Working

Julie Carranza, RDH, BS

Historically, one of the strongest attractions of a career in dental hygiene has been the flexibility that the profession can offer. From corporate to clinical, dental hygienists practice in a variety of settings. But Julie Carranza, RDH, BS, took advantage of the global need for preventive oral health care to practice in a setting where American dental hygiene professionals seldom do--Australia.

Carranza's adventure came at a time when she was looking for a way to "spread [her] wings" after a divorce. "I wanted to show my daughter Kelsie that girls can do whatever they want," she says. "They don't have to crawl in a hole after a divorce, and change is OK." Having practiced in the clinical setting for 12 years at the Wendel Family Dental Centre in Vancouver, Washington, she realized that her profession could be her ticket to adventure. She chose Australia because it was the sunniest place she could think of where she wouldn't face a language barrier seeking work.

As Carranza began researching her trip, she realized she had her work cut out for her. Dental hygienists looking to practice overseas face a number of obstacles. Most notably, almost all countries have stringent visa requirements for foreign workers. Additionally, there are tax obligations to be considered, the difficulty of arranging for housing and for schooling children, and cultural differences that require adjustments. Different countries also have different licensure requirements; Carranza had to go to Australia to complete both written and clinical exams before she could practice there.

The Internet was central to Carranza's planning efforts, particularly the Web sites of the American Dental Hygienists' Association, the International Federation of Dental Hygienists, and the Dental Hygienists' Association of Australia. She recruited a professional immigration agent--a lawyer who specializes in helping people arrange foreign visits for work and pleasure. "Without my agent, it would have taken so much longer," she says. "They know how to push the paperwork."

Carranza found work in Australia with a highly reputable periodontist whose maintenance program had outgrown his capacity. Patients due for a three-month check-up often had to wait six or seven months. During her stay, she learned this situation is not unique. "There are 120 periodontists and 20 million people--that's just not enough specialists," she says.

Carranza was shocked by Australia's lack of oral health care access. "As a whole," she says, "the preventive dental industry is nearly 10 years behind that of the United States." She saw patients who had been referred to her office by a general dentist long after periodontal treatment stood its greatest chance of success.

Australia presents a unique opportunity for dental hygienists looking to work abroad. While high levels of unemployment throughout the country generally limit jobs available to foreigners, Australia's need for clinical dental hygienists makes it vastly easier for them to receive the necessary working papers.

And American dental hygienists can make an impact on the Australian health care industry, Carranza found. Under her direction, the periodontist's office was able to establish a dental hygiene department to manage deep-scaling and maintenance patients, which allowed the periodontist to concentrate on surgery. Carranza also helped oversee hiring and organization within the practice. She says the work "opened [her] eyes to the opportunities outside of clinical hygiene," and that she looks forward to exploring the numerous nonclinical options the profession has to offer.

Carranza's trip was not all work and no play. During her 14-month visit, she and her daughter went whale-watching, snorkeled parts of the Great Barrier Reef, and made a walkabout in the outback, in addition to countless other activities. "We didn't have a TV in Australia, and we didn't miss it," she says. "I basically worked to earn money to play!" Carranza found her time in the outback to be among the most memorable parts of her trip to Australia. "It was so Australian: the hat, the shoes, the flies," she says.

Another memorable part of her trip was accepting a marriage proposal atop Ayers Rock, the world's largest monolith. Now home in the Vancouver area and helping her new husband ramp up an Australian franchise he brought to the United States, Carranza says she is practicing dental hygiene as a temp and becoming more involved with her local dental hygienists' association.

Carranza believes the trip was one of the most important personal and professional journeys she has ever undertaken. She has no plans for international travel as her daughter enters her preteen years, but acknowledges, "there's a lot of America to explore!"

This edition of Working was prepared by Daniel Bond.