Hygienists Can Practice Solo in Wisconsin Community Settings

Richard Gawel


On June 21, Governor Scott Walker of Wisconsin signed Act 20, which increases the settings in which dental hygienists can practice without the authorization and presence of a licensed dentist. Written by Representative Kathy Bernier (R-Lake Hallie) and Senator Sheila Harsdorf (R-River Falls), the legislation passed the Assembly as amended and was concurred in the Senate, both on a voice vote.

The expanded settings include federal, state, county, and municipal correction and detention facilities; facilities established to provide care for terminally ill patients; charitable institutions open to the public or members of a religious sect or order; nonprofit home healthcare agencies; nonprofit dental programs serving primarily indigent, economically disadvantaged, or migrant worker populations; nursing homes; community-based residential facilities and hospitals; facilities that are primarily operated to provide outpatient medical services; adult family homes; adult care centers; and community rehabilitation programs.

The bill’s passage follows intense lobbying from the Wisconsin Dental Hygienists’ Association (WI-DHA), which visited the offices of all 132 state legislators in Madison on March 9 to deliver informational packets about the bill. Members also met with legislators or their staffs to ask for support for the bill if they hadn’t already signed on to it. WI-DHA collaborated with other healthcare groups as well, such as the Wisconsin chapter of the American Academy of Pediatrics, the Children’s Health Alliance of Wisconsin, the Wisconsin Dental Association, and the Wisconsin Oral Health Coalition.

According to WI-DHA, the new law will improve oral health throughout the state since dental diseases are nearly 100% preventable, and dental hygienists are prevention specialists. However, the organization says that dental hygienists have been underutilized due to supervision restrictions, which the law now eliminates. By working at the top of their licenses, WI-DHA adds, dental hygienists can go to patients who cannot come to them and provide direct access to preventive care, saving costs for the state while improving oral health.

For example, there were more than 33,000 visits to hospital emergency rooms in Wisconsin due to otherwise preventable dental problems. Hospital-acquired pneumonia can be expensive and deadly, though dental hygienists working in hospital settings may be able to prevent it. Plus, only 20% of expectant mothers in Milwaukee county had a dental visit in the year before their delivery. Dental hygienists on maternity care teams can provide that care. Similarly, diabetics are prone to periodontal disease, and dental hygienists can assist there as well.      

“Removing unnecessary barriers to preventive oral care just makes sense,” said WI-DHA president Jennifer Martinson, RDH. “Licensed dental hygienists in Wisconsin look forward to providing their services without restrictive supervision, and we thank all those who recognize that value and supported this legislation. Our goal is to improve health and the quality of life especially for people who may have difficulty accessing dental care in other ways.”

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