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Editorial: County needs a school to train dental hygienists

There’s a cavity to fill in Snohomish County. Too few hygienists are available to fill open jobs.

By The Herald Editorial Board

If you’ve had difficulty getting an appointment with the hygienist at your dentist’s office for your regular cleaning — and the gentle reminder about the benefits of daily flossing — there’s a reason for that: too many job openings and not enough trained hygienists.

It’s not that the job doesn’t pay well.

Dr. Stephen Lee, who has a general practice in Silver Lake that he bought from his father 20 years ago, has had difficulty in filling — not cavities — but job vacancies in his office for hygienists and dental assistants.

“I’ve had ads out offering $65 an hour, pick your days, and I’m not getting a lot of bites,” Lee said. It’s not just his office, Lee said. Of the four dental practices in his building complex, three have had prolonged vacancies for hygienist positions.

In Snohomish County, as throughout the state, positions are not being filled — as is also the case elsewhere in the health care field — and patient appointments are being pushed back.

The hiring of hygienists from temp agencies has helped, Lee said, but patients prefer regular hygienists who know their habits and can build a relationship with them.

A 2020 survey of about 400 dental offices across the state, organized by the Washington State Dental Association and Delta Dental, found that about half had openings and were having difficulty in attracting qualified applicants for hygienist and dental assistant openings, said Bracken Killpack, a spokesman for the state dental association. The survey found that for every trained hygienist, there were three to four openings, and those jobs were on average open for longer than four months; openings for dental assistants — which can pay from between $21 to $34 an hour, depending on experience — were open for longer than three months.

“We’re throwing all that we can on trying to create more slots and strengthen the pipeline and the pathway for career growth and opportunity in the dental workforce,” Killpack said.

And topping the wish list for dentists, the dental association — and the tooth fairy — would be a dental hygiene training program at a college in Snohomish County.

“We would love to see Snohomish County add a dental hygiene program. There is not a dental hygiene school in the county. For a county as large as it is with 800,000 people — and you can throw Skagit County in there too — there’s not enough capacity.”

The closest training programs available are in the Seattle area and in Bellingham; another program is getting its start in Port Angeles at Peninsula College, Killpack said, but that means that prospective students — in particular older adults looking for a new career — are left with a long commute to get the training they need close to home.

An added benefit of such a training program, Lee said, would be the affordable care that would be made available to lower-income patients with whom students would practice their training.

“You’ve got, say 25 chairs, serving four people a day; you’re going to have thousands of people who are served in an underserved community getting oral hygiene and oral services taken care of that otherwise wouldn’t have,” Lee said.

Such a program, Killpack admits, isn’t an easy ask of colleges. It’s one of the more expensive programs a community college or university can operate, because of the specialized equipment and a shortage of faculty, he said. But supporters are reaching out to the colleges in the county as well as the state Board of Community and Technical Colleges. The effort is hoping to meet soon with officials at Everett Community College, he said, but there’s also been ongoing talks with state lawmakers regarding support for such programs in Snohomish County and elsewhere in the state.

Along with seeking the start-up of a program in Snohomish County, the effort also is working with state lawmakers and others to reform the state’s licensing requirements for hygienists so it’s easier for dental hygienists moving from other states to take jobs in this state.

Currently, hygienists in Washington state are trained and licensed to do more than basic cleaning of teeth and below gums, Lee said. Although not all perform these tasks, they are licensed to administer anesthesia and nitrous oxide and can even fill cavities with amalgam after the dentist has drilled a cavity.

The hope, Killpack said, is to adjust the license requirements so that a basic license is available, with endorsements for other tasks that require more training. The association also is hoping to win consideration of a national compact with other states that would ease licensing requirements — in particular for the spouses of members of the military — for hygienists already licensed in other states.

Lawmakers are being asked to address needs for training and education across numerous career fields, including law enforcement, building trades and nursing, behavioral health and other health care jobs. Yet, dental health is key to overall physical health. And prevention, such as is available through regular dental hygiene, is as important as the work of dentists. Lawmakers should look closely at reforms that can take advantage of those already trained and recognized by other states as ready to fill those jobs.

As well, local and state community college officials and lawmakers should look to expand training opportunities across the state — particularly in Snohomish County with 833,000 residents and growing — that can improve residents’ dental health and fortify the community’s economic enamel at the same time.

“If I were a community college in Snohomish County,” Killpack said, “I would look at this as creating a pipeline for very strong living wage jobs with regular business hours that are conducive for families, especially for single moms, allowing families to create generational wealth.”

That could bring a smile to the faces of a lot of folks.

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