Areas of Focus for the Future• The three main areas of focus that I feel hygienists need to focus on for the future are:• Education• Legislation/ self regulation• Access to care• … and yes, it’s enough to make your head spin!
EducationIn the ADHA focus report, one of the main goals is to “redesign the dental hygiene curricula based on the increasingly complex oral health needs of the public.” (Tripp, 2005)One of the main forces for advancing our profession is the quality of education each of us receives.Technology will play a big part in the future education of hygienists throughout the world. At the University of Maryland, Baltimore, they have stepped boldly into the 21st century with the education they are providing for their hygienists. The next few slides will highlight several of the areas that are very exciting.
Education• One interesting innovation is that they are teaching some of their students by distance education. These students are able to hear and see their faculty through video- conferencing. They also do online testing. The clinical portion is close to where they live, but connected with the University.• Students have access to learning modules and resource via their laptops at home, in the student clinic and in the simulation settings. (Fried, 2007)
Students are able to access a simulatedelectronic patient record and use thisinformation to provide treatment to thepretend (simulator) patient. This allows thestudent to prepare for actual clinical patienttreatment.
Virtual Education• The simulations were what I found most fascinating. They had patient simulations, they could “virtually scale” and explore with haptic devices. (Haptic technology, or haptics, is a tactile feedback technology that takes advantage of a users sense of touch by applying forces, vibrations and/or motions to the user. Wikipedia)• The instructors have remote site access and are able to evaluate students and correct any mistakes they might be making.• Students can learn scaling on a virtual tooth and learn to differentiate between calculus and tooth structure. (Fried, 2007) How cool is that?!
Education• Students can type on a virtual keyboard, which projects onto a surface which can then be easily cleaned. (Fried, 2007)
Education• This article on education ends with the following quote:• “Recognizing the needs of todays student population and how individuals learn reinforces the importance and necessity for high technology offerings.” “ The wave of the future is here and dental hygiene education will be on its crest.” (Fried, 2007)
EducationThe ADHA has suggested that a bachelors degree be the entry level for future dental hygienists. I think with all the advances in dentistry, it will take this much time to educate students in all the new research.They also advocate a PhD program for dental hygiene. We’re movin’ up!
Legislation• Christina N. Smith, a dental hygiene student, writes about her experience with legislation in an article entitled Supporting the Future of Dental Hygiene: A Student Experience with Association Involvement in Legislation• « This is where I discovered the world of politics as it relates to dental hygiene and realized the significance of legislative barriers with regards to addressing access to care disparities. Our association is essential to supporting the future of dental hygiene. Legislation is an important arena in professional organization.”
Legislation• One of the new goals of the ADHA is the following: – The dental hygiene profession will advance through effective advocacy by ADHA. – A “Future of Dental Hygiene Advisory Board” (FDHAB)has been set up which has made the following recommendations with regards to legislation: • Achieve self-regulation in all states • Increase the participation of dental hygienists in the legislative process. • Increase representation and participation of dental hygienists at all levels of government in order to influence public policies and programs. • Create multiple levels of clinical practitioners.
How are we doing?• The following information is from Stateline in Access Magazine and reports what is going on in the United States at this time. (All are direct quotes from the article)• The Connecticut Legislature is considering legislation to establish an advanced practice dental hygiene practitioner again this year.• Oregon opened its 2011 legislative session with both a dental therapy bill and a self-regulation bill before the legislature. Dental hygienist therapists would be able to provide all dental hygiene services without supervision. With the authorization of a collaborating dentist, the therapist could also provide restorative services Including ART, perform class I through V restorations, place preformed crowns, perform pulpotomies on primary teeth and nonsurgically extract primary and periodontally diseased permanent teeth.
• Washington State House Bill 1310 would create the practice of dental therapy in that state. In a model reminiscent of the Minnesota dental therapist structure, the new law authorizes dental therapists (DTs) who would provide restorative services and advanced dental therapists (ADTs), who would be licensed dental hygienists who have completed additional dental therapy coursework and would provide both restorative and dental hygiene services.• Arkansas proposed Senate Bill 42 to create a Collaborative Care Permit Program that would authorize dental hygienists to provide prophylaxes, fluoride treatments, sealants, and other dental hygiene services in public settings without the supervision of a dentist.• In Florida a bill is under review that would allow dental hygienists to provide dental charting, application of fluorides, application of sealants and the prophylaxis without the supervision of a dentist. (Stateline, 2011)
• Maine proposed Legislative Draft 70 that will allow direct reimbursement to dental hygienists practicing independently as authorized under the MaineCare program.• Nebraska legislators are considering whether to reduce some restrictions on dental hygienists currently providing certain services in public-health-related settings based on authorization by the health department rather than by a dentist.• The New York Assembly proposed Assembly Bill 111,amending the education law, to establish a collaborative practice agreement in which dental hygienists may perform all dental hygiene services without prior evaluation of a dentist or medical professional and without supervision in the office of any licensed dentist or in any appropriately equipped school or public institution. (Stateline, 2011)
• South Dakota House Bill 1045 would establish an option for collaborative practice. This would enable dental hygienists practicing according to a written collaborative agreement between themselves and a collaborating dentist to treat patients not previously examined by the dentist in such settings as nursing homes, public health facilities, prisons, community health centers and schools.• West Virginia is also considering a bill that would include dental hygienists and other health professionals in the states loan forgiveness program. According to House Bill 2052, dental hygienists are eligible to get $5,000 of outstanding loans canceled per year if, at the end of each fiscal year, they have received a student loan and rendered services as a licensed hygienist in an underserved area of West Virginia. (Stateline, 2011)
• On May 27, 2010, Ohio Governor Ted Strickland signed into law House Bill 190, establishing an oral health access supervision program in which dental hygienists may provide dental hygiene services in non-office settings without a dentist having previously seen the patient. (Stateline, 2010)• As you can see, there is a lot going on in the legislature right now. Much of it involves access to care, which is a “hot” topic right now. None of this legislation happens on its own. Behind the scenes are many actively involved dental hygienists. Are you one of them?
Access to Care• When dental hygiene students were asked to state whether or not they felt there was a need for an Advanced Dental Hygiene Practitioner (ADHP) that would provide diagnostic, therapeutic, preventive, and restorative services.• 47% felt there was an « extreme demand »• 47% felt there was an « average need »• And 5% felt there was « no need » for an ADHP (Barnes, 2007)• This correlates closely with the ADHA position on access to care and the need for a mid level practitioner. Many states are moving this direction as you have seen in the section on legislation.
Access to Care– In 2002 the ADHA implemented the “Future of Dental Hygiene” project.– Access to care was one of the main issues they discussed. Some of the areas of concern are the following: » Access to oral health is a right of all people » The oral and general health needs of the U.S. population are growing, and dental hygiene practice and education must evolve to meet them. » Dental hygiene is part of an overall health care delivery system, not simply an arm of dentistry. Dental hygiene must create an integrated model or oral health care delivery through partnerships with other health care providers. » Dental hygiene needs to identify and remove the barriers that restrict access to care. (Gurenlian, 2004)
In conclusion…• Education, legislation and access to care are all issues facing the future of dental hygiene. We are moving forward and with the continued support of all hygienists, we will continue to do so.
References• Barnes, W. e. (2007). ADHP and Access to Dental Care: The Dental Hygiene Students Perspective. Journal of Dental Hygiene , 1.• Fried, J. (2007). Innovations in Education and Technology. Journal of Dental Hygiene .• Gurenlian, J (2004). Dental hygiene focus for the future report previes. Access, 33,34• Smith, c. (2010). Supporting the Future of Dental Hygiene: A Student Experience with Association Involvement in Legislation. Access , 8,10.• Stateline. (2010). Access .• Stateline. (2011). Access , 25-26.• Tripp, H. G. (2005). Focus on Advancing the Profession. Retrieved April 5, 2011, from ADHA: http://adha.org/downloads/ADHA_Focus_Report.pdf