1.Background

While the concept of a quality job varies somewhat across time, countries, and industries, it is generally reported that employment ethics, income and benefits, working hours and work-family balance, job security and social protection, social dialogue, skills development, and continuing educa-tion, and workplace interpersonal relationships are among the factors that can be used to measure job quality^1,2). Quality work is important as it not only affects the attitudes and behaviors of individuals as members of an organization³⁾, but it is also related to their health and quality of life⁴⁾. In addition, as job satisfaction is related to job effectiveness and turnover intentions^5,6), it is necessary to create a work environment that meets the high-quality job conditions in order to maintain organizational stability.

The demand for jobs in the healthcare sector is steadily increasing due to the increase in national income and the aging population in South Korea⁷⁾, and healthcare jobs, which are centered on professional positions, are recog-nized as quality jobs. However, jobs in care and health services workers, medical technicians, and healthcare- related industries are reported to be poorly paid and not recognized as jobs with career prospects⁸⁾.

As for dental hygienists, emotional labor, stress, long working hours, and low wages have been raised as pro-blems, and the need to improve the working environment has been continuously raised^9,10). The reason for the need for quality jobs in the dental field is that the dental work environment affects job satisfaction, work commitment, and turnover intention of dental hygienists, and frequent turnover of dental hygienists can impair the stability of dental organizations and the efficiency of dental patient care^11,12).

To date, most studies on dental job quality have focused on dental hygienists to examine dental work-related charac-teristics^9-12), and it is hard to find studies that capture workers’ perceptions of the current dental work environ-ment and job conditions. In order to increase the number of quality dental jobs, it is necessary to survey and discuss with dentists, along with dental hygienists, their percep-tions of what is needed for a good work environment, given that in most dental practices, dentists are the practice owners and determine dental work policies and job condi-tions. Furthermore, it is necessary to investigate which work policies are associated with job satisfaction among dental workers and propose measures to improve the quality of dental jobs.

2.Objectives

This study aims to investigate the perceptions of dentists and dental hygienists regarding quality dental job condi-tions and to identify differences in perceptions based on job type. It is also intended to identify any difference in job satisfaction among dentists and dental hygienists de-pending on the work policies of the dental practice.

1.Ethics statement

This study was approved by the Institutional Review Board of Shinhan University (SHIRB-202303-HR-182-02).

2.Study design

This study examined the general characteristics of the participants, their perceptions of quality job conditions, and their job satisfaction with their current workplace’s work policies and job conditions through face-to-face or online surveys. In order to investigate the perception of quality job conditions, 13 conditions related to quality job indicators were identified based on previous studies^13,14), and a survey questionnaire was constructed asking respondents to rate their importance. This study reviewed the work policies that affect quality jobs^9,10,15,16) and selected 10 survey items to investigate the work policies of workplaces.

3.Sample size

This study surveyed dentists and dental hygienists working in dental practices for about one month starting in June 2023, either in person or online using Google Forms. By convenience sampling, participants were selected if they understood the purpose of the study and agreed to participate in the survey. The number of participants was calculated using G*Power 3.1 for Windows with a significance level of 0.05, an effect size of 0.5, a power of 95%, and a dropout rate of 10%, resulting in a minimum sample size of 142 for the t-test. A total of 142 participants participated in this study, and after excluding those with missing values, 132 parti-cipants were included in the analysis.

4.Intervention

The general characteristics of the participants included gender, job type, clinical experience, workplace type, and working hours per week. The workplace types were general hospitals, dental school hospitals, dental hospitals, and dental clinics, which were reclassified into dental and general hospitals, dental hospitals, and dental clinics for analysis.

Perceptions of quality job conditions were measured on a 13-item scale ranging in importance from “not important at all” (0 points) to “very important” (4 points) and then converted to a 4-point scale for analysis. Participants were asked to prioritize quality job conditions by ranking them from 1 to 3. The Cronbach’s alpha for the perception of quality job conditions item was 0.892.

The work policies of the studied workplaces were surveyed in 10 items, with each item rated as “there is a policy,” “there is a policy, but it is difficult to use,” “there is no policy,” and “I don’t know.” “I don’t know” was then reclassified as “there is no policy” for analysis.

Job satisfaction was rated as “very dissatisfied” to “very satisfied” and then converted to a 4-point scale for analysis.

5.Statistical methods

The general characteristics of the participants were ana-lyzed by frequency analysis, and the importance of quality job conditions was measured by descriptive statistics. In order to analyze the difference in job satisfaction according to the job type and work policies of the workplace, the normality of the dependent variable was examined, and since the Kolmogorov-Smirnov test did not follow a normal distribution (p<0.001), the Mann–Whitney U test, a non-parametric test, was performed. Statistical analysis was performed using SPSS 26.0 (IBM Corp., Armonk, NY, USA), and the statistical significance level was set at 0.05.

1.General characteristics

Dentists comprised 28.0% of the participants, while dental hygienists comprised 72.0%. The most common workplace type was dental and general hospitals (50.0%), followed by dental hospitals (27.3%) and dental clinics (22.7%). As for the working hours per week, 72.7% wor-ked five or fewer days per week (Table 1).

General Characteristics

Variable	Total	Dentist	Dental hygienist
Sex
Male	19 (14.4)	16 (43.2)	3 (3.2)
Female	113 (85.6)	21 (56.8)	92 (96.8)
Workplacetype
Dental and general hospitals	66 (50.0)	29 (78.4)	28 (29.5)
Dental hospitals	36 (27.3)	6 (16.2)	30 (31.6)
Dental clinics	30 (22.7)	2 (5.4)	37 (38.9)
Clinical experience
1∼2 years	32 (24.2)	16 (43.2)	16 (16.8)
3∼5 years	28 (21.2)	10 (27.0)	18 (18.9)
6∼10 years	23 (17.4)	9 (24.3)	21 (22.1)
11 years or more	49 (37.0)	9 (24.3)	40 (42.1)
Working hours per week
5 days or less	96 (72.7)	18 (48.6)	78 (82.1)
6∼7 days	36 (27.3)	19 (51.4)	17 (17.9)
Total	132 (100)	37 (28.0)	95 (72.0)

Values are presented as n (%).

2.Importance of quality job conditions

When asked about their top three priorities by profe-ssion, dentists rated income as the most important, followed by working hours and interpersonal relationships, while dental hygienists rated income as the most important, followed by holiday support and welfare, working hours, and interpersonal relationships (Fig. 1).

Fig. 1. Prioritizing quality job conditions.

Looking at differences by job type, dental hygienists rated all conditions as more important than dentists except income, indicating a statistically significant difference (p<0.05). In particular, the conditions with the greatest difference in im-portance between dental hygienists and dentists were holiday support and welfare, followed by human relationships and personal development potential (Table 2).

Importance of Quality Job Conditions

	Dentist (n=37)	Dental hygienist (n=95)	p-value
Income	3.57±0.50	3.72±0.52	0.064
Working hours	3.46±0.56	3.67±0.49	0.033
Employment security	3.30±0.57	3.64±0.58	0.001
Education and healthcare support	2.81±0.62	3.17±0.75	0.009
Holiday support and welfare	3.22±0.67	3.71±0.56	<0.001
Four types of social security contributions	3.41±0.60	3.73±0.51	0.001
Social reputation	2.92±0.55	3.26±0.72	0.006
Job autonomy	3.11±0.61	3.39±0.69	0.018
Individual empowerment	3.08±0.72	3.38±0.72	0.027
Comfortable and safe work environment	3.27±0.61	3.60±0.57	0.003
Interpersonal relations	3.16±0.69	3.58±0.63	0.001
Personal development potential	2.95±0.70	3.37±0.67	0.002
Industrial relations	3.00±0.62	3.40±0.64	0.001

Values are presented as mean±standard deviation.

p-values were Mann–Whitney test.

3.Status of work policies in studied workplaces

In terms of the work policies, 96.2% of the practices in the study were required to have the four types of social security contributions, but fewer had flexible working hours (19.7%), healthcare support (23.5%), and incentives (25.0%). There were 62.1% and 60.6% of workplaces supporting maternity and parental leaves, respectively. Training support (19.7%), flexible working hours (15.9%), and overtime pay (15.9%) were more likely than other items to have policies but were difficult to use (Table 3).

Status of Work Policies in Dental Practices

	There is a policy (%)	There is a policy, but it is difficult to use (%)	There is no policy (%)
Four types of social security contributions	96.2	1.5	2.3
Holiday expense support	44.7	5.3	50.0
Overtime pay	64.4	15.9	19.7
Incentives	25.0	6.1	68.9
Flexible working hours	19.7	15.9	64.4
Using annual, monthly, and sick leaves	86.4	9.1	4.5
Education support	49.2	19.7	31.1
Healthcare support	23.5	12.9	63.6
Maternity leave	62.1	6.8	31.1
Parental leave	60.6	3.0	36.4

4.Job satisfaction based on the work policies of workplaces

Looking at job satisfaction based on dental work policies, dentists who received holiday expense support (3.06 points) and overtime pay (3.19 points) were statistically significantly more satisfied with their jobs than those who did not (p<0.05).

Dental hygienists were statistically significantly more likely to be satisfied with their jobs if they received edu-cation support (2.61 points) and if they had access to parental leave (2.57 points) than if they did not (p<0.05) (Table 4).

Job Satisfaction according to Dental Work Policies

Classification	Dentist	Dental hygienist
Four types of social security contributions
There is no policy or is difficult to use	3.00±0.00	2.75±0.50
There is a policy	2.69±0.82	2.44±0.85
p	0.652	0.413
Holiday expense support
There is no policy or is difficult to use	2.37±0.68	2.41±0.96
There is a policy	3.06±0.80	2.51±0.64
p	0.006	0.830
Overtime pay
There is no policy or is difficult to use	2.33±0.80	2.35±0.94
There is a policy	3.19±0.54	2.49±0.80
p	0.001	0.511
Incentives
There is no policy or is difficult to use	2.70±0.79	2.45±0.88
There is a policy	2.71±0.95	2.46±0.71
p	0.803	0.943
Flexible working hours
There is no policy or is difficult to use	2.66±0.83	2.38±0.86
There is a policy	3.00±0.71	2.71±0.72
p	0.366	0.095
Using annual, monthly, and sick leaves
There is no policy or is difficult to use	2.50±0.85	1.88±1.25
There is a policy	2.78±0.80	2.51±0.78
p	0.379	0.188
Education support
There is no policy or is difficult to use	2.61±0.74	2.23±0.90
There is a policy	3.00±1.00	2.61±0.76
p	0.161	0.039
Healthcare support
There is no policy or is difficult to use	2.70±0.79	2.41±0.84
There is a policy	2.71±0.95	2.58±0.83
p	0.803	0.312
Maternity leave
There is no policy or is difficult to use	2.74±0.86	2.11±0.99
There is a policy	2.50±0.55	2.54±0.77
p	0.467	0.069
Parental leave
There is no policy or is difficult to use	2.69±0.82	2.00±0.92
There is a policy	2.80±0.84	2.57±0.77
p	0.830	0.006

Values are presented as mean±standard deviation.

p-values were Mann–Whitney test.

1.Key results

This study compared the perceptions of dentists and dental hygienists regarding quality dental job conditions and identified differences in perceptions based on job type.

As a result, both dentists and dental hygienists perceived income and working hours to be of priority importance for quality job conditions (Fig. 1). Decent wages and working hours are key components of the quality job indicators. In particular, working hours are perceived to be more important than in the past, and research on what constitutes a quality job among young people¹⁷⁾ has shown that even if wages are met, they do not perceive a job as good if it does not include elements of work-life balance. However, in this study, 27.3% of the participants worked 6∼7 days a week (Table 1), suggesting that the dental work environment was somewhat different from the workers’ perception. According to Oh and Hwang¹⁸⁾, who analyzed 299 dental hygienist job ads, dental hygienists report working an average of 8.99 hours per day and 5.3 days per week. Converting this to hours per week was 47.83 hours, which exceeded the statutory working hours of 40 hours. Since working hours are associated with musculoskeletal symp-toms, job stress, and turnover intentions^19,20), it is believed that regulations regarding adequate working hours are necessary to protect the health of dental professionals and to create a working environment in which they can provide quality dental care. In addition, according to this study, 64.4% of dental practices either have flexible working hours, but they are difficult to use or do not have flexible working hours at all, so dental practice owners need to establish policies for flexible working hours, such as flexitime, and create a work environment atmosphere and human resource management system that allows employees to utilize these systems if they want to.

In this study, dental hygienists considered holiday support and welfare, interpersonal relationships, and personal deve-lopment to be more important than dentists, and the diffe-rence in importance of these items was somewhat greater than the other items (Table 2). According to Oh and Hwang (2008)¹⁸⁾, 60.5%, 63.9%, and 43.1% of dental clinics reported that they had annual leave, monthly leave, and vacation in their job advertisements for dental hygie-nists, respectively, and 23.4% reported that they had em-ployee training, suggesting that the conditions considered important by dental hygienists as employees were not well reflected in the working environment. Choi et al.²¹⁾ found that annual and monthly leave systems, maternity and paternity leave systems, the provision of opportunities to participate in self-development, and hierarchical culture in dental practices were associated with dental hygienists’ turnover intentions. Since frequent employee turnover and leave are factors that reduce the productivity and efficiency of the organization, employers of dental practices should be concerned about the job quality that dental hygienists value from a dental management perspective and consider specifying these items in the work policies.

In this study, 60.6% of the participants reported having access to parental leave (Table 3), which was higher than the 46.8 percent reported in Kang et al.²²⁾, indicating a positive change from the past. Also, dental hygienists had statistically significantly higher job satisfaction when parental leave was available (2.57 points) than when it was not (p<0.05) (Table 4). This was in line with a previous study²²⁾ reporting lower turnover among dental hygienists with access to maternity and parental leave programs. Given the nature of the job, it is important for employers to support work-family balance, so employers should support dental hygienists’ maternity and paternity leave, as well as the ease of returning to work and the environment enabling the balance of work and childcare after returning to work.

2.Limitations and suggestions for further studies

This study was limited in representativeness as the parti-cipants were selected by convenience sampling, and the number of participants per dental practice was not limited, so there might be some bias due to participants from the same work environment. In addition, to investigate the per-ception of quality jobs, the importance of each condition was identified, but the desired level of each condition was not further identified. Future studies should limit the number of participants per organization, recruit similar numbers of participants by job and workplace types, and further disaggregate by quality job conditions.

None.

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Ethical Approval

The study was approved by the Institutional Review Board of Shinhan University (SHIRB-202303-HR-182-02).

Author contributions

Conceptualization: Bo-Young Park and Mi-Sook Yoon. Data acquisition: Mi-Sook Yoon. Formal analysis: Bo-Young Park. Supervision: Bo-Young Park. Writing-original draft: Bo-Young Park and Mi-Sook Yoon. Writing-review & editing: Bo-Young Park and Mi-Sook Yoon.

Funding

None.

Data availability

The datasets used and/or analyzed during the current study available from the corresponding author on reaso-nable request.