Tips to Avoid Working in Fast Food Dentistry aka Prophy Mills

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I remember the feeling of relief like it was just yesterday. I had jumped for joy after passing to officially become a registered dental hygienist! I was unstoppable, and I felt that I was finally about to have my life together.

That summer, I had multiple interviews lined up since most employers were asking for one to two days of coverage a week. My very first interview was offered by a doctor who practiced in Brooklyn, N.Y. I recall the rush of emotions and excitement of possibly finding my dream office to match my dream job.

At the time, I stood out from the rest of the recent graduates because, on top of experience working as a dental assistant in Manhattan, I had also worked as a dental hygiene student at a general office providing prophylaxis and exposing x-rays. The Jewish Foundation of Education for Women scholars program supported this externship.

That Gut Feeling

You know that gut feeling that emerges with realizing this is not the dream office, but it is too late to turn back? I sensed that from the moment I exchanged a few words with the front desk to the last thoughts spoken by the dentist.

We sat down in his shoebox of an office, and he skimmed my resume and said, “So, you just graduated?” Yes, correct; however, I am not new to the day-to-day expectations due to my externship as well as experience as a dental assistant.

He went to ask what my desired rate is, which I recall I had discussed over email for $40 an hour. He laughed and responded, “I don’t even know how you work, and you’re a new graduate. This is your first job, so I can offer you $30.”

I did not know how to respond, but I looked at him in shock that he was unable to ask the right questions and get to know me as an individual. I began to question myself: Am I not capable? Am I asking for too much? He said no one would offer $40 and started to plan days for me to work. I interrupted to ask about the schedule and expected routines. I told him I would have to think about it and left the office.

Jobs Smell Like Fast Food

I was completely baffled at how quickly I was judged based on the fact that I was a recent graduate, not to mention that the rate of pay was unacceptable. The hygiene schedule consisted of 30-minute prophylaxis, no assistant for x-rays, and 45 minutes for full mouth SRP. In addition, the office was still handwriting notes into paper charts! Later that day, I emailed him and informed him that I would not be taking the offer. As I expected, he countered with an offer to pay me more. Two years later, this employer is still searching for a hygienist!

Unfortunately, this was not the only office who tried to take advantage and expect fast yet efficient dental care for their patients. I have been practicing for two years, and there were numerous times I just wanted to give up. The majority of the offices in the New York City area are running “prophy mills” and serving what I like to call “fast food dentistry.” These employers could care less about how physically and mentally damaging it is for us, not to mention the poor patient care which would be rendered.

In the city, you eventually start to see a pattern of what standard care means outside of what we were taught. It comes down to production, and our worth is measured by dollar amounts. I believed my lowest offer was $25 an hour because the assistant would be taking x-rays. This employer even wanted me to do a working interview with no compensation.

A Familiar Bumpy Road

It has been a bumpy road for me, and the only factor that has kept me from leaving the field entirely is the passion I feel when I know I am making a difference. I love connecting, educating, and communicating with my patients. What I am not so fond of is the neck and back pain that went from physical to mental very quickly. I remember looking at my 9-7 schedule with no breaks, 30 minutes often double-booked, and thinking, “How can I do this?” I went from trying to adapt to eventually walking into work angry and burned out.

I decided enough of this pattern. I made the decision to pursue my bachelor’s in health service administration with the hope of having more opportunities beyond the clinical setting. I realized that I was just trying to run away from my problems instead of facing them. The truth is I am still trying to find the path that is the best fit for me. What matters is that I have not given up, and I am open to asking for help, talking to my colleagues, mentors, and family.

A Message for My Recent NYC Graduates

I know there are others out there like me who love what they do but are being overworked and underappreciated. If I could go back and handle things differently, I would probably start off temping before committing to an office. As nerve-racking as it is in the beginning, you get to feel out your day-to-day routine, staff, and the overall culture of the office. Temping also helps you decide whether you want to be a part of a specialty or not.

Do your research on the office and ask necessary questions during the interview, such as “May I see the hygiene schedule?” It is also important to ask what you will have to do within the time allotted. Ask about the instruments, and do not be afraid to ask for a tour. You will thank me later, trust me.

Always be confident in your abilities and accept that you will not always know everything. My first year, I had to learn how to use an intraoral scanner and how to incorporate laser into SRP treatment. Continually update your resume not only with the office info but with every new skill you learn.

Ask about commission or bonuses for any additional services that are required for you to provide. Some offices will compensate with commission or bonuses. This can range from whitening, aligners, oral appliances for sleep apnea, laser, or additional products you upsell.

We earned our license and degree with blood, sweat, and tears! We are not just a profession that just cleans teeth. Do not be afraid to counteroffer and claim what you can bring to the table. Employers can be intimidating, but if you value yourself, the right office will appreciate what you can bring to the table.

Now Listen to the Today’s RDH Dental Hygiene Podcast Below: