The Winds of Change

You’ve worked hard to obtain your education, and you’ve taken anywhere from 84 to 120 credit hours to complete a rigorous, focused curriculum.¹ You are confident that you’ve graduated with the skills and expertise necessary to safely perform your job. Once in the workplace, you obtain all the needed continuing education credits to maintain your license. In fact, you take more courses than are required because you want to enhance your knowledge and ensure that your patients receive the best possible care.

You keep your operatory and instruments in top condition, and routinely interface with your colleagues for advice and to share information. You have a long-standing relationship with your patients and vice versa. Nothing pleases you more than to see them improve their oral health. Nothing compares to the feeling of making them smile because your skills and dedication have made a difference in their lives. You love your chosen profession and would not want to do anything else. Sound familiar? You are a dental hygienist!

Now picture this … you are a foreign-trained dentist or a dental student in the United States who wants to work in oral healthcare but you’re not yet licensed. Your goal, of course, is to be a dentist and to practice in that field. If you’re a foreign-trained dentist, your education and skills can vary. In fact, you will need to obtain a degree from a Commission on Dental Accreditation-accredited program. Even if you participate in an advanced standing program, it will take 2 to 3 years to obtain your dental license.

However, according to recent policies enacted by the American Dental Association (ADA), it’s fine for you to practice as a dental hygienist, a profession for which you’ve had little to no training. In fact, according to the ADA, dental students in the US can also practice dental hygiene while they are in school. Their dental hygiene training is negligible. While the foreign-trained dentists and dental students are still subject to state licensing board requirements, the ADA considers this policy “empowering” states to alleviate the workplace shortage of dental hygienists.² I disagree.

Dental students and foreign-trained dentists might work as dental hygienists under the proposed policy, but they will never be dental hygienists. We become dental hygienists because we have a passion for the profession. We believe in the prevention-focused ideals on which dental hygiene was founded. Dental hygienists remain in practice because the connection with their patients is paramount, and because they are in it for the long haul. This is not a temporary steppingstone — it’s our heart and soul. Merely read the article on instrumentation (page 14) to understand the depth of our commitment. I challenge any dental student or foreign-trained dentist to demonstrate this level of knowledge, or to even care.

For too long we have allowed our profession to be supervised by a profession other than our own. While this presents an obvious conflict of interest, we have allowed it in good faith, knowing that we are partners in care. But when one partner disrespects the other, it’s time for change. It’s time for our own empowerment. Change needs to happen to make our profession autonomous, and it can’t happen soon enough. 

References

1. American Dental Education Association. Dental Hygiene Programs. Available at adea.org/godental/explore-dental-hygiene/dental-hygiene-programs. Accessed February 9, 2025.
2. American Dental Association. New ADA Policies Empower States to Alleviate Dental Workplace Shortage. Available at adanews.ada.org/ada-news/2024/november/new-ada-policies-empower-states-to-alleviate-dental-workforce-shortage/#:~:text=Under%20514H%2D2024%2C%20the%20ADA,Dr. Accessed February 9, 2025.

From Dimensions of Dental Hygiene. March/April 2025; 23(2):6.