or SIAST of U of M grads?

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waterbug100 in Nanaimo, British Columbia

51 months ago

Flossboss..you can't compare your situation to the many DH out in the field today trying to find a job - you have had yours for 8 YEARS, if I've read your post correctly.

The market today is COMPLETELY DIFFERENT. As stated above..the shortening of school curriculum equals more DH graduating than ever before. And I believe benefits are almost a thing of the past for most USA DH.

The market is so ridiculously saturated it's sickening. And it WILL get much worse before it gets better..if it does get better. This may be what the future of DH looks like for a long time to come. WAY TOO MANY DH FOR TOO FEW JOBS.

But, I'm glad to see you feel for the many DH that are having to compromise their ethics just to keep a job, any crappy job.

JackiePA..you are an EXCEPTION, and should not present yourself as the norm. You are only perpetuating what the schools do.. Life is much tougher for most DH, and to state otherwise is doing no one a service.

Think before you speak.

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FlossBoss in Oceanside, California

51 months ago

To Waterbug, smile and Suzanne,

In California full degree hygiene programs at universities and AA degree junior college dental hygiene programs only intake once a year at the fall semester as far as I know. These "career" private schools can be vastly different. Many are only 16 months or less in length and cost quite a lot more money for the students. Many in the dental field do not consider the graduates of these schools to be as "good" or as well trained. This may, or may not, be true as I do not have any first hand experience with one of these graduates but I do worry about the length and breadth of their education. Junior colleges also see patients through the summer but take 2 full years to complete and this is after the student has already completed the prerequiste college courses.

As for me being an exception, the recent graduate who came to work in my regular office now gets benefits too. She works 2 and 1/2 days (one full day every other week) while I work 4 full days every week. I mentored her on how to negotiate what she wanted and encouraged her to buy her first condo, which she did after a discussion with a CPA. She went to Cypress College and is an excellent hygienist. My boss (rightfully so) does not want to lose her and she is also on his retirement plan because I convinced him that she should take over for me when I retire and that excellent part time staff are vitally important to his practice as well as the full timers.

There is no doubt in my mind that dental hygiene is becoming an oversaturated field (at least here in California). All those articles in the written media portraying dental hygiene as being an up and coming highly paid profession and the proliferation of these private career colleges have contibuted to this. You can also blame all the hygienists who do not belong to the American Dental Hygiene Association. It may not be a "union" but it does try to look out for hygienists' interests and the public's welfare politically.

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JackiePa in San Diego, California

51 months ago

Waterbug and others,

Of course I am thinking before I speak, there is no need to get rude and abrupt again on here. I am also not an exception. As most of you know, I graduated almost 2 years ago, so I am a fairly new graduate. Every single one of the girls I graduated with in Colorado, found jobs immediately. I had a slightly longer experience finding full time work here in San Diego, but decided to temp in the mean time which is a wonderful alternative.

There are several ethical doctors who appreciate ethical and good hygienists. I have met and worked for, much more ethical DDS than ones that weren't. My mother, who has been practicing for 25 years, has been with her Doc for over 15 of those years.

So in my personal experience and personal "ties", I know much more people who are thriving and striving in their RDH careers, and I am so excited I am one of them.

FlossBoss, you made a very interesting point about being a member of the ADHA. Far too many hygienists are not, I am willing to bet none of these RDH's on this website are, and that is what is awful. The ADHA website found a few jobs for my girlfriends in school, and it is filled with a plethora of new research and information that I believe every single hygienist should be "honing" up on. It is refreshing to see another successful hygienist who is just as passionate about the profession after some years. I look forward to following in your footsteps!

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FlossBoss in Oceanside, California

51 months ago

I may have had my position for 8 years but I have not had a raise in 3 years. I asked for (and got) other things that were important to me. At my age, I would rather have some more time off. To all hygienists looking for a job, be as picky as you can in choosing a boss. Only work for the good guys. Don't be upset if you are not offered top pay even if you have a lot of experience. In California, dentists do not pay for experience. New graduates can get as much as the older hygienists if they produce the same for the practice. Once you get that job, you want every patient going to the front desk and WANTING to see you the next time because you are perceived as "better" than their last hygienist.(or last dentist that 'cleaned' their teeth! HaHa)
Your co-workers will tell the boss what the patients are saying. After 6 months of making the patients love you and gaining their trust so that they go out and schedule that crown, bridge or perio surgery because you have made them understand why it is necessary, that dentist will listen carefully to you asking for that raise or some benefits. The good guys will not want to lose you! If the dentist says that he can't afford it but agrees that you deserve it then keep your smile and go out and keep track of the $$ you are bringing in to the practce vs what you are paid for the next 6 months.
Only look for a new job if the one you have is intolerable. Do not leave a job until you have another one lined up. Intolerable is being expected to do something unethical or detrimental to the patient. I have found that the more I do what is best for the patient, the better things get for me professionally. DO NOT ever let a dentist treat you unprofessionally or make you feel unworthy. These are not the good guys.

If you feel you have to work for one of the bad guys, keep looking for a better one. They are out there!

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JackiePa in San Diego, California

51 months ago

You are absolutely RIGHT Flossboss!

I have patients that come in all the time and say... "Can I see you next time?" I am the only hygienist and the patients love that. And so does my doc, he is very appreciative of me and knows it would be very detrimental to lose me.

Good luck to the others looking... you CAN find ethical docs, we have such a rewarding career, and if you think nursing will be better with more jobs... think again!!

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FlossBoss in Oceanside, California

51 months ago

Oh, and for the most part, a lot of these private for profit hygiene career schools will do and say anything to get more and more students paying those $$$ for tuition. They don't care if you do not pass the boards or the clinical exams. They just want those applicants lining up for the "training" and willing to pay those high tuition fees in order to become a hygienist who makes a lot of money. The California public colleges care because they have to justify the cost of the program and if not enough students actually get a license then why have the taxpayers pay for the programs?

The good dentists will value a highly skilled hygienist who also has wonderful people skills and will make his practice grow. Look for dentists whose staff has mostly been there for years. This is a dentist who treats his staff well. That's why no one ever leaves. Sometimes it takes a while for the younger dentists to "get" this. So when they realize that they have a good staff member, they give them what it takes to make them stay. Training new staff over and over again gets frustrating and very costly to the dentist. Many hygienists get too picky over their chairs, their instruments, their masks, their glasses and so on. These are all thing that one can ask for LATER. Do not be perceived as a primadonna by the dentist or your co-workers. Take the trash out, bag those instruments, pick up a ringing phone and/or clean up an operatory for someone else. You are part of a team and they will love you for it and have your back when you need it. Everyone I work with is on my cell phone contact list and email list, even my dentists. In fact, I still trade emails with every dentist I have ever worked for longer than 2 weeks. I guess there aren't that many....only 5, including the first one I started with over 40 years ago.
I still LOVE being a dental hygienist!

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smile in Calgary, Alberta

51 months ago

FLOSSBOSS....Fabulous advice! You sound like a great mentor! In Canada, some of the provincial legislators require RDHs to part of the CDHA. How much this association actually does for us is debateable. It does give us our liability ins as part of the membership though. My guess is that most of the Canadian RDHs are part of the national association & this doesn't seem to help with the opening of all the schools. I believe that there are alot of good guys out but there really is an oversaturation of the bad guys. Alot of dentists went into practice for the almighty $$. I have noticed that in the past almost 30 years that I have been in the dental field, the field has really changed. I know of 1 dentist that covers ortho & implants for his staff but more dentists are charging their staff for simple rests. I feel horrible for those RDHs, DAs & receptionists that worked for those great dentists & had to leave for whatever reasons & now can't find suitable employment. I think attrition with dentists is also a factor in employment. Many dentists are on the verge of retirement, I know my dentist is. He won't be working within the next 10 yrs. He's at the point that he can quit whenever he wants to. Alot of dental staff is in this position. Unfortunately, we do live in an aging society.

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JackiePa in San Diego, California

51 months ago

smile in Calgary, Alberta said: FLOSSBOSS....Fabulous advice! You sound like a great mentor! In Canada, some of the provincial legislators require RDHs to part of the CDHA. How much this association actually does for us is debateable. It does give us our liability ins as part of the membership though. My guess is that most of the Canadian RDHs are part of the national association & this doesn't seem to help with the opening of all the schools. I believe that there are alot of good guys out but there really is an oversaturation of the bad guys. Alot of dentists went into practice for the almighty $$. I have noticed that in the past almost 30 years that I have been in the dental field, the field has really changed. I know of 1 dentist that covers ortho & implants for his staff but more dentists are charging their staff for simple rests. I feel horrible for those RDHs, DAs & receptionists that worked for those great dentists & had to leave for whatever reasons & now can't find suitable employment. I think attrition with dentists is also a factor in employment. Many dentists are on the verge of retirement, I know my dentist is. He won't be working within the next 10 yrs. He's at the point that he can quit whenever he wants to. Alot of dental staff is in this position. Unfortunately, we do live in an aging society.

Over-saturation of the bad guys?!?!?!??? Who on earth have you come across during your dental hygiene career? That is so sad! I highly disagree, my mom is right next to me and does as well, and so do my successful colleagues that I am friends with. It is unfortunate that you have had such bad experiences.... I hope you do realize though, that you are the minority on this topic. There are MUCH more good guys than bad.... again, it is unfortunate that you have experienced the latter.

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smile in Calgary, Alberta

51 months ago

JackiePa in San Diego, California said: Over-saturation of the bad guys?!?!?!??? Who on earth have you come across during your dental hygiene career? That is so sad! I highly disagree, my mom is right next to me and does as well, and so do my successful colleagues that I am friends with. It is unfortunate that you have had such bad experiences.... I hope you do realize though, that you are the minority on this topic. There are MUCH more good guys than bad.... again, it is unfortunate that you have experienced the latter.

I can show you dentists that throw dirty extraction instruments at their assistants, 1s that don't show up for work (1 even in his pjs if he does) constantly & don't understand why their recepts don't want to call to get yelled at when cancelling again (We actually had a pt come over from such an office who was cancelled 25 x), rdhs whose days are cut short b/c the dentist wasn't busy & took their pts, dentists firing people after they quit, insisting on doing work for staff & then charging them, yelling at staff in front of pts, taking excessive time off without paying staff, dentist telling temp agency not to send over girls with ovaries, substance abuse (easy when you can write your own Rx), dentist who refused to do work on a 3 year old whose upper lip was pratically ripped right off after a tobogganing accident (that was sad little girl came into our office), dentists too cheap to have proper sterilizing equipment & reusing gloves, dentists spanking/slapping kids, Don't forget the dentist that gave pts hiv on purpose back in the '80's (Florida right?). Oh the list goes on. OMG girl you definitely have not been in the field long! Dentists are a very unique group of people. Alot of this is not new. Some of it has even made the news esp dentist/hiv. BTW, I have actually have had the luck to work in some great offices. These are offices friends & collegues have worked in. In 28 yrs, I've seen & heard it all!

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smile in Calgary, Alberta

51 months ago

also, 1 or 2 bad guys are 1 or 2 too many!

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FlossBoss in Oceanside, California

51 months ago

Jackie,
You have to remember that smile is located in Canada and things might not be the same up there. Smile, is dentistry a part of your nationalized health care?

I was worried when I left my position and patients of 32 years up in the bay area of northern California to move to San Diego. I just trusted that I would find a good dentist and find myself another dental "home". Every dentist I have ever worked for has had staff that told me some horror stories of bad dentists. So I really don't know how many good guys vs bad guys are out there. When I moved to San Diego and temped for a while, I met a few of the bad ones myself. I temped for my good guy dentist for a month and he offered me the full time job and I immediately said YES even before I knew what I would be paid or even if I could have benefits. To me, it was more important to work in a great office than get an immediate reward of a high salary. It took about 2 years but I eventually got everything I could hope for. My co-workers said he would never change but guess what?...he bought me a brand new cavitron almost as soon as I asked for it and then bought one for the new hygienist when we needed more days of hygiene. He remodeled my hygiene room before his own! Now after leasing his office for over 17 years, he is about to buy a brand new building. (every dentist I have ever worked for has bought his own office real estate!)
So hygienists who have been lucky enough to stay with a good dentist for a long time have not always experienced the horror tales that some others have. I do believe that it is getting harder to find a good guy to work with. There are far too many of those clinics that clean teeth in 20 minutes and sign every patient up for 4 quads of RP/STC. Place Arestin in every pocket and nickel and dime every patient who ends up with a $20,000 treatment plan given to them by a "treatment coordinator". Managed care is not where I want to be in the future but it sure looks like it's coming.

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JackiePa in San Diego, California

51 months ago

Then like I said, you have definitely had some bad experiences, but know, you are NOT the majority! You're absolutely right, I am practically a new graduate... but all of my friends are hygienists- and my mother- and what you are experiencing is the MINORITY! You have clearly had very very bad "luck" if you repeatedly are taking jobs from these types of Docs. Your friends and colleagues hopefully escaped and ran like hell! I'm not saying they don't exist, but it is NOT THE NORM! Like FlossBoss said, do NOT accept jobs from these DDS's... keep looking! The economy is NOT THAT BAD for you to have to settle for an office like this!

You can find great/ethical/caring/patient centered dentists!!! They are out there!!

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JackiePa in San Diego, California

51 months ago

You are absolutely right FlossBoss.... if dentistry IS part of their socialized health care program, then this stuff most definitely would be a lot more common than here in the US.

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JackiePa in San Diego, California

51 months ago

It is just stomach wrenching that a lot of these "vet RDH's" would sway prospective dental hygiene students away from the profession just because they have had something rare happen to them.... It is a rewarding career, I love it so much. :)

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smile in Calgary, Alberta

51 months ago

JackiePa in San Diego, California said: Over-saturation of the bad guys?!?!?!??? Who on earth have you come across during your dental hygiene career? That is so sad! I highly disagree, my mom is right next to me and does as well, and so do my successful colleagues that I am friends with. It is unfortunate that you have had such bad experiences.... I hope you do realize though, that you are the minority on this topic. There are MUCH more good guys than bad.... again, it is unfortunate that you have experienced the latter.

Ask your dentist. He/she will tell you. He/she knows. The dental community is actually a small community. You probably don't understand this yet but you will. Give it time. Don't even try to argue this. You will just make yourself look very inexperienced.

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JackiePa in San Diego, California

51 months ago

There are a lot of "meat market" offices/corporations. I temped at Smilecare here in San Diego and it was sickening how they treated the patients and over diagnosed. Of course it happens, but it is not the 'norm'.

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JackiePa in San Diego, California

51 months ago

smile in Calgary, Alberta said: Ask your dentist. He/she will tell you. He/she knows. The dental community is actually a small community. You probably don't understand this yet but you will. Give it time. Don't even try to argue this. You will just make yourself look very inexperienced.

He/She knows WHAT exactly? Of course the dental community it small, which is the beauty of it because I get to network just about everywhere I go! I'm not sure the purpose of this post? You live in Canada, what makes you think over saturation is the problem here in the states? Much less my state? there are reasons for both.

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JackiePa in San Diego, California

51 months ago

smile in Calgary, Alberta said: I can show you dentists that throw dirty extraction instruments at their assistants, 1s that don't show up for work (1 even in his pjs if he does) constantly & don't understand why their recepts don't want to call to get yelled at when cancelling again (We actually had a pt come over from such an office who was cancelled 25 x), rdhs whose days are cut short b/c the dentist wasn't busy & took their pts, dentists firing people after they quit, insisting on doing work for staff & then charging them, yelling at staff in front of pts, taking excessive time off without paying staff, dentist telling temp agency not to send over girls with ovaries, substance abuse (easy when you can write your own Rx), dentist who refused to do work on a 3 year old whose upper lip was pratically ripped right off after a tobogganing accident (that was sad little girl came into our office), dentists too cheap to have proper sterilizing equipment & reusing gloves, dentists spanking/slapping kids, Don't forget the dentist that gave pts hiv on purpose back in the '80's (Florida right?). Oh the list goes on. OMG girl you definitely have not been in the field long! Dentists are a very unique group of people. Alot of this is not new. Some of it has even made the news esp dentist/hiv. BTW, I have actually have had the luck to work in some great offices. These are offices friends & collegues have worked in. In 28 yrs, I've seen & heard it all!

And if you can show me even 1 or 2 of the Docs you have just talked about, I would be very surprised. You have obviously chosen the wrong profession and maybe that has rubbed off onto your patients and even your dental team??

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FlossBoss in Oceanside, California

51 months ago

We all need to be brave enough to report dentists who do unethical things, malpractice type things and we all need to refuse to allow a dentist to belittle them at any time. Staff memebers should stick up for each other and band together against a boss acting like an idiot.
You can turn them in anonymously to your state dental board if you like. But PLEASE turn them in. I would walk out on a dentist who did such things as you stated, Smile, but only at the end of the day when I was finished with my last patient.

And I would do it politely and civilly but he/she would know exactly why I was leaving in no uncertain terms. If enough staff members quit on these type of dentists, they would not be working on an unsuspecting public. When you work for an unethical dentist, you are actively participating in what they do. When a dentist gets sued, everyone working in the office will get named in the lawsuit. Every licensed staff member needs their own malpractice insurance. It is really cheap insurance. I've had it for 40 years and never used it but hygienists have already been sucessfully sued. Your employers' insurance (if they had to pay out) will turn around and sue the staff member if it can be proven that they did something wrong. Hygienists work directly with the patient often unsupervised and are especially vulnerable to something like this. This is another reason why it pays for your patients to really like you and the dentist you work for. Mistakes can happen but patients sue when they are mad about something and don't feel that anyone listened to them or took care of the problem.

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JackiePa in San Diego, California

51 months ago

FlossBoss in Oceanside, California said: We all need to be brave enough to report dentists who do unethical things, malpractice type things and we all need to refuse to allow a dentist to belittle them at any time. Staff memebers should stick up for each other and band together against a boss acting like an idiot.
You can turn them in anonymously to your state dental board if you like. But PLEASE turn them in. I would walk out on a dentist who did such things as you stated, Smile, but only at the end of the day when I was finished with my last patient.

And I would do it politely and civilly but he/she would know exactly why I was leaving in no uncertain terms. If enough staff members quit on these type of dentists, they would not be working on an unsuspecting public. When you work for an unethical dentist, you are actively participating in what they do. When a dentist gets sued, everyone working in the office will get named in the lawsuit. Every licensed staff member needs their own malpractice insurance. It is really cheap insurance. I've had it for 40 years and never used it but hygienists have already been sucessfully sued. Your employers' insurance (if they had to pay out) will turn around and sue the staff member if it can be proven that they did something wrong. Hygienists work directly with the patient often unsupervised and are especially vulnerable to something like this. This is another reason why it pays for your patients to really like you and the dentist you work for. Mistakes can happen but patients sue when they are mad about something and don't feel that anyone listened to them or took care of the problem.

Very, VERY well put. Thank you.

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FlossBoss in Oceanside, California

51 months ago

Jackie,

When I was a young hygienist, the dentist who shared our suite used to throw instruments at his assistant. I was appalled! We who didn't work for him used to laugh and count how long each assistant lasted with him. That first year he went through 13 DAs!!! We moved into our own building soon after that. I think, in part, just to get away from him. My boss disliked the other guy intensely. So this type of dentist does exist.

I think sometimes these crazy guys have personal problems and issues with their own wives and they take it out on their poor staff. They usually bully the very ones who can handle it the least and the ones too scared to find another job.

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smile in Calgary, Alberta

51 months ago

FlossBoss... it is not part of the health care system yet. You are right about finding that good office. I have taken jobs b/c I need to feed my child, but if I got a bad vibe, I kept looking. I also did not apply at any of the office where they were constantly looking for help. These are "those" offices. Unfortunately, those graduating from school or relocating don't know that. For some, it may look as if there is alot of jobs out there but unfortunately "those" offices exist. This goes for everybody working in dental offices. We do have an assitant that comes in & helps us who works PT for 1 of those managed care offices. I guess in away, they do have their good points? as the dentist/s isn't/aren't the boss but an employee. That is about it though. I'm hoping this style of dentistry will go by the wayside just like Quest, Dentrix, etc. Over the years there have been lots of those businesses that operate dental offices. They really don't seem to stick around too long b/c the general public wants choice & don't want to be over treated & many know that they can go for a 2nd opinion. I might be being too optomistic though.
Jackie... these don't happen b/c of a socialized health care system. In fact, this probably wouldn't happen b/c there would be more accountability. & again, I DID NOT work in most of these offices but friends & collegues did. & AGAIN, 1 or 2 "bad guys" are 1 or 2 too many

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JackiePa in San Diego, California

51 months ago

FlossBoss in Oceanside, California said: Jackie,

When I was a young hygienist, the dentist who shared our suite used to throw instruments at his assistant. I was appalled! We who didn't work for him used to laugh and count how long each assistant lasted with him. That first year he went through 13 DAs!!! We moved into our own building soon after that. I think, in part, just to get away from him. My boss disliked the other guy intensely. So this type of dentist does exist.

I think sometimes these crazy guys have personal problems and issues with their own wives and they take it out on their poor staff. They usually bully the very ones who can handle it the least and the ones too scared to find another job.

Oh, I definitely know this type of animal does exist. I have been taken advantage of as a new graduate as well. Some have forced me to over diagnose.. whispering to me to chart a pocket as a 5 even if it's a 3. I said I would absolutely not do that, that it was everything against what I learned in school. I did not go back and temp for that office. My mom has also told me horror stories. I just have an issue with young students coming onto this forum and thinking that this is the norm. It isn't. Just because there are awful docs out there, there are more (at least in my experience from family and people that I know) that treat their office staff very well, or are at the very least, cordial.

Dental Hygiene is a fabulous profession and I hope that new students WILL pursue the career if interested!

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JackiePa in San Diego, California

51 months ago

smile in Calgary, Alberta said: FlossBoss... it is not part of the health care system yet. You are right about finding that good office. I have taken jobs b/c I need to feed my child, but if I got a bad vibe, I kept looking. I also did not apply at any of the office where they were constantly looking for help. These are "those" offices. Unfortunately, those graduating from school or relocating don't know that. For some, it may look as if there is alot of jobs out there but unfortunately "those" offices exist. This goes for everybody working in dental offices. We do have an assitant that comes in & helps us who works PT for 1 of those managed care offices. I guess in away, they do have their good points? as the dentist/s isn't/aren't the boss but an employee. That is about it though. I'm hoping this style of dentistry will go by the wayside just like Quest, Dentrix, etc. Over the years there have been lots of those businesses that operate dental offices. They really don't seem to stick around too long b/c the general public wants choice & don't want to be over treated & many know that they can go for a 2nd opinion. I might be being too optomistic though.
Jackie... these don't happen b/c of a socialized health care system. In fact, this probably wouldn't happen b/c there would be more accountability. & again, I DID NOT work in most of these offices but friends & collegues did. & AGAIN, 1 or 2 "bad guys" are 1 or 2 too many

1 or 2... think about the latter... there are hundreds of GOOD guys. Those bad ones will be weeded out. I don't know how more accountability would be taken due to a 'socialized' health care system. It seems like you would be allowed to 'get away' with a lot more. But that's a whole different post...

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smile in Calgary, Alberta

51 months ago

FlossBoss in Oceanside, California said: We all need to be brave enough to report dentists who do unethical things, malpractice type things and we all need to refuse to allow a dentist to belittle them at any time. Staff memebers should stick up for each other and band together against a boss acting like an idiot.
You can turn them in anonymously to your state dental board if you like. But PLEASE turn them in. I would walk out on a dentist who did such things as you stated, Smile, but only at the end of the day when I was finished with my last patient.

And I would do it politely and civilly but he/she would know exactly why I was leaving in no uncertain terms. If enough staff members quit on these type of dentists, they would not be working on an unsuspecting public. When you work for an unethical dentist, you are actively participating in what they do. When a dentist gets sued, everyone working in the office will get named in the lawsuit. Every licensed staff member needs their own malpractice insurance. It is really cheap insurance. I've had it for 40 years and never used it but hygienists have already been sucessfully sued. Your employers' insurance (if they had to pay out) will turn around and sue the staff member if it can be proven that they did something wrong. Hygienists work directly with the patient often unsupervised and are especially vulnerable to something like this. This is another reason why it pays for your patients to really like you and the dentist you work for. Mistakes can happen but patients sue when they are mad about something and don't feel that anyone listened to them or took care of the problem.

I did work for 1 of those dentists b/f & he actually was on the review committee. His butt was covered. He would come in & tell us who was suing who & who was trying to sue him. Dental staff are blackballed if they do report. Jackie this means they will never work in dentistry if they report.

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FlossBoss in Oceanside, California

51 months ago

I think perhaps smile from Calgary, Canada and Jackie from Encinitas, California are comparing apples to oranges.

If most dental offices in Canada are part of the national health care system there, then most would be like Smilesavers, Gentle Dental etc type of meat market clinics that we all hate so much. I have had patients bring me in treatment plans from these types of places and it was horrifying indeed the amount of money these people are being charged and what treatment they want to do on them. Plus the amount of time they plan to do the treatment in. 4 quads of RP/STC in an hour? Using an anethestic rinse?...what a joke....unless of course, the 4 quads each contain one 4 mm pocket. Anything to increase production, huh?

I suspect, Jackie, if you had seen the things that smile apparently has, you too would be horrified. She sounds pretty ethical to me. Dental hygiene in Canada sounds very unappealing to me for sure. I am glad that I am in California then. Dental hygiene has been very good to me and I am glad that I made the choice. Not sure how good it will be in the future though. I predict two tiers of hygienists in the future. Perio vs prophies......perio paid higher of course. All hygienists need to get themselves laser certified and make sure that they keep up on the latest technology. Most offices will soon be all digital.
If you want to be marketable, then you have to like to learn new things and then change what you do. That is one of the things that I have loved about hygiene. My days are varied. I see children (love 'em) and do sealants. I see phobic adults and turn them into really great patients with a lot of tender loving care. I do non-surgical perio treatment and perio maintenance and do a lot of what I call "motivational therapy". I love Oraqix when I can use it. I see a lot of my patients who are doing awesome and make my day easier. I sometimes get the restorative patients numb for my boss. (the assistants LOVE it when you do this!

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smile in Calgary, Alberta

51 months ago

Jackie, you are an interesting person. Do you listen to your patients as well as you do to those on this forum? You seem to be very selective to what you want to "hear" & from whom. 1st of all, you arguing about different things than the topics discussed b/c, my guess, is you want to give your 2 cents; 2nd, you seem to be agreeing with everything a RDH has to say when she is saying the same thing as everybody else but you want to argue with those from out of state, 3rd, do you seriously think that someone will stay in a feild for almost 30 years if they did not like it??!! We can like the field but not like the changes/direction it is going in, 4th, oversaturation means too many, almost like a cancer, doesn't necessarily mean it will overtake, but it is a problem: 5, I work for a good guy, I've been in this field long enough to know there is good out there & that you have to take the good w/ the bad. Go back & read the posts that you argue about, see where they are from, what they are talking about & read your reponses. You will see that they are quite often, 2 different things.

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FlossBoss in Oceanside, California

51 months ago

I have always ecouraged any students wishing to become hygienists to go through a full degree program if they can. So that if they get burnt out, they can pursue another type of career with their dental hygiene degree. A lot of our dental sales reps are ex-dental hygienists. Some go into teaching or research. Some become CEU providers and motivational speakers at conventions and courses. I happen to love private practice and working directly with patients. I have become so proficent with the intraoral camera that the company we bought it from wanted to hire me for conventions to demonstrate it. I take facial photos of all patients, first time at the dentist photos for the kids, birthday photos as well as before and after photos of the linguals of the lower anteriors. Not to mention photos of decay, broken teeth, fracture lines, pockets with the probe in them, abcesses, recession and evidence of grinding/sliding. The intraoral camera is the beat teaching tool we have in dentistry today if used properly! I just love it and use it on everyone. Some people say they do not want to look but almost everyone does after I get through....just get them to ask you a question.

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JackiePa in San Diego, California

51 months ago

FlossBoss,

You came into the forum a tad late, and I don't blame you for not scrolling back and reading all the posts.

I personally have only been practicing for just under 2 years. BUT, I worked at Smile Care in Mission Valley when I first started out and was completely appalled. I was being forced to treat 15-18 patients in 1 day! My back was killing me. I was forced to over diagnose and irrigate (sometimes with Listerine, not even CHX!) which we know has NO research proving it does anything beneficial. I saw some nasty asepsis practices too. I know these meat markets DO exists, and it is unfortunate that they are mostly HMO offices... which is exactly what Canada will have once they include it in their national health care system.

I graduated from the University of Colorado which a Bachelors degree, which I think should be the requirement. I did this so I could teach eventually, go into sales, give CE courses, etc. I am also interested in Vet dentistry and cleft lip/palate cases. I am actually thinking about pursuing a Masters degree in dental hygiene very soon, so I can even have more options and make myself stand out more in the struggling economy.

I am laser certified, know dentrix and digital radiographs very well, and also use the intra oral camera on every patient. Our doc requires us too, he won't even come in for an exam until pictures are taken. We are also incorporating the laser into our prophy costs. Soon, every single patient will have laser treatment, even prophy patients because my DDS feels so strongly about it.

I think since I have increased my credentials and have made myself STAND OUT, I was able to find such a great job almost right away. I was upset to hear a lot of these VET RDH's complain about the profession and try to steer students towards nursing... where you are "better appreciated, etc". Nursing has more flaws than dentistry, but that's a whole other post as well.

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waterbug100 in Nanaimo, British Columbia

51 months ago

Smile..Alberta has "managed care offices"? What exactly are they? Are they a corporation?

JackiePa and Flossboss...our dental system is not part of our national/provincial health program. The DDS opted out - they can make a lot more $$ being a small private independent business.

Unfortunately, since DDS are the owner/boss, this OFTEN creates mini gods. This is not a MINORITY..in fact, this is the MAJORITY. Most DDS are a creature apart. I have seen everything that has been posted above. The instances are NOT UNUSUAL! Dentistry is a world unto it's own.

There has always existed a slightly acrimonious relationship between DDS and RDH, as well as CDA - and it's based on $$ IMO. The DDS, in the past, resented the shortage that existed in Canada until about 2 or 3 years ago, resented the amount of money they had to pay to attract an RDH, regardless of the fact that we are direct producers...??

So, some DDS (don't know how many) decided to eliminate and completely override our assns. and lobby for more hygiene schools, and succeeded in opening over 34 in one province alone. Plus did away with the prerequisites and reduce the curriculum time. This has upped the amount of graduating RDH by probably 60% per year, and reduced the quality of RDH standards. We are seeing a flood of at least 1100 new grads per year. And we don't have the capacity to absorb these numbers.

So, the DDS are thrilled. 100s of RDH to choose from, literally. RDH wages have plummeted, RDH are fighting for even a day of work per week, standard of practice has fallen. PLUS, the economy has hurt private practice to the extent that most DDS have had to cut back work days, further reducing hygiene opportunities.

This has just exacerbated the already uneasy relationship, with the DDS now calling all the shots, and we have no recourse. We have little if any choice if presented with anything unethical.

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smile in Calgary, Alberta

51 months ago

FlossBoss... Dentistry is not part of the healthcare system here. We do have provincial plans for seniors & low income & a national plan for indiginous people but these do not cover very much (the prov 1s tend to cover 60% of very select procedures). England at 1 time had a national plan but again it did not cover well & tx wasn't often very good. I believe it was all about allotted time for procedures, ie, they tended to do pulpotomies on permanent teeth instead of endo. I'm sure you have run across this in you yrs of practise. It's pretty hard to charge "wrong" for the Canadian "plans" when 1 tx isn't covered anyways & 2, too many stipulations. We also get letters back from the gov't when too many narc Rx are written to a pt. These include those Rxd from MDs as well. In Alberta, with the proper training, we can administer LA, Rx, ortho, restorations & N2O2. As well, most provinces allow us to open our own practices. More & more are opening up. I can't wait until this is the norm! If properly administrated, a national dental plan would be beneficial for everyone involved. Most new offices are going digital & lasers are here as well. I do have to laugh when the American RDHs refer to prophies. Here in Canada, prophies are polishes, that is stain removal not spt's or pmt's depending on when you graduated.

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waterbug100 in Nanaimo, British Columbia

51 months ago

cont.

So, my point is...JackiePA..you have only been in this business for TWO years...you CAN'T KNOW what you are talking about. You haven't experienced enough to say very much.

Flossboss..you make a lot of sense. BUT, if you had to find a job today..you would find things very different then 8 years ago.

I agree, in an ideal world, we would all be working for someone we fit well with, had the same ethics as, were on the same page - however you want to word it...but that just is not the MAJORITY anymore.

The over abundance of RDH has created an even worse relationship with DDS and RDH. The balance has tipped completely to one side, and DH is taking a beating. Plus the economy has prioritized selling dentistry over the health of the client.

Now, this does not happen in EVERY practice, but I hear more often than not that this is indeed the case. Our ideal of being health practitioners primarily is being compromised. And from what I read on these forums, the same situation exists in the states.

My point being, flossboss, as much as I agree academically, with your ideals, the reality is..that your ideals may be a luxury of the past.

JackiePa...DENTAL IS NOT PART OF OUR NATIONAL/PROVINCIAL HEALTH CARE...AND WILL NEVER BE!! Stop talking about things you obviously know nothing about. IT IS PRIVATE, SMALL BUSINESS ONLY.

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FlossBoss in Oceanside, California

51 months ago

Jackie, that is impressive for a recent graduate like yourself! I use Dentrix in one office and Eaglesoft in my full time practice. I really like Eaglesoft much better. It is much more user friendly. Because I started using the camera immediately in my one day office, they made it mandatory for all the hygienists to have 4 photos up when the doctor comes in. If my current (and last) full time boss gets a laser for us hygienists, he would pay for us to get certified. I am too close to retirement to do so on my own if I would not use it.
I suspect that the powers that be in dentistry are attempting to "dumb down" hygiene and are slowly getting rid of the 4 year degree programs. Why they are allowing these 16 month private programs in California is beyond me unless they are deliberatly trying to flood the market with this type of hygienist in order to lower compensation for all hygienists throughout the state.
8 years ago I was a examiner/recorder for the California state clinical exam and I can tell you that a lot of applicants (at least at the junior college level) did not pass the first time. A lot of calculus was left behind and I was appalled at how many could not speak English properly. But I, like you, think that there are still enough good guys out there who will hire the best hygienist that they can find and treat them well in order to keep them. Keep 'em flossing!

Don't be too hard on each other, Jackie and smile, you are more alike than you realize.
My next door neighbor is a registered nurse at the local hospital and she is not all that happy with her profession so the grass is not always greener. Your satisfaction with your job must come from within yourself. I get great satisfaction from my patients who tell me almost every day that they love how I make their mouth feel and they enjoy coming to the dentist because of me! My smallest patients race back to my room to play with Mr. Slurpy and draw me a picture. How I love it!

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smile in Calgary, Alberta

51 months ago

Waterbug....
There is at least 1 managed care office here & the 1 know of has it's head office in Eastern Canada. They are alot of over tx plans, production goals, everyone in the office is an employee, pretty much the same as Quest, Dentrix (not the software), etc. Did you go to the PDC?

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