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Research ArticleCritical Issues in Dental Hygiene

Dental Hygiene and Direct Access to Care: Past and present

Cynthia C. Gadbury-Amyot, Melanie L. Simmer-Beck, Ann Lynch and Lisa J. Rowley
American Dental Hygienists' Association October 2023, 97 (5) 24-34;
Cynthia C. Gadbury-Amyot
Division of Dental Hygiene, University of Missouri-Kansas City School of Dentistry, Kansas City, MO, USA
Contributor, Oral Health in America: Advances and Challenges, National Institutes of Health, Bethesda, MD, USA
MSDH, EdD, FADHA
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  • For correspondence: [email protected]
Melanie L. Simmer-Beck
Department of Dental Public Health and Behavioral Science, University of Missouri-Kansas City School of Dentistry, Kansas City, MO, USA
MS, PhD
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Ann Lynch
Advocacy Division, American Dental Hygienists’ Association, Chicago, IL, USA
BA
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Lisa J. Rowley
Pacific University School of Dental Hygiene Studies, Hillsboro, OR, USA
RDH, MS
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Abstract

The American Dental Hygienists’ Association (ADHA) defines direct access as the ability of a dental hygienist to initiate treatment based on their assessment of patient’s needs without the specific authorization of a dentist, treat the patient without the physical presence of a dentist, and maintain a provider-patient relationship. In 2000 there were nine direct access states; currently there are 42 states that have authorized some form of direct access. The ADHA has been instrumental in these legislative initiatives through strong advocacy efforts. While research and data support the benefits of direct preventive/therapeutic care provided by dental hygienists, many barriers remain. This paper chronicles key partnerships which have influenced and advocated for direct access and the recognition of dental hygienists as primary health care providers. The National Governors Association (NGA) released a report in 2014 suggesting that dental hygienists be “deployed” outside of dental offices as one strategy to increase access to oral health care along with reducing restrictive dental practice acts and increasing the scope of practice for dental hygienists. The December 2021 release of the National Institutes of Health report, Oral Health in America, further supports greater access to dental hygiene preventive/therapeutic care. This paper also reflects on opportunities and barriers as they relate to workforce policy, provides examples of effective state policies, and illustrates an educational curriculum specifically created to prepare dental hygienists to provide oral health services in settings outside of the dental office. Dental hygiene education must ensure that graduates are future-ready as essential health care providers, prepared to deliver direct access to dental hygiene care.

Keywords
  • dental hygiene
  • access to care
  • direct access
  • dental hygiene education
  • essential health care providers
  • Received July 24, 2023.
  • Accepted September 18, 2023.
  • Copyright © 2023 The American Dental Hygienists’ Association
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American Dental Hygienists' Association: 97 (5)
American Dental Hygienists' Association
Vol. 97, Issue 5
October 2023
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Dental Hygiene and Direct Access to Care: Past and present
Cynthia C. Gadbury-Amyot, Melanie L. Simmer-Beck, Ann Lynch, Lisa J. Rowley
American Dental Hygienists' Association Oct 2023, 97 (5) 24-34;

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Dental Hygiene and Direct Access to Care: Past and present
Cynthia C. Gadbury-Amyot, Melanie L. Simmer-Beck, Ann Lynch, Lisa J. Rowley
American Dental Hygienists' Association Oct 2023, 97 (5) 24-34;
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Keywords

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  • dental hygiene education
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