Dr. Esther Wilkins and a Century of Change

Dr. Esther Wilkins
Dr. Esther Wilkins / © Yoon S. Byun

Dr. Esther Wilkins

In December 2016, the world of dentistry lost a remarkable and groundbreaking woman, just three days after her 100th birthday. Esther Wilkins, the “matriarch of dental hygiene” was first licensed as a hygienist in 1939, and presided over decades of revolutionary changes in oral health and dental practice.

Esther Wilkins’ long career in the field spanned sweeping changes such as:

The evolving role of women. When Wilkins became a dentist in 1949, less than 2% of practitioners were women. Today, nearly 30% of working dentists are women.

The evolving role of hygienists. Originally conceived in 1913 as a role for women to educate children on appropriate oral hygiene techniques, the first dental hygienist was licensed in 1917, and the first male hygienist was licensed in 1965. Today, there are over 200,000 active hygienists in the United States, and they have become essential to all aspects of patient and preventive care in dental health, as well as key staff members of nearly every dental practice.

Changing society and changing dental practices. Nearly every aspect of dentistry has changed in the past 70 years, with some notable highlights:

  • In 1950, the first fluoride toothpaste was introduced to consumers.
  • In 1957, the first high-speed air-driven contra-angle handpiece was invented, greatly increasing the speed of dental services.
  • In 1958, the first fully-reclining dental chair was introduced.
  • In 1960, the first electric toothbrush was developed in Switzerland and marketed to US consumers.
  • Also in 1960, lasers are first approved for soft tissue use in periodontal disease.
  • In 1971, hygienists are allowed to wear pants at work.
  • In 1989, the first at-home teeth bleaching kit is introduced to consumers.

Recent decades have seen sweeping technological innovations transform every aspect of oral health and patient care, including research with advanced nano-materials, advances in imaging and diagnostics, refined use of lasers and composite materials, and ever-more refined tools and techniques for improving patient comfort and compliance. The world of dental care and hygiene has been completely transformed in the past 70 years.

Dr. Esther Wilkins Biography

Throughout all these changes, Esther Wilkins remained a tireless educator and advocate.

  • In 1938, while studying science at Boston’s Simmons College, she attended a lecture on public health careers. The lecture so inspired her that she walked over to the children’s dental clinic at the nearby Forsyth School, and decided to become a dental hygienist.
  • In 1939, having received her certificate in dental hygiene, she began working with dentist and soon-to-be mentor Frank Willis, in Manchester-by-the-Sea, Massachusetts. After several years, she decided to return to school and become a dentist.
  • In 1948, she was accepted to the Tufts University dentistry program, but the dean persuaded her to wait another year when there would be at least one other woman in the program. She attended the program the following year, with two other women in her class.
  • In 1950, she accepted a position at the University of Washington, founding their dental hygiene program. She found that the existing textbooks and materials were outdated and insufficient, and began writing and mimeographing her classroom materials for her students.
  • In 1959, a textbook seller visited her office and, seeing all her mimeographs, suggested that she write a textbook of her own.
  • In 1960, the first edition of her fundamental textbook, Clinical Practice of the Dental Hygienist, was published. Updating and revising this book was to become her life’s work.
  • In 1966, she returned to Tufts University to earn an Advanced Periodontal Certification and became a professor at Tufts University School of Dentistry
  • In 2011, she was made Professor Emeritus at Tufts University School of Dentistry.
  • In 2016, she passed away, just after her 100th birthday.

Dr. Esther Wilkins Legacy

Her decades as a teacher and educator influenced every aspect of modern dental care. By both maintaining Clinical Practice of the Dental Hygienist textbook throughout 12 editions and teaching dentistry for 45 years, her care, standards, and professionalism influenced hundreds of thousands of active practitioners today.

Clinical Practice of the Dental Hygienist remains the cornerstone text in nearly every dental hygienist program in the United States and has grown in popularity worldwide. Every edition had a new color on the cover, and many hygienists identify themselves with the color of their particular copy. This comprehensive textbook covers all aspects of dental hygiene, from radiologic diagnosis and techniques to treat patients with special needs and medical/dental areas of concern. Wilkins also discusses risk assessments, dental ethics, and cultural issues, while teaching all practical aspects of the work of a hygienist. She considered the ongoing work on this book to be her full-time job and delayed her marriage due to the demands of working on it.

The Wilkins/Tufts Explorer was developed by Wilkins, who wanted a specialized tool to detect caries and explore pocket characteristics. This tool is in use in nearly every dental practice in the United States and worldwide, appreciated for its simplicity and effectiveness.

Esther Wilkins was an exceptional figure in American dentistry, and her impact and legacy are nearly immeasurable. During and after her lifetime, she received awards and recognition from Tufts University School of Dental Medicine, the Lucy Hobbs Project, the International College of Dentists, The American Dental Hygienists’ Association, and more. The City of Boston even declared December 9, 2006, as Esther Wilkins day. Thanks to her tireless efforts, not only has the work and training of a dental hygienist changed forever, but millions of Americans have healthier mouths and teeth because of Wilkins’ work. We all owe her gratitude and recognition.

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Kara Vavrosky, RDHEP
Kara Vavrosky, RDHEP, is a co-founder and the chief content officer of Today’s RDH, an independent educational publishing company for dental hygienists, encompassing articles, a podcast, virtual continuing education events, and self-study continuing education. Today’s RDH was launched in 2018 after Kara built her social media presence with her largest following on her Facebook page, Dental Hygiene with Kara RDH, which was created in 2013. An Oregon Institute of Technology graduate, Kara has a deep passion for spreading knowledge about the importance of oral health and its association with systemic health. Kara’s passion extends to helping other hygienists understand current protocols and evidence-based research – all with the goal of lifting dental hygienists and the dental hygiene profession. Kara was recognized in 2020 as one of the Top 100 Women in Media for her entrepreneurship as a co-founder of Today’s RDH. In 2022, she was recognized by the American Dental Hygienists’ Association for their Standout Seven Award in the Entrepreneur category. Kara lives in Vancouver, Washington, just outside Portland, Oregon, with her husband, Ben, and their four Chihuahuas. When she’s not working, Kara loves riding the Oregon Dunes on her quad, spoiling her Chihuahuas, and spending time with her close-knit family.