I have dedicated my life to public health for two years in an effort to simultaneously save the world and achieve financial homeostasis. The beautiful thing about public health is that I have the most appreciative patients. My patients have been waiting sometimes their entire lives to receive the treatment I offer. The sad truth about being a public health dental hygienist is that you are often overworked and underpaid. In private practice a hygienist that is working without an assistant normally sees about 8-9 patients in an 7-8 hour day. At my office the goal is 15 patients in 9 clinical hours. I have seen 19 patients in a workday before. A part of me wanted to slit my wrists with a 4r4l scaler and die but the philanthropic part of me left feeling accomplished! A small stupid voice inside me said, “You did it girl, now no texting tonight just put those hands in ice!”. Only clinicians will understand that your body hurts after providing a truly selfless service. And only hygienists and the laborers that scrape barnacles from the bottom of boats will understand how hard calculus is to remove from a tooth. 

When I imagine dental public health I imagine a very large ship out on the rough seas. The ship’s captain is floating above in a pope mobile like hovercraft with a mimosa. The patients are all huddled on the main deck clutching their entry tickets like a lifeline. And below in the belly of the ship are the workers. We are rowing this massive ship with tiny oars towards an island where everyone can get the healthcare they need when they need it. 


 We believe that if we keep rowing we will eventually be relieved and more people will come to help the patients on the main deck. Another thought is that maybe the captain in his hovercraft will say, “you know this is really too much, maybe I should turn on the ship’s engine, the workers need a break.”
I love what I do and even where I do it. I dry my tears at the end of the hard days with the good experiences I have with patients daily. But is it really supposed to be this hard? What can we do to help more people get access to dental care? How can we entice more providers to choose public health as a specialty?
Washington, DC is the Mecca of social services. Some of my patients have only been in the country for a few months and head straight to my chair after registering for school and their health benefits. This is ideal in theory correct? The problem is that there are simple not enough dental providers available to accommodate the need. 

According to the American DentalEducation Association (ADEA), the average debt per graduating senior is $247,227. When students graduate from dental and dental hygiene programs they are faced with the predicament of eliminating debt while entering one of the the most expensive career fields. 

The cost to provide dental care is so high that there are only 50 dental schools in the country and over 200 medical schools. The shortage of dental professionals has been severe for the last 20 years. The few that are produced from dental programs, sans nest egg, have some major decisions to make. 
 A dental hygienist can work at a federally qualified health center and be granted up to 50,000 dollars towards educational loans in exchange for two years of servitude. They actually direct deposit 50,000 U.S. Dollars to your bank account. My check went directly to Mrs. Sallie Mae and changed my life. I think most people can row a giant ship on the rough seas for two years if they are blessed with this opportunity. The other option upon graduation is to work at a private practice for 45 dollars an hour or more and see 8 patients a day. This second option is extremely attractive for a new clinician that is transferring from the four hour appointments we have in school to the 40-60 minute appointments in private practices. In public health offices, appointments are some times as little as 20 minutes. At my clinic we have a 3 patients per an hour goal which is unthinkable to my private practice colleagues and would probably make my former teachers gasp and faint. 

I chose to row the oars and I believe it was the best decision for me. I am blessed with a modern facility with new instruments and equipment. Not only have I benefited financially but the experience that I have gained as a clinician is priceless. I hope that in the future we can fix the many issues that are crippling the public health system in an effort to attract more providers. The current public health environment is not one where I can see myself long term due to the patient volume. I imagine my fingers curling up into ramen noodle like swirls every time I complete a debridement. There is no amount of ergonomics that can make the work that I do seamless. However, the work has to be done and the people have to be cared for so I continue to row.