As a dentist in the early 1900s, Dr. Alfred Civilion Fones was concerned about the number of patients losing their teeth due to dental caries and periodontal disease. Convinced that the removal of plaque, calculus and sugared substances from the surfaces of the teeth and gingival margins could reduce or prevent tooth loss, he began a crusade to persuade others in the dental and medical fields that some dental diseases could actually be prevented. This vision of disease prevention was almost unknown in a field where tooth extractions were frequent treatments for dental problems. Against the support of many health professionals, in 1906, Dr. Fones trained Irene Newman to be the first dental hygienist in the world. Her purpose was to provide preventive dental cleanings or prophylaxes to his patients. The results were successful. So successful, that he spent much of his time during the next years spreading the word about this new member of the dental team. In 1913, he opened the Fones School of Dental Hygiene in Bridgeport, Connecticut and the philosophy of teaching dental disease prevention had then begun. The Encyclopedia Britannica states, “Dental hygiene was the most important development of the dental art appearing in 1911-1922”.
This new vision of Dr. Fones was two-fold. Not only did he think it important for dental hygienists to work in private dental offices with patients who could afford its services, he thought it equally important that dental hygienists provide outreach services to those who could not afford private dental care. He and Irene Newman instilled in their students the benefits of both private and public health dental hygiene. To this day, dental hygiene programs in the United States are required to have a clinical and public health component. In other words, prevention and access to care continue to remain the philosophy of dental hygiene. Positive actions have been taken in recent years in Connecticut to address the access to care issues specific to the state. The Connecticut General Assembly passed legislation that formalized its commitment to improving access to oral health care by addressing a number of policy issues that impact the delivery of oral health care service. In 2007, there was the passage of higher Medicaid provider rates. The limited number of dentists in Connecticut who provide services to the underserved is significant. Nationally, dental hygienists are listed among the top ten fastest growing health care occupations with the Bureau of Labor Statistics (BLA) predicting that the current population of over 150,000 dental hygienists will grow by 30 percent by 2016. Conversely, the dental profession is growing at a much slower rate, with the number of dentists who retire annually, approximately 6,000, outpacing the approximately 4,000 dental school graduates that enter the workforce each year. BLS data notes that the population of dentists is not anticipated to be able to meet the growing health care needs of the country over the next ten years.
The Advanced Dental Hygiene Practitioner (ADHP) model developed by the American Dental Hygienists’ Association (ADHA) is a mid-level oral health provider designed to serve as the oral health equivalent to the nurse practitioner. ADHA began the process to establish the new provider in 2004 and over the past four years has solicited input for stakeholders in oral health on the development of the draft ADHP competencies.
The ADHP will increase utilization of finite health care resources and will enable more patients to be seen and referred to dentists or other health care professionals for comprehensive care. ADHPs are envisioned to work in collaboration with dentists and other members of the oral health care team to deliver quality oral health care services in a variety of public health settings, such as community health centers, school-based health clinics, Head Start or pre-school programs, long-term care facilities, and hospitals. The demand for oral health services is particularly acute in such venues and the advanced dental hygiene practitioner can help fill the need in underserved communities.
The ADHP concept takes into account the workforce realities our country, and Connecticut specifically, are facing. The model leverages the talents and expertise of the existing dental hygiene workforce by adding a new provider to the oral health care team. The ADHP will be a licensed dental hygienist educated at the Master’s-level and will have an expanded role in treating patients by providing diagnostic, preventive, restorative, and therapeutic services directly to the public.
As society places an ever-growing demand on dental disease prevention and access to care, the dental hygiene profession continues to be in the forefront of providing servicesto those who can and cannot afford the care. The State of Connecticut is known for its invention of the hamburger, the submarine, the sewing machine, the subway sandwich, the telephone, the Frisbee, wiffle ball, and more. Let’s never forget that our State is also known for the inventor and as the birthplace of dental hygiene.
Written by Meg Zayan, RDH, MPH, EdD
CDHA Central Office PO Box 54 Darien, Connecticut 06820 PHONE:(203)210-5600 FAX:(203)210-5129