Vickie Nardello's background as a dental hygienist at a private practice in an affluent suburban practice in Connecticut didn't prepare her for what she discovered in a more urban setting: a major discrepancy in the dental needs and dental care access.
Her commitment to improving the dental health of Connecticut children led her to active involvement as the president of both the Connecticut Dental Hygienists' Association (CDHA) and Waterbury Dental Hygienist Association and a member of the American Dental Hygienists' Association (ADHA). She became active in government relations on a state and national level, including a stint as a consultant to the National Head Start program, and spent three years as an advocate assisting a professional dental hygiene lobbyist.
The grassroots legislative efforts intrigued Ms. Nardello. With the support of local political activists and the dental hygiene community, she made a bid to become Democratic state representative for the Prospect, Conn., district of the Connecticut General Assembly. A close race against a strong incumbent was a learning experience; her second bid led to victory. At the time of this interview, she has served as a state legislator for more than a decade and is the vice chair of the Energy & Technology Committee and chair of the Public Health Subcommittee of the Medicaid Managed Care Council.
Ms. Nardello continues her 'day job' as public health dental hygienist and manager of a school-based dental clinic for the Hartford Public School System. She initially earned a dental hygiene associate's degree from University of Bridgeport and built on it to complete a B.S. in dental hygiene. She then went on to earn a master's of science in health education from Southern Connecticut State University in New Haven.
She urges students to consider the dental hygiene field, and notes that "Dental hygienists of the future will be likely to be practitioners with an expanded role… As the shortage of dentists becomes more acute, dental hygienists will be called upon to address unmet dental needs."
Your dental hygiene career has included private practice care, dental hygiene education, consultant to the Federal Head Start program and your current role as public health dental hygienist and manager of a school-based dental clinic. What led you to shift from a patient-care focused career to the field of dental hygiene education?
My shift from private practice to public health was a result of wanting greater independence in the dental hygiene decision-making process. I value the autonomy and personal responsibility that is integral to functioning in a public health setting. In private practice, you are constrained by the practice patterns of the dentist.
Describe a typical day (or week) of work for you as a Public Health Dental Hygienist for the Hartford Board of Education. What are your key responsibilities?
My day involves planning the daily schedule according to the school schedule, providing examinations, radiographs, prophylaxis, oral hygiene instructions, fluoride and sealants, providing feedback to parents, billing for the days procedures and planning for the following day.
My key daily responsibilities are scheduling, providing preventive care to students in grades pre-kindergarten through eight, interacting with parents and staff, submitting billing data and making sure that patients are completely prepared to see the dentist for treatment needs so that he can concentrate fully on restoring teeth rather than administration, data collection and submission of statistics.
You have served as a state legislator for more than a decade. How did your role as a dental hygiene professional and educator lead you into state politics?
My interest in becoming a state legislator came from my experience as the president and legislative chair of the Connecticut Dental Hygienists' Association. I became expert in the legislative process and quite by accident a legislator's wife asked if I might be interested in running. I have always believed in the power of education and the legislature was a logical next step in my education. With the support of the dental hygiene community, I made the decision to seek state office.
As a state legislator, how have you tapped into your dental hygiene education and career to help shape public policy?
My dental hygiene education has formed the basis for my philosophy regarding health care and the important role of prevention and maintaining and ensuring quality. I also believed in using resources wisely and utilizing each health professional to their full capabilities. Every time I deal with a health issue regardless of the area, I find that prevention, quality, resource allocation and workforce issues are central to all the discussions.
You are president of both the Connecticut Dental Hygienists' Association and Waterbury Dental Hygienist Association and a member of the American Dental Hygienists' Association. How have membership and your various leadership roles impacted your career?
My membership in the Connecticut Dental Hygienists' Association and the American Dental Hygienists' Association provided excellent preparation for entering politics. Professional associations help develop interpersonal skills, knowledge of issues, the ability to speak before groups, the ability to debate different points of view and the understanding that in organizing there is power to move an agenda. ADHA debates resolutions and holds caucuses much like the political process. The leadership roles that I took forced me to step out of my comfort zone and work for the issues I believed in. They provided a broad range of experience that has helped shape who I am today.
How did you get involved in professional presentations and acting as a keynote speaker at professional events? What drives this type of 'extra' professional involvement?
A dental hygienist friend literally dragged me to my first meeting and from there I realized quite quickly that unlike other professions dental hygienists worked in isolated environments and needed the chance to come together as a group. At that time they were very timid and unlikely to challenge authority. I sensed a void and sought to fill it. I am driven by the fact that I have always believed that dental hygiene was a profession and not just a 9-5 job. Professions demand commitments beyond the normal work day and a true profession fosters lifelong learning. Each meeting provides an opportunity to learn. I have always been comfortable speaking publicly. As the only dental hygienist serving in the state legislature, my experiences have been unique. In turn, those experiences have fostered requests to speak to others throughout the country.
You have received awards from both the state and national dental hygiene associations for outstanding contributions to the profession of dental hygiene. What do these honors mean to you on a personal and professional level?
The awards that I have received are a public recognition of the many hours which I have devoted to advancing the profession. It is especially meaningful to be recognized by your peers, because they have an understanding of the demands of being a dental hygienist. They also recognize the risks of taking a public position that is subject to strong opposition from other professions.
What are some favorite projects that you've been involved with in your career? What makes them stand out?
My favorite projects were achieving independent practice for dental hygienists in public health settings and obtaining monies that increased access to care by funding expansion of the dental public health infrastructure. Taking the opposite view of the dental profession has presented many challenges. Obtaining money in a state budget also provides serious challenges, since there are many interests competing for state dollars.
You built on a dental hygiene associate's degree to earn a B.S. in dental hygiene and then a master of science in health education. How did you choose the schools you attended?
I chose the University of Bridgeport because it was the only dental hygiene school in the state and its dental hygiene program had an excellent reputation. I chose Southern Connecticut State University because of its proximity and it was one of the few schools to offer a master's in health education.
Would you change anything about your education if you could?
My dental hygiene education was close to a military boot camp at the time. It was very stressful. Dental hygiene education has become more humane over the years. I would also have liked more emphasis on functioning independently.
What factors should students consider when choosing a dental hygiene school or program? How do dental hygiene certificate programs at technical and community colleges differ from those offered by institutions that confer degrees?
Students should consider the school's reputation, their ability to meets the demands of the dental hygiene schedule and financial needs. Certificate programs differ from schools that confer degrees by having to focus on the technical competencies necessary to provide dental hygiene services. They are more often based in community colleges.
What advantages are offered to those who go on from a certificate or AA program to earn a bachelor's degree in dental hygiene? For those who go on to attain post-graduate degrees in the field?
The advantages of a degree are that degree programs provide a broader base of education that goes beyond the technical competency and that can prepare students for a more independent role. They are often based in larger setting allowing more interaction with diverse groups. The length of the program allows more time to develop critical thinking skills. Post graduate degrees allow the student to broaden their education beyond dental hygiene and into related fields. Advanced degrees are necessary for educational, administrative and public health positions.
How should students expect the curriculum to prepare them meet the trends and challenges the field of dental hygiene faces over the next decade?
Again curriculum is not my area of expertise, but I do know that the dental hygiene curriculum is rigorous and with its emphasis on sciences students need to come well-prepared in order to succeed. Today's curriculum must prepare students for ever expanding functions, the ability to diagnose, to make independent decisions, and to address ethical dilemmas that may be presented.
How has the growth of the Internet impacted dental hygiene education?
The growth of the Internet has allowed online courses, but I am a firm believer in the need for interaction between student and teacher. Teachers serve as role models and mentors. Developing clinical skills demands close teacher student interaction. I believe the Internet has a limited role.
Any tips for students as they transition into life as a dental hygiene student?
Life as a dental hygiene student is very demanding. Be prepared for long hours and exacting preparation. The nature of the profession demands it. Without a demanding curriculum quality will be compromised. However, all of the efforts will be worth it. There are many rewards for those who graduate.
How could the educational system be changed to better serve dental hygienist students and society as a whole?
The educational system could be better changed to serve both dental hygiene and society by maintaining rigorous standards rather than diluting curriculum. Dental hygienists of the future will be likely to be practitioners with an expanded role. Those additional responsibilities will require committed students who adhere to the highest principles. Dental hygiene educators will have to tailor their instructional methods to the needs of individual students more than they do today.
How can the reality of a career as a dental hygienist differ from typical expectations?
The reality of a dental hygiene career can be different than expectations based on the employer. The level of decision-making is directly related to the philosophy of the employer. Often employers do not recognize the educational preparation of dental hygienists, and relegate them to a minimal role in office policy.
What are the best ways to land a job as a dental hygienist?
The best way to get a job is to speak to other dental hygienists who know the area.
How available are internships or other hands-on learning experiences?
Internships in our area (Connecticut) are limited; more internships would be very beneficial to students. They provide a real world experience and hands on learning.
How is the job market now in the industry? How do you think it will develop over the next five years?
The job market is excellent and will continue to be excellent. The diminishing number of dentists is favorable to the job prospects of dental hygienists.
What can recent dental hygiene school graduates expect as a salary range starting out? Once they gain experience?
The salary range is varied according to geographic area but is excellent in the Connecticut area. Unfortunately experience is not adequately compensated. However, it does give you the ability to assess your own worth and articulate it.
What hot issues are emerging in the overall field of dentistry that will impact the dental hygiene profession?
The issue of systemic diseases and their impact on dental health, the move toward cosmetic dentistry, the shortage of dentists, expanded functions for dental assistants and the development of an advanced dental hygiene practitioner will be emerging issues. They will all affect the dental hygiene profession.
Do you feel that is important to be passionate about the field of dental hygiene in order to be successful?
Success can be defined in many ways but I am a firm believer that passion is necessary in any profession that you choose. It's especially important in dental hygiene because without passion the daily routine can give way to boredom. Passion encourages clinicians to go beyond the boundaries of private practice and to think globally.
What other career advice can you offer future dental hygienists?
Dental hygienists need to build confidence both in their clinical skills and in their decision making. They should not compromise their ethics to meet the needs of an employer. As the shortage of dentists becomes more acute, dental hygienists will be called upon to address unmet dental needs. I expect expansion of their role through the acceptance of a mid-level provider and I expect a lifelong need to update skills through continuing education.
Is there anything else you can tell us about yourself, your career, or the field of dental hygiene that would be interesting or helpful to dental hygiene students
When I graduated from dental hygiene school, I had no idea that my life would take this path. I fully expected to be a clinical dental hygienist in private practice. I would tell students not to be afraid to take risks and not to be afraid to fail. People learn through failure. Believe in yourself and your abilities. Opportunities may present themselves and doors may become open to you. Take those opportunities and open those doors. Life will be richer in the knowledge that you will gain, the people that you will meet and the experiences that you will have. Never stop learning, both formally and informally.