Working

by Kate Zimmermann

Overcoming obstacles has been par for the course for Judy Boothby, RDHAP, BS. She has faced lawsuits and major opposition at nearly every turn as she has struggled to create her private dental hygiene practice that now thrives in the greater Sacramento, California area.

Proper oral health care for patients in nursing homes is a subject not often addressed according to Boothby, but she didn't realize to what extent it was ignored until her father was diagnosed with an inoperable brain tumor and confined to a nursing home. It was then when Boothby found that patients' oral health care often was "seriously neglected, not treated, and seldom understood." She thought: "There must be a better way to deal with this problem of oral care of a critically or terminally ill patient." The thought sparked her idea for a mobile dental hygiene practice, which would later earn her the distinguished Pfizer/ADHA Awards for Excellence in Dental Hygiene

Boothby worked as a dental hygienist in a dental practice in Sacramento, California for 15 years until, in 1987, the California State Legislature through the Office of Statewide Health, Planning, and Development approved a pilot program for 18 dental hygienists, including Boothby, who were given the authority to practice independent of dentists.

Lawsuits ensued; the California Dental Association (CDA) argued that allowing dental hygienists to practice alone could lead to their diagnosing patients, which posed a health risk to the public, according to CDA. In result, California's yellow pages refused advertisements for the dental hygiene practices for fear that inclusion of the ads would prompt state dental associations to pull their own listings. Boothby was even barred from some nursing homes and dental offices because the dentists there wouldn't allow a private-practice dental hygienist inside their facilities.

Boothby didn't give up. And as the journey continued, she found new patients--families who needed and appreciated the oral health care she could provide.

After a long, drawn out court battle, the state eventually licensed 21 dental hygienists to provide independent-practice dental hygiene care to patients who had obtained a prescription from a dentist or physician. The California Dental Hygienists' Association successfully lobbied to change the dental practice act of the state to create the new credential, Registered Dental Hygienist in Alternative Practice (RDHAP), of which Boothby holds the first in the state.

These days Boothby is very busy maintaining one of the fastest-growing businesses in Sacramento. She works at least 50 hours a week visiting 30-40 patients in nursing homes, assisted living facilities, and private homes. Her daughter, Heather Boothby, has a degree in gerontology, like her mother, and is her chairside dental assistant and office manager. Boothby participates in a radio show for seniors, educating them about dental hygiene and answering questions from callers. She also is a dental coordinator for agencies in the Sacramento area for the developmentally disabled. She recently was invited to lecture to the first graduating class of RDHAPs at West Los Angeles College. "It's so inspiring for me to meet 17 young women who've met the requirements for licensure for RDHAP and who are choosing a dental hygiene practice of their own," Boothby says, adding, these are some of the "best and brightest" hygienists in the state.

She loves her job mostly for the reward that she gets from seeing the changes that occur in her nursing home patients when they receive proper oral care. She tells the story of an elderly woman in a nursing home, whom the staff said "not to bother seeing, because she wouldn't let anyone in her mouth." This resident was classified by the home as being difficult and angry all the time and she would never leave her room. When Boothby started visiting with her, she learned that the patient was just embarrassed by her remaining teeth because they were broken and decayed, and because her partial denture didn't fit properly. Once Boothby started treating her oral conditions, this once-isolated woman made quite a transformation. Her mouth became healthy--free of infection, bleeding, and pain. She received some temporary fillings and was referred to a local dentist who extracted some teeth to make room for her new partial denture. She began going to meals and activities in the dining room, gained weight, and started dressing up and putting on makeup. Boothby says that she became the "belle of the ball… she, and many others like her, made it all worth it!"

Judy Boothby, RDHAP, BS, may be reached at judyboothbyrdhap@sbcglobal.net or through her Web site at www.RDHAP-JudyBoothby.com.