Expanded Roles for Hygienists Improve Populations’ Oral Health

Dentistry Today


The population’s oral health notably improves in states where dental hygienists are allowed by law to practice at higher levels of professional competence and skill, according to the SUNY University at Albany’s Center for Health Workforce Studies (CHWS). Individual states’ laws and regulations define scopes of practice for health professionals. 

CHWS researchers examined 2014 scope of practice parameters for dental hygienists nationwide and found that in states where dental hygiene scope of practice rules were closely aligned with dental hygiene professional competence, there was a statistically significant association with positive oral health outcomes in the population.

In 2001, the researchers developed the Dental Hygiene Professional Practice Index, a numerical tool to measure the state-level professional practice environment for dental hygienists. The mean composite score on the index increased from 43.5 in 2001 to 57.6 in 2014 on a 100-point scale.

The researchers also analyzed the association of each state’s composite score with tooth extractions among the adult population because of decay or disease. After controlling for individual-level and state-level factors, multilevel modeling showed that more autonomous dental hygienist scopes of practice had a positive and significant association with population oral health in both 2001 and 2014.

“Demonstrating that broader scopes of practice for dental hygienists are correlated with better oral health outcomes is very useful, especially in public health settings,” said Margaret Langelier, deputy director of the Oral Health Workforce Research Center at CHWS and leader of the study’s research team.

“The impact of scope of practice is an important consideration for policymakers when identifying strategies to increase the availability of preventive oral health services, particularly for underserved populations,” said Langelier.

The study, “Expanded Scopes of Practice for Dental Hygienists Associated with Improved Oral Health Outcomes for Adults,” was published by Health Affairs.  

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