How to become a dental hygienist: What you need to know

Teeth. Teeth are quite possibly the antecedent of first impressions, and yet so widely undervalued and underappreciated. Most people are aware that teeth serve an important function in facial aesthetics, verbal language formation, and the consumption of certain foods, but they lack the knowledge on how to properly care for them so that they can last a lifetime.

What is a Registered Dental Hygienist (RDH)?

A Registered Dental Hygienist (RDH) is a dental professional who is trained to remove soft and hard deposits from above and below the gingiva by using hand scalers and ultrasonic scalers. Dental hygienists also take radiographs, place localized antibiotics, place fluoride on high-risk patients, deliver local anesthetics (not all states allow this), utilize laser therapy (not all states allow this), communicate their findings to the supervising dentist and to the patient, provide screening exams and, perhaps most importantly of all, educate the patient on how to properly care for their own teeth and gums.

What do you need to do to become a Registered Dental Hygienist (RDH)?

To become an RDH, you will need to complete approximately two years of prerequisite courses which can include anatomy and physiology, microbiology, college algebra, and chemistry. These prerequisite courses are in addition to general education requirements such as psychology, speech, and sociology. Dental hygiene programs can require entrance exams or be GPA-based or lottery-based. Many allied health programs, including dental hygiene, can be fiercely competitive. It is possible that you may not get accepted upon on your first application. Dental hygiene programs are offered through community colleges with technical schools and universities also offering degrees. There are some dental schools that also offer hygiene degrees. You will want to choose a program that is accredited by The Commission on Dental Accreditation (CODA), which means that the school or program has met certain criteria and are held to strict standards regarding their curriculum. An accredited program will help ensure that you meet the learning objectives to successfully complete your degree and licensing exams.

Upon admittance to a dental hygiene program, you will complete a rigorous didactic curriculum split between the classroom and the clinic. In the classroom, you will find an intense schedule that includes head and neck anatomy, radiology, oral pathology, oral embryology and histology, and periodontology. In addition to the heavy class loads, you will also be learning instrumentation on live patients. Some programs will have you recruit your own patients and some programs will schedule patients for you. You will have specific requirements to meet to pass clinic for that semester. The requirements are classified by the severity of the patient’s periodontal condition. The dental hygiene coursework is approximately two years long to obtain an associate’s degree in dental hygiene with the option to further your education if desired with either a bachelors or master’s degree. Students will pursue bachelor’s degrees in hygiene to get into sales positions with dental companies, higher education, or public health roles. A master’s degree in hygiene can help you get into research positions or higher education opportunities.

When you have completed all of the coursework and clinical requirements through your program, you will be eligible to sit for your national board exam. This is an extensive exam which tests your foundational knowledge built over the last two years of the hygiene program. You will also need to take a clinical exam to be licensed by the state in which you desire to practice. The clinical exam is performed on a live patient who meets certain oral deposit criteria. Depending on which exam you take, there may be a few other written exams to complete, such as law and ethics and jurisprudence. As it stands right now, each state has its own criteria to practice should you decide to move from your originally licensed state. You will be able to find out each individual state’s requirements by visiting their dental board’s website.

There are also regional board exams available if you’d like to have the option to practice in a different state without having to retake multiple tests. These exams have reciprocity with certain states within a region and allow for minimal exams and testing to get licensed.

What happens to Registered Dental Hygienists after their schooling and exams?

The education doesn’t stop after you have completed your schooling. Dental hygienists are required to complete CE (continuing education) classes every license renewal period. Each state has different guidelines, so it is best to check your particular state’s dental board’s website to see how often you will need to renew and how many CE units are required. You will also be required to complete a biannual CPR course for healthcare providers.

RDHs often work in private or corporate dental offices. However, there are many different settings for the hygienist to provide care. Physician offices, school settings, public health offices/centers, and traveling hygienists (similar to traveling nurses) are all options to provide dental hygiene services.

There are some states that allow dental hygienists to practice independently outside of a traditional dental clinic setting. These RDHs provide screening exams and therapeutic hygiene services and refer to dentists when appropriate. These services are particularly valuable in rural or underserved areas where access to a dentist can be challenging and the cost-prohibitive for many patients who desperately need dental care. Many independent practicing RDHs serve the geriatric and homebound populations. If this is something that sounds interesting to you, you would need to be licensed as a Registered Dental Hygienist first and then find out what requirements that particular state needs you to complete by contacting their dental board.

Consequent to all necessary exam passage and fees paid, you will receive a license to practice. A dental hygienist is a valuable asset to the dental and medical communities. Many people are unaware of the extensive knowledge that hygienists have and the skills they possess. Educating patients is critical in helping them achieve optimal health and with continued research linking systemic and oral health, it becomes even more critical.

Knowledge is power! Dental hygiene is a challenging program to complete, but can be such a rewarding career, both personally and financially.

Denali Knudson is a 2013 graduate of the exceptional dental hygiene program at Fresno City College in Fresno, Calif. While in school, she was honored to be the recipient of the Dean’s Medallion award. This award is based on academic excellence, the ability to overcome obstacles, and how the students face adversity. Denali credits her motivation and drive for always achieving the goals that she sets for herself. She is currently pursuing a degree in software engineering while working as an RDH part-time. Denali has been working for the last eight years in private practice and enjoys educating patients on the constantly emerging connections between oral and systemic health. She is also very interested in the role that malocclusion plays in so many patients’ dental and systemic issues. She also loves volunteering her skills for underserved populations. 

Note on photo: Photo by Tobi from Pexels

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