Evolving Trends Improve Dental Hygiene’s Professional Standing

Patti DiGangi, RDH


Dentists and hygienists often hit lists of the best jobs. After our laughter subsides, we shrug our shoulders and think, “Yeah, cool, I have a good profession.” Yet the traditional job descriptions used in these surveys are usually frozen in time, like a wooly mammoth in a glacier. Here’s an example from the 2018 US News & World Report list:

“Dental hygienists will clean a patient’s teeth, removing tartar, stains and plaque as they brush, floss and scrape. Dental hygienists are also involved in educating patients on the best ways to brush and floss teeth, as well as which products to use.” 

We’re basically relegated to the role of mouth custodian.

Compare the hygienist job description with that of a nurse practitioner

“Nurse practitioners, also known as advanced practice registered nurses (APRN), are registered nurses with additional education. This extra schooling allows these professionals to take patient histories, perform physical exams, order labs, analyze lab results, prescribe medicines, authorize treatments and educate patients and families on continued care. Nurse practitioners specialize by ‘population,’ such as women’s health or pediatrics. And they can also work in research or academia.”

Pretty impressive, right?

Not to worry! The present and immediate future is looking bright for hygienists, considering the role that hygienists play in the healthcare system when you look at the current trends that are causing our profession, and its corresponding job description, to rapidly evolve.

Dental hygiene is currently described in mechanistic traditional ways that haven’t changed much in the more than a hundred years of the profession. This model has brought a certain level of positive outcomes for those people who have been served. Yet many people have not been served, and they don’t have access to care.

This access to care dilemma is not limited to low-income populations. There are many others with no access due to location, lack of mobility to reach brick and mortar dental practices, and more. This is all changing with greater direct access to patients and teledentistry—one of the factors that is morphing hygiene toward a model closer to that of a nurse practitioner.

Teledentistry is a rising trend and an expansion of the traditional dental practice. Patients can have a virtual dental home in addition to a physical one to serve them when, where, and how it fits their current life circumstances. 

Also, teledentistry can increase a practice’s quality of care and revenue streams by providing profitable outreach to the community without adding more chairs. What’s more, teledentistry is not limited to connecting with patients. Of equal if not greater importance is enhanced inter-professional communication and patient care collaboration.

Teledentistry is a means to an end—improving a patient’s oral-systemic health. It can improve collaboration and referral systems between dental practitioners. These systems can be duplicated across all healthcare disciplines. 

For example, nurses have direct access to patients. Johnson & Johnson has launched the Campaign for Nursing’s Future, a $50 million national initiative to enhance the nursing profession. It has evolved over time to focus on new issues including access to care.

Conversely, lack of access to oral health care is a critical issue in the United States due to disparities in the healthcare delivery system.

Access to care is an important related trend that justifies the need for dental hygienists to have greater direct access to patients. Direct access as defined by the American Dental Hygienists’ Association refers to the ability of dental hygienists to initiate treatment based on their assessment of a patient’s needs without the specific authorization of a dentist, treat the patient without the presence of a dentist, and maintain a provider-patient relationship. 

There are currently 40 states with some level of direct access. It’s a good start. Dental hygienists must play a vital role in the solution to eliminate these disparities and ensure quality oral health and improved total health for all. Expanded clinical responsibilities, acceptance of direct patient access, and the connectivity of teledentistry are emerging trends that are rapidly eradicating the tooth custodian job description.

Ms. DiGangi believes dentistry is no longer just about fixing teeth. Dentistry is oral med­icine. Her work helps dental professionals embrace the opportunities and understand the metrics that accurate insurance coding provides. The ADA recognized her expertise by inviting her to write a chapter in its CDT 2017 Companion book and again for its CDT 2018 Companion. She holds publishing and speaking licenses with the ADA for Current Dental Terminology and a license for SNODENT diagnostic coding. She is the author of the DentalCodeology series of easy-to-read bite-size books. Her latest book, DentalCodeology: ROMA Manual on Dentistry, was cowritten with Benson Baty, DDS. She can be reached at patti@dentalcodeology.com.

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