Dental hygienists in Italy: Where are we?
Olivia Marchisio, RDH, DHA, PhDc, reviewed the development of dental hygiene in Italy during the recent Belgian Society of Periodontology session. She also shared her take on the future of the profession in the country, and how she sees the role of the hygienist changing in coming years.
As presented to the Belgian Society of Periodontology
I believe in order to succeed, we must know the past, understand the present, and foresee the future.
In 1978, the University of Bari was the site of the first school for dental hygienists in Italy. The first 14 dental hygienists in Italy graduated in 1981. Also in 1981, thanks to the first dental hygiene graduates from Bari, the Associazione Igienisti Dentali Italiani (AIDI) was founded.(1) The goal of this Association is to promote the dental hygienists’ role within Italy.
A Ministry Decree from the Italian Government in January 1988 defined, for the first time, the professional roles and tasks of dental hygienists. In 1989, AIDI became a member of the International Federation of Dental Hygienists (IFDH). In 1993, the first National Labour Contract was signed in Rome, and the dental hygiene role was recognized.(2)
A Ministry Decree in September 1994 declared “rules concerning the Dental Hygienists’ location and professional profile.” Dental hygiene was then considered a Technical Health Care Profession in the medical care area. The Bologna Declaration of June 1999 put in motion a series of reforms needed to make European Higher Education more compatible and comparable, more competitive and more attractive for Europeans and for students and scholars from other continents. Reform was needed then, and reform is still needed today if Europe is to match the performance of the best performing systems in the world.(3)
This declaration makes an easier academic system, which includes a first level degree (three years) and a second level degree (two years). Dental hygienists second level degree is a degree in the area of technical health professions. Through this formative training, dental hygienists can access management positions in both public and private organizations. A second level degree also allows entrance to PhD programs and second level master's programs.
Currently, Italy has three national associations: AIDI, UNID, and SIDID. There is a national research association/society called SISIO. There are 6,000 dental hygienists in Italy and 60,000 dentists. In 2005, AIDI’s Constitution was strongly reformed. The most important changes made were: Association offices renewal; more democracy within the association; and more members’ involvement within the association’s activities. The DH Newsletter was started in January 2006 to celebrate the 25th year of activity of AIDI. It’s a scientific magazine free for all members.
Medicine is no longer the only branch, new health sciences have been born in the last years, with a variety of different professions emerging. There is a demand for dental hygiene practitioners, as this category has started to be recognized by dental professionals. The responsibility of performing nonsurgical periodontal therapy and bleaching procedures is permitted by to dental hygienists. Usually, the first visit is to a dentist, who then sends the patients to dental hygienists for the nonsurgical periodontal treatment.
It takes teamwork with dentistry, its specialties, and dental hygiene. What do I see for the future?
I see a change in the relationship between the patient and the dental hygienist. It used to be that the practitioner (physician, dentist, dental hygienist) played the central role, now the patient assumes that role. Teamwork within the office, hospital setting, and in interdisciplinary settings will be vital. Dental hygienists will have private roles, public roles, and social roles.
The dental hygienist is considered a privileged interlocutor, as he or she is the professional within the dental office who sees the patient most often during the year. Some dental hygienists have opened their own offices, as allowed by law. In a public setting, the dental hygienist will assume more health roles, educational roles, and research roles. You will find dental hygienists in hospitals and in public settings in order to meet the needs of all social class needs.
Regarding educational roles, the number of dental hygienists acting as teachers and coordinators in universities is increasing. The goal for the coming years is to increase the number of dental hygiene educators and coordinators in dental hygiene programs. Regarding research, some dental hygienists in Italy are working as researchers. As in the public role, in this field, the goal is to increase the number of practitioners who work in the research area. The next step is to create more dental hygienists with a PhD degree in order to increase dental hygienists in research positions.
In a social role, a dental hygienist can help the underserved to access public health care programs. There will be greater cooperation between dental and social programs. Examples are: Overland for Smile; Health Smile projects in schools; and Festival della Salute, an activity dedicated to promote health habits (also oral health) for consumers. Working with and developing programs for those with special needs will increase. The Deontological Code consists of: “Rules and Principles That Dental Hygienists Must Respect and Make All People Respect in the Exercise of Their Profession. These Rules Move the Choices inside the Different Liability Levels.”
The European Dental Hygienist Federation was founded in 1998 during the IFDH Congress in Florence, but it was implemented in 2001 on May 5th at Utrecht. In Utrecht, eight nations signed the European Federation constitution: Italy, Spain, Swiss, Germany, Austria, Portugal, and Holland. After this, two other two nations became European Federation members: Slovakia and Czech Republic.
“NON AVERE PAURA DI AVERE CORAGGIO” (“Don’t be afraid to be brave”)
--Pope Giovanni Paolo II
Olivia Marchisio, RDH DHA, PhDc, Istituto Stomatologico Tirreno Versilia General Hospital, is a PhD student in Nanobiotechnologies and Nanobiosciences, University of Genoa.
To read more articles in RDH eVillage FOCUS written by Olivia Marchisio, click here.
To read more about dental hygiene internationally, click here.