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Maintain Professionalism in a Digital Age

Follow these strategies to create a professional reputation across all facets of social media.

Do you have a Facebook account? Do you frequently “like” pages and statuses of your friends? Do you “pin” ideas or recipes that you want to try? Do you host a blog? If you answered yes to any of these questions, then you are like the 47% of adults in the United States who use social media.1 As social networking sites have become commonplace, the boundaries between health care professionals and patients have blurred. While social networking may be fun and appear harmless, dental hygienists, as well as all health care professionals, must retain professionalism in their online presence.


The profession of dental hygiene strives to encourage and maintain high professional standards. The American Dental Hygienists’ Association has published an extensive Code of Ethics to ensure that dental hygienists maintain a high level of professionalism and ethical responsibility.2 The preamble of the Code of Ethics includes the statement “Our actions, behaviors, and attitudes are consistent with our commitment to public service. We endorse and incorporate the Code into our daily lives.”2 The Code of Ethics also outlines dental hygienists’ professional responsibilities (Table 1). In light of technological advances, the integration of the Code of Ethics “into our daily lives” has become more pervasive. In today’s world it is not only what we say or do, but also what we “tweet,” “like,” or “pin.”


The most commonly visited sites on the Internet are those dedicated to social networking.1 The most popular site, Facebook, has 901 million users.3 Many other social networking sites are used across the world, each with its own unique features. And it is not just young people who are flocking to social networking sites—older adults age 65 and older are the fastest growing population of users.4 It is likely that you, your patients, and possibly your dental practice participate in at least one social media site. A recent survey found that 52% of dental practices use social media, with Facebook being the most popular.5

The use of social networking sites makes the line between personal and professional lives less clear. Because work is a key component of most people’s lives, many identify their workplace or profession in their online profile information. Regardless of how prevalent and casual social media has become, maintaining a professional image must not be forgotten when the work day is over. Dental hygienists have a responsibility to positively represent the profession. Teachers, airline crew members, and hospital staff are just a few of the professionals who have lost their jobs for posting something unprofessional on a social networking site.6–9 In many cases, the offending remark was posted after work hours and on personal computers. Employers frequently evaluate a potential employee’s social networking profile, and may even request access during an interview.10 The American Medical Association has issued a policy “Professionalism in the Use of Social Media” to help guide physicians in the appropriate use of social media.11 As oral health professionals, dental hygienists need to be aware of their online presence and evaluate their digital footprint.


When using social media, the following factors should be considered.

1. Privacy Settings

Understand and use the privacy settings available on social networking sites. Most sites allow users to control who sees certain aspects of their profile and posts. Privacy settings change frequently, so they need to be evaluated on a regular basis. Privacy controls can also be complex, especially to novice users, so you may want to decide against posting something if you are not comfortable with a wider audience viewing it. Also remember that when you allow “friends” to see your posts, they can save the image or distribute it in a less restricted venue.

Best Practice: Keep your privacy settings as strict as possible, but realize that anything you post may be viewed by someone outside of your intended audience.

2. “Friending” Patients

Initially “friending,” “following,” or “liking” your patients’ profiles or status sounds like an innocent, friendly gesture. You may not have anything illegal, distasteful, or unprofessional on your profile, but there still may be posts and images that you don’t want your patients to see, such as vacation photos of you in a swimsuit or political opinions. Before opening your profile to your patients, evaluate whether the content of your profile is appropriate for the audience.

Best Practice: Do not “friend” patients on social networks. Another alternative is to have a professional profile separate from your personal profile. “Friend” your patients on your professional profile and post information related to oral health.

3. Health Information Standards and Privacy

Maintaining patient privacy is the most important issue related to the use of social networking sites by health care professionals. The Health Insurance Portability and Accountability Act (HIPAA) requires that 18 different identifiers be removed before information is considered de-identified or no longer personal health information. 12 Identifiers that may inadvertently be posted on a social networking site include geographical subdivisions smaller than a state, dates, and other identifiable characteristics. Also, conversations related to the health care of a patient cannot be done through a public social network. If you maintain a professional profile, understand the boundaries of the interactions that can occur on a social networking site. Consequences for unknowingly violating HIPAA privacy laws can include fines up to $50,000 per violation.13

Best Practice: Do not post patient information on social networking sites. Be mindful of standards related to personal health information and privacy.

4. Monitor Your Online Presence

Whether you are an active user of social media or only log in a few times a year, you need to monitor your online presence. One way to do this is to periodically enter your name on an Internet search engine. This will help identify information that is posted online about you.

Best Practice: Each quarter, conduct an online search of your name.

5. Think Before Posting

When participating in online social networks, blogs, or other social media remember that what you post is a reflection of you. Your online postings may be viewed by a larger audience than you intended. As a dental hygienist, your postings also represent the profession and your place of employment, especially if you identify these associations on your profile.

Best Practice: If you are hesitating about posting something, think about it for 24 hours and decide if you really want to release it. Be aware that even though it is a personal page, it can represent more than just you.


Social media is an excellent way to communicate, advertise, and express yourself online. There are many ways to positively impact the profession and your patients through social media, but these outlets can also be too accessible and facilitate unprofessional discussion and interaction. Dental hygienists should evaluate their online presence and strive to maintain the professionalism and integrity of the profession in person and online.


  1. Hampton K, Goulet LS, Rainie L, Purcell K. Social Networking Sites and our Lives. Available at: Accessed September 7, 2012.
  2. American Dental Hygienists’ Association. ADHA Code of Ethics. Available at: Accessed September 7, 2012.
  3. Facebook. Facebook Fact Sheet. Available at: Accessed September 7, 2012.
  4. Madden M. Older Adults and Social Media. Available at: Accessed September 7, 2012.
  5. Henry RK, Molnar A, Henry JC. A survey of US dental practices’ use of social media. J Contemp Dent Prac. 2012;13:137–141.
  6. Dahl R. Oakwood Hospital Employee Fired for Facebook Posting. Available at: Accessed September 7, 2012.
  7. High School Teacher Loses Job Over Facebook Posting. Available at: Accessed September 7,2012.
  8. Fired Over Facebook: 13 Posts That Got People Canned. Available at: Accessed September 7, 2012.
  9. Cain J, Fink JL. Legal and ethical issues regarding social media and pharmacy education. Am J Pharm Educ. 2010;74:184.
  10. Stern J. Demanding Facebook Passwords May Break Law, Say Senators. Available at: Accessed September 7, 2012.
  11. American Medical Association. Professionalism in the Use of Social Media. Available at: Accessed September 7, 2012.
  12. HIPAA Privacy Rule and Public Health-Guidance from CDC and the US Department of Health and Human Services. Available at: Accessed September 7, 2012.
  13. Bradbury SG. Scope of Criminal Enforcement Under 42 U.S.C §1320d-6. Available at: Accessed September 7, 2012.

From Dimensions of Dental Hygiene. October 2012; 10(10): 28-30, 32.

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