ADHA Supports Senate Committee Examination of Health Care Workforce Issues

Chicago—February 12, 2008—The American Dental Hygienists’ Association (ADHA) applauds the Senate Health, Labor, Education, and Pension Committee for holding a hearing to address health care workforce issues of the future. The Committee hearing is timely given recent events and research which highlight the difficulties Americans face in accessing oral health care services—particularly children, the elderly, and minority populations.

As the largest national organization that represents the interests of more than 156000 licensed dental hygienists and the patients they serve, ADHA is committed to improving the public’s health through the promotion of preventive services and advocacy in support of increased access to oral health care.

The dental hygiene profession has been identified by the U.S. Bureau of Labor Statistics (BLS) as one of the fastest growing professions in the country. The population of dental hygienists is projected to increase by 30 percent from 2006-2016. AS the link between oral health and total health continues to emerge, the focus on the importance of preventive care will increase and the need for services provided by dental hygienists will continue to grow.

Dental hygienists are licensed health care professionals educated and trained to prevent and treat oral disease while in its early stages. In order to practice as a dental hygienist, an individual must graduate from an accredited dental hygiene education program housed in a college or university, and pass a regional clinical or state examination, as well as a national written exam. There are currently 243 dental hygiene education programs in the United States, including 17 at the master’s degree level. In spite of the growth in the population of dental hygienists, dental hygiene education programs are currently experiencing significant faculty shortages.

Dental hygiene practice regulations vary from state to state, however a growing number of states—currently 22—allow dental hygienists to perform services outside the scope of direct supervision of dentists to bring much needed care to the underserved populations who are unable to obtain care in a traditional dental office. Additionally, 12 states have provisions in place which allow dental hygienists to receive direct reimbursement for dental services provided to patients covered by Medicaid.

In contrast to the booming professional population of dental hygienists, the most recent BLS data notes that the employment of dentists is not anticipated to keep pace with the increased demand for dental services. The American Dental Association found that while 6,000 dentists retire annually, only 4,000 new dentists graduate from dental schools. As the U.S. population ages and the need for oral health care services increases, the shortage of dentists will become even more pronounced.

In an effort to increase access to oral health care services and greater utilize the dental hygiene workforce, ADHA has developed the Advanced Dental Hygiene Practitioner (ADHP) provider model. ADHPs will be licensed dental hygienists who are Master’s level educated and trained to provide an increased scope of oral health services to patients in underserved areas. ADHPs will perform the traditional range of preventive services currently administered by dental hygienists as well as therapeutic, palliative, prescriptive, diagnostic, and minimally invasive restorative services. The ADHP will serve as a mid-level provider in oral health, functioning as a new member of the dental team.

The concept of a mid-level provider in oral health is not a new one. Over 40 countries currently have established mid-level providers in oral health, including Canada, the United Kingdom., Australia, and New Zealand. In the United States, mid-level providers in medicine, such as nurse practitioners and physician’s assistants, helped streamline the delivery of medical services.

The concept of a mid-level oral health provider in the United States is reinforced by the growing body of data that illustrates the significant access to care problems which millions of Americans face on a day-to-day basis. In 2000 the Surgeon General issued the landmark report Oral Health in America which identified the “silent epidemic” of oral disease and called on oral health stakeholders to find solutions to improve the nation’s health.

Still, there are a number of disturbing statistics which highlight the access to care crisis in oral health in America. Tooth decay, while preventable, remains the nation’s most common chronic disease of childhood. More than 100 million Americans lack dental insurance And last February, 12 year old Deamonte Driver of Maryland died after an untreated abscessed tooth lead to a bacterial infection which spread to his brain.

ADHA believes the ADHP represents a timely, effective mechanism to help increase access to oral health care services for those who are currently disenfranchised from the oral health care system. As a Master’s level educated, licensed professional able to provide care directly to patients in a variety of public health settings. ADHPs would serve as a new entry point into the oral health care system which would refer patients in need of additional care to dentists or other health care providers.

As the second Session of the 110th Congress begins, ADHA applauds the Senate Health, Labor, Education, and Pensions Committee for examining the important workforce issues that directly impact individuals’ ability to access needed care. Additionally, ADHA recognizes the efforts of Senator Sherrod Brown and Senator Jeff Bingaman who will each introduce legislation this session to increase access to oral health care.

ADHA is the largest national organization representing the professional interests of more than 156,000 dental hygienists across the country. Dental hygienists are preventive oral health professionals, licensed in dental hygiene, who provide educational, clinical and therapeutic services that support total health through the promotion of optimal oral health. For more information about ADHA, dental hygiene or the link between oral health and general health, visit ADHA at http://www.adha.org.

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