The Role of Dental Hygienists in Providing Access to Oral Health Care

This issue brief summarizes variations in policies affecting dental hygienists and describes some of the alternative provider models and legislation that states have enacted to leverage dental hygienists in an expanded capacity.

(View/Download)

Executive Summary

Basic oral health care is an important determinant of overall health, yet access to it remains a challenge for millions of Americans. To address barriers to access, particularly in underserved and vulnerable populations, states are considering expanding the oral health care workforce, especially dental hygienists, who typically perform preventive oral health services, including fluoride and sealant applications and prophylaxis (cleanings). These services prevent cavities and gum disease, which, when left untreated, can result in more serious health conditions. Although the curriculum and training requirements for dental hygienists are based on national accreditation standards, the policies and regulations affecting dental hygienists vary widely among states. To increase access to basic oral health care, some states have explored deploying dental hygienists outside of dentists’ offices. States also have explored altering supervision or reimbursement rules for existing dental hygienists as well as creating new professional certifications for advanced-practice dental hygienists.

Although limited domestic research exists on the safety and efficacy of an expanded scope of practice for dental hygienists, studies of pilot programs have shown safe and effective outcomes. International research provides stronger evidence that advancedpractice dental hygienists deliver safe, high-quality care. As states face more demand for oral health, they
should examine the role that dental hygienists can play in increasing access to care by allowing them to practice to the full extent of their education and training.

This issue brief summarizes variations in policies affecting dental hygienists and describes some of the alternative provider models and legislation that states have enacted to leverage dental hygienists in an expanded capacity.