By JoAnn Gurenlian, RDH, MS, PhD, AAFAAOM, FADHA
September 25, 2025
Don’t miss Shelley Hammond’s session at ADHA25 in Long Beach, CA on Sunday, October 5 – ED27: Empowering Dental Hygienists to Advocate for Your Profession.
The ADHA commissioned a white paper to address the urgent need to expand dental hygienist scope of practice nationwide as a key strategy to combat America’s oral health crisis.
The Crisis
Available for download at adha.org/WhitePapers.
Despite being one of the wealthiest nations, over 40% of low-income adults have untreated caries, 60% of older adults suffer from periodontal diseases, and millions live in “dental deserts” without access to preventive care. These conditions are not only painful and costly but also deeply tied to systemic health issues and mental well-being.
The white paper, authored by Shelley Hammond, MMC, reveals troubling gaps between Americans’ dental care intentions and reality. Millions live in areas of dental care shortage, and periodontal diseases alone cost billions in lost productivity annually.
Policy Impact Evidence
Restrictive state laws limiting dental hygienist autonomy create major barriers to care, but the paper presents compelling evidence that expanding hygienists’ ability to practice independently can significantly improve access, reduce emergency room visits, and lower long-term healthcare costs. Colorado, which allows full autonomy, reports only 10% of low-income adults describe their oral health as poor. Mississippi, which restricts practice, sees 27% reporting poor oral health.
Four Key Solutions
- Permit dental hygienists to practice to the highest national level
- Remove restrictions on practice settings
- Support mobile, portable, and tele-dentistry utilization
- Enable direct reimbursement for dental hygienist services
The Path Forward
When dental hygienist autonomy increases, preventive care access improves dramatically in underserved areas. Empowering hygienists to provide the care they were educated to perform isn’t just professional advancement—it’s essential healthcare policy that can solve America’s oral health crisis.
To download the complete white paper “Missed Potential: How Expanding Dental Hygienists’ Roles Can Bridge America’s Oral Health Gaps,” visit adha.org/WhitePapers.
____________________________________
JoAnn Gurenlian, RDH, MS, PhD, AAFAAOM, FADHA is the ADHA Director of Education, Research & Advocacy, professor emerita in the Department of Dental Hygiene at Idaho State University, and former president of the American Dental Hygienists’ Association, 1990-1991.
