Inside Dental Hygiene
June 2013
Volume 34, Issue 4

She Wrote the Book on Dental Hygiene

Esther M. Wilkins, BS, RDH, DMD: Dental hygiene’s grande dame

A tireless worker for the profession, at 96, Esther M. Wilkins, BS, RDH, DMD, is still a force for change and a testament to a life well lived. A Simmons College graduate, who became first a dental hygienist, then a general dentist, and ultimately a periodontist, she literally wrote the book on dental hygiene. Her Clinical Practice of the Dental Hygienist is considered to be the Bible for dental hygiene students, and is now in its 11th printing. She even has a dental instrument—the Wilkins/Tufts Explorer—named after her.

Wilkins credits many with contributing to her professional achievements, including her older sister Ruthie, who was her earliest mentor, and her first employer, Frank Willis, who modeled the promise of preventive dentistry. She learned about the dental hygiene career from an elective course on public health at Simmons.

“When I was graduating from Simmons College, I was not completely happy about the opportunities that my science degree offered, and became interested in dental hygiene, so I was next a student at The Forsyth School for Dental Hygienists in Boston,” Wilkins tells Inside Dentistry.

Wilkins first began to appreciate the impact preventive dentistry could have on lifelong oral health during her many years of practicing as a dental hygienist. She and Willis would walk to the local middle school four mornings a week to provide dental care for all the school children in a two-chair clinic in the school’s attic.

“I was very happy when I was in dental hygiene practice after Forsyth: I loved the service I could give my patients, and I loved the community where I practiced. Part of my work was in the community dental clinic for the students in grades 1 to 8,” she says. “I was employed by a dentist who believed the prevention aspects are so very important. Somewhere along the line after several years, I felt a need to know more, and so I applied to dental school.”

Wilkins was one of three women in her entering class at Tufts Dental School in 1948. Then, after completing dental school in 1949 and an internship at the Eastman Dental Dispensary in Rochester, NY, the following year, the newly minted dentist chose not to practice dentistry but to instead to become the first director of dental hygiene at the University of Washington School of Dentistry in Seattle.

That first class contained eight students, and, as director of the program she ran for more than 10 years, she developed the curriculum and taught a majority of the classes during the early years.

According to several accounts, the genesis of the first edition of her book was an accumulation of mimeographed handouts she wrote and distributed to her students.

“Practically all potential textbooks were much too simple or old for our school. So with my faculty, we made a handbook of the various topics needed for our students,” Wilkins says. “After several years, it turned out to be a big thick manual in a metal clasped folder. We never did approach a publishing company, and I don’t recall ever saying we wanted to.”

Then, in 1959, a visiting book-publishing representative asked about the bursting loose-leaf binder that held what was a patient care handbook. Wilkins says he told her, “We should publish this.”

Clinical Practice of the Dental Hygienist was published that fall, as planned. In addition to meeting her exacting standards, subsequent editions are distinguished by the color of their covers. The cover’s hue is more than trivial. ‘Every edition is a different color, you see,” Wilkins explains in a TuftsNow article. “When I ask a dental hygienist what year she graduated, she’ll say ‘Yellow book.’ So I know immediately it had to be between ’71 and '76.”

Wilkins tells Inside Dentistry, “Every 5 to 6 years we were asked for another edition. It has been a full-time responsibility and a constant requirement for attention and analysis of dental hygiene education. What do dental hygienists need to learn and apply to help the profession to grow?”

A few years after the first book was published, Wilkins’ next career move was a return to Tufts Dental School to pursue a specialty in periodontics. There she has remained as a member of the Department of Periodontology for more than 45 years.

However, because spreading the word on preventive treatment has meant educating dental hygienists and dentists, Wilkins has been involved in continuing education for dental hygienists since 1967. Over the years, she has presented more than 750 programs in all 50 states and numerous countries.

“Many dentists think the registered dental hygienists in their private practice still ‘clean teeth’ before he or she does their dentistry,” Wilkins says. “With the Bachelor’s of Science degree as the practice entry in a majority of colleges now, we are changing all that. Today’s education gives a wider range of practice, which includes a variety of specialty learning to treat a variety of handicaps, disabilities, the aging population, pediatric patients—every possible type. But more than that, in a truly multidisciplinary team practice, the dental hygienist can provide the elements of the dental hygiene process of care, and do the initial preparation similar to what the nurse practitioner does for the medical specialists.

“This could be especially true in periodontal practices where the initial therapy involves a complete removal of calculus and thorough detailed teaching the self-care, which is essential if periodontal care can be complete and periodontal surgery, including implants, can be successful and lasting. This special advanced dental hygienist in a general dental practice has a really effective influence for the many patients who cannot be transferred to the periodontal specialist. By going ahead to get my dental degree after my general practice dental hygiene, I had hopes of helping dentists understand what a multidisciplinary team practice can do for their patients and their satisfaction in what their objectives for the health of patients can mean to them personally,” she says.

Ann Battrell, MSDH, Executive Director of the American Dental Hygienists’ Association, notes the enormous influence Wilkins has had. “As an author, educator and mentor to generations of dental hygienists, Esther M. Wilkins has had great influence in shaping the dental hygiene profession. Most dental hygienists identify their years in dental hygiene by the color of Esther’s book when they were in dental hygiene school. The American Dental Hygienists’ Association is grateful for her longstanding, vocal support of the dental hygiene profession and ADHA.”


1. Dr. Esther Wilkins. RDH Magazine. http://www.rdhmag.com/articles/print/volume-22/issue-8/columns/dr-esther-wilkins.html. Accessed May 8, 2013.

2. Flaherty J. By the Book. March 13, 2012. http://now.tufts.edu/articles/book. Accessed May 8, 2013.

3. Simmons. http://alumnet.simmons.edu/page.aspx?pid=2088. Accessed May 8, 2013

4. Hovliaras-Delozier CA. Esther M. Wilkins, BS, RDH, DMD: A mentor and icon in dental hygiene . Professional Savvy. 2008;April:34,35,37. access http://www.professionalsavvychd.com/files/articles/PS_-_Acc0408SFWilkins_Esther_M_Wilkins_BS_RDH_DMD_A_Mentor_and_Icon_in_Dental_Hygiene.pdf. Accessed May 8, 2013.

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