HCDM 52 | Dental Hygiene


It is always said that prevention is better than cure. Of course, the same goes when taking care of your teeth, which calls for proper dental hygiene. Discussing how to maintain excellent oral health and avoid diseases with Dr. Richard Marn is dental hygienist Sarah Liebkemann RDH, BSDH. She explains how her profession differs from dentists as well as the most common misconceptions and challenges surrounding this field. She also talks about how being a dental hygienist can transcend to helping patients boost their self-confidence. Sarah even shares her passion for educating people about dental hygiene, which she expresses through her artworks and upcoming children’s book.

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Educating People About Dental Hygiene With Sarah Liebkemann RDH, BSDH

We’re going to be talking with a healthcare professional who’s excited about her job so much so that besides the clinical work she’s doing, she’s doing advocacy. She’s helping educate students and patients. She’s also using her degree to help educate the public in the public health arena. That was very enlightening to me that she’s using her degree to cover many different bases in trying to help people. We’re going to talk with Sarah Liebkemann in North Carolina. She is an RDH, a Registered Dental Hygienist. She’s excited about her career that she’s pursuing a Master’s in Dental Hygiene. She does other wonderful things in oral health because oral health is often on her mind. She’s doing a lot of other things to help bring awareness, good traits and good education to her patients.

If you think this episode or other episodes are great and you think I deserve it, please give me a five-star rating. If you think it’s worth a comment, hopefully, pleasant versus not so pleasant, that’d be welcome and I would love to hear feedback from you. You can always check out my website, HealthCareersWithDrMarn.com or HCWithDrMarn.com. That’s what I want to let you know about. Without further ado, let’s jump into it.

How are you doing, Sarah?

I’m doing great. How are you doing?

I’m good. Let’s jump into it. Could you introduce yourself and tell us a little bio?

I’m Sarah Liebkemann. I’m a Registered Dental Hygienist. I earned my Bachelor’s Degree in Dental Hygiene from UNC Chapel Hill back in 2019. Since then, I’ve been earning my Master’s Degree in Dental Hygiene Education, also from the University of North Carolina at Chapel Hill.

As a dental hygienist, what do you do clinically to help people?

The main thing that I do clinically to help people is helping them prevent disease. We do a lot of motivational interviewing with patients to learn about their values, their oral health goals and help them maintain health. We also do a lot of non-surgical periodontal therapy for people who have gum disease. Things like gingivitis or periodontitis where their gums have an infection. That’s the type of thing we do procedures to help remove that infection and get them back on the path to health.

What are the usual steps to becoming a hygienist?

It’s straightforward. To be a clinical dental hygienist, all you need to do is an Associate’s degree. They are offered at a lot of different community colleges. It’s a thing that you can do right out of high school. You do the prerequisites, you can jump right in and then start practicing clinical dental hygiene. There are other career options available as well. You can get into advocacy and research. You can work at a university, teaching, which is what I like. To have access to those types of careers, you would do either a Bachelor’s or Master’s Degree in Dental Hygiene, which involves a little bit more education.

To work as a clinical hygienist, all you need is an Associate’s degree. How many years is that usually?

It’s only two years.

What do you love most about what you do?

There are a lot of things that I love about what I do. The patients are always the biggest thing for me. It’s seeing somebody make a breakthrough. A lot of patients don’t know a whole lot about the importance of prevention and how it’s linked to their overall health. When they come in, we’re able to make that connection and educate patients about that link between their oral health and the rest of their body, that breakthrough is meaningful. I like working with students as well. Being able to train the next generation of oral health practitioners and help foster the same types of values that are important, that patient-centered care. Seeing students adopt those values and then make that impact feels like a ripple effect. You feel like, “My influence is being able to reach a lot further than it would with just me practicing independently.”

HCDM 52 | Dental HygieneWhat is a least favorite part of your career?

The least favorite part is some of the restrictions that come with dentistry. It’s not something that is often reimbursed. A lot of people struggle financially to be able to have some of the options that we recommend. You’re stuck between a rock and a hard place sometimes when patients want to care for themselves and want to take these steps. There are external burdens that prevent them from being able to follow through with some of those desires. It’s hard to see. Your heart aches for them when you’re in that type of circumstance.

You mentioned that you can become a hygienist with either a 2 or 4-year degree. What’s the decision-making process in that? Why would you choose one over the other?

Whether you have an Associate’s degree or a Bachelor’s degree or a Master’s degree, all those dental hygienists are equally qualified to provide clinical care. The main difference is opening up opportunities for other career pathways. Let’s say you wanted to do research in a lab or you wanted to be an advocate or you wanted to be a teacher or work for a big company like Colgate or Crest, those are the types of opportunities that you would have available to you if you continued your education and did either a Bachelor’s or Master’s Degree in Dental Hygiene.

What’s the difference between what a hygienist does and a dentist? Both of which do work in and around the mouth and teeth.

In terms of the area of focus, I feel like dental hygienists focus a lot on preventive care. Looking at before the disease process or trying to get some of that gum disease under control, whereas when the dentist steps in, a lot of times, it’s because there is something that needs to be fixed. There’s already tooth decay. There’s something that needs restorative work. The dentist and dental hygienists get to team up. Each person takes that important role in the care team. In addition, the dentist is usually the one who owns the practice and acts as the team leader. Although the hygienist should have a role in co-treating the patient with the dentist and work as a team, the dentist is usually the one managing the practice.

Can a hygienist ever work solo?

It depends on where you live. In some states like California and Alaska, dental hygienists are more of a mid-level care provider. They can practice independently. Some states have it to where hygienists can practice independently but only in areas where there are exceptional needs like in some of those dental deserts and high-risk areas. In other states, it’s restricted. The scope of practice is very limited. Particularly where I live in North Carolina, dental hygienists have to have direct supervision from a dentist at all times.

I love to hear a story or an example of a patient that you’ve taken care of that made you feel like this career was a great choice for you.

I had this sweet patient who had not come in for a dental cleaning in a long time. Getting to know her and talking to her a lot, the biggest reason for her was that she had some gaps between her teeth. She liked that once the plaque had built up. There was calculus, which is hard plaque filling those spots. It seemed like there weren’t gaps in her teeth. We had several appointments because the type of cleaning she needed was an in-depth one where we’d numb the tissues. She came back for 3 or 4 appointments because it took that long to remove everything.

Over the course of our appointments, we got to know each other. I have some people in my life who have those gaps and it gives their smile character. I told her that that’s how I felt about it. I thought that they were pretty. After that, I could notice a big turn in her attitude towards it. Being told that from my perspective had a big impact on her for some reason. She embraced it and leaned into it. I noticed that her home care has improved as she came back to finish the cleaning. She was cleaning her teeth a lot more consistently. She said to me how big of an impact that statement had on her.

That goes to show that getting to know your patients and why they do the things that they do is such an important step. Often, we think we need to treat what the patient presents us. We are treating the symptoms rather than the root cause. For this patient, it was an aesthetic concern. Let’s say this patient still had aesthetic concerns after I had said that, even suggesting treatment options like putting some veneers to fill those holes in between her teeth may have had an impact and allowed her to embrace her oral hygiene routine. That’s a part of that patient-centered care that is so important when you’re looking at prevention.

That’s awesome how even words with intention can have a powerful effect on someone’s life. What’s your typical day like as a dental hygienist right now?

I’m earning my Master’s Degree in Dental Hygiene Education, which means that I’m teaching students how to be dental hygienists. A clinical day for us looks like going in at 8:00 AM. I’ll usually have about five students that I am supervising. Each one of them is treating a patient. I’ll go in to give some guidance and show some technique and also check-offs and supervise the whole appointment. It can be a little bit challenging because patients come in with different needs. Being able to keep track of each patient’s needs and their health circumstance and bouncing around from operatory to operatory requires a lot of critical thinking and good note-taking. That continues until about 5:00 PM. After that, I usually have meetings and stuff in the evening. Those usually wrap up around 8:00 PM or 9:00 PM. I have long days.

Getting to know your patients and why they do what they do is an important step in the healthcare scene. Share on X

Is that also because you’re in this Master’s program?

Yeah. For hygienists who practice, it’s typically between 8:00 to 5:00, sometimes even 8:00 to 3:00 if you have a practice that has early ending hours.

In other words, most hygienists do not work as long as you do because you’re also educating and also doing this Master’s program.

For hygienists who are in non-traditional careers like academia, the hours are probably a little bit longer.

What misconceptions do people have about dental hygienists?

A lot of people hear the word cleaning and they automatically associate it with getting their nails or their hair done. It seems like a very cosmetic thing. Not a lot of people tie it to health outcomes or even recognize how related it is to their overall physical health. That’s probably the misconception. In real life, dental hygienists are health professionals that perform these procedures to help maintain good oral health and help to address times when the disease has already progressed into gingivitis or periodontitis.

Maybe there needs to be a better word than cleaning.

It’s a self-fulfilling prophecy because we use the word cleaning because it is what patients know, but then it also reaffirms that misunderstanding.

How would you describe your work-life balance as a hygienist?

I really love my career. I fulfill a lot of my personal time with things that are related to dentistry because it brings me joy. The times when I’m not thinking about oral health, it’s probably when I’m hanging out with friends or family and spending quality time with the people that I love. Otherwise, even recreationally, I love to fill my time with things that are related to oral health.

What do you think the future outlook is like for dental hygienists?

My vision for the future of dental hygiene has to do with moving into that mid-level care provider role and being able to reach those populations who do not have access to the care that they desperately need. A lot of times, those barriers can involve transportation issues, financial barriers and sometimes even fear of the dentist. There’s a lot of dental anxiety that’s prevalent. Looking at a place where dental hygienists can practice independently and then refer whenever there is a need for restorative work would best utilize what hygienists are trained to do and also reach those populations that desperately need care.

HCDM 52 | Dental HygieneIt almost sounds like public health. There’s a role in public health for dental hygienists.

That was one of the reasons why I chose to go into dental hygiene rather than choosing to be a dentist. I very much view it as a public health role. There’s a lot of potential for interprofessional collaboration because dental hygienists spend so much time with their patients, learning about their lives and their circumstances. Often, we’ll learn things that raise flags for possible referrals to things like social work or nutrition.

What type of students would best flourish in this career?

Students who are empathetic, organized and are interested in having that face-to-face patient contact would do well in dental hygiene. It takes organization. There’s a lot of note-keeping and meticulous documentation. Most of all, it’s compassion. You want to approach your patients with empathy and a non-judgmental attitude. That’s one of the most important keys to successful motivational interviewing. I would advise any student who thinks that that type of role is appropriate for them to take a closer look at dental hygiene.

Hopefully, the students reading will key into that. I want to jump into a little bit about your origin story. What were you like as a student? Were you very studious when you were in high school and such?

I was pretty studious in high school. I generally did pretty well. I went to university and I got my butt kicked in certain classes. In the beginning, you’re taking some of those more advanced sciences. I had a period where I questioned whether or not I had what it took to be a healthcare provider. Luckily, I was able to pull myself up and power through. I changed the way that I approached studying and it was very effective. I went from more of a passive learning strategy to an active learning strategy. Even with just that one class, I was able to take myself from barely struggling to get by to flourishing and doing well.

What did you do? What was the transition there for you?

It was microbiology. I tried to learn everything. I had a great teacher. She gave us so much information and reading. I was like, “I need to learn everything.” I read every page. I looked at everything and I spent all day every day studying for that class. The issue was that I wasn’t spending my time wisely. I should have spent more time studying the things that mattered and not spend so much time learning some of the minutiae that weren’t going to be relevant to what we were tested on. It was more of making a transition from trying to memorize all the details to understanding the big picture and being intentional about the way that I studied and studying through a method that forced memory retrieval. Doing things like flashcards and practice tests instead of reading and looking at things. That was that key transition. That might have been one of the reasons why I decided that I wanted to be a professor. Oftentimes, students may think that they’re struggling and they might think, “I don’t have what it takes.” In reality, it’s the approach that’s off a little bit and needs a little bit of correction.

Was that something you identified yourself or was there somebody mentoring you who has helped you through that?

I was lucky that I was able to figure it out for myself. I did go during office hours to my professor. I showed her all my notes and she was like, “You need to be studying more deliberately.” She did give me that little tip-off. I was glad that I had approached her. She gave me a little bit of a nudge and helped me out. It was a little scary though to change the way that had been working for me for so long and to say, “I need to take this chance. It’s either going to work out well or it’s going to work out poorly.”

What year was this?

This was in 2016 or 2017. I was doing my prerequisites for the Dental Hygiene Program. This was before I was even in dental hygiene school. I was trying to get my prerequisites to be able to enter the Bachelor’s of Dental Hygiene Degree program.

You’re in college already?

Yes. We talked about how Associate’s degree, you can go straight out of high school and go to a community college. I went to a university because I had thought that I would do Biology and then become a dentist. My original intention was, “I’m going to go to a university to get my science degree and then become a dentist and go into dental school.” I then learned about this dental hygiene that was your degree, that’s your major. I was like, “I could be able to see patients earlier if I took that path. I could do that and then major, then I’ll go to dental school.” During my time in the Dental Hygiene program, I fell in love with dental hygiene. I realized that everything that I wanted to do as a dentist, I could do as a dental hygienist without having to spend as much time and money in school.

The greatest challenge people face now is not having the education to make informed decisions. Share on X

That’s a big factor, that time and money. That’s something to consider for a lot of people. You weren’t thinking about being a hygienist in high school. You were thinking about being a dentist for that first 1 or 2 years of college, and then you changed your degrees mid-college to go into dental hygiene.

I didn’t even know the difference between a dentist and a dental hygienist at that point. I knew that I liked teeth a lot and I was interested in oral health. I hadn’t learned about dental assisting or dental hygienists yet. Once I got into college and I saw that program and I learned more about it, that was when the switch flipped for me. I learned that a lot of these types of public health ideas that I was interested in fit nice to that niche with dentistry as a dental hygienist.

Were there other careers that you were considering at all?

Not too much. I did think about being an elementary school teacher in K-12 because I love working with students and seeing that light bulb go off. That’s another way that it worked out. Even as a dental hygienist practicing clinically, there’s a pathway to continue on and find those niche areas. For me, I found that in teaching.

Is there anything that you can look back on that you would have done differently?

I wish that I would’ve learned about dental hygiene in high school. I wish I would have heard this show and learned about all these different careers instead of thinking of the major ones like dentists or doctors. That’s one thing that I wish I would’ve done. Everybody reading this is already a step ahead of me in that way because they’re exposing themselves to these different career options that are so great and so needed.

I’d like to jump into my little rapid-fire questions. What’s your favorite dessert?

Crème brûlée.

Who is your favorite artist?


What’s something you could eat for a week straight?

Fried chicken.

If you had to live in a different state, what would it be?

HCDM 52 | Dental Hygiene

Dental Hygiene: Students who are empathetic, organized, and interested in face-to-face patient contact would do well in dental hygiene.



Do you currently own any stuffed animals? If so, what’s their name?

I do. I have it right here.

This is very nerdy. Can you tell the readers what we’re looking at?

This is an instrument that we use. It’s a push scaler. A scaler is a type of tool that we use in dental hygiene to remove bacteria from the tissues. This is a stuffed version of it. It has a little smiley face. Its hands are in the air with purple legs and arms.

Do you keep this in your room?

I have it on my desk. I have a bunch of seemingly nerdy, dental hygiene things on my desk.

What’s your favorite clothing brand?

Maybe Anthropologie.

What comes easily for you that is more difficult for other people?


What are the greatest challenges you think people face now?

Not having the education to make informed decisions.

If you're artistically inclined, lean into it and look for a way to give back to the world by embracing your talents. Share on X

That’s it for the rapid-fire questions. Thanks for participating in that. You do the artwork. Can you tell us about that and why you’re doing that? I see it on your Instagram feed.

One of the things that I don’t get to do as a dental hygienist is arts. Dentists get to shape teeth. There’s this huge artistic component that I feel like if there’s one thing that I’m missing out on by choosing dental hygiene over dentistry, it’s probably the artistry of being a dentist. One of the ways that I like to embrace my artistic side is by creating educational oral health resources for kids that their parents, teachers, and other dental providers can use to help engage them and excite them.

I do it online. I have a little drawing tablet. It’s pretty easy. Pretty much anybody could teach themselves how to do it. If you’re artistically inclined and passionate about something, you should lean into it and try to see a way that you could give back to the world by embracing your talents. Beyond that, I’m also creating a children’s book for dental hygiene. I haven’t finished it yet. I’m still working on some of the illustrations because I’m a bit of a perfectionist with them. It’s called Set Sail for Smile Isle.

When is it going to come out?

Probably in 2021. The reason why I decided I wanted to make this book was because I see a lot of books about dentistry and dental hygiene that focus a lot on the actual brushing and flossing but they don’t talk about why. I also wanted to introduce a few different concepts relating to public health into the book. I’m trying to weave those in a way that’s fun and exciting for kids and something that can get everybody excited.

For the readers, you got to check out Sarah’s artwork. She displays some of it on her Instagram feed. It’s adorable. Especially if you have kids and are interested in educating them. You also have some resources as well on your links on your Instagram. If you’re interested in that, check that out. Where can people find out more about you, Sarah?

Mostly on my Instagram. My Instagram tag is @SLL.Stories. I’m in the process of creating a website. You can reach me via my Instagram. Feel free to direct message me. I’m always looking for opportunities to collaborate with people and connect.

Thanks for letting everybody know about that. To let everybody know, I am connected to you because my wife recommended I reach out to you. My wife is a pediatric dentist. She loved the artwork you’re doing and the artistry. That was foremost on her mind because she came out with her own book on pediatric dentistry talking about teeth and when they erupt. She said, “You got to check out Sarah. Connect to her.” That’s how we got connected. I’m glad I did. Maybe you and my wife can collaborate on something. I’m happy you came to this show, Sarah. Thank you so much.

Thank you so much for having me. A big thank you to your wife for connecting us. Her book looks excellent. She has a lot of great resources as well. It’s inspiring to see people lean in and use their passions for a good purpose.

Thanks for tuning in. To learn more about our guests or other past guests, check out my website, HealthCareersWithDrMarn.com or HCWithDrMarn.com. If you like what you read, please go to my website, add your name and email to my email list, that way you can get the latest announcements and news as they arise. You can also find me on Instagram @DrRichardMarn. Thank you so much for reading. I’ll catch you on the next episode.

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About Sarah Liebkemann RDH, BSDH

HCDM 52 | Dental HygieneGraduate Teaching Assistant and Candidate for Masters of Dental Hygiene Education at the UNC Chapel Hill Adams School of Dentistry. Strong leadership experience in student organizations and projects related to interprofessional education, student research, teledentistry, and dental academia.