Working as a hygienist in a European dental practice can be a dream come true.
However, as moving abroad to any new country is no easy task, prepare yourself in many ways to face your soon-to-be reality. Here is the essential guide to life and work in a dental practice in Europe.
What is it like to work in a European dental practice?
This will vary with who you ask. There are many reasons why life and work in a European dental office may or may not work out, and some are deeply personal.
Firstly, unfulfilled expectations can paint our view of things in a negative light. In other words, the more you prepare ahead of the move abroad and know what to expect, the less disappointed you will be by unexpected changes.
Also, the reasons why you choose to move abroad will be the force behind your drive to make it work.
It is also true that there are fewer jobs around as a dental hygienist abroad than in years past. This just means that you have to work to forge your own path. But you can make it happen!
Let’s look at what it’s like to work in a Western European dental practice as a hygienist, as opposed to a North American dental office.
The attraction to Western Europe
Countries in Western Europe are often very well developed and are good places to live. For instance, Germany and Switzerland are two such countries with high standards of living. The residents of both enjoy frequent travel overseas, low levels of crime, good schools, free higher education and advanced health and dental care.
One can easily travel between countries by train or car. The culture, history, food, drink and art of Western Europe are world-class, and tourists flock to these countries every year to see them first-hand.
However, we Americans enjoy many of these same benefits. So why would we want to move overseas and work in these countries? I’ll show you some of the similarities and differences between European a dental practice and those in North America, and let you work that out for yourself.
The operatory of a European dental practice
Your office or school most likely uses equipment by Adec or KaVo. These companies are also the main firms in Germany. Most, if not all dental offices are paperless. Some are half-paperless and, just like in the U.S., don’t rely 100% on their computer software. However, the software is present and usually available in most rooms, which is convenient for perio charting.
Many offices in Germany use Dampsoft, Charly, or Z1 as their practice management software. In Switzerland, ZaWin is popular. These are very similar to our Dentrix, Eaglesoft, and Open Dental, in the way that they perform.
A relatively new software for charting all things perio is Parostatus.de. “Paro Status” is the German expression for “periodontal charting.” This software can be integrated into the office’s main practice management software.
You may have your own x-ray unit in your room. Most, if not all offices use digital radiography. If you do not have your own x-ray unit, there will be a separate, common radiology room for your part of the office.
The dental instruments and products
The dental instrument suppliers in North America are often the same ones as in Germany and Switzerland. There are a few local producers but most offices use well-known names.
Companies such as Hu-Friedy, American Eagle, EMS, Dentsply Sirona, and Planmeca are as common in Germany as they are in North America.
Cavitron (Dentsply) ultrasonic scalers are less popular in Europe, though you may find some offices that use them. Europeans use EMS (Swiss) piezo units more often than the Cavitron. The corresponding EMS Airflow is also more common than the Cavitron Prophy Jet.
Homecare products by Tepe (Swedish) are common, as are topical fluoride applications by Elmex (German). The major multi-national companies like Procter & Gamble (Crest), Colgate, GlaxoSmithKline (Sensodyne) and Johnson & Johnson (Listerine) are also always present.
Dental hygiene treatments in Europe
Perio Maintenances, Adult Prophys, Child Prophys, Gross Debridements, ScRP, Sealants, Bleaching, and Laser therapy are the bulk of your practice in Germany and Switzerland. Periodontal disease is rife in Europe as prevention of dental disease has only recently become popular.
You will likely spend the majority of your day treating moderate to advanced Perio. This could be in the form of Perio Maintenances or ScRPs. Easy Prophys and Child Prophys will be about 20% of your day. This can change if you set up a consistent recall system and work on patient compliance.
Dental offices in Europe do not use Radiographs as a preventative measure. In other words, they only use them when really necessary. Most offices have a Panoramic radiograph machine in the office and do encourage its use. Many dentists rely upon the panoramic (OPG in German) for a baseline.
FMXs are not taken as often. Some offices only take bitewing radiographs every one-two years and periapicals only as needed.
Switzerland does recognize U.S. radiology training and will allow us to take radiographs in the dental office. However, Germany does not, and requires their own radiographic safety course.
This course costs about €500 and lasts for three days. Your employer may pay for your course if they need you to be able to take x-rays. If you do not have the German radiology certificate, you can not take radiographs.
The schedule in a European dental practice
In Switzerland, one-hour appointments in a traditional dental office are the norm. Dental chains and DSOs may not allow as much time.
In Germany, the time can vary even in traditional offices. Some offices with a well-established recall system allow patients to be seen in 45-minute time blocks, rather than hour blocks. This is something to clarify during your interview.
Most dentists like to perform an exam at each recall appointment. The nice thing is that the exam is usually done in a different operatory to help keep Hygiene on schedule.
Practices vary in terms of whether the dental hygienist or the front office is in charge of scheduling the next appointment, though in either case, patients should leave with a recall appointment. Offices also vary in terms of the time allotted for SRPs.
From my experience, no less than 1.5 hours is allotted for a half-mouth SRP and no less than two hours for a full mouth.
In Germany, dental hygienists may not administer local anesthesia (as a rule). In Switzerland, hygienists can administer local anesthesia, as long as they have the license to do so. So, in Germany a dentist will anesthetize for you in another room or add extra time to your appointment to give the local anesthetic.
For insurance patients in Germany, the perio charting is done and submitted to insurance with a pano beforehand for a pre-authorization. For private patients, things are a lot more flexible and the SRP can even be started right away if time allows.
Switzerland, which has only private patients, is not limited by the dictates of an insurance company. Therefore the scheduling is much easier. Germany dental insurance functions a lot like the U.S. and the scheduling arrangement depends upon the insurance limitations.
The work culture of a European dental practice
Germans and Swiss are generally serious when it comes to work and expect a job well done. These cultures also value job longevity. It is quite normal to see front office staff and dental assistants in Europe who work for the same practice for 20 years or more.
It is important for the hygienist to stay on schedule and take care of the things that we are responsible for. Dental coworkers in Europe are normally willing to assist you with your work if they have the time and ability to do so. But they want each person to carry their own load.
Most European dental employers are easy to talk to and welcome feedback that will improve their dental practice or hygiene department. Some offices work to create a nice, family-like environment. Also, some employers arrange after-hours activities to maintain staff morale high.
Vacation time and other benefits are valued, respected and defended, so there’s no need to worry about being taken advantage of in that way. Your vacation is plentiful but you should decide upon your vacation days as early in the year as possible. This will make it easier to set your schedule for the year.
Your social life overseas
Your social life can make or break your time abroad. Some dental hygienists describe their time overseas as being so lonely that it pushed them to return home. But others describe it as the best time of their lives.
Those who really enjoy the experience of work abroad often look for ways to stay longer instead of heading home. Many factors can explain this difference.
The first and most important factor is the location of the job. Is it a big city or a village? Is it international or very old fashioned? Are other expat hygienists in the same area or are you the only international dental hygienist for miles? Are other expats around at all?
No matter how nice the job offer sounds, the reality is that you will need expat friends and other dental hygienists around for your sanity.
This is useful for bonding, support, travel and other things that will help you adjust to your new country. Areas with high concentrations of expats and international dental hygienists are the best places to conduct your search for work in Europe.
These may also be the hardest places to land a position. But if you take your time and don’t rush, it can work out.
As you can see, work as a dental hygienist in Europe can be a lot like work in North America. But the benefits, vacation and travel possibilities that you get while working in Europe are far better.
This has been a huge, life changing opportunity for many dental hygienists over the years, which has allowed them to grow personally and professionally.
Taking advantage of such an opportunity requires due diligence and hard work. But if you do it right, it could be the best decision of your life.
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