Survey: Independence for Dental Hygienists
The Hygienist May Someday Be an Independent Practitioner
In this poll, we asked dentists:Do you support expanding the role of dental hygienists as independent practitioners?
Four out of five dentists don’t think hygienists should have greater independence. A full 81% of dentists responded, “No - many of these proposed changes would harm dental practices and offer patients a lower standard of care.” Only 19% replied, “Yes - Granting dental hygienists greater autonomy would improve access to care for patients across the country.”
The most significant factor in determining a dentist’s vote was geographic location. Rural dentists were four times more likely than their urban or suburban colleagues to support greater independence for hygienists. As rural areas are more likely to suffer from a shortage of dentists, it may be that rural dentists see hygienists as a way to improve access to care for rural patients.
Specialists were completely (100%) opposed to granting hygienists more independence. While most general dentists were in agreement, one in five general dentists (21%) did favor greater rights for dental hygienists. See the full survey results.
Here are some of the comments our dentists had to share:
Go to Dental School
- “If hygienists want to practice dentistry, go to dental school.” (suburban Illinois)
- “Hygienists would be great independent practitioners upon graduating dental or medical school.” (suburban Connecticut)
There’s No Replacement for a Dentist’s Supervision
- “Expanded roles would be great within a dental practice. It’s not a matter of money, but of complete and thorough care for all.” (urban Florida)
- “Expanding the role of hygienists MUST ensure that patients do not receive fragmented care.” (rural New Hampshire)
What About the Business Model?
- “The business model doesn’t make sense anyway… Hygienists generally do low-profit procedures; the overhead would kill them.” (urban Arkansas)
- “We have it in Colorado and it has had absolutely no impact. Hygienists are not the autonomous entrepreneurial sort.” (urban Colorado)
- “There is no money in prevention so these hygiene offices would go out of business.” (urban California)
Standards of Care Must Be Maintained
- “My concern is the insurance industry will find it easy to set up hygiene clinics that promote minimal care, not optimal.” (urban North Carolina)
- “Only a dentist can diagnose decay and periodontal disease.” (suburban Washington)
- “The mean reason that I need to do more surgery then would have been necessary is poor root planing by hygienists.” (Periodontist, urban Iowa)
In Defense of Dental Hygienists
- “It is us, hygienists, who have the potential to overlook dollar signs in our patients and do the right thing.” (Hygienist, suburban California)
- “I think that it would be great for hygienists to work on their own… in some cases they have a better eye for things than the doctor.” (Not a dentist, suburban Illinois)
Alaska Says It’s the Wave of the Future
- “Dentists have been trying to protect their turf by restricting or denying auxiliaries the ability to provide services… In Alaska, dental health aid therapists are working outside the regulation and licensing of dentistry. We need to wake up and be more receptive to auxiliaries doing portions of patient care and be in control of the education, licensing and regulation of these auxiliaries. It will happen with us or without us.” (suburban Alaska)
Read more comments or check out the full survey results. And feel free to post your own comments!
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March 31st, 2007 at 6:26 am
“There is no money in prevention, so these hygiene offices would go out of business.”
This comment was in the survey of dentists concerning independent dental hygiene practice. I find it ironic that dental hygienists are most concerned about prevention, unlike dentists who are more concerned about the money. Isn’t that why the rural areas in this country are suffering? No money in it for the dentists. Let the hygienists offer early preventative care to pediatric patients, ie. MI care, instead of the old drill ‘em and fill ‘em mode of care now present with most dentists.
Patricia F. Memmo RDH
March 31st, 2007 at 1:16 pm
I just read the results of the survey indicating most dentists do not want hygienists to become more independent because they do not want the standard of care to be diminished. I would like to survey the same dentists and find out how many of them utilized expanded functions assistants in their practice. These assistants are placing the sealants, making temporaries, placing amalgams and resins, removing cement, and adjusting the fillings. The dentist basically drills the holes and leaves, then comes back supposedly to check the final result.
I can assure these dentists that the standard of care has diminished. I have seen more residual cement causing plaque retention, perio problems, and pain. I believe these assistants who practice for a short time on models, and are usually trained by each other (as I have no knowlege of any expanded functions training programs) are doing more to diminish the standard of care than allowing more access by hygienists, (who are well trained and capable) to perform procedures that could improve the quality of lives and health. I am not blaming the assistants, and in some cases, their fillings are much better than the dentist. However, many are not skilled, or have any dental background other than what they have learned on the job.
I say the dentists (not all) want their cake and the ability to eat it too.
How sad for the unsuspecting public. I think it is a big control issue.
April 2nd, 2007 at 2:11 am
Just because a person goes to dental school it doesn’t mean that they are more capable than a hygienist, in the dental field you learn with experience. They can do just a good a job if they chose to go to dental school. In australia, a lot of people are moving from Dentistry into hygiene, because it is very good money and they are well respected as oral health proffessionals, and are able to own their own practice. I don’t think that dentists should look down at hygienists, as they are in a legue of their own, just like the dentist is also in a legue of their own.
August 12th, 2008 at 8:47 pm
Is it a question of expanded responsibility or independence? I don’t see that a reasonable hygienist wants to practice dentistry. Rather they want to provide a service (cleanings) on their own that dentist see as low-profit procedures. This is considered a disruptive business model in corporate world and can be quite profitable.
An example of a disruptive business model is the cellular industry. Originally the big phone companies didn’t actively pursue cellular technology because they believed the quality of service wasn’t good enough. But smaller companies ended up taking customers away from the major phone companies because consumer determined that the convenience of cell phones is more important than the quality of the call.
Whether its right or not, I see a similar attitude among consumers of dental care. The service hygienist want to provide is more convenient and “good enough” than waiting hours in a dentist office for a quality observation.
As an outside observer, I suggest that dentist begin embracing this disruptive business model and figuring out how both the hygienist and dentist can profit from it. Hygienist are on to something here.
There are many more examples of “good enough” models that have changed industries. Think of digital music. Finally the record producers got on board.