Help! Let me out!

By Heidi Emmerling Muñoz, PhD

Get your bachelor's degree. That is the short answer for making the transition out of clinical dental hygiene to a nonclinical career. Once you have your bachelor's, employment and educational opportunities await you. Many have asked me about my path out of clinical hygiene, and I will happily tell you my unusual story, followed by suggestions for a variety of paths some dental hygienists have taken on their way out of the operatory. Those paths differ depending on if there is something pushing you out of your clinical role immediately (such as an injury or wrongful termination) or not; fortunately mine did not, so I took my time.

Like the majority of dental hygienists, I received an associate's degree. I knew going into the program that an associate's degree would afford me fewer opportunities than a bachelor's. However, at the time, there were no four-year programs near my residence and relocating for school was certainly not an option. Besides, who needed options? I was young, married, wanted a family, and really saw no need to delay jumping into private practice for what I perceived as "fluff" classes such as literature and history. For my clinical position, the associate's degree was perfect. I received top-notch instrumentation and patient-care skills, earned an amazing income, and was able to work as much or as little as I wanted.

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Other articles by Emmerling Munoz

• Catch some ZZZs: Knock out sleep apnea
  
• Holistic approaches to chronic disease
  
• How to interview for your first position as a dental hygienist

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But it didn't take me long to grow restless. The idea that I completed more than three years of education to receive a two-year degree weighed heavily on me; I was obsessed with getting a bachelor's degree just to have it. This obsession with obtaining a bachelor's degree coincided with my growing disillusionment of the insecurity inherent in private practice clinical hygiene. We've all been there: being asked to compromise ethical standards, being promised bonuses that never materialized, receiving a pink slip within weeks of being vested in the retirement program, being subject to whimsical (or empty) schedules such as cancelling days at the last minute, facing interpersonal conflicts with key people (e.g., the wife/office manager, jealous assistants, etc.). I was beginning not only to feel the desire of getting the bachelor's degree; I was beginning to see the necessity. Corporate positions, teaching positions, administrative positions, or anything else that seemed like a natural transition required a minimum of a bachelor's with a master's being more competitive. The dental hygienists I saw involved in politics all had bachelor's or master's degrees. While my associate's degree served my original purpose of private practice clinical dental hygiene, it left me with nowhere else to turn.

Finding a degree that seemed like a logical extension to dental hygiene was trickier than I had imagined. Whether it was nursing, nutrition, biology, business, or political science, none would acknowledge nor award credit for the "vocational" units. After much research, I found a very expensive, private, accredited degree completion program that counted the vocational dental hygiene credits as well as professional experience toward a bachelor's in health arts. Although it was pricey, I felt I could not afford to pass it up. Besides, it was structured specifically for working professionals so I was able to keep my day job and take the courses at night. At the time I wanted nothing more from a bachelor's degree than a stepping-stone out of clinical practice. I hadn't yet found the specific path or end goal.

Then my life changed. I took an elective literature class and fell in love with the idea of writing. I dabbled with literary devices, the language of feminism, and the discourse of philosophy and politics. I was especially drawn to the use of language and the way language and writing impacted people -- both as a reflection of the writer and the message heard by the reader. I was involved in local and state dental hygiene politics, which involved a specific type of discourse. I was also fortunate to have landed the "Perspective" column in RDH, where I was able to fuse my very unusual combination of passions of writing and dental hygiene. Hence, it was the perfect storm that clarified my path: the literature class, my political involvement, and writing the column.

Once I completed my bachelor's in health arts, I knew I would not stop there. At this intersection of composition and dental hygiene, I was excited at the possibility of exploring how writing could empower dental hygienists and also how composition and rhetoric could better address the needs of future health-care professionals. This lofty goal would require graduate work.

Unbeknownst to me, I couldn't just waltz into a university and start taking graduate courses; I would need to get letters of recommendation and be accepted into a program. I would also need to do some PR work to convince the chair of the department that a dental hygienist with virtually no undergraduate coursework in English should be admitted to the English department master's and doctoral programs. Finally, I would have to form a committee of tenured professors comprised of folks in the English Department as well as a nurse who was an anthropology professor and a dental hygienist who was a professor in public health. The committee would design my course of study, guide my thesis/dissertation, and finally administer the comprehensive oral exam covering all my graduate coursework and proposed research. Once my research was completed and had gone through numerous rounds or revision and rewriting, they would administer the defense where they would poke holes in my master's thesis and doctoral dissertation until they were satisfied that my original research was worthy of entrance into academia.

As a side note, I found zero pushback from the English Department about my proposed research. They saw and supported my vision 100% from day one. The biggest pushback was, and continues to this day, from the dental hygiene community, which struggles to see the connection. It is my goal to show the community how inextricably linked composition and dental hygiene are.

Armed with my brand new PhD, I accepted a teaching position in the writing program at the University of California Santa Barbara, where I taught senior level writing to students entering health-care fields (mostly premed and predental). This was a perfect fit for my background.

I also taught research writing, magazine writing, and writing for science and engineering majors. It was an amazing appointment in a beautiful campus. However, my temporary, nontenure track contract ran out, and I was offered a tenure track back at my dental hygiene alma mater.

I jumped at the opportunity to work with my mentors and had high hopes of empowering associate degree hygienists through the vehicle of composition, infusing more of an attitude of autonomy and independence. It has often been argued that making the step from vocational to professional status, then from professional to academic status all involves writing and research. It was an honor to reenter dental hygiene after my hiatus. I was able to become colleagues with my former mentors, teach courses I never dreamed I would ever teach, work with some remarkable students, obtain tenure, and also serve as interim director and an ADA accreditation team consultant. In spite of these amazing opportunities, I could not avoid the lure of teaching composition.

While I was sad to leave my alma mater, I happily transferred back to teaching writing, where I remain today, teaching and designing writing courses, including technical writing for career technology students.

Teaching writing is a better fit and much more comfortable for me. I am still able to combine the two fields of composition and dental hygiene. Having the dental hygiene background lends me credibility and familiarity with workplace writing, discourse and genres as I design writing courses for future health-care professionals and students in the business and career technology divisions.

Having no desire to reenter clinical dental hygiene or teach dental hygiene, after 27 years of licensure, 20+ years in private practice, and five years' teaching dental hygiene, I made a decision last year to let my license expire. I feel extremely fortunate that I was able to make this decision voluntarily. I never suffered from a disabling injury like so many of my colleagues. I also feel fortunate that I am still asked to contribute articles and consult on nonclinical issues within dental hygiene.

While I am a huge advocate of keeping one's options open, it was a very personal decision for me to see myself as a true, bona fide composition instructor rather than a dental hygienist piddling and playing at composition even though I had my doctorate. As long as I had the safety net of the license, it served as a crutch. I would not recommend that everyone who leaves clinical practice let his or her license lapse, and in many roles, such as teaching, people need to maintain their license. But for me it was the right decision.

As a side note, I have spoken to dental hygienists who chose not to renew their licenses, and when they found the need to reactivate, the procedure was not difficult for them.

The take-away message here is to get your bachelor's degree as a foundation. Next, explore your interests, and do what you love. As the saying goes, if you love what you do, you will never have to work another day for the rest of your life.

Heidi Emmerling Muñoz, PhD, is a professor of English at Cosumnes River College. Prior to her current position, Dr. Muñoz was interim director and professor of dental hygiene at Sacramento City College. She has written numerous articles and columns and is a frequent contributor to RDH. Dr. Muñoz can be reached at [email protected].

Shifting to another career

Knowing where you stand financially and educationally, you are in a position to make your shift. Here are some very general guidelines for common nonclinical opportunities:

• Writing, speaking, and presenting -- Although fun and creative outlets, these activities are best viewed as supplemental activities/income if you want to speak or write about something within dental hygiene. I am pretty widely published in the field and would still not count on these as covering more than a few pairs of cool shoes and handbags, let alone my food and housing needs. I don't know any dental hygienist who does this full-time or is able to be self-supporting on this alone. Some view these activities as steppingstones to more lucrative projects such as freelance consulting or corporate visibility (either by the corporation you are working with to sell products to clinicians, or a corporate rep in the audience recognizing you as a potential employee or spokesperson).

To get speaking and writing gigs, you need to have some content knowledge in a specific area of dental hygiene (or curiosity and the ability to conduct research), communication skills, and the ability to network. Having specialized experience or certification in the content you hope to write or speak about lends you credibility and gives you an edge. For example, someone who has not administered local anesthesia would have a hard time convincing readers or audience members that he or she knows the best technique for doing a mandibular block. It goes without saying that speakers need to have good public speaking skills and the ability to prepare visual slides. Writers need to have discipline to get the article done in a timely manner, an organizational and stylistic flair, and, of course, good grammar. Consider Toastmasters or college courses in public speaking, writing, computer applications, and perhaps basic business skills to draw up contracts. Degrees in English, journalism, or communication are not necessary but the skills are essential.

• Education -- The rule of thumb for teaching is to possess at least one degree above what the institution awards. Thus, if you want to teach a didactic class at a community college, you should have a minimum of a bachelor's degree. If you want to teach at a university, you need a master's. Teaching is getting relatively competitive, so if you are hoping to teach even at the community college level, you should consider having at least a master's degree. Being an adjunct clinical instructor at a community college is less rigorous. Where I taught, one could be a clinical faculty member if one either had a bachelor's or three to five years' clinical experience. Obviously active licensure is a must. If you aspire to be a director, a dean, or a vice president, a master's degree is the minimum with a doctorate preferred. Most folks who teach have their bachelor's degrees in a science-related field (biology, nutrition, chemistry), master's degrees in education or community health, or doctorate in education or educational leadership; however, it is not essential. My degree is in English, but I showed the relationship to dental hygiene because my doctoral dissertation explored how writing impacted the success of dental hygienists.
• Corporate positions -- Different companies have different requirements, but all of those that I am familiar with have minimum requirements of a bachelor's degree, the ability to travel (to offices, trade shows, schools), and good writing and speaking/presenting skills. Business skills would be desirable if the position requires sales. Network with your sales rep and go to the trade shows armed with business cards and resumes to drop off at booths. Attend wearing nice business attire as opposed to uniforms or sweats.
• Change agents -- Some dental hygienists are passionate about patient advocacy or politics. To work for the state or the county, a minimum of a bachelor's degree in dental hygiene or a related field is required. Other desirable degrees to consider might be public health, community health, political science, or prelaw. Dental hygienists have become clinic directors, health-care administrators, and even elected politicians to effect change.
• Other -- In addition to the above, dental hygienists have ventured in diverse categories with a wide range of formal training, time, and financial commitment. Hygienists have become:
• Independent orofacial myologists (28 hours of training and approximately $2,300 cost)
• Estheticians (1,400 to 1,600 hours and $2,500 to $9,000 cost for full cosmetology)
• Dieticians (generally a master's degree)
• Speech therapists (master's degree)
• Nurses (two-year, four-year, and master's programs and $20,000 to $80,000 cost depending on in-state or out-of-state tuition, number of program years, and if it is public or private college)
• Dentists (three to four years post hygiene and approximately $400,000 cost)
• Attorneys (four years and approximately $100,000 cost)
• Physical therapists (master's level, $15,000 to $42,000 cost)
• Personal trainers (200 to 1,200 hours or three to 10 months and $49 to $7,000 cost)
• Chefs (three to four years and $2,000 to $36,000 cost)
• Yoga instructors (certification)
• Homeopathic practitioners (certification)
• Models, artists, novelists, publishers, editors (may require a journalism degree in some instances), consultants, motivational speakers, and organizers

Still others have gone the direct sales route (Tupperware, Mary Kay, Avon, BeautiControl, Scentsy, etc.) and made decent careers from this. The start-up cost and training are minimal (usually less than $500 for a beginning inventory kit and no real training required), but it takes a lot of persistence and a relatively large network combined with natural social skills to book parties, recruit others, and follow up with clients if you are serious about making this a full-time business with a full-time income. I continue to do Tupperware and BeautiControl on a very small scale since I am my own best client.

This list is by no means comprehensive. Once you have identified your passion, research the steps you must take. Some of your skills and coursework may be transferrable, while other positions will require special education or certification.

Seek the degree and the passion

Just as I am not recommending dental hygienists abandon their licenses, I recognize not everyone shares my passion for writing or getting a PhD in English. While I took the road less traveled, there are more frequently traveled paths dental hygienists have taken out of clinical practice. The first step is to get a bachelor's. Truly, any bachelor's works. There are more and more degree completion programs, including online programs, that make it very easy to work while completing a bachelor's degree. Also, more associate programs have articulation agreements with universities than ever before. Research the universities near you, have your transcripts sent to a campus counselor, and see how many courses you would need to complete your bachelor's degree. The bachelor's is your key to unlocking virtually any nonclinical position.

The second step is to find your passion. If you want out of clinical dental hygiene, where do you want to go? Why do you want out? If you are not injured, perhaps you want a different type of clinical position. If you already know where you want to go, you are ahead of the game. I didn't know until I was in the throes of completing my bachelor's. Shirley Gutkowski and I coauthored The Purple Guide: Paper Persona Workbook (http://www.rdhpurpleguide.com, $65) which I highly recommend in helping you discover what makes you tick, where your strengths lie, specific action plans to reach your goal, and guides to producing the written documents (resume, CV, portfolio, letters, website, social media presence, business cards, etc.) needed to network and apply to your specific jobs or programs. The workbook is a companion to the main book (Paper Persona, $45 or $99 for the two books together). The workbook also serves as a place to keep all of your information in hard copy form.

Another helpful activity for some dental hygienists is attending CareerFusion (https://careerfusion.net/). It is four-plus-day (22 CEU) retreat aimed specifically at dental hygienists who want to expand their horizons. The first-time cost is $2,150, and for every year thereafter the cost is progressively less. Dental hygienists who either want to supplement their clinical career with some part-time freelance writing and presenting gigs, or make the transition to a full-time corporate position have attended this workshop. I attended several years ago and found the mentoring and networking valuable, not to mention fun.

Once you discover where you want to go, the next step is to do your research and find the requirements and certifications or experience you need to acquire to get to your destination. Do you need to take a public speaking class? (Toastmasters is practically free.) Perhaps a writing class? Join a local writers' group? A PowerPoint or Prezi class?

If you sustained an injury, termination, or other situation where you need to exit immediately, you will need to do your legal and financial homework. You need to decide if it is a good idea to continue in clinical practice just a little longer to squirrel away some money, or if it would make the situation worse. Investigate if you have a case for wrongful termination, unemployment, or a workers' compensation award. Research any grant and loan opportunities. Is there a side job you can do to supplement your finances through your transition?