Roadblocks or Freedom? Using Boundaries in the Dental Office and Life

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The word boundary is often misused or misunderstood. Many of my counseling clients believe that a boundary means being harsh, aggressive, or saying “no” at every turn. Often, they think that they will ruin or lose relationships if they suddenly request a different behavior or way of being from a person.

Dental hygienists, for example, struggle with a boundary governing time management in their jobs. Enabling dental hygienists to establish an effective boundary with their time is discussed below.

It is sometimes true that the implementation of a boundary can end a relationship. It is always true that a new boundary will change a relationship. Both of these outcomes can be positive.

I spent years not realizing that I had poor boundaries ‒ mainly because I did not understand what they were. I did not know that saying “yes” to everything even when I did not want to was a poor boundary. I thought I was being selfless. I did not know keeping my feelings to myself when someone hurt me was a poor boundary. I did not recognize how to be assertive and speak the truth to repair or end a relationship. Instead, I stewed in resentful silence, which taught the person it was okay to treat me as such.

Aggression vs. Assertiveness

Before we take a deep dive into boundaries, it is important to understand the difference between aggressiveness and assertiveness. Aggressiveness is being demanding, loud, threatening, and angry. Assertiveness is being purposeful, insistent, conciliatory, confident, and respectful.1

Assertive behavior is needed when deciding to enforce a new boundary. An aggressive person might say, “I am tired of you never sterilizing your instruments. You make my life miserable.” On the other hand, an assertive person could say, “When you do not sterilize your instruments, I must do it. It puts me behind. I need us to work together to get all the instruments finished.”

Assertive people say what they want and need without intentionally hurting someone else’s feelings. This can create clear expectations and reduce conflict.

Loose, Rigid, and Healthy Boundaries 

Boundaries are expectations that are intended to keep you safe in relationships. Healthy boundaries help people stay in their own lane and know what behaviors are anticipated to maintain well-being in the relationship.

Two types of unhealthy boundaries are loose and rigid. When someone has loose boundaries, they may say “yes” when they want to say “no.” This leads to resentment. They may over-share information that leaves the other person feeling uncomfortable or themselves feeling vulnerable.2 People with loose boundaries often feel taken advantage of, which breeds further bitterness. They believe that they are selfless and accommodating when, in fact, they are causing themselves mental anguish and passively damaging the core of relationships.

Rigid boundaries occur when someone holds things too close to the vest, putting walls up during attempts for a connection. The boundary instigator may think they are simply protecting themselves, but it leads to isolation because others will eventually stop trying to connect.2

Six Types of Boundaries

Most of us face six types of boundaries, either personally or professionally. They include physical, emotional, sexual, time, financial, and intellectual. Healthy boundaries have many grey areas and require self-awareness and intentional execution.

Physical boundaries include your personal space such as touching, physical space, and individual needs such as sleep and hunger. When that flirty patient moves in too close for a hug after every appointment, an assertive and healthy physical boundary is, “I am not a hug person, but I like to shake hands.” When your office manager schedules you back-to-back patients all day with no break, a healthy boundary might look like, “I need to eat. I am going to take a 15-minute break every day at 12:30. Be sure that is worked into my schedule.”3

Emotional boundaries involve being uncomfortable sharing feelings or oversharing emotions or personal information and disrespecting or using others’ emotions against them. These boundaries are about respecting feelings.3 Examples of emotional borders are:

  • Not oversharing with coworkers in which you do not have a close friendship.
  • Reserve personal issues for a few trusted confidants.
  • When needing to vent, ask your coworker when a good time for them is to listen.
  • When a friend comes to you with a problem, ask, “Would you like advice or for me just to listen?”
  • “When I have shared personal information with you in the past, I felt criticized. I am willing to share if you will respect my feelings as my own and not take them personally.”
  • “I want to be available to give you 100% of my attention. I am not able to do that now. Can we speak later today after work?”

When we start setting emotional boundaries, it creates a safe place for both parties.

Healthy sexual boundaries include:

  • Consent
  • Agreeing to preferences and what feels safe
  • Privacy about the sexual relationship

Unhealthy sexual boundaries are assault, jokes, unwanted innuendos, and touching. None of these are appropriate in the workplace. Setting sexual boundaries can feel very uncomfortable if you are not accustomed to speaking openly about sex.

In an adult consensual relationship, healthy sexual boundaries are asking for consent, letting your partner know what you desire, and feeling safe to say no or not tonight. When unhealthy violations occur, a person may sulk or pout when not getting what they want, lie about past sexual health issues or contraception, criticize their partner about their preferences or fantasies, and tell others about the intimate details of our private experiences.3

When someone pushes sexual limitations in the workplace, it is essential to always speak up. This may sound like:

  • “I do not want a sexual relationship with you.”
  • “Stop making sexual jokes. It is inappropriate and not well-received.”
  • “Stop touching me like that.”

If you have set these parameters with the person committing the offense and they do not stop, it needs to be reported to the proper chain of command. We should all feel safe in our workplace and not hesitate to speak out against sexual harassment or abuse.

Time boundaries have been my biggest struggle. Time is a precious resource in today’s society. As working adults, we are pulled in many different directions with people demanding our time. It is important to protect time for self-care, personal business, and achieving your work and personal goals.

As a dental speaker, I used to find that I would get weekly requests from people asking me to speak for free. At first, I would accept because I wanted the experience. As this continued, I implemented a new boundary: I tell the requesting person my speaking fee (if they do not request it) before the end of the first conversation. This has eliminated any confusion and significantly reduced the number of people that make this request. Now, I have one or two give-back projects a year that bring me joy. I no longer feel taken advantage of because I have set a healthy boundary.

Many dental hygienists struggle with time boundaries in the dental office when offices request unreasonable tasks. A few ways to set time boundaries are:

  • “I am paid from 9-5; I will not be staying later unless I am compensated.”
  • “I do not do 30-minute hygiene visits. It leads to poor patient care. I need 45 to 60 minutes if you would like for me to continue to work here.”
  • “If you are going to require me to clock out when I do not have a patient, I will not stay and stock operatories. I will leave the office during that time to take care of my own business.”

These bold statements can seem intimidating to a boss, but these boundaries must be set if we wish to take back control of our profession.

Financial or material boundaries concern your belongings and money. Loaning people money or items that do not get returned in their proper condition is a serious boundary violation and relationship killer. Before lending anything to anyone, consider their history. If someone has a mile-long track record of not paying back money or returning items such as clothing or books, perhaps it is time to kick that person off your gravy train. Consider language such as, “I want this returned in the same condition,” “last time I loaned you money, you did not pay me back. I am no longer available for loans.”3

Intellectual boundaries refer to having the right to your thoughts and opinions without being criticized or belittled. As part of this boundary, it is our responsibility to be mindful of when and where to express certain opinions and thoughts appropriately. Intellectual boundaries are often violated by parents in divorced relationships when bad-mouthing or revealing secrets of the other parent to the children.3 This causes ongoing harm to the children as they should not be privy to adult affairs.

A friend recently told me about an incident where another friend called her inappropriate names after a heated discussion about politics. Not giving someone freedom to their opinion and resorting to personal attacks and name-calling is intellectual boundary warfare and, unfortunately, ended that relationship. Some ways to maintain intellectual boundaries are:

  • “I will no longer discuss this topic with you if you continue to call me names.”
  • “I noticed that you blew me off when I said that. Can you help me understand why?”
  • “We disagree on this topic. If you cannot respectfully listen to my perspective, this conversation is over.”

As you can see, boundaries are a two-way street. Each person has a responsibility not to bulldoze others’ limits and set appropriate and meaningful ones for themselves. A critical factor that must be carried out with every boundary I have mentioned is that you must follow through with the consequence. You are a sitting target for ongoing drama and heartache if you do not.

For example, if I tell someone that this conversation is over, I must walk away. If I state that I will quit this job if conditions do not change, I better be ready to walk out the door when the boundary is, once again, trampled. If I do not uphold my intended consequence, the boundary violator wins and continues to push my buttons. The responsibility then lies in my hands.

Upholding boundaries can be a difficult task at first, making you feel harsh and uncomfortable. When you first set a new boundary with someone, they will push back. People tend to want to maintain their abuse or inappropriateness because we have allowed it for so long. To them, their boundary is okay for the relationship. If you stick to your guns, carry out the consequence, and stand confident in your decision, the person will eventually modify their behavior or exit the relationship ‒ both of which are positive outcomes. Stand strong and happy boundary setting, friends.

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  1. Neumann, F. (2014). Assertiveness vs. Aggressiveness. Psychology Today.
  2. Moore, M. (2022, August 29). How to Mend Porous Boundaries Today. PsychCentral. 
  3. Tawwab, N.G. (2021). Set boundaries, Find Peace: A Guide to Reclaiming Yourself. TarcherPerigee.
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Kandice Swarthout, RDH, LPC
Kandice Swarthout, RDH, LPC, is a Licensed Professional Counselor and Registered Dental Hygienist. She is a full-time dental hygiene educator in Texas, where she teaches community dentistry and research. Kandice is the owner of Inspired Education & Wellness, where she is a speaker, writer, and private practice therapist. Her unique blend of clinical expertise in both dental hygiene and mental health equips her to assist fellow healthcare professionals in recognizing not only their patients’ needs but also their own, fostering deeper connections with the healthcare community. Kandice’s dedication extends to her role as an approved provider for Texas Health and Human Services, specializing in human trafficking training for healthcare providers. Additionally, Kandice brings a touch of fun and camaraderie to the dental community as the co-owner of Muffins & Mimosas Dental Study Club. She offers engaging, in-person dental continuing education that creates a warm and welcoming environment for friends and colleagues to come together to learn. Read her articles in Today’s RDH column, Mental Health Spotlight. Contact Kandice through her website at or on social media @The Counselor Hygienist.