Advancing the profession

July 29, 2005
The ADHA announces a broad initiative to ensure the continued growth of the dental hygiene profession.

The American Dental Hygienists' Association released its "Focus on Advancing the Profession" report during its annual session in Las Vegas last June. The report, which was presented during a panel discussion that encouraged feedback from ADHA members who attended, outlined a series of goals in six areas to strengthen the profession in the future.

The association said achieving the goals would "bring about positive change for the dental hygiene profession." The areas targeted by these goals are in research, education, practice and technology, licensure and regulation, public health, and government.


Perhaps no area will affect more hygienists than some of the proposals on dental hygiene education. The ADHA points out that the American Dental Association controls the accreditation process for the dental hygiene education system. The ADHA report quoted the statistic of how, since 1990, 95 new dental hygiene programs have been established and only two offer a baccalaureate program.

The education initiatives addressed by the ADHA report focus on several factors:

• The closing of baccalaureate dental hygiene programs

• The growth of two-year associate degree programs

• A lack of motivation for associate degree graduates to later pursue a bachelor's degree

• A resulting lack of educators who are qualified to teach at dental hygiene programs

"The failure to standardize entry level at the baccalaureate level has had an adverse impact ... Given that some other professions and allied health professions have already moved beyond the baccalaureate degree as the entry to practice, dental hygiene must plan for the advanced degree as the entry to practice in the future," the ADHA report said.

The goal is to implement the bachelor's degree as the "entry to practice" within five years, and for the master's degree to be the "entry" within 10 years after the bachelor's degree becomes the standard.

The dental hygiene profession, of course, would seek an "independent" organization to accredit its education programs, meaning that the ADA's role would be greatly reduced.

Relevance to practicing hygienist: If you have an associate's degree, within the near future, most of your peers could be possessing a bachelor's degree, possibly impacting job opportunities and serving as an additional motivation to earn a bachelor's degree. Unless a dental hygienist is still very young and new to the profession, many hygienists who are already practicing will not be directly affected by the push for a master's degree for "entry" to the profession.

Practice and technology

The ADHA has supported ways to meet the needs of "underserved populations" for years, and a recent solution that has surfaced is the advanced dental hygiene practitioner (ADHP). The association points to a dwindling number of dentists and an increasing number of dental hygienists, suggesting that the ADHP could bridge the gap in providing certain services.

The ADHP would have greater diagnostic leeway and more skills typically associated with restorative dentistry. This group of dental hygienists would be working in a variety of practice settings, including with other health-care professionals such as physicians or corporate health services.

Dentists have long sought "direct reimbursement" as a method of relieving the cash-flow burden associated with some dental insurance plans. The ADHA report suggested that dental hygiene would also lend its support to direct reimbursement as a method of income generation for the ADHP.

The "technology" part of this area of the ADHA report primarily refers to a call to dental hygienists. The association believes hygienists need to use evidence-based dentistry more vigorously in adopting innovative approaches to treatment.

Relevance to practicing hygienist: For many hygienists who feel stifled by traditional private practice, the option to become an ADHP will be welcomed. There is additional training involved, and it will be interesting to observe how dentists react to the intrusion into restorative care. The number of dentists is becoming smaller, not obsolete. The ADA will still be a force to be reckoned with.

Licensure and regulation

Dental boards consisting primarily of dentists regulate the dental hygiene profession. The ADHA report asserts that the time has come for dental hygienists to self-police their profession. The report called for "consumer representation" in a new system of self-regulation.

The association wants to standardize licensure requirements for all states, and one benefit of this goal would be licensure by credentials, enabling dental hygienists to relocate to other states without the hassles typically associated with such moves.

Relevance to practicing hygienist: If a dental hygienist desires a change of scenery or follows a spouse to a different state, he or she won't feel like an unwanted "rookie" — forced to jump through hoops just to make a living.


For research, the ADHA refers to its National Dental Hygiene Research Agenda that was established in the mid-1990s. The association seeks to increase the number of dental hygienists with doctoral or master's degrees to conduct research on "health services, access to care/underserved populations, and health promotion/disease prevention." Other aspects of this goal includes raising appropriate funds for research, improving communication between researchers, and improving the standards of reporting research used by dental journals.

Relevance to practicing hygienist: The ADHA wants to "educate all dental hygienists in the scientific method so that they are competent in searching and evaluating the literature and adopt an evidence-based philosophy." If research is of interest to a dental hygienist, she will be more strongly encouraged in the future to pursue the training needed to study research issues. In addition, hygienists will be better prepared to interpret the research, translating it into evidence-based therapies, clinical applications, product selections, and not being "fooled" by advertisers.

• A resulting lack of researchers who lack the academic background to conduct scientific research into areas relevant to dental hygiene

Public health

The association supports the federal government's call for "public health interventions." The ADHA report seeks to increase the number of dental hygienists who are trained in public health, as well as the promotion of dental hygienists to leadership positions in public health.

Relevance to practicing hygienist: As with the ADHP proposal above, the public health setting offers hygienists some career opportunities outside of traditional clinical hygiene.


Similar to the section on public health, this section of the ADHA report calls for my hygienists to be employed by federal, state, and local governmental agencies. Interestingly, the ADHA also said some political objectives should be achieved, including more dental hygienists being elected to political bodies, lobbying for specific types of health-care legislation and school loan repayment programs, as well as governmental internships for dental hygiene students.

Relevance to practicing hygienist: These political efforts safeguard the duties of a clinical hygienist, as well as salaries and other responsibilities attributed to dental hygienists. The ADHA recognizes that the voice of dental hygienists in the political process has been weak in the past. It's time for voters who are dental hygienists to flex a little muscle.

The ADHA report can be viewed in its entirety at