The editorial below appeared in the February 1991 issue of RDH magazine.
by Irene Woodall, RDH, PhD
No challenge? No excitement? Nothing to write about? That's crazy. It is all there ready to be said. I'm not 22 anymore, but I still can see an opportunity when it exists. My dental hygiene "coming out" party was in 1968. I didn't know it at the time, but the challenge and opportunity of speaking before the American Dental Association while I was at the tender age of 22 would launch me into a whole new way of looking at and working within dental hygiene.
The ADA was holding a conference for dentists who were in charge of public relations for their respective state or local organization. My friend and colleague, Jean Bedore Collins, had been asked to address how dental hygienists could fit within a public relations scheme for dentistry. She couldn't attend, so she asked me to substitute for her.
I was too impetuous and self-confident to be scared. So I set out to write and practice a presentation that lasted about 25 minutes. It was my first major presentation. Apparently I was a hit, because I made the front page of the ADA News and my presentation was published by the Maryland Dental Association in their journal.
Message Springboard
I haven't thought about that event in many years, but in retrospect, it really was a springboard for me.
I discovered I could speak publicly and carry a message that awakened people. The ADA told the staff at the American Dental Hygienists' Association about me and I was soon asked to chair a national committee for the ADHA, where I met wonderful people and had several years of opportunities to develop leadership skills and learn about those things that tie us together as a profession as well as those factors that keep us diverse.
The key is that I learned that I could step out of the dental hygiene operatory, even beyond the teaching environment, and carry a message (right or wrong!).
We haven't done enough of that in dental hygiene. We tend to stick to the tried and true, the legally defined role, the safe approach to spreading information about ourselves and about proper oral care. We stick to displaying our credentials on the wall (a good idea, no matter what else we do) and to occupying part of our discussion time with new patients by telling them about our education and profession. Undoubtedly some of you are recalling that you don't even do that very often or perhaps very convincingly. Some of us still attend career days to explain the merits of the profession and how one can prepare for dental hygiene education. But far too often we don't take the risk or the opportunity to step out and proclaim who we are.
Where Is Our Spotlight?
As a profession, we are not in the spotlight; we haven't done anything exciting enough for the spotlight to find us; and we have not claimed the spotlight.
There are no television series about "'Jerry Flanders, RDH." There is no syndicated column about oral hygiene that features a dental hygienist.
Rarely do you see a dental hygienist being interviewed on local television, let alone national programs. Even Ms. magazine hasn't taken the time and space to target our profession or one of its members to describe the unique economic and political situation we are in or even to focus on proper oral hygiene.
Why do you suppose that is? I think it is because we were taught to walk in the shadow of the boss, to stay two steps behind, to defer, to accept second class citizenship in the area of oral health. We were taught that we weren't good enough to have our names on the door, to own our own business cards with "RDH" on them, to speak on television unless a dentist was with us to correct our errors, or to publish on oral health topics for patients. Some of these things were actually written in the dental practice acts! Others were the edicts of the local dental ethics committees.
What was so startling about my presentation back in 1968 was that a dental hygienist was speaking to dentists and making suggestions about what they could do better.
Even more startling was the idea that dental hygienists could be the best spokespersons for dentistry both in the dental office and out in the public. We could extol the benefits of proper oral care and invite people in for good dentistry without the message sounding like it was an advertisement (still a taboo back then).
Shocked, Thrilled And Delighted
The dentists in the audience were shocked; some were thrilled and delighted that the obvious had been said out loud in an ADA sanctioned meeting, others thought I was a bit uppity. But it was a step forward that needed momentum for it to make a real difference.
Obviously the momentum was not to happen. I'm still waiting for the second step. And now we are, sadly, still arguing with dentistry over issues that most clinicians don't even understand or care about. In the meantime, the power of organized dentistry is making dental hygiene look less like a good place to be in the 1990s.
I think a major factor in this rift is our reluctance to stand up publicly for who we are and how we see ourselves as part of oral care. We should be carrying the message to the public in every medium that we can find. We should be extolling the virtues of high quality dental care, encouraging people to seek that care and to learn about what they can do as partners to help keep their teeth. But it should be clear that dental hygiene is an important, essential profession that specializes in prevention and in the initial treatment of periodontal problems.
Shouldn't the public know there is an alternative if their own dentist is not probing for periodontal pockets, is not as concerned about soft tissue health as about dental caries, and never uses anything more than a rubber cup to clean teeth? Those people ought to seek out a dentist who has a dental hygienist who was educated to perform comprehensive oral hygiene care. We should tell the public to look for that quality.
The ADA and the American Academy of Periodontology are developing programs to teach practicing dentists how to find periodontal disease. They have developed a high quality "triage" approach to the exam that uses a probe with simplified markings that can help a dentist decide the difference between health, beginning disease, and advanced disease. The program helps the dentist decide when the patient needs a complete periodontal exam and treatment that focuses upon periodontal problems. Dental hygienists already know how to perform these functions.
They had to know in order to pass National Boards and state practical examinations for licensure. Shouldn't it be clear to the AAP, ADA and to the public that we support high quality diagnosis and treatment and that we want to ensure that these procedures are a routine part of dental care?
Stepping Out
Stepping out of the operatory and out of the safe haven of an educational program sometimes means sticking out one's neck. If you don't stick it out, the big breaks don't happen. Saying "yes, I can and I will" and then actually taking the step to shake up the status quo and to introduce new ideas could put us in the spotlight. It could make us an indispensable part of the oral care world. The public might even begin to describe us that way.
They might even select a dentist based on whether a hygienist works with that person. We will feel good about ourselves and grow in confidence and competence in our relationships with the public and our co-profession, dentistry.
I don't think it is possible to function as a profession without public relations. Whether you do anything actively or simply watch the passing scene – the relations are there; the passive ones are usually of poor quality. I'd like to see us build good public relations, to be active and dynamic and on target, to make all groups feel good about us because what we profess is unquestionably good for them as well as for us.
No challenge? No excitement? Nothing to write about? Nothing to say on television? That's crazy. It is all there ready to be said artfully. It is all there for us to grab and work with. I'm not 22 anymore, but I still can see an opportunity when it exists. It exists now.
Irene Woodall, PhD, RDH, was the senior consulting editor for RDH during the 1980s and early 1990s. Many of her commentaries withstand the test of time.
