PURPOSE. The purpose of this research was to investigate the reasons dental hygienists consider leaving or leave dental hygiene and to determine if the reasons vary by employment category. METHODS. In March 1988, mail questionnaires designed by the author were sent to a nationwide sample of 1,008 dental hygienists who graduated in 1982 and who had been surveyed every six months beginning in their senior year of dental hygiene school. Consideration of leaving dental hygiene was ascertained with an open-ended question. Responses to this question were categorized into five determinants of work change: economic, psychological, sociological, physiological, and environmental. Chi-square analysis was used to ascertain if determinants of work change were associated with employment. RESULTS. Responses were received from 812 dental hygienists--an 81% response rate overall and an 83% response rate from subjects with valid addresses. While 82% of the respondents were employed in dental hygiene, 7% were employed outside of dental hygiene, and 12% were not employed. Of the respondents, 57% had considered leaving dental hygiene within six years after graduation. Reasons for considering leaving varied by employment status. Dental hygienists currently employed in dental hygiene stated a wide variety of reasons for considering leaving, but most important were psychological factors. Environmental (family responsibility) factors were most important for unemployed dental hygienists, while economic factors were most important for dental hygienists employed outside dental hygiene. CONCLUSIONS. Factors identified in this research can be used to help understand, and to design efforts to enhance, career retention. Additional research is needed to determine whether the causative factors for job turnover and career turnover are different or essentially the same.