April 24, 2014
Recent reports rank dental hygiene as the number ten job out of 100 jobs published by U.S. News, with a reported annual salary of $68,153. Despite these reports, dental hygienists nationwide report market saturation, poor pay, lack of benefits, and increasing demands on production. New graduates are forced to compete against desperate applicants possessing many years of experience, advanced degrees, and clinical expertise. Dentists are aware of the rigorous curriculum dental hygiene students endure, but what can a new graduate do to increase her chances of being hired?
Income power of hygienists and dental assistants in 100 U.S. cities
In addition to a saturated market, the hiring process for dental hygienists has changed dramatically. Applicants are being asked to do working interviews, which may last for days, even weeks. These dentists are in-turn filing a 1099-MISC with the IRS once the applicant reaches $600.00 worth of “services.” A 1099-MISC is used if you are an independent contractor since it is not clear from the IRS description that hygienists do not qualify as independent contractors. Independent contractors have no taxes withheld from their paychecks; the hygienist must pay federal and state income taxes quarterly on an estimated basis. How would a new graduate know how to encounter these hurdles?
You will stand out if you can demonstrate depth of clinical knowledge, beyond the educational setting. Dental hygiene students and dental hygienists alike are familiar with the typical interview questions such as: Do I get to order my own instruments? How long do I have with each patient? What are the benefits? These questions reflect poorly on the applicant, especially in a desperate market. Hygienists must be familiar with current dental terminology codes (CDT), which many hygienists learn on the job rather than in school. To ask questions in an interview that demonstrate knowledge beyond the classroom, simply refer to CDT codes. A dentist will see this as production potential.
The dentist worries about hiring new graduates for several reasons, largely based on time management concerns, which ultimately affects production.
New graduates can demonstrate production potential at an interview simply by asking the right questions. These questions include:
Do you use the CDT code 4342 when scaling and root planing one to three teeth in conjunction with an adult prophy 1110?
CDT code 4342 is defined as scaling and root planing one to three teeth per quadrant. For example: A patient presents for a 1110 with two 6mm pockets. The 4342 allows the hygienist to bill for services she is already providing. This new code addresses fewer than four teeth in each quadrant needing root planing.
What is the office soft tissue management program for your 4910 patients?
It is important for the new graduate to discuss an office’s soft tissue management program or periodontal maintenance program because this will vary dramatically from the school setting. The new graduate must present herself as adaptable as well as knowledgeable beyond the classroom. If there is no soft tissue management program, offer to create one!
What is the office procedure for a patient who presents with heavy subgingival calculus and 4-6 mm pockets? Do we perform 4355 and reappoint for 4341?
Full mouth debridement (D4355) is defined as full mouth debridement to enable comprehensive oral evaluation. This code should not be abused, as it is not a definitive treatment —it is preparatory in nature. This code must be followed up with either a prophylaxis (D1110) or scaling and root planing (D4341/D4342). Gross debridement remains to be a controversial topic and is not part of most hygiene programs’ curricula. However, many dental offices use this code prior to scaling and root planing, so it is important to express knowledge of this code and/or procedure.
Chairside medicaments such as Arestin, supplemental fluorides (prescription and varnishes), and chlorhexidine are also ways a new graduate can demonstrate product knowledge and production potential. Ask questions like:
- What chairside medicaments do you use?
- How much do you charge for Arestin?
- Do you participate in the Arestin Rx Access Program? (The Arestin Rx Access Program utilizes patients’ medical prescription benefits to cover the treatment.)
- Do you sell Prevident in the office?
These questions demonstrate a hygienists’ knowledge beyond the classroom.
To compete in the current economic climate, a new graduate must demonstrate clinical knowledge beyond the classroom and educational setting. This can be accomplished by asking the right questions. The above questions allow the dentist to see that you possess more knowledge beyond four-hour prophy appointments, textbooks, and excessive documentation.
