The Chicken and the Egg meets Ground Hog Day

Feb. 29, 2008
The author asks, "How can they apply the word "independent" to direct access dental hygiene when we know all aspects of health care must be interdependent?"

By Susanne Kuehl RDH

Have you heard about direct access dental hygiene on New Hampshire public radio?

It's Ground Hog Day for direct access dental hygiene in New Hampshire. Again. I've been a RDH for 30 years and I can't for the life of me figure out what all the fuss is about when our profession tries to increase access to care.

When the subject turns to working (GASP) "unsupervised" why does the same care we give day after day suddenly become unsafe for the public? Why is the amount of education that earns us a license to practice after passing national, regional, and state exams become suddenly "not enough"?

Why do legislators ask us about the high cost of a dental chair, when it's up to a bank to loan money for small businesses, not the Board of Dental Examiners? Why does the undocumented testimony from the dental society about "failures to safeguard" patients weigh more heavily than the evidence-based data found in the written testimony from our colleagues in Colorado and Washington State?

How can the conversation about dividing the team hold any salt when we want every dental office to employ at least one dental hygienist? How can they apply the word "independent" to direct access dental hygiene when we know all aspects of health care must be interdependent?

Why do I feel like I am saying the same thing again and again and again?

When you add up the shortage of dentists, the oral systemic link, the huge need for oral care for the uninsured, and multiply it by factors like diabetes and heart disease you can see that the oral care "perfect storm" is upon us. But dental hygienists can change the weather! We are trained, licensed, highly capable professionals. Common sense dictates that you put your finger in the dike before you spend your time mopping up the water on the floor.

We will never drill and fill our way out of this mess. Prevention costs less than repair work. For every dollar spent on prevention, between $8 and $50 is saved in restorative treatment.

Nurses listening to our testimony ask why aren't we self regulated, and seem to ignore that our bills, HB1208 & SB393 include a provision for an advisory committee to the dental board to create rules and possible credentialing for direct access status. We explain that our dental board only has two hygiene voting members even though we out number dentists in the state. However, without the egg (direct access) allowed to incubate how can it ever develop into a chicken (self regulation)? Or does self-regulation HAVE to come first so it can lay some direct access eggs?

Have you seen the Wallace and Gromit cartoon, Chicken Run? Having been hopelessly repressed at the chicken farm where they are held, Rocky the rooster (Mel Gibson) and Ginger the chicken (Julia Sawahla) lead their fellow chickens in a great escape. Ginger doesn't let many failed attempts deter her from seeking freedom nor stop believing that one day they will fly over that wall. It's time to control our own eggs and manage our own chicken coop.

In a political landscape paying a lot of attention to the spiraling costs of heatlh care; it seems to me that our time has come in the eyes of consumers and the patients who need our care. We need out-of-the-box thinking to create dozens of business models that can reach patients where they live, such as nursing homes, schools and pediatrician offices. We need more care, in more settings, with more collaboration between all health disciplines not less. It's time to break the Ground Hog day legislative litany by creating a conversation with the media that highlights safe, affordable, preventive dental hygiene services as an integral part of total health care.

Please join New Hampshire hygienists by calling or writing New Hampshire public radio with your comments and testimony. Help us remind our legislators, that the only losers in delaying these bills are the consumers who need our care.

Background articles in the news:

Susanne Kuehl, RDH, is co-chair of Direct Access Dental Hygiene in NH:
Safe, Affordable, Preventive Dental Hygiene Care, a 30-year ADHA member, and past president of NHDHA. She can be contacted at [email protected]..