While you advocate for those in your care, the American Dental Hygienists’ Association (ADHA) is advocating for you and the dental hygiene profession. Learn where the ADHA stands on the issues that matter to you and reflect the voice of the dental hygiene profession.
Position statements and papers are a guide and amplify the views of dental hygienists while educating decision-makers and others. Expand each link to read the full statement.
The American Dental Hygienists’ Association (ADHA®) opposes the adoption of the Dental Access Model Act, crafted by the American Dental Association (ADA) and supported by the American Legislative Exchange Council (ALEC).
This proposed model advocates for dental assistants to perform scaling — a critical, preventive and therapeutic procedure that falls within the scope of dental hygiene practice that requires specialized education and clinical training.
The Dental Access Model Act is based on a recently initiated pilot program supported by the Missouri Dental Association and legislation enacted in Wisconsin. The Act and its adoption are controversial because there are no available data or reported outcomes of the pilot program demonstrating safety, appropriateness, or efficacy of allowing dental assistants to perform scaling procedures. Prematurely expanding this model without supporting evidence endangers patient safety, compromises quality of care, and undermines the established standards of dental hygiene practice. Further, the minimal training of an oral preventive assistant is not comparable to the extensive didactic and clinical education required for dental hygienists to competently perform these services.
While the new model Act may increase productivity, it primarily increases profits for private fee-for-service dental practices, rather than making dental care more accessible to all those in need, including the underserved. This model demonstrates dentists’ prioritization of self-interest rather than the interest of the public.
Dental hygienists provide high quality preventive and therapeutic oral health care, which involves far more procedures than scaling. Their expertise encompasses thorough general and oral health assessments, including oral pathology screenings, periodontal staging and grading, performing breathing and airway assessment, identifying caries, providing preventive care, performing complete scaling therapy for patients with gingivitis, carrying out scaling and debridement for those with periodontitis, facilitating behavior, assisting with tobacco cessation and nutritional counseling and offering evidence-based individualized recommendations for self-care. When dentists authorize inadequately trained personnel to perform scaling, the public should be advised that they are at risk of receiving substandard care.
In addition, the ADA incorrectly assumes that there are many healthy patients that need only limited care. In fact, most Americans suffer from either gingivitis or periodontitis, making comprehensive dental hygiene care essential. Scaling alone, without other preventive and therapeutic services, poses risks including long-term implications for oral and overall health. Even seemingly healthy individuals require the comprehensive preventive care provided in a visit with a dental hygienist, which goes far beyond what a scaling assistant can offer.
It is contradictory that while the ADA claims their model will solve dental workforce shortages, they are creating another group that also requires supervision. Further, the ADA opposed ALEC’s endorsement of dental therapists – proven licensed providers who have safely delivered quality care to underserved populations for over 15 years in the United States. Dental therapy will increase access to care and is not tied to a private fee-for-service model.
Another concern with adopting this model is ADA’s failure to engage ADHA in discussion during its development and continuing to disregard existing workforce shortage data that suggests straightforward solutions. Additionally, ALEC neglected to perform due diligence by failing to obtain testimony from ADHA and other key stakeholders before endorsing this Act. The adoption of this Act requires further study while simultaneously acknowledging dental therapy legislation that ALEC supported in the past.
For these reasons, the ADHA firmly opposes the adoption of the Dental Access Model Act and urges stakeholders to pursue evidence-based solutions that prioritize patient safety and improved access to oral healthcare.
The ADHA encourages individuals and state groups to express their opposition to the Dental Access Model Act by contacting their state legislators, members of the ALEC Board of Directors, or ALEC’s CEO Lisa Nelson at [email protected].
To learn more about ADHA’s positions on workforce shortages and dental hygiene education, and the policy related to scaling visit adha.org/positions.
© American Dental Hygienists’ Association, 2024
The American Dental Hygienists’ Association (ADHA®) maintains its strong support of community water fluoridation as a safe, effective and equitable public health measure.
The consumption of fluoridated water has been proven to prevent dental caries and improve the oral health of individuals of all ages. Decades of rigorous scientific research and endorsements from respected organizations, including the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), validate its effectiveness in significantly reducing dental caries in children and adults.
The ADHA urges dental hygienists to advocate for the adoption and continuation of water fluoridation in their communities, to educate the public on its safety and effectiveness, and to collaborate with other health professionals on the promotion of community water fluoridation as a measure to combat oral health disparities.
More than 70 years of research have consistently demonstrated that fluoridating public water supplies is a safe and cost-effective way to reduce tooth decay and alleviate the broader burden of dental disease. The ADHA supports this evidence-based practice as part of our mission to improve oral health outcomes and ensure a healthier future for everyone.
To view ADHA’s policies and other resources on fluoride and community water fluoridation visit https://www.adha.org/fluoride.
© American Dental Hygienists’ Association, 2024
The American Dental Hygienists’ Association (ADHA®) opposes policies for alternative dental hygiene licensure pathways for non-hygienists.
The ADHA opposes any policies supporting dental students, residents, and foreign-trained dentists with an alternative pathway to obtain dental hygiene licensure and practice dental hygiene in the United States and increasing the faculty-to-student ratios in dental hygiene education programs.
Allowing those in roles that are complementary to dental hygiene to practice the profession without the same extensive dental hygiene education and practical training is harmful to patients and damaging to the standards of the dental hygiene profession.
U.S. dental hygiene education at programs accredited by the Commission on Dental Accreditation (CODA) is deeply comprehensive and includes significant faculty supervision for upholding the highest standards of dental hygiene practice. The curriculum for dentists dedicated to dental hygiene is not comparable.
The ADHA firmly believes that any individual seeking to practice dental hygiene in the U.S. must complete a CODA-accredited dental hygiene education program, and meet the clinical training, examination and practice requirements necessary to earn a dental hygiene license, without exception.
© American Dental Hygienists’ Association, 2024
The American Dental Hygienists’ Association (ADHA®) recognizes the dental hygiene workforce shortage and supports appropriate strategies to retain and build the workforce.
As the largest organization advocating for the dental hygiene profession, the ADHA recognizes the workforce shortage of dental hygienists, dentists and other allied oral healthcare workers. An increase in the recruitment and retention of trained, educated, licensed professionals to restore and grow the oral healthcare workforce is needed.
In order to fully address the dental hygiene workforce shortage, it is critical to rely on data that have been collected from dental hygienists regarding their current and future needs. The 2022 research report, “Dental Workforce Shortages: Data to Navigate Today’s Labor Market”, produced through a collaboration between the ADHA, the American Dental Association (ADA) Health Policy Institute and other oral healthcare organizations, identified several chronic factors, beyond pandemic-related and retirement reasons, driving dental hygienists to leave the profession. The report revealed staff retention challenges citing inadequate benefits, non-responsive compensation, poor communication, lack of professional fulfillment and negative workplace culture as key contributing factors to workforce attrition.
While the ADHA does not support the resolutions adopted in October 2024 by the American Dental Association (ADA) concerning dental workforce shortages, we look forward to addressing the identified workforce-related issues in partnership with the ADA and other related dental professional organizations.
The ADHA supports addressing the issues that underlie workforce departures and enhancing recruitment into the profession as more appropriate strategies to retain and build the dental hygiene workforce. The ADHA is leading efforts to resolve dental hygiene workforce shortages through constructive measures. These include supporting and advising on the creation of additional entry-level dental hygiene programs and on the increase in capacity of current entry-level dental hygiene programs, where appropriate. The ADHA offers webinars and workshops on addressing workplace culture, leadership, professional empowerment and autonomy. Additionally, the ADHA is developing a new chairside recruitment program aimed at expanding the dental hygiene workforce. We encourage other dental professional organizations to address their specific workforce issues.
The ADHA recognizes the complexity of the situation and supports collaborating with other dental-related groups on fostering professional autonomy and empowering dental hygienists to work to their full scope of practice, which will lead to better health outcomes for the public and improve workplace culture.
© American Dental Hygienists’ Association, 2024