Question: How do you know when it’s time to leave an office? I feel like I do not believe in the dentistry we provide, and I struggle with my coworkers when they provide supervised neglect on patients who are clearly periodontal patients.
Answer: Let me start by saying I’m sorry you’re in this position. I’ve been there far too often in my career. It became the driving force for me to step into lecturing and create practical protocols for science-based information. I feel it’s my duty as a hygiene mentor to remind you that no office is perfect.
I suggest that you have a conversation with leadership expressing your concerns about the continuity of the office protocols. Before this conversation, be sure you’re aligned with the ADA standards of care and the AAP classifications. Use phrases such as, “I’m concerned … ” “With the office reputation in mind … ” and “The patient experience … ” to help reduce the blame game. We never want to speak negatively about our peers. Look for a continuing education program to attend as an office to calibrate the team to ensure the same philosophy of care.
Unfortunately, insurance can be a driver for the standards an office teams sets. We must be aware of insurance but not dictated by it. Having a team that supports the clinical evidence of periodontal disease by providing insurance companies with everything they need to confirm the diagnosis of periodontal disease is a critical component of treatment success. Additionally, insurance narratives, comprehensive notes, and AI can support insurance claims. Remember that whether the service is covered doesn’t change the level of disease present.
Once you’ve expressed your concerns to leadership about the lack of compliance with the AAP and the ADA recommendations of soft tissue management, then you must wait. Allow the office a grace period to hear your concerns and implement a change. Personally, I like to see action within 30 days, even if it’s simply signing up for CE. I also like to set a deadline for when I’ll begin to look for another position if the changes aren’t made.
Don’t stay in an office that makes you feel like you must compromise the care you provide or, frankly, compromise your license. I’ve been in multiple hygiene positions where the team was not aligned with how we treat periodontal disease. This created friction among providers and patients and negatively impacted the entire office.
My best advice is to follow your intuition. Perhaps you’ve been at this place for a long time and have had multiple conversations without resolution. This may be just one of the many factors of your position that have you questioning your future at this office.
If you decide to resign, do so with a minimum of a written two-week notice. I find that it’s best to keep the letter and notice vague to keep a respectful reputation in your community. A simple, “I have accepted a clinical position that is more aligned with how I want to advance in my career” is to the point and leaves out all your frustrations that won’t serve anyone.
Remember, there’s an office out there that will love your attention to detail, respect your clinical knowledge, and be excited to treat periodontal disease in its earliest stages. By leaving the “good enough” office, you can move on a position that aligns with how you practice!
Editor's note: This article appeared in the March 2025 print edition of RDH magazine. Dental hygienists in North America are eligible for a complimentary print subscription. Sign up here.
