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Practice Settings & Non-Traditional Jobs
Guide to 22 Alternative Practice Settings
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Clinical Dental Hgyiene—Employee
Great for:
- Those who prefer to have set hours and a constant working environment(s) and salary.
- Those who prefer to concentrate on the technical and service sides of dental hygiene.
- Those who have little interest in the administration and business aspects.
Jobs
- Dental hygienist working in a solo or group practice for general dentists or specialists
Upsides
- Employment and salary stability that comes from being an employee versus self-employed
- Employer contributions to CPP and EI
- Possible bonuses and financial contributions to professional development and continuing education (see Employment Statistics and Trends for statistics regarding employee benefits among CDHA members)
- Financial risk is with the employer, not the dental hygienist
Possible Downsides
- Limited freedom and flexibility of scheduling, hours, and workplace
- Limited control over decision making
- Fewer income tax deductions compared to self-employed dental hygienists
- Lack of vertical movement in the job
- Repetitive work environment
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Clinical Dental Hygiene—Self-employed, Contract
Great for
- Those who want the freedom and flexibility to define their workplace in terms of hours, clients, place of work, and methods used.
- Those who are interested in running the business side of a dental hygiene practice and who will be able to deal with the stresses of being self-employed.
Jobs
- Dental hygiene contractor, who has contract(s) with any number of dental practices to provide dental hygiene services.
Upsides
- Freedom and flexibility of scheduling, hours, and workplace
- The ability to make many more deductions from income tax than an employee dental hygienist, such as deductions for equipment purchases and travel expenses
- Opportunity to make a greater margin of profit, provided such aspects as number of clients and fee-collection efficiency are taken care of
Possible Downsides
- ack of employee benefits such as payment for statutory holidays and vacation pay
- Increased financial risk because of self-employment
Visit Self-Employed vs. Employee Status for the legal differences between being an employee and being self-employed.
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Clinical Dental Hygiene—Self-Employed, Independent Practice
Great For:
- Those who prefer to be independent in their work and don't need the stability that comes from working in a dentist's practice.
- Those who can live by the phrase, "business is business."
- Those with excellent business and interpersonal skills who desire a challenge.
Jobs
- Freestanding dental hygiene clinics and mobile dental hygiene services
Upsides
- The ability to set up a practice on one's own terms and determine the hours, billing, and clients
- The workplace is owned by the dental hygienist
- Even greater freedom and flexibility than self-employed dental hygienists
Possible Downsides
- Lack of employee benefits (payment for statutory holidays and vacation pay)
- Financial risk because of self-employment
- There may be competing interests from other oral health providers
- There may be problems with current regulations (depending on the province), such as requirements of orders for treatment for scaling in Ontario, and the 365-day rule in British Columbia
Visit Self-Employed vs. Employee Status for the legal differences between being an employee and being self-employed.
Article of interest: "The Challenges of Setting up a Business" (Margit Juhasz, 2002, Probe Vol. 36.5: 195). **These practices are mainly found in British Columbia and Ontario.**
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Public Health
Great For
- Those who have a passion for the community and want to help those who are less advantaged.
- Those with previous experience in program planning and management, as well as an understanding of the ethnic and demographic diversity of the community.
Jobs
- Working in a public health department or unit, and school districts
- Conducting oral health assessments and referrals, providing preventive services, and developing educational strategies to change health behaviours of clients
- Fluoride mouth rinse programs, oral health presentations, health fairs, and smoking awareness and prevention
Upsides
- Flexibility
- Variation of the job and personal growth
Possible Downsides
- Somewhat lower pay than those working in clinical practices
Article of interest: "Healthy Mouth ~ Healthy Body: A Mouth Care In-Service Pilot Project" (Mickey Emmons Wener, Carol-Ann Yakiwchuk, and D.J. Brothwell, 2003, Probe 37.1: 15).
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Long-term Care
Great For:
- Those with excellent interpersonal skills.
- Those who want to define their own job, make their own hours, etc.
- Those who are able to convince long-term care organizations that their clients need dental hygiene care.
Jobs
- Mobile, self-employed position providing dental hygiene care—preventive and educational—in acute and extended care facilities
- Providing clinical and educational services for patients and residents
- Providing staff and caregiver/family training in oral hygiene
- Serving as advocates and change-agents to ensure that the health care needs of their diverse population are met
- Working part-time in extended care and the rest of the time in a traditional practice.
Updates
- Field growth because of Canada's aging population
- Flexible work hours and personal gratification
- Ability to help the clients who most need help
Possible Downsides
- Morale and stress difficulties because dental hygienists must deal with non-compliant patients and patients with dementia
- Red-tape concerns vary according to province or territory
- Some limitations due to supervision requirements
Article of interest: "Alternative Practice in Long-Term Care Facilities" (Marilynne Fine, 2002, Probe 36.5: 190).
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Hospital
Great For
- Those who thrive on busy atmospheres.
- Those who are energetic, and enjoy meeting diverse and varying challenges.
Jobs
- Dental hygienist within a hospital or clinic
- Dental manager of a hospital's oral health program and services
Upsides
- More opportunity for vertical promotion than in a clinic
- Varied tasks and challenges
Possible Downsides
- Stressful and hectic work atmosphere
- Encounters with red tape
Article of interest: "The Roller-Coaster Ride of My Life, or the Life of a Dental Hygienist/Dental Manager in a Pediatric Facility" (Anne Clift, 2002, Probe 36.4: 135).
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National Defence / Canadian Armed Forces
Great For
- Those who have an interest in working in the Canadian Forces.
- Those who enjoy variety and challenges in dental hygiene.
- Those who don't mind relocating when needed.
Jobs
- Dental hygienist for the Canadian Forces (can be enlisted or not), both in a clinic and in the field
Upsides
- Paid training (if a member of the Canadian Forces) in exchange for obligatory service
- Strong emphasis on continuing education
- Standards the same across the country
- Clients all aged 18 to 55 and in good medical health
- Cost not an issue, and the dental hygienist's salary is calculated in relation to quality of care, not production
- Unique challenges and experiences, and a greater variety of tasks related to practising dental hygiene in a field operation
- Chance for advancement within the Canadian Forces
Possible Downsidess
- Change in postings and deployment that may impede developing relationships with clients, as well as cause lapses in care and hygiene progress
- Limited freedom and flexibility
Website of interest: Department of National Defence, Career Opportunities in National Defence and the Canadian Forces— Civilian Careers
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Education
Great For
- Those who are dedicated to dental hygiene education.
- Those with patience and good interpersonal skills.
- Those who are willing and able to continue their education (most kinds of teaching will require at least a bachelor's degree, if not more).
Jobs
- Working for universities, community colleges, or private teaching facilities
- Possibilities for research and publication
Upsides
- Vertical movement possibilities
- The ability to work with and train future dental hygienists
- A prominent role in the dental hygiene community
Possible Downsides
- Limited interaction with clients
- Fewer jobs than in clinical dental hygiene
Website of interest: Dental Hygiene Educators Canada
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Research
Great For
- Those planning to continue their education; a BSc or MSc is generally required for research, if not a more advanced degree.
Jobs
- Write grant proposals
- Develop research methodology
- Collect and analyze data
- Conduct clinical, biomedical, health systems or environmental research
- Conduct research surveys
- Write articles and scientific papers for professional publications
- Perform reviews and evaluate products
Upsides
- An extremely important role in the advancement of dental hygiene
- Many challenges and opportunities
Possible downsides
Visit University of Manitoba School of Dental Hygiene, Research Interests
Document of interest: CDHA Research Agenda
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Sales
Great for
- Those with excellent interpersonal skills.
- Those who enjoy travelling and encountering challenges.
- Those who are self-motivated, disciplined, assertive, flexible, and organized.
Jobs
- "Combination of educator, troubleshooter, and resource person"
- Trade-show industry; distribute goods and inform colleagues about a product.
Upsides
- Building relationships through customer service
- Lots of travelling
- Money is made on a commission and bonus basis, and there are benefits including car/travel benefits
- Opportunities for professional development, education, and learning experiences
- Results can be seen immediately, versus clinical dental hygiene where results are long-term
Possible downsides
- Low salaries, although made up for in many cases by commission revenues
- A thick skin required, as there may be many rejections of the products being sold
- Stress in the long-term, and there are very long hours
- Being away from home very frequently and for long periods
Article of interest: “From Clinic to Desk" ( Angela Best, 2002, Probe 36.1: 29).
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Publishing
Great for
- Those with an aptitude and a desire to write as well as to research.
- Those who want to continue their education past a diploma or undergraduate degree.
Jobs:
- Writing for national and international medical, dental, and dental hygiene journals
- Writing for news magazines, trade journals, textbooks, consumer publications, children's books, newsletters, brochures, or handouts for dental offices
Upsides:
- Increased career prospects
- >Ability to influence the oral health professions and the public
Possible Downsides
- No interaction with clients
- A long way from the practical side of dental hygiene
Visit Journal of Contemporary Dental Practice
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Dental Insurance
Great for
- Those interested in more of an office job
- Those who want opportunities for vertical movement
Jobs
- Working in the claims division, marketing division, or administration of an insurance broker
Upsides
- Excellent benefit packages
- Standard work hours
Possible downsides
- Must start at the bottom of the industry and work up
- The political atmosphere
Visit Canada Life: Canadian Division: Dental
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Administration
Great for
- Those interested in more of an office job
- Those who want opportunities for vertical movement
Jobs
- Office manager
- Program coordinator
- Public health administration
- Administrator at dental hygiene schools
- Programs in health promotion, disease prevention, and managed care
Upsides
- Provides an opportunity for vertical movement
Possible Downsides
- Removed from the practical side of dental hygiene, although not necessarily from the clients
Visit Pennsylvania College of Technology: Dental Hygiene—Health Policy and Administration Concentration
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Consulting
Great for
- Those who may want to go on to get an MBA and are interested in the business of dental hygiene.
Jobs
- Training
- Facilitation
- Coaching
- Consulting
- Education
Upsides
- Ability to make a very good income
- Experience in the business side of dental hygiene without becoming removed from the practical side
Possible downsides
- A large emphasis on business
VisitAdvanced Hygiene Concepts Inc.
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Computer Software, Web Design
Great for:
- Those with skill and interest in computers, web design, and software design.
Jobs
- Creating websites for oral health professionals and other businesses
- Diagnostic software
Upsides
- Good salaries
- Challenging and interesting work
Possible downsides:
- No opportunity to use practical dental hygiene skills
- No interaction with clients
Visit Dentrix Practice Management Software
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Dental Laboratory Work
Great for
- Those who want to continue their education to postgraduate study.
- Those who are interested specifically in the scientific side of dental hygiene.
Jobs:
- Product testing
- Fabrication of oral health products (restorations, implants, etc.)
Upsides:
- Still able to interact with clients in some cases
- Good salary
- Opportunities for vertical movement
Possible downsides:
- Demanding work
- Can be repetitive (depending on the field)
Visit Bio Dent Laboratories, Toronto
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Staff Placement Agency
Great for
- Those with excellent organizational and interpersonal skills.
- Those with contacts, or the ability to make contacts, in the dental hygiene and dental professions.
Jobs
- Promotion and facilitation
- Working with both employers and employees to create correct fits
Upsides
- Local and international career opportunities
- Travelling and exploring
Possible Downsides
- No clinical work
- No interaction with clients
Visit Global Hygienists Community
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Law and Dental Hygiene
Great for
- Those interested in getting a law degree and practising law.
Jobs:
- Health, personal injury, professional negligence, or employment law
- Teaching health law/jurisprudence courses to dental hygiene students
Upsides:
- Good salary
- Helpful combination of practical knowledge and legal knowledge
- Job security
Possible Downsides
- One sees only the negative aspects of dental hygiene
- Little or no interaction with the many good aspects
Visit Girones & Associates
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Government Regulation and Policy
Great for:
- Those interested in politics and policy.
Jobs
- Regulation monitoring and enforcement
Upsides:
- Ability to work on dental hygiene issues at the macro level, where policies and regulations that affect dental hygiene are created
- Challenges
- Potential for promotion
Possible Downsides
- No opportunity to maintain clinical skills
Visit Health Policy and Communications Branch, Health Canada
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Consumer Advocacy
Great for:
- Those dedicated to social movements and to the cause of consumers.
- Those with good organizational and technical skills (such as knowledge to enable internet networking).
Jobs
- Helping consumers obtain access to care
- Developing networking systems that match existing resources with health care needs
- Advising consumers on insurance policies, commercial products, and political issues affecting oral health care
Upsides
- Would be very rewarding for someone who is passionate about consumer advocacy
- Could address a relatively untapped niche
- Ability to maintain contact with the general population
- Opportunity to help others
Possible Downsides
- Job security would be extremely hard to obtain; consulting and internship work would likely be the primary methods of employment with consumer advocacy groups, although an independent, private business could be set up for a certain group of people in a certain area. There are few real barriers, but at the same time there is little support or precedent. Finding a way of securing income from consumer advocacy work would be difficult.
Visit International groups concerned with toxins in dentistry
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Change Agents
Great for
- Those who are politically minded.
- Those who are dedicated to a cause within dental hygiene and want to influence business, government agencies, and public attitudes and behaviours. In many cases, further education and/or experience will be needed.
Jobs:
- Lobbying
- Law consulting
- Being an expert witness (in government committee hearings)
- Health promotion
Upsides:
- Provides a great challenge and experience for those interested in this area of dental hygiene
- Can provide vertical movement
- Can lead into a wide variety of other jobs
Possible Downsides:
- Lobbying and consulting does not allow the dental hygienist to maintain clinical skills
- It can be discouraging because government and business change is slow
Visit The Health Action Lobby Group (HEAL)
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Volunteering
Great for
- Those who are dedicated to dental hygiene.
- Those who want to get involved with their community or travel around the world.
- Those who are in the position to take anywhere from a few days to a couple of years to work in another country or region.
Jobs
- Educating and practising abroad, especially in developing countries
- Providing services to underprivileged areas and people in Canada
Upsides:
- Great opportunities to travel and to help people (especially children) in need
- Provides great experiences in teamwork, meeting challenges, and providing oral care in a less-than-ideal setting
Possible Downsides
- Usually requires self-financing or the ability to obtain income through part-time work
- The challenges can be great, and frustration can result from continued exposure to stressful situations and poor conditions
Visit DentalJobs.net (look under "Volunteer"); CDHA’s Working & Volunteering Abroad
Resources on Alternative Practice Settings
There are many resources for finding information about alternative practice settings and non-traditional jobs for dental hygienists:
- CDHA's Canadian Journal of Dental Hygiene (formerly Probe) has featured many articles discussing alternative dental hygiene jobs and opportunities.
- "Alternative Practice," an article by Melinda Ferguson, contains a vital guide to non-traditional jobs.
- "The Roller-Coaster Ride of My Life, or the Life of a Dental Hygienist/Dental Manager in a Pediatric Facility," an article by Anne Clift, describes in a funny and engaging way the hectic but rewarding life of a dental hygienist working in a children's hospital.
- The CDHA document, Dental Hygiene: Definition, Scope and Practice Standards, has information on the different elements and practice environments of dental hygiene, and addresses the responsibilities and practice standards of dental hygienists.
- The book, Dental Hygiene Theory and Practice (Michele Darby and Margaret Walsh, Harcourt Brace & Company, Philadelphia: 1995), contains a chart of the "Six Interrelated Roles of the Professional Dental Hygienist" (15), and is a great resource for dental hygiene students and professionals.
- The feature article of the July/August 2001 issue of Probe (now the Canadian Journal of Dental Hygiene) is titled "Alternative Dental Hygiene Practice: Access, Cost, and Harm Considerations." It was written by D.W. Lewis for the College of Dental Hygienists of Ontario, and it addresses "the accessibility, cost, and safety issues for patients when dental hygienists provide self-initiated dental hygiene care unsupervised by dentists"
(139). The main focus of the article is on the availability and accessibility that unsupervised dental hygiene would bring.
- In "Evolution, Not Revolution” (Fran Richardson, 2002, Probe 36.1: 24.), Fran Richardson claims, “the future of dental hygiene in Canada does not lie in the traditional private practice with our dentist colleagues." This article addresses self-regulation and the future of dental hygiene, and advocates for an expanded and more independent role for the profession.
- "The Political Economy of Dental Hygiene in Canada" (Pran Manga, July 2002, Canadian Dental Hygienists Association).
- "From Clinic to Desk" (Angela Best, 2002, Probe 36.1: 29) describes the personal experience of a dental hygienist who moved into sales, and outlines the benefits and challenges of the job.
- "Entrepreneurship" (Pat Spencer, 2002, Probe 36.5: 181) was written by a dental hygienist who was drawn to dental hygiene for long-term care residents and set up her own practice. This article includes important information about entrepreneurship and the qualities that are vital to an entrepreneur, as well as information about the role of dental hygiene in community and long-term care.
- "Alternative Practice in Long-Term Care Facilities" (Marilynne Fine, 2002, Probe 36. 5: 190). A dental hygienist working in an independent operation for long-term care facilities describes her entrance into, and the operation of, an alternative practice.
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"Healthy Mouth ~ Healthy Body: A Mouth Care In-Service Pilot Project" (Mickey Emmons Wener, Carol-Ann Yakiwchuk, and D.J. Brothwell, 2003, Probe 37.1: 15.) This article describes the details and process of setting up the Health Promotion Unit to serve the community.
Sorting Out the Terminology
Independent Practice
The independent practice of dental hygiene is often visualized as a freestanding dental hygiene practice, but it is more correct to think of it as a way of directly accessing dental hygiene care. The goal is to increase the public's access to care, not to have dental hygienists working in isolation from dentists or other health providers. The freestanding dental hygiene practice may look very different from a traditional dental office, depending on the dental hygienist's area of focus. Read more
information on Independent Practice
Unsupervised/Autonomous Practice
Unsupervised practice means dental hygienists can make treatment decisions within their scope of practice without the supervision of a dentist. The status of supervision is defined within the provincial dental hygiene regulations.
Self-regulation
Self-regulation means being accountable to the public for your actions.
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