COVID-19 update: Office is open with policy changes.

COVID-19 update: Office is open with policy changes.

When a person goes in for their annual teeth cleaning, they most likely spend the greater portion of their time with the hygienist. But do a dental hygienst’s duties stop at cleaning? According to hygienist Candice Feagle, they certainly don’t:

How to embrace the phrase, “Oh, you’re just a hygienist!?”

I am certain that every hygienist has heard the phrase, “Oh, you’re just a hygienist.? I recently attended a function, and someone I was introduced to uttered the dreaded phrase. The ?just? hit me in the chest as if I was wearing a shirt with a bull?s-eye on it. Everyone around us continued to engage in their conversations, and I noticed I was the only person in the room that actually reacted to the ?just.?


Yes, I am just a hygienist:.

  • Yes, I just review the patient?s medical history with them verbally because sometimes when patients are nervous they forget to write valuable medical information down on forms.
  • Yes, I just talk to my patient for 45 minutes while I am ?cleaning teeth? in order to help them feel comfortable and more importantly assess their stress level while gaining insight into their overall health.
  • Yes, I just perform oral cancer screenings, periodontal charting, decay assessments, oral hygiene assessments, sealant placements, fluoride treatments, detailed explanations regarding dental treatments, and deal with any other overall health concerns they may have, often referring them back to their physician.
  • Yes, I just sterilize the operatory, equipment, and dental instruments according to state regulations to ensure the health and safety of my patients and myself.
  • Yes, I just obtained my bachelor?s degree in allied dental health, completed continuing education requirements, maintained my local anesthesia license, maintained my dental hygiene license, maintained my nitrous oxide administration credits, and continue to research dental technology to ensure that my patients are receiving the best dental hygiene care possible.

. . . I know the varied abilities and diverse opportunities being a hygienist represents. Still, I’ve chosen to fully embrace the phrase, “you’re just a hygienist.” Why? I do so to follow the brilliant and humble example of the Dalai Lama who once said, “I describe myself as a simple Buddhist monk. No more, no less.” My fellow hygienists, I hope you are proud to be just hygienists! Read the full article here . . .

It’s pretty disheartening to hear that a professional who has a key role in maintaining people’s oral health is so undervalued. Is it because patients are unappreciative? Is it because dentists are unappreciative? Is it because hygienists set themselves short?

While this Ms. Feagle is just one hygienist with one opinion, her ideas certainly have some weight in relation to a recent ADHA article:

ADHA white paper looks at hygienist?s role in diagnosis

?Through dental hygiene diagnoses, dental hygienists educate patients on behaviors that minimize risks of oral infections, help detect risk factors for infectious diseases and cancers of the head and neck,? said ADHA president Betty Kabel, RDH, BS. ?This elevates the role of the dental hygienist within the overall health care system, as we seek to expand the access to oral care. It?s important to utilize the dental hygiene diagnoses regularly and consistently to ensure optimal care for our patients.?


While dental hygienists? rigorous education prepares them to provide preventive and therapeutic oral health services, the profession?s scope of practice varies from state to state. ADHA emphasizes that it is important for dental hygienists to fully utilize their education to provide oral health care services that fall within their scope. Read full article here . . .

Maybe hygienists are undervalued not because of people’s off-hand remarks about “just being a hygienist,” but because the sector hasn’t tapped into their extensive education. Not only do they have to take classes in neck & head anatomy, chemistry, biology, etc., but they have to be flexible enough to deal with patients and fill in wherever they are needed in the office.

While Ms. Feagle and the ADHA have expressed concerns about the untapped potential of hygienists, researchers in New York have found that when hygienists had expanded roles, preventative dentistry measures improved:

Can expanding hygienists’ practice improve adult care?

Does expanding a hygienist’s scope of practice translate to improved oral healthcare at the state level? Researchers from New York believe it does, according to the results of a survey published this month in Health Affairs.


With the debates about dental therapists and dental telemedicine ongoing, researchers from the University at Albany in New York updated a previous study to investigate if hygienists with an expanded practice options could reduce the oral disease burden.


“Scope of practice for dental hygienists … had a positive and significant association with having no teeth removed because of decay or disease,” wrote lead study author Margaret Langelier and colleagues (Health Affairs, December 2016, Vol. 35:12, pp. 2207-2215).


You can read more about the changing roles of hygienists at the American Dental Hygienists’ Association (ADHA) website. The association is concerned with this profession’s value, since “confusion still exists on how to implement it into daily practice.”


As the focus of public health oral healthcare has shifted from treatment to prevention, reaching underserved populations has received increased attention. Fifteen years ago, study authors created a new index to quantify hygienists’ scope of practice. With the current study, they wanted to see if any change in index scores also correlated with an expansion of hygienists’ scope of practice.


In 2001, the authors created the Dental Hygiene Professional Practice Index (DHPPI), which is comprised of four categories:

  • Regulation
  • Supervision by practice setting
  • Tasks permitted under varying levels of supervision
  • Reimbursement

The authors also compiled state-by-state scores and found that states that had new or expanded dental hygiene practice models had higher scores in general than states that have not enacted an expanded practice model.

Read the full article here . . .

So while it is disappointing to hear hygienists feel undervalued, at least the issue is being recognized and not swept under the carpet. Ideally more studies will be conducted to get a better feel for these state-by-state score differences.