Dental Hygiene and Direct Access to Care: Past and present.

The American Dental Hygienists' Association (ADHA) defines direct access as the ability of a dental hygienist to initiate treatment based on their assessment of patient's needs without the specific authorization of a dentist, treat the patient without the physical presence of a dentist, and maintain a provider-patient relationship. In 2000 there were nine direct access states; currently there are 42 states that have authorized some form of direct access. The ADHA has been instrumental in these legislative initiatives through strong advocacy efforts. While research and data support the benefits of direct preventive/therapeutic care provided by dental hygienists, many barriers remain. This paper chronicles key partnerships which have influenced and advocated for direct access and the recognition of dental hygienists as primary health care providers. The National Governors Association (NGA) released a report in 2014 suggesting that dental hygienists be "deployed" outside of dental offices as one strategy to increase access to oral health care along with reducing restrictive dental practice acts and increasing the scope of practice for dental hygienists. The December 2021 release of the National Institutes of Health report, Oral Health in America, further supports greater access to dental hygiene preventive/therapeutic care. This paper also reflects on opportunities and barriers as they relate to workforce policy, provides examples of effective state policies, and illustrates an educational curriculum specifically created to prepare dental hygienists to provide oral health services in settings outside of the dental office. Dental hygiene education must ensure that graduates are future-ready as essential health care providers, prepared to deliver direct access to dental hygiene care.

Dental hygiene and direct access to care: Past and present.

The American Dental Hygienists' Association (ADHA) defines direct access as the ability of a dental hygienist to initiate treatment based on their assessment of patient's needs without the specific authorization of a dentist, treat the patient without the physical presence of a dentist and maintain a provider-patient relationship. In 2000, there were nine direct access states; currently, there are 42 states that have authorized some form of direct access. The ADHA has been instrumental in these legislative initiatives through strong advocacy efforts. While research and data support the benefits of direct preventive/therapeutic care provided by dental hygienists, many barriers remain. This paper chronicles key partnerships that have influenced and advocated for direct access and the recognition of dental hygienists as primary healthcare providers. The National Governors Association released a report in 2014 suggesting that dental hygienists be 'deployed' outside of dental offices as one strategy to increase access to oral health care along with reducing restrictive dental practice acts and increasing the scope of practice for dental hygienists. The December 2021 release of the National Institutes of Health report, Oral Health in America, further supports greater access to dental hygiene preventive/therapeutic care. This paper also reflects on opportunities and barriers as they relate to workforce policy, provides examples of effective state policies and illustrates an educational curriculum specifically created to prepare dental hygienists to provide oral health services in settings outside of the dental office. Dental hygiene education must ensure that graduates are future-ready as essential healthcare providers, prepared to deliver direct access to dental hygiene care.

A Baccalaureate Education Curriculum to Prepare Dental Hygienists for Expanded Public Health Practice.

UNLABELLED: A baccalaureate dental hygiene education program was intentionally designed and implemented to prepare dental hygienists to work in expanded public health practice. BACKGROUND: Expanded practice dental hygienists (EPDH) in Oregon practice without the supervision of a dentist to provide dental hygiene services for underserved patients with limited access to dental care. Ten competencies were identified for the successful EPDH, and then these competencies were incorporated into the curriculum of a baccalaureate dental hygiene program. METHODS: When recent graduates of the innovative program were surveyed, results indicated that they felt well prepared for expanded practice, they had a high level of interest in working as an EPDH, and all were planning to apply for an expanded practice permit. Two graduates and their unique contributions to individuals in need are profiled. CONCLUSIONS: Intentional preparation of dental hygienists for expanded public health roles suggested the need for a baccalaureate curriculum designed specifically for that purpose. Advocacy and collaboration among educators, legislators, and administrators in Oregon led to the development and implementation of such an innovative dental hygiene education program at Pacific University. Graduates are likely to pursue opportunities working as EPDHs. Further research will document the viability of this purposefully designed curriculum to prepare dental hygienists to help meet the public need for optimal oral health.