Dental hygiene practitioners will increase access to dental care
To the Editor:
I would like to take this opportunity to thank and applaud State Rep. Smitty Pignatelli for his longstanding commitment to the expansion of quality oral health care across all of Massachusetts. Rep. Pignatelli is the lead sponsor (along with Senate Majority Leader Harriette Chandler) of a bill that would markedly increase access by creating a midlevel provider, a Dental Hygiene Practitioner, modeled after the nurse practitioner model of care.
The Dental Hygiene Practitioner (DHP) would be a licensed dental hygienist who has completed educational requirements equivalent to other midlevel practitioners in Massachusetts, such as nurse practitioners and physician assistants. Like these other midlevel practitioners, DHPs would expand access to underserved areas and low-income populations. This has already been demonstrated by mid-level dental practitioners in Minnesota, where 78 percent of patients seen by these practitioners are publicly insured.
In order to expand access in an impactful way, we believe it is necessary to create a new highly trained and educated midlevel practitioner who would establish a collaborative agreement with a licensed dentist, as opposed to adding additional duties to lower level practitioners. We do not believe that expanding the responsibilities of existing practitioners, such as a dental assistant, is the correct approach. Each practitioner within dentistry has completed a level of education and training that is directly proportional to and appropriate for the scope of their practice. As compared to the 4+ years of education that a DHP would be required to complete, a dental assistant may only need 2 years of formal education in the field, or perhaps even less.
To ensure high quality and safe care with expanded scope of practice, the curriculum for DHPs builds on licensed dental hygienists’ training and includes a more rigorous licensing exam. These additional requirements allow DHPs to have a larger scope of practice where the level of education and experience directly correlates to increased public safety and greater expertise. This also ensures that consumers of dental care are adequately protected throughout the state.
I’d also like to clear up the misconception that public health dental hygienists (PHDHs), established by the omnibus oral health legislation signed into law in 2010, are not making a marked difference in the Commonwealth. Every day, many of the most vulnerable residents of the Commonwealth, often children and elders, receive much needed oral health care from PHDHs. The existence of PHDHs does not cost the Commonwealth anything, and yet saves the state thousands of dollars in unnecessary expenditures on oral healthcare, including in emergency rooms.
Access to dental care continues to be a problem throughout the United States and across Massachusetts; however, it is an especially salient issue in the Berkshires and Western Massachusetts. The Berkshires specifically lack care for low-income individuals with public insurance. Creating a midlevel dental practitioner will increase the number of highly skilled dental providers and will ensure greater access for publically insured individuals.
The writer is past president of the American Dental Hygienists’ Association – Massachusetts Berkshire.