Director's Message: "Dwarf Planet?" "Dwarf Hygiene?" More or Less.

    Sept. 29, 2006
    The ADA's attempt to create a new team position begs the question: Whatever happened to that other group ... uh, they were called dental hygienists?

    Last month, the International Astronomical Union (IAU) — the people who officially keep track of the heavenly bodies; i.e., the planets &mash; ruled that Pluto is not a planet after all.

    So for those readers who are parents, or for anyone who tutors young minds, we will not only be struggling with the "new math" that has been causing a disconnect between antiquated adults and youth. Science is now causing yet another ripple between what we learned in school and what the younger generations will learn. We have to remember that there are eight planets, not nine. Or do we?

    As the members of IAU are debating "What is a planet?" here on Earth the American Dental Association is constantly rehashing the question, "What is a hygienist?"

    According to the American Dental Hygienists' Association, "Dental hygienists are preventive oral health professionals, licensed in dental hygiene, who provide educational, clinical, and therapeutic services that support total health through the promotion of optimal oral health."

    Sounds like a solid definition to me.

    So why, in May of this year, did the ADA propose a new team member category? They refer to it as an "innovative answer" to the problem of access to care. This new member — called the community dental health coordinator (CDHC) — "would work under the supervision of a dentist (that's a shocker) and will connect with federally qualified health centers and community groups like senior citizen centers and school boards to promote dental health," according to the ADA. (Click here for more information: www.ada.org.)

    In addition, the ADA states that the "CDHCs most likely would be trained in dental schools, community colleges with existing dental hygiene and dental assisting programs, hospitals, or community health centers."

    Of course the length of training will vary and it is a little sketchy.

    Huh? I thought that we could already work in the following health-care settings: private dental practices; hospitals; managed-care organizations; federal, state, and municipal health departments; primary and secondary school systems; private businesses and industry; correctional institutions; and private and public centers for pediatric, geriatric, and other special-needs care.

    So why is there a need for a CDHC?

    Since lack of access to quality oral health care is, according the Surgeon General's Report (2000), an "oral health crisis," the ADHA's approach of creating a task force to develop the Advanced Dental Practitioner (ADHP) appears to be a more prudent approach. Why? (Click here to learn more: www.adha.org.)

    The ADHP, according to its draft statement, will provide "diagnostic, preventive, therapeutic, and minimally invasive restorative services to the underserved public and connect those in need with more advanced care."

    Plus, to elevate any perceived issues with public safety in the delivery of such services, the ADHA is developing a master level curriculum, which will build upon the current dental hygiene education.

    In October, the ADA will come together for its 147th Annual Scientific Session. During one or more of the House of Delegates meetings, the topics of CDHC, ADHP, access to care, quality cost-effective services, and dental hygienists will be discussed. It appears to me that the educated, rational voting member would prefer not to dumb down the profession of dental hygiene by creating a superficial team member — all in the name of increasing access to care. And that the enlightened ADA member would abandon the self-serving mentality of "scarce hygienists." I define this mentality as the belief that self-regulated dental hygienists accessing the segment of the population that is not currently seeking care will somehow threaten their dental practices.

    Rather than continuing this hygiene-dental war, the ADA House of Delegates should embrace the reality that dental schools are graduating fewer dentists, that the edentulous rate is continuing to drop, and approximately 53 percent of those age 17 and older have some form of periodontal disease. It is my professional hope that organized dentistry will realize that the oral-systemic link is not going away, and the body of knowledge and interest from our patients, other medical communities, and commercial entities is credible. These trends will undeniably fuel the need for expansive, educated, and self-regulated practitioners — dental hygienists, for example.

    You don't have to be an astronomer to feel a special connection to Pluto, because dental hygiene has been in that orbit since its inception. Similar to the mind-numbing discussions by some of the scientists in the IAU who are bickering over what a planet is and is not, it is this author's hope that the ADA moves out of its self-imposed black hole, spinning its axis defining and redefining hygienists.

    It's a little embarrassing for the ADA to continually wrangle over dental hygiene's future, since, on other side of the solar system, the ADHA — together with new multidisciplinary teams — is sharing intergalactic space. We are proving that the dark matter of the ADA will not prevent oral health successes and advances, which will prove to be astronomical for our patients.

    Kristine A. Hodsdon, RDH, BS
    Director, RDH eVillage