Oral Health Group

Hygienists Brace for Pitched Battles with Dentists in Fights Over Practice Laws

October 19, 2021
by News-Medical.Net

This year, the Illinois legislature was considering measures to expand oral health treatment in a state where millions of people live in dental care deserts.

But when the Illinois State Dental Society met with key lawmakers virtually for its annual lobbying day in the spring, the proposals to allow dental hygienists to clean the teeth of certain underprivileged patients without a dentist seemed doomed.

State Sen. Dave Syverson, a Republican legislative leader, warned against the bills even if they sounded minor. “It’s just getting the camel’s nose under the tent,” he said in an audio recording of the meeting obtained by KHN. “We’ll have, before long, hygienists doing the work that, if they wanted to do, they should have gone to dental school for.”

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1 Comment » for Hygienists Brace for Pitched Battles with Dentists in Fights Over Practice Laws
  1. Suzanne M Newkirk says:

    I would like to address inaccuracies made by IL Dental Society (ISDS) lobbyist, Dave Marsh, on why the ISDS killed legislation to allow IL public health dental hygienists to provide preventive services for patients in prisons, nursing homes and mobile dental vans without an initial dental exam. The ISDS said they did not support the legislation for “patient safety reasons.” However, there is no data to indicate hygienists initiating basic preventive services they are educated and licensed to perform harm patients without a prior exam.

    In his reference to hygienists providing preventive care in nursing homes, Mr. Marsh said, “I just don’t feel anybody with a two-year associate’s degree is medically qualified to correct your health. They’re trained to clean teeth. They take a sharp little instrument and scrape your teeth. That’s what they do. That’s all they do.” He also stated there was a “scarcity of research” on the benefits of dental hygienists having more professional freedom.

    Had Mr. Marsh looked he would have found a plethora of data that supports less restrictions be placed on hygienists to provide services they are educated and licensed to perform. In 1986, a CA demonstration project allowed hygienists to open independent practice and provide prophylaxis, fluoride, root planing and exams. Researchers compared the 7 hygiene practices to 6 dentist-owned practices and found the hygienists provided equal or better care in most areas, including infection control. The hygienists kept more accurate medical records, including patient follow up with his/her physician on important findings, more thoroughly recorded results of soft-tissue examinations and periodontal status and performed better calculus removal. The study also found the hygienists provided more services to Medicaid patients than the dentists.

    What Mr. Marsh didn’t say was that in 2015, when the IL legislature considered legislation to allow hygienists employed in public health settings to provide basic hygiene services for Medicaid and low-income patients prior to an initial dental exam, the quid pro quo from ISDS for not killing the bill was a provision to allow dental assistants to provide “coronal scaling” for low-income patients up to 12 years old.

    Although Mr. Marsh suggested a lack of research on the benefits of hygienists having more professional freedom, data indicating patient benefits from a superficial scaling above the gumline is non-existent. Supragingival scaling is part of a complete prophylaxis, it does not replace it, nor does it increase access to care for underserved population groups, unlike the now defunct IL hygiene legislation.

    Dental Association Political Action Committee’s (PAC’s) use their deep pockets to leverage legislators all the time, such as IL Senator Dave Syverson who is not only the first cousin of the ISDS Past-President, but in an audio recording found by Kaiser Health News (KHN), Syverson made it very clear that when it comes to voting on dental issues that benefit IL underserved, he will put his own interests of attending ISDS freebie dinners and receptions ahead of the public every time. For the approximately 60 million Americans living in dental deserts this situation is all too familiar.

    In July 2017, the WA Post reported on “The unexpected political power of dentists” and cited “a political force so unified, so relentless and so thoroughly woven into American communities that its clout rivals that of the gun lobby.”

    For years, dental hygienists have advocated at the state and national levels to fill a critical need most licensed dentists are unwilling to address; providing basic preventive and therapeutic dental hygiene services they are licensed and educated to provide for America’s underserved.

    It’s time for state political and professional leaders to step up to the plate and make decisions based on what is in the best interest of the public they serve instead of themselves.

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