Opening the Door to Opportunity

GRADUATE EDUCATION in dental hygiene can provide a vast array of possibilities outside of clinical practice, not only career-wise but also in the advancement of the profession, personal growth, and furthering the oral health of the general public. By definition, graduate education refers to programs that lead to master’s or doctoral degrees. Some graduate programs lead to advanced certification or postdoctoral preparation.

Most discussions and publications about dental hygiene education focus on the competencies and roles of entry-level practitioners, most scholarships target entry-level students, and most people entering dental hygiene become clinicians.Yet in higher education, business, research, and public health arenas, career opportunities abound for dental hygienists with master’s and doctoral degrees.

Regardless of discipline, the purpose of graduate education is to prepare leaders. Those enrolled in master’s and doctoral degree programs are in preparation for a lifetime of leadership and service. They can look forward to careers in academia, government, and business. As examples, graduate degree candidates may prepare for roles as:

• Faculty in higher education
• Directors of dental hygiene programs
• Deans of health science colleges
• Managers of professional relations
• Researchers in university or business settings
• Professional speakers, writers, or consultants
• Oral health product industry representatives
• Community-based practitioners and managers

Some dental hygienists pursue graduateeducation to become dentists, physicians,and lawyers, using their people-oriented skills and organizational talent as the springboard. In these varied roles andemployment settings, dental hygienists experience increased knowledge, responsibility, respect, personal affirmation of achievement, professional growth, career opportunities and advancement, and financial success. Certainly a graduate degree is no guarantee of success but it can provide the portal to a new career and an everexpanding collegial network outside of the private practice environment.

EARNING AN ADVANCED DEGREE

Although dental hygienists pursue graduate education in a variety of disciplines, there are 10 Master of Science in Dental Hygiene degree programs in the United States. Most master’s programs require 1 to 2 years of coursework, a comprehensive examination on the coursework, and a major graduate project or thesis. Because there are no doctoral programs in dental hygiene, dental hygienists interested in earning a doctorate must apply to programs in disciplines like allied health, health services research, business, higher education, educational technology, or health administration. Doctoral programs generally require 2 to 4 years of coursework including a comprehensive examination and a dissertation. Typically, graduate programs require either a thesis (original research and report completed as partial fulfillment of master’s degree requirements) or a dissertation (original research and report completed as partial fulfillment of doctoral degree requirements). Although most people initially find the thesis or dissertation requirement intimidating, this work is completed with the guidance and mentorship of a faculty group (the thesis or dissertation committee) that is interested in seeing the graduate candidate succeed.

From the graduate research experience, most degree candidates are able to develop and present a research poster or podium presentation at a state, national, or international professional meeting, and then follow this scholarly experience with the publication of at least one research report (Figures 1 and 2). Without this on-going discovery and transfer of evidence-based knowledge, practitioners and the profession will stagnate and their roles in society may become obsolete. Furthermore, dental hygienists in a variety of roles make intelligent, informed decision based on the findings of researchers, prepared via graduate education and beyond. Oral Health in America: A Report of the Surgeon General noted the shortfall in men and women choosing careers in oral health education and research, signaling opportunities for qualified dental hygienists in these areas.¹

FACULTY SHORTAGES

As in most disciplines, future generations of the profession are influenced by graduate education. One major goal of graduate education is to prepare qualified educators and most graduate students seek careers in academia (Figure 3). However, the number of dental hygienists enrolled in graduate programs is miniscule compared with the need for qualified, credentialed, diverse faculty.2 Palmer views the acute faculty shortage as one of the most serious recruitment issues facing the profession.3 Wilder et al found that 61% of the dental hygiene program directors had a full-time faculty vacancy in their programs between 1994-1996.4 The job market for dental hygienists in the private practice sector is strong and this trend is expected to continue throughout the first quarter of the century, with the federal government projecting large increases in dental hygiene employment opportunities.5 Given the projected need for dental hygienists, educators at the master’s level and above will follow suit in high demand.

Further complicating the faculty shortage problem is the prediction of a significant faculty exodus of those who began their careers in the 1960s and 1970s.2 With anticipated faculty retirements and more than 260 entry-level dental hygiene programs in the United States, additional programs in over 40 countries including Europe, Asia, Africa, and the Middle East, and only 10 master’s degree programs in the world, the dental hygiene faculty shortage is expected to worsen. Of the dental hygiene programs participating in a recent survey, 68% reported that over the next 5 years, they will need to replace current full-time faculty and 73% of these replacements are due to retirements.2 Therefore, dental hygienists desiring employment opportunities outside of private practice should give consideration to academic careers as faculty, program directors, deans, provosts, and college presidents.

Following are just a few of the academicians who began their careers as dental hygienists: Patricia Cormier, RDH, MEd, EdD, president, Longwood University; Connie Drisko, RDH, DDS, FACD, dean of the Medical College of Georgia School of Dentistry; Deborah Hardy, RDH, MS, dean of Instruction, Lakeland Community College; Cheryl Samuels, RDH, MS, PhD, provost, Texas Woman’s University; Deanne Shuman, RDH, MS, PhD, chair, Gene W. Hirschfeld School of Dental Hygiene, Old Dominion University; Cheryl L. Townsend, RDH, DDS, MSD, private practice; Margaret M. Walsh, RDH, MS, EdD, professor, Department of Preventive and Restorative Dental Sciences, University of California at San Francisco; and Esther M. Wilkins, RDH, DMD, clinical professor at Tufts University School of Dental Medicine.

BENEFITS FOR THE PRACTITIONER

In contrast to an undergraduate degree, graduate curricula allow dental hygienists to specialize in an area of interest and develop research skills. Graduate education is a catalyst for new knowledge, accelerating the rate of discoveries and invention. Priorities for dental hygiene research have been carefully promulgated by the American Dental Hygienists’ Association (ADHA) in the National Dental Hygiene Research Agenda.6 To actualize this agenda, dental hygienists, via graduate education, learn to write grants, conduct research, and publish evidence-based information upon which everyday clinical decisions are based. These research and communication competencies are sought after by employers in academia, business, public health, and government.

Although private practice dental hygienists have benefited from being in high demand, this demand has also created challenges for the profession. Too many of today’s students are prepared mainly for private practice, with few taking the educational paths that lead to varied career opportunities. Some practicing dental hygienists yearn for careers that allow them to continue to improve the quality of people’s lives beyond the clinical setting. Graduate education provides the career advantage and mobility that many hygienists desire after years of practice.

A few dental hygienists who have expanded their career options through graduate education are: Caren M. Barnes, RDH, MS, coordinator of Clinical Research, University of Nebraska Medical Center; Phyllis L. Beemsterboer, RDH, MS, EdD, associate dean, Academic Affairs, Oregon Health and Science University School of Dentistry; Judith A. Davison, RDH, JD, book author and attorney at law; Kathy J. Eklund, RDH, MPH, director of Infection Control and Occupational Health and coordinator for Educational Outreach, Forsyth Institute; Maria Perno Goldie, RDH, MS, international lecturer on women’s health; Ann B. Matika, RDH, MS, president, A & A Pro-Den-Temps; Pam Overman, RDH, EdD, assistant dean for Academic Affairs, University of Missouri-Kansas City; Anna M. Pattison, RDH, MS, editor in chief of Dimensions of Dental Hygiene , associate professor at University of Southern California, private practitioner, textbook author, and international lecturer on instrumentation; Dorothy A. Perry, RDH, PhD, assistant dean, Curricular Affairs, University of California, San Francisco; Karen B. Williams, RDH, PhD, director of the Clinical Research Center, School of Dentistry, University of Missouri-Kansas City; and Pamela Zarkowski, RDH, MPH, JD, executive associate dean, Patient Management, University of Detroit Mercy School of Dentistry.

FURTHERING THE PROFESSION

Professions must be educationally competitive to earn societal trust and recognition. As a whole, dental hygienists are generally less educated than practitioners in occupational therapy, physical therapy, or cytotechnology. Some allied health professions have worked to require advanced degrees for entry into practice. The high percentage of women dental hygienists and the educational level of the majority of dental hygienists affect professional status and autonomy. Advanced levels of education within the ranks of the profession increase the value of the profession to society and advance the credibility of the profession in the eyes of the consumer. Goals such as self-regulation, direct reimbursement for services, and practice autonomy may be more achievable if the public views the profession as highly educated.

IMPROVING ORAL HEALTH

The publication of Oral Health in America: A Report of the Surgeon General sparked national attention on the part of the federal government and the oral health professions to address the problem of disparity in oral health status and access to care for all population groups.1 Part of the strategy to meet the needs of underserved populations and to attract minorities into the oral health professions is to prepare more minority oral health professionals as both private and communitybased practitioners and as faculty who influence future generations of dental hygienists.7 An educational environment characterized by diversity enhances the educational process and the ability of students to render health care to culturally diverse clients and to attract and mentor other minorities and internationals into the profession.

Dental hygiene master’s degree programs are contributing in this area by recruiting minority and international students but greater numbers of graduates with master’s and doctoral degrees are needed to make a discernable impact on health care worldwide. Efforts to reduce widespread disparity in oral health status and access to care as a priority have placed a greater emphasis on attracting diverse dental hygienists who are able to serve the public outside of the traditional dental office, who would be Medicaid providers or reimbursed by third party payers directly, or who could participate in government influencing legislative and public policy decisions. This requires dental hygienists interested in combining public service, public policy, and public administration. For some examples of dental hygienists who have chosen these career paths, visit the web version of this article.

Following are some examples of hygienists working in public service: JoAnn Gurenlian, RDH, PhD, who recently campaigned for the New Jersey State Legislature; Vickie Nardello, RDH, MEd,  state representative and assistant majority leader, Connecticut Legislature; Dolores Malvitz, RDH, MPH, DrPH, acting director, Division of Oral Health, National Center for Chronic Diseases, Prevention and Health Promotion, Centers for Disease Control; Marcia Brand, RDH, PhD, director, Office of Rural Health Policy, Health Resources and Services Administration, US Department of Health and Human Services; and Helene Bednarsh, RDH, MPH, infection control specialist, Boston Public Health Commission.

MAKING IT HAPPEN FOR YOU

Graduate education is an opportunity to advance the person, the profession, and the health of the population. Graduate programs are responsive to the growing number of dental hygienists who want to make career changes, develop new marketable competencies, and continue their contributions to the health of the nation and the world outside of the traditional practice setting. Dental hygiene master’s degree programs seek qualified persons, diverse in talent, interest, age, gender, race and ethnicity, religious beliefs, and cultural backgrounds and who are committed to hard work. Since minorities comprise a very small percentage of enrollments in dental hygiene nationally (African American: 3%, Hispanic: 4.7%, Native American: 0.5%, Asian: 4.7%), educational programs are particularly interested in minority candidates, who in turn are likely to attract more diverse people into dental hygiene.^2,8

The master’s degree programs in dental hygiene offer a variety of options from traditional on-campus residency programs, to convenient off-campus extension sites and distance education formats. Graduate programs differ in goals, requirements, specialization, course offerings, specific degrees granted, and financial aid opportunities. At some institutions, the accelerated bachelor’s-to-master’s degree program is available to those interested in earning degrees as quickly as possible. Employed dental hygienists can take advantage of part-time study options that allow them to remain in the workforce while advancing their educational credentials. ADHA maintains a listing of various degree programs specially designed for dental hygienists at:www.adha.org/careerinfo/dir_education.htm

CHOOSING A GRADUATE DEGREE PROGRAM

The programs available from a variety of institutions reflect multiple opportunities, formats, and environments for the dental hygienist to excel. Selecting the right program is essential.

1. Visit the websites of the master’s degree programs in dental hygiene. Compare the course offerings, review curricula and program goals in relation to your personal goals. Although a visit to the program is ideal, with the Internet, CD-ROM recruitment materials, and virtual tours, a campus visit is not usually mandatory.
2. Email or call the graduate program director to discuss your interests, career goals, and financial aid options. Some institutions offer fellowships and research/teaching assistantships that can defray costs and offer excellent experiences that support career goals. Scholarships may be offered by some professional organizations like ADHA, the National Dental Hygienists’ Association, the Hispanic Dental Association, the Canadian Dental Hygienists’ Association, and the American Dental Education Association. These organizations sometimes offer small grants that can be used to fund thesis and dissertation research while in school.
3. After careful inquiry, select the programs that best meet your interests, lifestyle, and career goals and apply in plenty of time to ensure eligibility for financial aid.
4. Once accepted, work with the graduate program director to develop a course of study that meets your interests and personal obligations. Know that graduate study can be challenging, but the rewards are numerous.
5. Always keep an eye on the future. Your career goals, lifestyle, and interests should guide the choices, but be sure to build a foundation for the possibility of doctoral or even postdoctoral study.
6. Acquiring desirable employment is the goal following graduate school. ADHA sponsors the Career Resource Center on its website atwww.adha.org. This web-based search service is an excellent resource for dental hygienists seeking employment. Other employment opportunities can be found at www.nih.org, www.monster.com, and www.employmentguide.com. Dimensions of Dental Hygiene now offers a career center where jobs are posted, as well as an interactive forum that focuses on career on its website (www.dimensionsofdentalhygiene.com). Institutions of higher education, large corporations, and public health agencies typically post employment opportunities on their websites. Most universities maintain a career management office with personnel and material resources to assist students and alumni in landing that ideal position. Dental hygienists who take charge of their careers typically connect with these types of job searching resources.

SUMMARY

An undergraduate degree no longer assures today’s dental hygienist will prosper in our global, knowledge-based economy. Advancements in oral health, disease prevention, health care delivery, and access to care for underserved and underinsured populations cannot be made solely by practitioners working in private practice. Solutions need the input of dental hygienists educated in public health, research, management, education, public policy, political leadership, and consumer advocacy, just to name a few. Competencies in these roles are the focus of master and doctoral level programs. Graduate education builds on existing roles and experiences of dental hygienists and increases the likelihood that the profession has the cadre of diverse people to creatively and intelligently meet challenges. The profession needs dental hygienists who hold both master’s and doctoral degrees. Moreover, the profession needs members who support and encourage colleagues to pursue graduate education.

References

1. US Dept of Health and Human Services. Oral Health In America: a Report of the Surgeon General. Rockville, Md: US Dept Health and Human Services, National Institute of Dental and Craniofacial Research; 2000.
2. Nunn PJ, Gadbury-Amyot CC, Batrell A, et al. The current status of allied dental faculty: a survey report. J Dent Educ . 2004;68:329-344.
3. Palmer PR. Career recruitment, finding the future of the profession. Access. 2003;17(9):16-23.
4. Wilder RS, Mann G, Tishk M. Dental hygiene program directors’ perceptions of graduate dental hygiene education and future faculty needs. J Dent Educ. 1999;63:479-483.
5. US Dept of Labor, Bureau of Labor Statistics. Fastest growing occupations, 2002-2012. Available at:www.bls.gov/emp/emptab3.htm. Accessed July 29, 2004.
6. Gadbury-Amyot CC, Doherty F, Stach DJ, Wyche CJ, Connolly I, Wilder R, 2000-2001 American Dental Hygienists’ Association Council on Research. Prioritization of the National Dental Hygiene Research Agenda. J Dent Hyg. 2002;76(2):157-166.
7. Haden, NK, Catalanotto FA, Alexander CJ, et al. Improving the oral health status of all Americans: roles and responsibilities of academic dental institutions: the report of the ADEA President’s Commission. J Dent Educ . 2003;67:563-583.
8. Haden NK, Morr KE, Valachovic RW. Trends in allied dental education: an analysis of the past and a look to the future. J Dent Educ . 2001; 65:480-495.

From Dimensions of Dental Hygiene. September 2004;2(9):12-14, 16.