The Role of Dental Hygienists in Providing Access to Oral Health Care: Are you in charge of your future?
The Role of Dental Hygienists in Providing Access to Oral Health Care is a new paper released by the National Governors Association that summarizes various policies dealing with the role of hygienists and examines alternative models and practices from states. Maria Perno Goldie, RDH, MS, takes a look at highlights of the report.
We know the six roles of dental hygiene: clinician; educator; researcher; administrator/manger; and advocate, all with a focus on improving the health of the public. We know that basic oral health is an important determinant of overall health, yet access to care is still a challenge for many Americans. Dental hygienists can play an important role in improving access to high-quality services, especially for underserved or vulnerable populations, according to a new paper released by the National Governors Association (NGA).(1)
The Role of Dental Hygienists in Providing Access to Oral Health Care summarizes various policies governing the role of dental hygienists and examines alternative models and practices from states. To increase access to basic oral health, some states have explored policies that would permit and even encourage dental hygienists to practice outside dentists’ offices. Specifically, states have looked into altering supervision or reimbursement rules, as well as creating professional certifications for advanced-practice dental hygienists. Thus far, studies of pilot programs have shown safe and effective outcomes.
In spite of the fact that most oral health diseases are preventable, the rate of tooth decay, periodontal diseases, oral cancers, and other conditions is high. Data shows that certain population groups are disproportionally affected.(2) Low income people, minority ethnic groups, and low-income Americans are among these groups. About 25% of children have untreated tooth decay. The rate among low-income children is more than twice that for children with more income (31% versus 14%). African American and Hispanic children also have elevated rates compared to White children (28% and 29% versus 19%). Medicaid and CHIP cover comprehensive dental benefits for children, but 30% of children with private health insurance are uninsured for dental care.(2)
States with over 30 percent of the population living in a Dental Health Professional Shortage Areas (HPSA) are: Alabama (31.8%); Delaware (30.1%); Louisiana (50.6%); Mississippi (57.8%); Montana (33.7%); and New Mexico (38.3%). Low health literacy is also associated with reduced use of dental care.
According to the report, increasing the delivery of affordable preventive services outside of the dental office might reduce the most serious concerns of limited access to dental care. Dental hygienists are capable of assuming an even more important role in expanding affordable access.(1)
We know that a major barrier to the increased use of dental hygienists is scope of practice and supervision requirements mandating that hygienists work directly with dentists to provide prophylactic services. To increase access in high-need populations, and to provide dental hygienists incentives to practice in those communities, some state proposals for expanding dental hygienist practice limit such expansion to hygienists practicing in shortage areas or underserved populations.
To learn more, read the entire report.(1)
1. National Governors Association. http://www.nga.org/files/live/sites/NGA/files/pdf/2014/1401DentalHealthCare.pdf.
2. Henry J. Kaiser Foundation, Oral Health in the U.S.: Key Facts (June 2012), http://www.kff.org/uninsured/upload/8324.pdf.
3. Designated Health Professional Shortage Areas (HPSA) Statistics, Health Resources and Services Administration (HRSA), February 2012. Percentages calculated using 2010 population data from U.S. Census Bureau, available at http://census.gov/2010census/data/.
4. Sheida White, Jing Chen, and Ruth Atchison, “Relationship of Preventive Health Practices and Health Literacy: A National Study,” American Journal of Health Behavior 32 no. 3 (2008): 227–342. http://www.ncbi.nlm.nih.gov/pubmed/19765202.