ADHA submits comments in support of South Carolina FTC ruling

Aug. 31, 2007
FTC consent order settled charges that state board of dentistry "unlawfully restrained competition."

The American Dental Hygienists' Association (ADHA) recently submitted comments in support of the Federal Trade Commission (FTC) consent order settling charges that the South Carolina State Board of Dentistry "unlawfully restrained competition in violation of Section 5 of the FTC Act by adopting a rule that required a dentist to examine every child before a dental hygienist could provide preventive care — such as cleanings — in schools." The charges against the State Board of Dentistry were originally brought in September 2003.

After a series of appeals reaching the Supreme Court, the FTC charges that the board unlawfully restrained competition through the inaction of the emergency rule were upheld. Prior to the final FTC vote, the agency opened the matter up for a 30-day public comment period, which ended July 19, 2007.

The ADHA submitted comments authored by ADHA Executive Director Ann Battrell, RDH, MSDH, in support of the FTC consent order which emphasized the need to facilitate direct access to preventive oral health care services administered by dental hygienists, especially for the economically disadvantaged.

"The children of South Carolina are the winners in all of this," said Battrell. "Because of the FTC's appropriate and justified intervention, dental hygienists working with Health Promotion Specialists now provide preventive oral health services directly to school children in more than 300 schools in 36 school districts throughout South Carolina.

"Approximately 20,000 school children are served annually. Many of these children have never before received any oral health care services. School principals and school nurses applaud the delivery of oral health services in the schools, citing the quantifiable benefits of this on-site care, including far fewer dental emergencies. As the National Rural Education Association has recognized: 'for a child to be ready to learn in school, a child must be healthy and free from pain. One proven strategy for reaching children at high risk for dental disease is providing oral health services in school-based health centers.'"

ADHA has acknowledged full support for the proposed consent order, which would require the South Carolina Dental Board to (1) affirm and publicize its support for the state legislative policy that prevents the Board from requiring a dentist examination as a condition of dental hygienists providing dental care, including cleanings, sealants, and fluoride treatments, in public health settings, and (2) provide written notice to the FTC prior to any action relating to the provision of preventive dental services by dental hygienists in public health settings.

The FTC decision requires the Board to publicize the terms of the decision to interested parties in the state, specifically through the notification of all current and new dental and dental hygiene licensees and through a written announcement to school superintendents. ADHA also submitted for review the following recommendations:

• The Board should be required not only to send the announcement to all school district superintendents, but to all school principals and school nurses.

• The Board should be required to urge in its transmittal letter that school principals and school nurses place the FTC settlement -- and what it means for the delivery of oral health services in the schools -- on the agenda of the meeting that district principals and district school nurses hold each month.

• The Board's announcements and other communications surrounding this consent order be written in "plain language" that is readily understandable to the average reader.

• The Board should be directed to publicize on its Web site the Centers for Disease Control recommendation that "school-based or school-linked pit and fissure sealant delivery programs be part of a comprehensive population-based strategy to prevent or control dental caries in communities because such programs are effective in reducing tooth decay in children and adolescents."

"In 2003 the Surgeon General noted ' … additional flexibility and capacity of the oral health-care workforce is sorely needed …' " said Jean Connor, RDH, ADHA president. "Direct access to a dental hygienist makes it easier for the public to get preventive care. Improving access to oral health services is a challenge that requires innovative change to the current oral health care delivery system. ADHA applauds the FTC's assistance in eliminating undue barriers to competition that prevent markets from functioning as effectively as possible."

A complete case history is available on the Federal Trade Commission Web site at