1. The Future of Dental Hygiene
By Kathleen Young

2. Areas of Focus
for the Future
• The three main areas of focus that I feel hygienists need
to focus on for the future are:
• Education
• Legislation/ self regulation
• Access to care
• … and yes, it’s enough to make your head spin!

3. Education
In the ADHA focus report, one of the main goals is to “redesign
the dental hygiene curricula based on the increasingly
complex oral health needs of the public.” (Tripp, 2005)
One of the main forces for advancing our profession is the
quality of education each of us receives.
Technology will play a big part in the future education of
hygienists throughout the world. At the University of
Maryland, Baltimore, they have stepped boldly into the 21st
century with the education they are providing for their
hygienists. The next few slides will highlight several of the
areas that are very exciting.

4. Education
• One interesting innovation is that they are teaching some of their students
by distance education. These students are able to hear and see their
faculty through video- conferencing. They also do online testing. The
clinical portion is close to where they live, but connected with the
University.
• Students have access to learning modules and resource via their laptops at
home, in the student clinic and in the simulation settings. (Fried, 2007)

5. Students are able to access a simulated
electronic patient record and use this
information to provide treatment to the
pretend (simulator) patient. This allows the
student to prepare for actual clinical patient
treatment.

6. Virtual Education
• The simulations were what I found most fascinating. They had patient
simulations, they could “virtually scale” and explore with haptic
devices. (Haptic technology, or haptics, is a tactile feedback technology
that takes advantage of a user's sense of touch by applying forces,
vibrations and/or motions to the user. Wikipedia)
• The instructors have remote site access and are able to evaluate
students and correct any mistakes they might be making.
• Students can learn scaling on a virtual tooth and learn to differentiate
between calculus and tooth structure. (Fried, 2007) How cool is that?!

7. Education
• Students can type on a virtual keyboard, which projects
onto a surface which can then be easily cleaned. (Fried,
2007)

8. Education
• This article on education ends with the following
quote:
• “Recognizing the needs of today's student
population and how individuals learn reinforces
the importance and necessity for high technology
offerings.”
“ The wave of the future is here and dental
hygiene education will be on its crest.” (Fried,
2007)

9. Education
The ADHA has suggested that a
bachelors degree be the entry level for
future dental hygienists. I think with
all the advances in dentistry, it will
take this much time to educate
students in all the new research.
They also advocate a PhD program for
dental hygiene. We’re movin’ up!

10. Legislation
• Christina N. Smith, a dental hygiene student, writes about
her experience with legislation in an article entitled
Supporting the Future of Dental Hygiene: A Student
Experience with Association Involvement in Legislation
• « This is where I discovered the world of politics as it
relates to dental hygiene and realized the significance of
legislative barriers with regards to addressing access to
care disparities.
Our association is essential to supporting the future of
dental hygiene. Legislation is an important arena in
professional organization.”

11. Legislation
• One of the new goals of the ADHA is the following:
– The dental hygiene profession will advance through
effective advocacy by ADHA.
– A “Future of Dental Hygiene Advisory Board” (FDHAB)has
been set up which has made the following
recommendations with regards to legislation:
• Achieve self-regulation in all states
• Increase the participation of dental hygienists in the legislative
process.
• Increase representation and participation of dental hygienists at all
levels of government in order to influence public policies and
programs.
• Create multiple levels of clinical practitioners.

12. How are we doing?
• The following information is from Stateline in Access Magazine and
reports what is going on in the United States at this time. (All are
direct quotes from the article)
• The Connecticut Legislature is considering legislation to establish an
advanced practice dental hygiene practitioner again this year.
• Oregon opened its 2011 legislative session with both a dental therapy
bill and a self-regulation bill before the legislature. Dental hygienist
therapists would be able to provide all dental hygiene services
without supervision. With the authorization of a collaborating
dentist, the therapist could also provide restorative services Including
ART, perform class I through V restorations, place preformed crowns,
perform pulpotomies on primary teeth and nonsurgically extract
primary and periodontally diseased permanent teeth.

13. • Washington State House Bill 1310 would create the practice of dental therapy
in that state. In a model reminiscent of the Minnesota dental therapist
structure, the new law authorizes dental therapists (DTs) who would provide
restorative services and advanced dental therapists (ADTs), who would be
licensed dental hygienists who have completed additional dental therapy
coursework and would provide both restorative and dental hygiene services.
• Arkansas proposed Senate Bill 42 to create a Collaborative Care Permit
Program that would authorize dental hygienists to provide prophylaxes,
fluoride treatments, sealants, and other dental hygiene services in public
settings without the supervision of a dentist.
• In Florida a bill is under review that would allow dental hygienists to provide
dental charting, application of fluorides, application of sealants and the
prophylaxis without the supervision of a dentist. (Stateline, 2011)

14. • Maine proposed Legislative Draft 70 that will allow direct
reimbursement to dental hygienists practicing independently as
authorized under the MaineCare program.
• Nebraska legislators are considering whether to reduce some
restrictions on dental hygienists currently providing certain services in
public-health-related settings based on authorization by the health
department rather than by a dentist.
• The New York Assembly proposed Assembly Bill 111,amending the
education law, to establish a collaborative practice agreement in
which dental hygienists may perform all dental hygiene services
without prior evaluation of a dentist or medical professional and
without supervision in the office of any licensed dentist or in any
appropriately equipped school or public institution. (Stateline, 2011)

15. • South Dakota House Bill 1045 would establish an option for
collaborative practice. This would enable dental hygienists
practicing according to a written collaborative agreement between
themselves and a collaborating dentist to treat patients not
previously examined by the dentist in such settings as nursing
homes, public health facilities, prisons, community health centers
and schools.
• West Virginia is also considering a bill that would include dental
hygienists and other health professionals in the state's loan
forgiveness program. According to House Bill 2052, dental
hygienists are eligible to get $5,000 of outstanding loans canceled
per year if, at the end of each fiscal year, they have received a
student loan and rendered services as a licensed hygienist in an
underserved area of West Virginia. (Stateline, 2011)

16. • On May 27, 2010, Ohio Governor Ted Strickland signed into law
House Bill 190, establishing an oral health access supervision program
in which dental hygienists may provide dental hygiene services in
non-office settings without a dentist having previously seen the
patient. (Stateline, 2010)
• As you can see, there is a lot going on in the legislature right now.
Much of it involves access to care, which is a “hot” topic right now.
None of this legislation happens on its own. Behind the scenes are
many actively involved dental hygienists. Are you one of them?

17. Access to Care
• When dental hygiene students were asked to state whether or not they
felt there was a need for an Advanced Dental Hygiene Practitioner (ADHP)
that would provide diagnostic, therapeutic, preventive, and restorative
services.
• 47% felt there was an « extreme demand »
• 47% felt there was an « average need »
• And 5% felt there was « no need » for an ADHP (Barnes, 2007)
• This correlates closely with the ADHA position on access to care and the
need for a mid level practitioner. Many states are moving this direction as
you have seen in the section on legislation.

18. Access to Care
– In 2002 the ADHA implemented the “Future of Dental
Hygiene” project.
– Access to care was one of the main issues they discussed.
Some of the areas of concern are the following:
» Access to oral health is a right of all people
» The oral and general health needs of the U.S. population
are growing, and dental hygiene practice and education
must evolve to meet them.
» Dental hygiene is part of an overall health care delivery
system, not simply an arm of dentistry. Dental hygiene
must create an integrated model or oral health care
delivery through partnerships with other health care
providers.
» Dental hygiene needs to identify and remove the barriers
that restrict access to care. (Gurenlian, 2004)

19. In conclusion…
• Education, legislation and access to
care are all issues facing the future of
dental hygiene. We are moving
forward and with the continued
support of all hygienists, we will
continue to do so.

20. References
• Barnes, W. e. (2007). ADHP and Access to Dental Care: The Dental
Hygiene Students' Perspective. Journal of Dental Hygiene , 1.
• Fried, J. (2007). Innovations in Education and Technology. Journal
of Dental Hygiene .
• Gurenlian, J (2004). Dental hygiene focus for the future report
previes. Access, 33,34
• Smith, c. (2010). Supporting the Future of Dental Hygiene: A
Student Experience with Association Involvement in Legislation.
Access , 8,10.
• Stateline. (2010). Access .
• Stateline. (2011). Access , 25-26.
• Tripp, H. G. (2005). Focus on Advancing the Profession. Retrieved
April 5, 2011, from ADHA:
http://adha.org/downloads/ADHA_Focus_Report.pdf