by Mark Hartley
Did you know that all 3,000-plus hygienists in Minnesota aspire to be dentists?
It was news to me. I was intentionally copied on an e-mail about the recent legislation in Minnesota. The new law creates two new dental professions in that state — dental therapist and advanced dental therapist provider.
A dentist wrote on the e-mail chain, "Remember, hygienists want to be dentists without going to dental school. Their educators believe their schools are equal to ours."
So I had to wonder about the 3,000-plus professionals who are licensed to be dental hygienists in Minnesota. Do they fleetingly think about becoming dentists? I fleetingly think about writing a best-selling novel. I fleetingly think about articles I should write before becoming distracted. I fleetingly think about composing a new nursery rhyme for schoolchildren. They're such nice kids.
My guess is that, at some point, most dental hygienists fleetingly think about whether enrolling in dental school is a good career move. What's not a guess is that American hygienists do not seek a shortcut to become dentists. What they search for is a certain flexibility to creatively use their noggins to provide better dental care to Americans, the Americans who are not receiving it the old-fashioned way. If they could, hygienists would just wander out on the street and start delivering care, but there are laws and regulations against such a charitable endeavor.
The American Dental Hygienists' Association very painstakingly established the foundation to amend the laws. The Advanced Dental Hygiene Practitioner position in dentistry is the result of many think tanks and committee meetings charged with the responsibility of coming up with solutions for improving access to care. Those responsibilities were not casually executed. Minnesota's names for the positions above are based on these discussions, as well as discussions within the ADA for advancing the roles of dental assistants.
Dianne Glasscoe Watterson, the Staff Rx columnist in RDH, responded to the e-mail mentioned above. "This midlevel status is an attempt to meet the dental needs of many people by extending the training of hygienists to include simple procedures, such as fillings and simple extractions," she wrote. "I believe hygienists have been over-trained and under-utilized for many years. Hygienists do NOT want to become dentists, but they DO want to WORK and be treated with respect."
I could not have said it better myself. Maybe Dianne should fleetingly think about writing a best-selling book.
Dr. Sheri Doniger, a former hygienist who became a dentist and served as the editor of Woman Dentist Journal, wrote me not long ago about a statistic. How many dentists are former dental hygienists? It's a good question, but not one that RDH can answer (it has very few dentists among its subscribers). So we briefly discussed doing a survey to determine how many current hygienists are considering a career as a dentist.
But Kristine Hodsdon, the director of RDH eVillage, put her foot down. "No!" she said emphatically. "I'm not a fan of that question. Dental hygiene is a distinct profession with our own duties and responsibilities. I'm not comfortable with asking how many hygienists want to be a dentist. To me, it implies that dental hygiene isn't 'good enough' as a profession when, in fact, it is. With the changes in practice acts, dental hygiene should no longer be considered a 'stepping stone' to dentistry."
In her e-mail, Glasscoe Watterson added, "It's the old turf war. The volunteer work I've done with Mission of Mercy here in Frederick has given me a different perspective regarding the overwhelming dental needs in this country. 'Overwhelming' is not a strong enough word."
A spokesperson for the dental association in Minnesota said, "This hasty and drastic measure puts patients' safety at risk."
We've heard the patient safety argument before, and we'll hear it again before it's all over. But it reminds me of a question I've been meaning to ask for a long time. When did the nontreatment of dental disease in a large segment of the American population become safe?
Mark Hartley is the editor of RDH magazine.