Inside Dental Hygiene
October 2021
Volume 0, Issue 0

Diversity in Dental Hygiene

Nick Hornsberry

The dental hygiene image needs an update. When depicted in movies, books, and on television, dental hygienists have been homogenously female and are almost always of European ancestry. This lack of diverse representation in media poses a threat to the sustainability and future of the industry, and most importantly, contributes to real-life health outcomes for the most underserved communities.

As the Diversity, Equity, and Inclusion (DEI) Manager at Heartland Dental, the nation's largest dental support organization, my charge is to elevate how we understand and prioritize diversity in all that we do for our supported doctors, their team members, and their communities. Increasing diversity in our industry will benefit current hygienists, the next generation of talent in the field, and the overall population at large.

A Look Back

The practice of dental hygiene dates back to over 100 years ago, when Irene Newman became the first apprentice to implement dental hygiene duties, leading to the establishment of America's first dental hygiene program in 1913.1 While the field has advanced since then, dental hygienists continue to resemble Newman and remain predominantly female.

The dental hygiene profession has historically struggled with equity among those who set guidelines for, educate, and become oral health practitioners. After the founding of the American Dental Hygienists' Association in 1923, it wasn't until 1964 and the Civil Rights Movement that restrictions for admission based on race and color were removed, along with the word "female," from its constitution and bylaws—a clear indication that progress within the field has consistently lagged behind societal change.2

Fast forward to present day, the industry still faces a critical need to increase diversity. According to the July 2019 United States Census Bureau data, 328,239,523 people lived in the country, and almost 40% of the population were people of color.By comparison, data from that same year by DataUSA showed that people of color made up close to 20% of dental hygienists.4 When comparing gender disparities within the profession to the general population demographics, the numbers are even further apart, with over 95% of dental hygienists being female.4 This demonstrates that there are major areas of opportunity to recruit a more inclusive workforce.

Benefits of Diversity

Enhancing diversity in dental hygiene has widespread advantages that add value for current and future hygienists by enriching talent, increasing patient satisfaction, and improving patient-provider communication.

A diverse workforce expands talent, creating a broader range of skills among employees, as well as a range of experiences and perspectives, increasing the potential for better health outcomes. Staff diversity also promotes innovation, inviting creativity and execution in new, yet effective, ways. By building a practice of people with different backgrounds, experiences, and approaches to work, creative concepts are enabled.

Future hygienists also benefit from improved diversity in the industry. Incorporating diversity into the recruiting process expands the pool of prospective talent, increasing the likelihood of finding skilled, qualified people, which enhances a practice's reputation. Diversity also fuels the pipeline for growth. The more opportunities available for people of diverse backgrounds, the more likely those recruits are to find quality jobs.

Studies also show that more diversity in oral health care improves patient outcomes. Children of color see dentists and receive preventive services, such as fluoride treatments or sealants, less often than their white peers. Increasing the racial, ethnic, and gender representation among hygienists reduces barriers and expands access for the most underserved communities. When barriers to care are removed, practices can receive more patients and treat more people in the community.

Because all patients seen by a dental practice are unique and distinct from one another, hygienists must be equally diverse to serve them. With multiple languages present, barriers are reduced, and patients are more comfortable during what can be uncomfortable situations. When varied customs and traditions are embodied in the workforce, practitioners are better able to relate to their patients.

African American adults (aged 20-64) experience untreated tooth decay nearly twice as often as white Americans, which leads to black seniors suffering total tooth loss at almost double the rate of white individuals over age 65.5 However, when patients are seen by hygienists who look more like them, speak their language, and understand their background, they are more likely to receive necessary screenings and treatment.

Boosting Diversity

At Heartland Dental, we've given purposeful thought to how we can lead the dental support industry when it comes to diversity, equity, and inclusion. As a result, we've done some rigorous work over the last several months in the following areas:

• Enhanced Recruitment and Training: This includes improving our best practices for recruiting and hiring, assessing the company's efforts to identify opportunities for deepening partnerships with a broad range of colleges and universities. In addition, company-wide training for all employees is being updated to help team members better

• Employee Resource Groups (ERGs): We will begin offering ERGs to all members that will provide opportunities to connect with others with shared identities, give advice, share ideas, and find mentors.

• Continued Focus on Heartland Dental's Core Values: Collaboration, balance, and celebration ultimately enable Heartland Dental to:

1. create and sustain a culture of inclusiveness.

2. better understand supported doctors' and team members' experiences while developing strategies to achieve a healthy work-life balance.

3. promote gratitude and recognition for supported doctors and team members.

4. encourage career growth and development while fostering a strong culture of diversity, inclusion, and excellence in patient care.

By bridging existing gaps and concentrating resources to build a workforce reflective of the people it serves, diversity can be a vital tool for growth and change in our industry.

About the Author

Nick Hornsberry
Diversity, Equity, and Inclusion (DEI) Manager
Heartland Dental


1. Hygiene at the Forefront. Inside Dental Hygiene. 2013;34(4):6-12.

2. Hakes H. The History of Dental Hygiene: Development through the Years. June 16, 2020. https://www.todaysrdh.com/the-history-of-dental-hygiene-development-through-the-years/. Accessed September 2, 2021.

3. Quick Facts: United States. United States Census Bureau website. https://www.census.gov/quickfacts/fact/table/US/PST045219. Accessed August 5, 2021.

4. Dental Hygienists. DataUSA Website. https://datausa.io/profile/soc/dental-hygienists. Accessed August 5, 2021.

5. Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion. Disparities in Oral Health. Centers for Disease Control and Prevention Web site. Updated February 5, 2021. https://www.cdc.gov/oralhealth/oral_health_disparities/index.htm. Accessed September 3, 2021.

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