By Lancette VanGuilder BS, RDH, PHEDH, CEAS, FADHA
March 12, 2026

Healthcare is changing rapidly, and the dental hygiene profession is evolving with it. Dental hygienists have consistently adapted to meet emerging needs: as prevention specialists, patient advocates, and partners in patient care. That essential spirit of progress is rooted in a growth mindset.

In practice, a growth mindset means building on our clinical foundation while staying open to innovation, expanded roles, and new opportunities that strengthen both patient care and professional impact. The recent ADHA policy supporting the exploration of doctoral entry-level educational pathways reflects our ongoing professional conversation about how dental hygienists continue to lead in prevention-focused healthcare.

Specifically, ADHA has adopted policy supporting the dental hygiene doctorate as a future entry-level degree, with the goal of enhancing clinical competencies, expanding scope of practice, and positioning dental hygiene more fully within the broader healthcare system.^¹ This policy has prompted considerable discussion across our profession. That discussion is important and reflects engagement, and the shared passionate commitment of dental hygienists to protect our patients and our professional identity. Here is what this policy does, and just as importantly, what it does not do.

Why An Educational Evolution Is Needed Now

This policy is not retroactive. It’s forward-looking. It does not require practicing dental hygienists to return to school, nor does it diminish the value of associate- or bachelor-prepared clinicians delivering excellent care every day. It does not immediately change licensure requirements, scope of practice, or clinical expectations.

Dental hygienists today are highly educated prevention specialists, and nothing about this policy changes that.

First, Some Reassurance

Modern healthcare increasingly emphasizes prevention, chronic disease management, interdisciplinary collaboration, and expanded access to care. Oral health is inseparable from systemic health, and dental hygienists are uniquely positioned to serve as integral healthcare providers.

Dental hygienists are expressing interest in greater integration within healthcare environments where prevention specialists collaborate as full partners in patient care. Some hygienists are already working in medical practices, public health clinics, schools, long-term care settings, sleep and airway programs, and community outreach initiatives, although these models remain uneven nationally.

Higher education supports professional advancement and helps dental hygienists integrate into healthcare systems that continue to evolve. It strengthens research capacity and policy influence. It also supports leadership development and positions dental hygienists more fully within interdisciplinary care models. The goal is not to replace clinical care but to amplify professional impact.

Learning from Physical Therapy: A Real-World Example of Professional Evolution

Dental hygiene is not the first healthcare profession to navigate this kind of transition. Looking at other professions provides useful context as dental hygiene explores its own future. Physical therapy provides one of the clearest parallels.

A Brief Timeline of Physical Therapy Education

• Early physical therapy education began as certificate-based training programs.
• By the late twentieth century, bachelor’s degrees became standard entry-level preparation.
• During the 1990s, programs transitioned toward master’s-level education as patient complexity and healthcare integration expanded.
• In 2000, the American Physical Therapy Association introduced Vision 2020, identifying the Doctor of Physical Therapy (DPT) as the future entry-level degree.
• Accreditation standards evolved gradually over the following decade.
• By 2016, the Commission on Accreditation in Physical Therapy Education required the DPT for accredited entry-level programs.^²

It’s important to note that clinicians educated under earlier models were not displaced. Transitional doctoral programs were optional, and clinical expertise remained central. Educational advancement opened new doors without closing any for those already practicing.

Dental hygiene is exploring a similar path, one focused on workforce sustainability, healthcare integration, and patient-centered prevention.

Change in any profession raises important questions. As dental hygiene continues to make waves in healthcare, conversations about workforce impact, access to care, and educational pathways are both expected and necessary.

Addressing Workforce Concerns Thoughtfully

A common concern is whether advancing educational pathways could limit access to care or worsen workforce shortages. Access matters. Cost, time, and program availability must remain part of this conversation.

Evidence from other healthcare professions suggests that advancing education strengthens the workforce over time, rather than diminishing it. Research in nursing indicates doctoral education and advanced practice preparation contribute to improved patient outcomes, stronger professional leadership, and greater influence within healthcare systems.^³ Limiting access to graduate nursing education has also been identified as a potential threat to workforce stability and health equity.^⁴

Similarly, physical therapy literature suggests advanced educational preparation supporting direct patient access can improve care efficiency, patient outcomes, and access to care.⁵

Associate and bachelor pathways remain essential to today’s workforce. The ADHA policy acknowledges that balance while encouraging exploration of future professional possibilities.

What Evidence Shows About Advancing Dental Hygiene Education

Conversations about advancing dental hygiene education are not new. Professional literature has emphasized for decades that strengthening educational pathways supports both public health outcomes and the long-term health of the profession.

Earlier analyses noted that advancing dental hygiene education supports improved oral and overall health outcomes while keeping the profession responsive to changing healthcare needs.⁶ More recent research highlights the importance of doctoral-prepared dental hygienists in building a strong scientific foundation through research for dental hygiene and supporting that integration.⁷ Without that foundation, professions often rely on external disciplines to define their evidence base, potentially limiting their growth and influence.

Studies also suggest graduate-prepared hygienists may experience expanded career opportunities, increased professional credibility, and greater leadership capacity.⁸ These findings show how advancing education can raise the ceiling of what is possible within the profession, creating space for dental hygienists to lead in research, education, policy, and prevention-focused healthcare. Education is consistently identified across the literature as a key driver of professional visibility, research, healthcare integration, and expanded access to prevention-focused care.

Primary Care Integration: Aligning Education, Practice, and Opportunity

For dental hygienists to fully integrate into healthcare, education, scope of practice, and practice settings must advance together. These elements are connected: when one moves forward, the others tend to follow. Healthcare teams operate within shared clinical frameworks, and aligning educational preparation with those environments helps ensure dental hygienists are recognized as the prevention specialists they are.

An evolution in dental hygiene education does not create integration alone, but it supports stronger collaboration, clearer professional recognition, and expanded opportunities for dental hygienists to practice at the full extent of their training.

Making Waves. Moving Forward.

Dental hygienists have always been change-makers. We prevent disease. We educate and advocate. We screen, coach, and connect oral health to whole-body health every day. That prevention-centered identity is our strength.

Exploring doctoral entry pathways is one ripple in a larger wave that positions dental hygienists as primary care prevention specialists within healthcare systems.

This is not about abandoning our roots or diminishing the value of clinical excellence. It’s about building forward intentionally.

When dental hygienists lead as prevention specialists — with purpose and vision — the ripple effect extends far beyond dentistry, reaching healthcare systems, communities, and the next generation of professionals.

That is how we make waves — not just for today, but for all dental hygienists who will carry this work forward.

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References

1. 1. American Dental Hygienists’ Association. “Board Approves New Policies at Fall Meeting in Long Beach.” October 3, 2025. https://www.adha.org/newsroom/board-approves-new-policies-at-fall-meeting-2025/.
   2. Commission on Accreditation in Physical Therapy Education. Standards and Required Elements for Accreditation of Physical Therapist Education Programs. Alexandria, VA: CAPTE, 2016. https://www.capteonline.org/globalassets/capte-docs/capte-pt-standards-required-elements.pdf.
   3. Kim, Mi Ja, Hugh McKenna, Patricia Davidson, et al. “Doctoral Education, Advanced Practice and Research: An Analysis by Nurse Leaders from Countries within the Six WHO Regions.” International Journal of Nursing Studies Advances 4 (2022): 100094. https://doi.org/10.1016/j.ijnsa.2022.100094.
   4. Barnes, Joshua. “Limiting Access to Graduate Nursing Education: A Policy Shift That Threatens Workforce Stability and Public Health.” American Nurse Journal, December 16, 2025. https://www.myamericannurse.com/limiting-access-to-graduate-nursing-education-a-policy-shift-that-threatens-workforce-stability-and-public-health/.
   5. Cattrysse, Erik, Jona Van den Broeck, Robin Petroons, Amber Teugels, Aldo Scafoglieri, and Emiel van Trijffel. “Impact of Direct Access on the Quality of Primary Care Musculoskeletal Physiotherapy: A Scoping Review from a Patient, Provider, and Societal Perspective.” Archives of Physiotherapy 14, no. 1 (2024): 20–28. https://doi.org/10.33393/aop.2024.3023.
   6. Gurenlian, JoAnn R., and Ann Eshenaur Spolarich. “Advancing the Profession through Doctoral Education.” Journal of Dental Hygiene 87, suppl. 1 (January 2013): 29–32.
   7. Palmer, Sierra K., Ellen J. Rogo, and JoAnn R. Gurenlian. “Exploration of the Scholarship of Doctoral Prepared Dental Hygienists.” Journal of Dental Hygiene 95, no. 6 (December 2021): 63–72.
   8. Nathe, Christine. “Impact of Education on Your Career.” Dimensions of Dental Hygiene 18, no. 7 (July/August 2020): 12–14. https://dimensionsofdentalhygiene.com/article/impact-education-career/.

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Lancette VanGuilder, BS, RDH, PHEDH, CEAS, FADHA, is the Clinical Director of Sierra Sleep, Airway & Wellness Center in Reno, Nevada, where she focuses on airway health, sleep-disordered breathing, and interdisciplinary patient care. An international speaker and advocate for prevention-focused healthcare, she also serves as the 2025-2026 President of the American Dental Hygienists’ Association (ADHA). Lancette is the host of the Beyond Breathing podcast, where she explores the connections between oral health, airway science, sleep and whole-person wellness.