ADHA Report Shows How Dental Hygienists Can Close America’s Oral Health Gap
A new white paper from the American Dental Hygienists’ Association reveals that outdated restrictions on dental hygienist practice are fueling America’s oral health crisis. Expanding dental hygienist autonomy, the report argues, is essential to bridging care gaps, reducing costs, and improving population health.
The American Dental Hygienists’ Association (ADHA) has released a white paper, “Missed Potential: How Expanding Dental Hygienists’ Roles Can Bridge America’s Oral Health Gaps,” highlighting the urgent need for policy changes that would allow dental hygienists to practice at the top of their license. The report underscores how restrictive state laws and systemic barriers are limiting access to care for millions of Americans while contributing to the nation’s staggering oral health and economic burdens.
According to the research, 40% of Americans who plan to receive dental care never actually obtain it, largely due to access challenges. An estimated 24.7 million people live in federally designated dental care shortage areas, and 1.7 million residents lack access to a provider within a 30-minute drive. The costs of these barriers extend beyond health: periodontal diseases alone are estimated to result in $154.06 billion annually in lost productivity.
The report compares oral health outcomes in states with varying degrees of hygienist autonomy. In Colorado, where dental hygienists enjoy full autonomy and can even own practices, only 10% of low-income adults report poor oral health. By contrast, in Mississippi, where dental hygienists must work under strict supervision, 27% of low-income adults describe their oral health as poor.
Beyond physical impacts, poor oral health carries a psychosocial toll. One-third of United States adults report being embarrassed about the condition of their teeth, and one in five experiences anxiety because of it. Among children, untreated dental pain is linked to lower academic performance, missed school days, and diminished self-esteem. The white paper argues that preventive care delivered by dental hygienists could significantly reduce these consequences while supporting better overall well-being.
The ADHA white paper identifies four key policy reforms to expand access and reduce disparities:
- Allow dental hygienists to practice to the highest national standard without unnecessary supervision requirements.
- Remove restrictions on practice settings so hygienists can deliver care in schools, long-term care facilities, community centers, and other underserved areas.
- Support mobile, portable, and teledentistry models to reach patients who cannot access traditional dental offices.
- Provide direct reimbursement for dental hygienist services to create a sustainable workforce and reduce financial barriers.
The report emphasizes that empowering dental hygienists is not about replacing dentists but about extending the reach of preventive care to communities in need. With more than 200,000 licensed dental hygienists in the US, expanding their scope of practice represents a practical, cost-effective strategy to address shortages, reduce emergency department visits for preventable oral conditions, and improve long-term health outcomes. Click here to read more.
